**Blood sugar balance in thyroid** Balancing blood sugar levels in Hashimoto's thyroid is very important for people who want to manage thyroiditis and the fatigue that comes with it. This is one of the first steps you should take to improve your thyroid condition. Also, there are various solutions for controlling Hashimoto's fatigue. Many people with Hashimoto's do not realize that they may have blood sugar fluctuations, even if they are thin. You may feel very hungry during the day. Or you may eat high-carbohydrate foods that cause large blood sugar fluctuations. The noteworthy point is that these fluctuations can have negative effects on the adrenal glands, which lead to an increase in **thyroid** antibodies. ### **Importance of blood sugar level in Hashimoto's thyroid** In general, changes in diet and lifestyle can help control blood sugar levels naturally. People with **Hashimoto** can control blood sugar and **Hashimoto's treatment** by making changes in their diet and lifestyle. Some people may not even need medication if blood sugar is observed. Many studies have shown that up to 50% of people with Hashimoto's have carbohydrate intolerance. This means that when they eat high-carbohydrate foods, their blood sugar levels rise quickly. This leads to low blood sugar levels (reactive hypoglycemia) and symptoms such as irritability, dizziness, anxiety, and fatigue. ### **What is the effect of blood sugar imbalance on Hashimoto's disease?** Blood sugar and thyroid levels are closely related. A research paper has shown that patients with diabetes are up to three times more likely to develop a thyroid disorder. When blood sugar levels fluctuate constantly, changes in blood sugar levels are recognized as chronic stress and can lead to an increase in the hormone cortisol. The increase of this hormone causes the production of inflammatory proteins and increases the immune response. These changes can lead to excessive release of cortisol and cause chronic fatigue, mood swings and increased thyroid antibodies. In fact, in general, increasing stress in the body can lead to weakening of the thyroid. The increase of thyroid antibodies aggravates Hashimoto's disease. **What is blood sugar?** Blood sugar, or glucose, is the main source of energy for the body that comes from the food we eat. This glucose is absorbed from the small intestine into the bloodstream. The pancreas produces insulin to help control blood sugar levels. This extra insulin stores glucose in the form of glycogen and sends it to the liver. ### **When do blood sugar fluctuations occur?** Blood sugar swings occur when blood sugar levels are out of normal range, usually caused by consuming too many high-sugar carbohydrates. A spike in insulin does a lot to bring blood sugar levels down, but that spike in insulin can lead to a craving for more rich carbohydrates and start the cycle of blood sugar swings all over again. The symptoms that indicate the imbalance of blood sugar levels in the body are: - Hormonal problems - Fatigue - Depression - Anxiety - Insomnia - Weak brain function - Chronic pain ### **How can you tell if your blood sugar is out of balance?** Dizziness, weakness and anxiety for no reason can be among the symptoms of low blood sugar in Hashimoto's thyroid. Disturbances in blood sugar levels are very common in Hashimoto's. Many people with Hashimoto's suffer from low blood sugar (hypoglycemia) in the early stages. Hypoglycemia is known as a primary risk factor for developing diabetes. It can also lead to exacerbation of Hashimoto's and other autoimmune diseases Below are some of the symptoms of low and high blood sugar. Note that these lists are general symptoms to help you manage daily changes in blood sugar levels. But these symptoms may be signs of diabetes. If these symptoms are persistent and severe, but diabetes has not yet been diagnosed, it is better to see a doctor. ### **Symptoms of low blood sugar:** Craving for sweet foods - Irritability - Dizziness - Feeling angry - Constant need to eat to control fatigue - Sensation of tremors - Anxiety - Forgetfulness - Blurred vision - mental fog - Coldness of the limbs - Heart palpitations - Fatigue - Pale skin - Nausea and vomiting - Difficulty speaking ### **Symptoms of increased blood sugar level:** - Feeling tired after eating - Constant hunger - Craving for sweet foods that does not decrease even after eating them - Waist circumference is larger than hip circumference - Frequent urination - Increased appetite and thirst - Difficulty losing weight If you experience dramatic changes in blood sugar levels after eating meals, you may have reactive hypoglycemia. Reactive hypoglycemia is often caused by a large insulin release immediately after eating and is usually characterized by a rapid fall and rise in blood sugar levels. **blood sugar imbalance in hypothyroidism** Imbalance of blood sugar is common in people suffering from hypothyroidism as well as reactive (explosive) hypoglycemia. You can easily test your blood sugar using a simple blood glucose meter. This device uses a small blood sample from your finger. Just as blood sugar is important in Hashimoto's thyroid, it is also important for people with hypothyroidism. Changing the lifestyle and having a healthy diet can have a great effect on improving the thyroid condition. Dr. Seyed Ahmad Fanai is a thyroid and parathyroid surgeon and an active member of the American Association of Thyroid Surgeons (ATA). You can contact us for appointment and consultation.