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Key Takeaways

• Hashimoto’s thyroiditis impacts metabolic health and may lead to insulin resistance and an increased risk for metabolic syndrome or type 2 diabetes for some.��
• Managing Hashimoto’s includes thyroid medication, an anti-inflammatory diet, exercise, good sleep, and blood sugar monitoring.��
• Regular health monitoring is key to managing both thyroid and metabolic health.

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Hashimoto's thyroiditis (named after the man who first described this condition) is a chronic autoimmune condition in which the immune system mistakenly attacks the thyroid gland, causing inflammation and damage. The damaged gland produces fewer thyroid hormones and side effects. Hashimoto’s thyroiditis is a common cause of hypothyroidism.^1,2

The connection between Hashimoto’s thyroiditis and other autoimmune conditions, including type 1 diabetes, suggests a potential impact on metabolic health (including insulin and blood glucose management).^1,2��

This article will explore how Hashimoto’s thyroiditis impacts metabolic health, including its impact on metabolic processes and conditions like insulin resistance. Learn research-backed strategies for managing both conditions effectively.

What is Hashimoto’s Thyroiditis?

Hashimoto’s thyroiditis is an autoimmune condition in which the body attacks the thyroid gland. More precisely, the thyroid gland is enlarged and overrun with lymphocytes (a type of white blood cell). This immune system attack irreversibly damages the thyroid cells and their ability to make thyroid hormones, resulting in an under-performing thyroid.²��

The presentation and development of Hashimoto’s thyroiditis involve an interplay between environmental factors and genetic background.²��

Hashimoto’s is most prevalent in women aged 45 to 55 years, who are white, but it can affect people of all types. Family history increases your risk.¹��

Environmental factors can trigger autoimmune diseases in people predisposed by their genetics. Some triggers include bacterial and viral infections, cigarette smoking, exposure to harmful chemicals, and limited exposure to environmental factors (living in an almost sterile environment).��

Diet factors (excessive iodine, decreased selenium intake, and gluten) can also activate Hashimoto’s thyroiditis in some individuals.²�� A poor diet, like the Western-style diet abundant in processed foods, high-fat, high-sugar, high-salt, and low-fiber foods, also increases the risk of inflammation.³

Common symptoms of hypothyroidism include:

• Cool and drink skin
• Coarse hair
• Loss of body hair
• Hoarse voice
• Edema or swelling
• Bradycardia (slower than normal heart rate)
• Muscle cramps
• Gallstones
• Constipation
• Low or depressed mood
• Memory problems or difficulty concentrating
• Weight gain
• Joint stiffness
• Fatigue or tiredness
• Fertility problems

Symptoms emerge as the damaged thyroid can no longer keep up with the needed thyroid hormones, resulting in low levels of thyroid hormones.²

Thyroid hormones play many roles in the body, including regulating metabolism and how the body manages fat, carbohydrates, and protein. Alterations in hormone levels can disrupt metabolism, leading to high blood sugar levels.³��

The Link Between Hashimoto's and Metabolic Health

Metabolic health is how well your body converts food into energy and how your body uses that energy. Poor metabolic health (also called metabolic syndrome) can put you at risk for heart disease and type 2 diabetes.⁴��

Hashimoto’s thyroiditis can affect metabolic health due to low thyroid hormone levels. Thyroid hormones help you release proper insulin amounts.��

With hypothyroidism, your body releases less insulin, resulting in elevated blood glucose levels. Insulin helps your body regulate blood glucose levels and use that glucose for energy or storage.⁵

Over time, elevated glucose levels can make your body less responsive or sensitive to insulin ( insulin resistance) and predispose you to metabolic syndrome.⁵��

Bodies experiencing low thyroid hormone levels and elevated blood sugar levels are also in a state of chronic, low-grade inflammation, making it hard to feel their best and contributing to unfavorable symptoms.⁵

Insulin Resistance and Hashimoto's

Researchers continue to find associations between Hashimoto's, insulin resistance, and diabetes. These conditions share biochemical, hormonal, and genetic ties that impact thyroid hormone activity and insulin sensitivity.⁵��

About 11% of people with diabetes have thyroid dysfunction, with autoimmune issues being a link between the two.��

Unmanaged diabetes (both type 1 and type 2) may cause a low thyroid (T3) hormone state, even if other thyroid labs look normal, indicating the beginning stages of hypothyroidism and its side effects.⁵��

Type 2 diabetes often begins long before it’s diagnosed. Over time, the body gradually becomes less effective at producing and responding to insulin, especially with a poor diet and lack of physical activity.

As mentioned earlier, impaired thyroid function can cause your pancreas to make less insulin, leading to elevated glucose levels. Repeated and chronically elevated blood sugar levels can lead to insulin resistance.��

A negative cycle can occur as Hashimoto’s leads to hypothyroidism. Hypothyroidism can alter glucose metabolism and lead to insulin resistance, which worsens Hashimoto’s thyroiditis due to chronic inflammation and autoimmune response.

Taking steps to stop the cycle and achieve control can help you manage your health and well-being.

Managing Metabolic Health with Hashimoto's

Many treatment and management recommendations are effective for Hashimoto’s thyroiditis.��

Not every person with Hashimoto’s will struggle with glucose management or metabolic health, but it is wise to follow a healthy lifestyle to prevent future complications and feel your best.

Here are some changes to manage your thyroid and blood sugar levels:

1. If you have Hashimoto’s thyroiditis, you will likely require lifelong levothyroxine substitution (medication) to ensure your body receives adequate thyroid hormone and can help reduce side effects on all body systems. Work with your health care provider to manage your dosage and monitor thyroid hormone levels.^1,2��

2. Adopting an anti-inflammatory diet, such as the Mediterranean diet, may also support thyroid health. This diet emphasizes whole, minimally processed foods like fruits, vegetables, whole grains, beans, nuts, olive oil, and fish and limits red meat, added sugar, and processed grains. Research has shown that following the Mediterranean diet for three months reduces oxidative stress and improves thyroid function.⁶ Additionally, individuals with Hashimoto’s disease should be screened for celiac disease as these two autoimmune diseases are often associated. While research is still emerging, some evidence suggests a gluten-free diet may slow disease progression or assist with symptom management in individuals with Hashimoto’s disease.^1,2,6

3. Regular physical activity is beneficial for preventing type 2 diabetes and helping control blood glucose levels. Regular movement helps your cells become more sensitive to insulin, which works better to lower your blood sugar levels.⁷ A randomized controlled trial investigated the effects of exercise type on thyroid function and quality of life among 60 women with hypothyroidism. The study found that aerobic, resistance, and a combination of both improved thyroid function and quality of life. Resistance training significantly improved thyroid function, while the combination of aerobic and resistance exercise resulted in the most significant improvements in quality of life.⁸

4. Sleep can be impacted by hypothyroidism. Studies have shown a relationship between poorly managed hypothyroidism and insomnia, which may exhibit as short sleep duration, longer time to fall asleep, and low sleep quality. Some of the side effects of hypothyroidism include muscle and joint pain, cold intolerance, and anxiety, which can further make it harder to get quality sleep.⁹ Work on establishing a good sleep routine while you regulate your thyroid hormone levels with your healthcare provider. This might include a relaxing bedtime routine, minimizing screen time, avoiding caffeine or alcohol in the hours before bed, and setting a reasonable bedtime to allow yourself enough restful sleep.��

5. Finally, stay on top of your blood sugar levels. People with Hashimoto’s can have altered glucose metabolism that leads to insulin resistance, inflammation, and eventually metabolic syndrome or type 2 diabetes.��

Annual blood sugar tests, like the A1C test, which measures your average blood sugar levels over the past three to four months, can help identify changes that may indicate pre-diabetes and help you get your numbers under control. If you have other diabetes risk factors, more frequent monitoring may be needed.

Regular medical monitoring and sharing any health changes with your healthcare provider can help you feel your best and achieve optimal metabolic health.��

Adopting a healthy lifestyle, which includes thyroid hormone level management and supplementation, an anti-inflammatory diet, regular exercise, good sleep habits, and consistent blood sugar monitoring, will support you in managing Hashimoto’s disease and promote overall well-being.

The Bottom Line

Hashimoto’s thyroiditis, an autoimmune condition, can impact metabolic health by disrupting thyroid hormone production and leading to insulin resistance and metabolic syndrome. Individuals with Hashimoto’s are at risk for elevated blood sugar levels and insulin resistance.��

Managing Hashimoto’s through thyroid hormone replacement, an anti-inflammatory diet like the Mediterranean diet (and possibly considering a gluten-free diet), regular exercise, good sleep habits, and blood sugar monitoring can help improve both thyroid function and metabolic health and prevent long-term complications.��

Learn More With 91�������’ Expert Advice

Maintaining healthy blood sugar levels is essential to long-term health. Certain health conditions, like Hashimoto’s disease, require more careful attention to eating and exercise to support metabolic health.

A 91������� continuous glucose monitor (CGM) allows you to track your blood sugar levels in real-time, helping you understand how diet, food choices, and exercise affect your body and levels. These positive changes can help you improve your health.

Learn more about nutrition and health tips on 91�������’ blog, written by health and nutrition experts.