What is the cause of low blood sugar in hypothyroidism? How to prevent it?

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What does hypoglycemia mean in hypothyroidism?

Low blood sugar or hypoglycemia is a condition in which your blood glucose (sugar) level is lower than normal. Mild symptoms of hypoglycemia include dizziness, palpitations, anxiety or nervousness, sweating, tremors, irritability, hunger, nausea, weakness, or drowsiness. Its more severe symptoms include headache, confusion, vision and coordination problems, seizures and coma. Hypothyroidism leads to insufficient production of thyroid hormones. These hormones play a vital role in regulating the body's metabolism, and when their levels decrease, the speed of the body's performance decreases in many areas, including sugar metabolism.

The cause of hypoglycemia in hypothyroidism

Low blood sugar (hypoglycemia) occurs in hypothyroidism due to several complex metabolic mechanisms. Lack of thyroid hormones, which play a vital role in regulating blood sugar, causes this problem. The main causes of hypoglycemia in hypothyroidism include the following:

Reduction of glucose production in the liver

One of the main roles of thyroid hormones is to regulate the production of sugar in the body. These hormones tell the liver to use its reserves to produce glucose when blood sugar levels drop (such as between meals or during the night).

In hypothyroidism, this vital process of producing sugar from non-sugar substances (gluconeogenesis) slows down. In addition, the process of glycogenolysis (the breakdown of glycogen into glucose) is also affected, and the liver's ability to release sugar into the bloodstream is reduced. This disruption in sugar production makes the body vulnerable to hypoglycemia.

insulin resistance

Some research shows that hypothyroidism can lead to insulin resistance. In this condition, the body does not respond properly to insulin, which often causes blood sugar levels to rise. However, this same dysregulation can impair the body's ability to properly manage sugar when it drops. This problem indirectly leads to hypoglycemia attacks and makes the management of both diseases more difficult.

Increased sensitivity to insulinN

While many diabetics are insulin resistant, hypothyroidism may lead to increased sensitivity of cells to insulin. This phenomenon causes the body's cells to absorb more sugar from the bloodstream with less insulin. Rapid and excessive absorption of sugar causes a sudden and severe drop in blood sugar and hypoglycemia symptoms. This situation can be dangerous especially in people who have naturally high insulin levels.

Decreasing the production of insulin-opposing hormones

Thyroid hormones also affect the production of other important hormones in the body. Cortisol and growth hormone are the most important hormones that are affected by hypothyroidism. Both of them have opposite action to insulin. That is, these hormones help the body to keep blood sugar high when necessary. In hypothyroidism, the production of these hormones decreases and the body has difficulty in regulating and dealing with hypoglycemia. This problem causes the body to not be able to properly manage blood sugar in stressful situations or during prolonged starvation.

Slowly releasing insulin from the body

The slowness of metabolism in hypothyroidism, in addition to affecting the production of blood sugar, also affects the speed of clearing and removing hormones from the body. In this condition, the rate of insulin release from the bloodstream decreases. As a result, insulin remains in the body for a longer time and its lowering effect on blood sugar is prolonged. This long-term persistence of insulin continuously keeps blood sugar low and leads to frequent drops in blood sugar.

Does levothyroxine cause hypoglycemia?

Levothyroxine is the main drug for the management of hypothyroidism. This pill is a synthetic version of thyroid hormone T4 and by replacing this hormone, it helps the body to return its metabolic processes to normal. Levothyroxine tablets (Levoxin) usually do not cause hypoglycemia. In fact, this medicine increases the body's metabolism and raises blood sugar by restoring the level of thyroid hormones to normal.

However, the effect of this drug is different in diabetic people. Levothyroxine can increase the effectiveness of diabetes medications (such as insulin or blood sugar-lowering pills). Therefore, if a person has diabetes and hypothyroidism at the same time and starts taking levothyroxine, the current dose of diabetes medication may be too much for him and lead to hypoglycemia.

Note: Therefore, levothyroxine is not a direct cause of hypoglycemia; Rather, it is an indirect factor that requires close monitoring by a doctor. In such a situation, the doctor prevents a severe drop in blood sugar by adjusting the dose of diabetes medications.

Prevention of hypoglycemia in hypothyroidism

Prevention of hypoglycemia in hypothyroidism is very important, especially in people who have diabetes and hypothyroidism at the same time and experience frequent hypoglycemic attacks. Pay attention to the following points to prevent low blood sugar:

Balanced and regular diet:

Following a whole, balanced diet rich in lean proteins, whole grains, fruits and vegetables is important for managing blood sugar. These foods slowly release sugar in the body and prevent its extreme fluctuations. It is also recommended to include foods rich in essential minerals such as iodine (in fish and dairy products) and selenium (in Brazil nuts and eggs) in the diet to support the proper functioning of the thyroid gland.

Consumption of small and frequent meals

Instead of three heavy meals a day, it is better to eat frequently and in small amounts. This will keep your blood sugar levels steady throughout the day and prevent sudden drops. This strategy is especially important for people who are prone to hypoglycemia; Because it allows the body to always have a source of energy available.

hypothyroidism diet

Regular physical activity

Regular exercise plays a vital role in managing hypothyroidism as well as blood sugar fluctuations. Physical activity helps improve insulin sensitivity. This means that the body's cells respond better to insulin and blood sugar is more effectively controlled. Also, exercise plays a role in strengthening the overall health of the thyroid. However, to avoid putting too much pressure on the body, consult your doctor about the type and intensity of exercise.

Monitoring blood sugar

Regular and accurate measurement of blood sugar is very important, especially in people who have hypothyroidism and diabetes at the same time. This monitoring will help you identify your low blood sugar patterns and understand what triggers them. By accessing this information, you can adjust your diet or medication dosage with the help of your doctor in such a way as to prevent future attacks of hypoglycemia.

Stress management:

Stress is one of the most important factors that can affect the body's hormonal balance, including thyroid function and blood sugar control. By involving the adrenal glands, constant stress aggravates symptoms related to hypothyroidism and blood sugar fluctuations. To manage stress, get help from options such as exercise, meditation, reading, listening to music or talking with friends.

Starting the day with protein

Choosing breakfast plays an important role in controlling blood sugar throughout the day. Starting the day with a protein-rich meal instead of simple carbohydrates will help you manage your blood sugar more stably. Protein helps to slow down the absorption of sugar in the body and prevents the sudden increase and then drop of blood sugar.

Improving sleep quality:

The quality and amount of sleep has a direct effect on the metabolic health of the body. Increasing sleep at night by 30 minutes to one hour helps to improve blood sugar control. Adequate sleep allows the body to regenerate well and maintain its hormonal balance.

Bring snacks:

If you are prone to hypoglycemia, never leave home without a snack. This simple habit is very effective in preventing a sudden drop in blood sugar. An ideal snack should be a combination of carbohydrates and some protein or healthy fat to provide sustained energy.

Regulation of medicines

Hypothyroid medication (such as levothyroxine) affects how diabetes medications (both oral pills and insulin) work. By increasing the body's metabolism, this drug can increase the effectiveness of blood sugar-lowering drugs and lead to a severe drop in blood sugar if the dose is not adjusted. Based on the results of the tests and your clinical symptoms, the specialist doctor will recommend the most appropriate dose of the drug.

Last word

Hypoglycemia basically means a mismatch between insulin (either from an external or internal source) and blood sugar levels (either through meals or through intravenous feeding). An inappropriate increase in insulin levels leads to a decrease in blood glucose levels, which in turn triggers a series of physiological protective mechanisms. The relationship between hypothyroidism and hypoglycemia is a complex issue that results from several metabolic mechanisms.

This situation occurs in addition to the decrease in sugar production in the liver due to the change in insulin sensitivity and the decrease in sugar regulating hormones. Following a balanced diet, having regular physical activity and consulting a doctor to accurately adjust medications can effectively prevent hypoglycemia and improve your quality of life.

1404-06-23

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