By Josh Redd, MS, DABFM, DAAIM, Chiropractic Physician
Although researchers have found different factors that can trigger Hashimoto’s hypothyroidism, such as gluten, certain viruses, and even particular environmental toxins, one of the most common is also the most overlooked: A blood sugar imbalance.
Americans are notorious sugar and carb addicts and have the high blood sugar to prove it. The Centers for Disease Control estimates almost one third of Americans have a high blood sugar disorder, ranging from insulin resistance (pre-diabetes) to diabetes.
Regular consumption of desserts, sweet coffee drinks, sodas, starchy foods such as bread, pasta, and white rice, and other processed carbohydrates has helped to make Americans the most obese and chronically sick population in the world.
High blood sugar is so inflammatory that it sets the immune system up to be more predisposed to developing an autoimmune disease.
Autoimmune disease is a condition in which the immune system erroneously attacks and destroys body tissue, and it so common today it dwarfs cancer and heart disease combined. Yet most people go undiagnosed until the condition is advanced. People suffering with autoimmunity typically have to visit multiple doctors and go years suffering with progressively worsening symptoms before receiving a diagnosis.
Hashimoto’s hypothyroidism, an autoimmune disease that attacks the thyroid gland, is one of the most common autoimmune diseases today. Other common autoimmune diseases include multiple sclerosis, type 1 diabetes, vitiligo, alopecia, Crohn’s disease, and psoriasis, just to name a few.
How blood sugar becomes too high and imbalanced
We only need about a teaspoon’s worth of sugar in the bloodstream at any one time, a level that can be met through non-starchy vegetables alone. The average American eats more than 17 teaspoons of sugar a day! The American Heart Association offers a happy medium, recommending you don’t exceed 6 teaspoons of sugar a day, or 25 grams.
And that’s just added sugar. When you consume starchy processed carbs like pasta or white rice, they quickly convert to sugar in your bloodstream.
Consistently consuming sugars and high-carb foods forces the pancreas to secrete ever larger amounts of insulin to lower the amount of sugar in the bloodstream. These insulin surges then cause blood sugar to drop too low, which causes you to crave sugar, creating a vicious cycle between high and low blood sugar, energy crashes, food cravings, sleep problems, and more.
Sadly, this is just a normal day for many Americans. Yet these blood sugar imbalances underlie many health issues, including Hashimoto’s hypothyroidism, heart disease, hormonal issues, fatigue, depression, anxiety, insomnia, chronic pain, dementia and Alzheimer’s, and more.
Over time, the constant insulin surges exhaust the body’s cells and they become insulin resistant. This means glucose can’t get into the cells, causing fatigue and sugar cravings. Instead, the excess sugar remains in the bloodstream, triggering inflammation, damaging the blood vessels and the brain, exacerbating autoimmune issues such as Hashimoto’s, and being converted to fat for storage.
It is these insulin surges and drops that flare up the autoimmune response with Hashimoto’s. That means low blood sugar, high blood sugar, a combination of both, and insulin resistance are all factors that triggers autoimmune Hashimoto’s flares.
What is normal blood sugar?
You can check your fasting blood sugar with a store-bought glucometer. Check it first thing in the morning after having gone at least 12 hours without eating or drinking anything other than water.
The lab range for fasting blood glucose levels is between 70 to 105 mg/dL. The American Diabetic Association designates a fasting blood sugar level of 106 to 126 to be insulin-resistant or prediabetes, while anything above 127 is diabetes.
In functional medicine we like to see it between 85 and 99, with anything over 100 signifying insulin resistance mechanisms have set in.
At RedRiver we rarely see blood sugar over 90 unless the patient has insulin resistance, and we do thousands of labs.
Symptoms of low blood sugar
If your blood sugar is below 85, eat every two to three hours to stabilize your blood sugar. It doesn’t have to be a full meal. A few bites of something with protein, fiber, and/or healthy fat between meals and a light snack before bed will help stabilize blood sugar if yours is chronically low, and thus help manage Hashimoto’s hypothyroidism.
If you have these symptoms, you may suffer from chronically low blood sugar:
- Craving for sweets
- Irritable or lightheaded if go too long without eating
- Depend on coffee for energy
- Eating relieves fatigue
- Shaky, jittery, or tremulous between meals
- Agitated or nervous between meals
- Easily upset when blood sugar is low
- Poor memory, forgetfulness
- Blurred vision
- Insulin resistance
How blood sugar becomes too low
Chronic low blood sugar typically develops in people who tend to under eat and skip meals. Although intermittent fasting may be appropriate in the case of high blood sugar or healthy blood sugar, it can make the person with low blood sugar worse. These people skip breakfast because they don’t have an appetite or they feel nauseous in the morning. That’s because low blood sugar dysregulates appetite signals in the brain and raises adrenal hormones, both of which can cause nausea, loss of appetite, and feeling wired.
Low blood sugar also stems from eating foods that are too sugary or starchy. The typical person with low blood sugar skips meals, under eats, and then when they do eat it’s something like a fruit smoothie, a sweet yogurt, or some overly sweet or starchy food that causes blood sugar to spike and then crater.
Symptoms of high blood sugar
If your blood sugar is over 99 you may have insulin resistance. You need to manage your carb intake so you don’t feel sleepy after meals. You also need to divvy up your portions to avoid overeating, as that causes insulin resistance. Regular exercise—a combination of aerobic, strength training, and high-intensity interval training (HIIT)—will help sensitize cells become more sensitive to insulin.
If your blood sugar is over 126 you should be screened for diabetes, however in functional medicine we become concerned if fasting blood sugar is over 99. Managing insulin resistance is vital if you have Hashimoto’s hypothyroidism.
See if you have any of these symptoms of insulin resistance:
- Feel sleepy after meals
- General fatigue
- Constantly hungry and craving foods
- Must have sweets after meals
- Eating sweets does not relieve your craving for them
- Waist girth equal to or larger than hip girth
- Frequent urination
- Increased appetite and thirst
- Difficulty losing weight
- Migrating aches and pains
If you’re a woman, insulin resistance causes testosterone to spike so you develop balding, facial hair, and other male characteristics. If you’re a man, it raises estrogen levels so you develop male breasts and other female characteristics, and you cry more easily. These are some pretty undesirable consequences for a sugar habit that also worsens your Hashimoto’s hypothyroidism autoimmune condition.
How blood sugar becomes too high
High blood sugar is something we more commonly see in functional medicine. This is because the standard American way of eating is a perfect set up for insulin resistance. People can develop insulin resistance when they’ve had low blood sugar for a long enough period that the cells develop resistance to the insulin surges caused by eating starchy foods.
Overeating is another common cause of high blood sugar. American restaurants are a case study in overly large portions and many people don’t feel like they’ve eaten a proper meal unless they feel stuffed and sleepy afterwards. Insulin receptors on cells stay sensitive to insulin through the effects of regular exercise. A sedentary lifestyle contributes to the development of insulin resistance. The toxic nature of industrial food oils also contribute to insulin resistance through their damaging effects on cellular receptors.
And, of course, a diet high in sweet and starchy foods is a major contributing factor to insulin resistance. Pastas, pizzas, breads, breakfast cereals, desserts, lattes loaded with syrup, white potatoes, and all the comfort foods we so commonly associate with the American way of life are actually major contributors to our crushing epidemics of diabetes, Alzheimer’s, and autoimmunity.
It’s very common for people to suffer from symptoms of both high and low blood sugar as these are two polar opposites on the same spectrum. An inflammatory diet, undiagnosed food sensitivities, environmental toxins, and major life stressors are other examples of factors that contribute to this spectrum of dysglycemia.
Can I eat “fake” sweeteners?
The emphasis on stabilizing blood sugar is on removing sweets and lowering or removing processed carbs from your diet. This comes as a shock to some people who can’t imagine life without caramel lattes, bagels, or bowls of pasta.
The first thing many people look for is how to substitute sugars with artificial sweeteners.
Artificial sweeteners aren’t worth the health risks.
The primary sweetener used in diet sodas, aspartame (which goes by names like Equal and NutraSweet), has been linked to numerous cardiovascular conditions, including stroke, heart failure, and heart attack. In fact, a nine-year study of 60,000 women showed women who drank two or more cans of diet soda a day were 50 percent more likely to die of heart disease.
Aspartame also has been linked to multiple health conditions, including brain tumors, birth defects, cancer, and memory loss. It overstimulates production of the brain neurotransmitter dopamine, which can eventually result in depression, migraine headaches, and seizures.
Numerous complaints have been lodged with the FDA against aspartame. However, the industry continues to argue for its safety.
Other FDA-approved artificial sweeteners — saccharin, neotame, sucralose, and acesulfame potassium — have also been associated with increased risk of heart disease and other health conditions.
What about natural sweeteners such as xylitol, erythritol, and sorbitol?
These are sugar alcohols that are “low-calorie” because they are either poorly digested or poorly absorbed, which means they impart fewer calories and are less likely to raise blood sugar.
Although they haven’t been studied much compared to artificial sweeteners, their main side effects appear to be gastric distress in some people. Because sugar alcohols are largely indigestible, they pull water into the digestive tract and can cause diarrhea. Also, their indigestibility can cause them to ferment in the gut, causing bloating, gas, and distention.
This may be bad news for people working to repair leaky gut and you probably need avoid them if you have small intestinal bacterial overgrowth (SIBO), irritable bowel syndrome (IBS), Crohn’s, need to be on the FODMAPS diet, or have other digestive problems.
While there is evidence that artificial sweeteners can raise blood sugar through altering gut bacteria, natural sweeteners don’t seem to produce the same effects. However, they may encourage you to eat too many foods that will detract from your health, such as baked goods.
It may be hard to believe, but when you start eating a whole foods diet and feeling better, you naturally lose your cravings for sugars and sweets. As time goes on, you instinctually associate them with feeling worse. Moderate consumption of fruit can be enormously satisfying as a natural dessert once you have weaned off the hard stuff.
How to stabilize your blood sugar
The sooner you give your pancreas a rest, the better your chances of stabilizing our blood sugar. This will go a long way to helping you better manage your Hashimoto’s hypothyroidism.
Here are some tips to stabilize your blood sugar and better manage Hashimoto’s hypothyroidism:
- Clear your cupboards and fridge of processed foods and those that contain sugar, even if they seem to be “healthy,” like packaged granola and energy bars.
- Eat whole, “real” foods made with ingredients you recognize and without pesticides, additives, or any ingredient you can’t pronounce.
- Eat seven to 10 servings of produce a day. A serving is a half-cup or, for lettuce and leafy greens, a cup.
- Avoid simple carbs like sugar and white flours and eat complex ones found in high-fiber foods. These digest more slowly and don’t cause a surge in glucose.
- Regular exercise, particularly high intensity interval training, makes muscles more sensitive to insulin.
- Sleep well, night after night. Sleep deprivation promote inflammation and obesity.
About Dr. Redd
Josh Redd, MS, DABFM, DAAIM, is a chiropractic physician and author of the Amazon bestselling book The Truth About Low Thyroid. Dr. Redd owns seven functional medicine clinics in the western United States and sees patients from across the country and around the world who are suffering from challenging autoimmune, endocrine and neurological disorders. Dr. Redd also teaches thousands of health care practitioners about functional medicine and immunology, thyroid health, neurology, lab testing, and more.