If the thyroid experiences hyperactivity, (referred to as hyperthyroidism or Graves Disease) an increase in the production of the hormone thyroxin occurs. As a result, metabolic activity speeds up causing weight loss (despite an increase in appetite), rapid heart rate, shortness of breath when exercising, muscle weakness and difficulty in concentrating. Hyperthyroidism is less common in T1D’s but much more prevalent in older women.
If the thyroid is underactive (hypothyroidism or Hashimoto’s disease) , metabolic activity slows down leaving one to feel sluggish, sleepy, fatigued, weight gain despite no change in dietary habits, chills, constipation, dry skin, lack of concentration, heavy menstrual flow, low blood pressure and a slow heart/pulse rate. Complicating diagnosis is that these symptoms may also be confused with depression.
In some individuals, the cause of hypothyroidism is due to an autoimmune attack by the body’s own antibodies against the thyroid gland similar to the way the pancreas is prevented from producing insulin by the autoimmune destruction of beta cells. It would appear that individuals who exhibit one autoimmune disease are at risk for another.
As you might expect one of the major risk factors for thyroid disease is Type 1 diabetes, an autoimmune disease in itself. The difficulty for the physician is that the symptoms of a faulty thyroid are similar to a host of other medical conditions.
Although neither disease directly affects blood sugar levels they do impact the ability of the body to manage sugar. When the thyroid is overactive insulin clears the body faster leaving you with unexplained hyperglycemic events. As you might expect the reverse scenario exists when the thyroid is underactive. Insulin moves through the body slowly resulting at times in unexplained hypoglycemia.
One of the problems encountered by insulin dependent Type 1 individuals is unexplained weight gain. This may be a sign of an underactive thyroid.
Both thyroid diseases can be diagnosed with certainty by immunoassaying for serum TSH ( thyroid stimulating hormone) levels. Likewise the presence of TPO anti-thyroid peroxidase antibodies is helpful in predicting the development of autoimmune induced thyroid disorders.
Treatment is lifelong hormone replacement therapy by pill.
Regardless of which condition is encountered, physicians need to anticipate fluctuations in blood glucose levels and treat accordingly. Physicians aren’t quite sure why autoimmune disease occurs but it is apparent that genetics plays a role given that autoimmune disorders tend to ‘run in the family’ and when you acquire one it is likely you will develop another.