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Can Graves Disease Cause Diabetes?

Background

Background

Hyperthyroidism is a condition of thyroid hyperfunction and overproduction of thyroid hormones. Autoimmune Graves' disease is the most common cause in young people, especially women, and toxic goitre or toxic adenoma are more common in older individuals. BACKGROUND In 1786 Caleb Perry made the first description of the association between goitre and exophthalmos. In 1835 Graves and in 1840 von Basedow independently described the condition associated with their names. Toxic multinodular goitre (Plummer's disease) was first described in 1913. Graves' disease accounts for nearly 60% of cases of hyperthyroidism, and occurs at a median age which is 20 years younger than patients with adenoma (about 10% of cases), and 10 years younger than multinodular goitre (30% of cases). Adenoma and multinodular goitre have a higher prevalence in iodine-deficient areas than in iodine-sufficient ones[1]. These different groups of patients have different relationship to diabetes. Diabetes is more likely to occur in hyperthyroid patients [2], and glucose intolerance is often present in untreated hyperthyroidism. Autoimmune thyroid disease also frequently occurs within type 1 diabetes (anti-TPO antibodies are present in up to 50% of insulin dependent diabetes mellitus patients) or vice versa, in the Autoimmune Polyendocrine Syndromes[3], due to overlapping HLA associations. Thyroid dysfunction does not cause type 1 diabetes, but patients with Graves' disease are more likely to develop type 1 diabetes, and vice versa. EPIDEMIOLOGY A Japanese study showed that patients on treatment for hyperthyroid Graves’ disease are almost twice as likely to develop type 2 diabetes than members of the general population, are less likely to have been overweight, and are less likely to have a family history of Continue reading >>

The Link Between T1d And Thyroid Diseases: Hashimoto's And Graves

The Link Between T1d And Thyroid Diseases: Hashimoto's And Graves

Editors Note: This content has been verified byMarina Basina, MD, a Clinical Associate Professor at Stanford University. Shes a clinical endocrinologist and researcher with a focus on diabetes management and diabetes technology. Dr. Basina is an active member of multiple medical advisory boards and community diabetes organizations, and she is on the Beyond Type 1 Science Advisory Council. The two most common thyroid diseases that co-occur with Type 1 diabetes are Hashimotos or hypothyroidism and Graves or hyperthyroidism. The estimated prevalence of hypothyroidism due to Hashimotos thyroiditis ranges from 4 to 19% of people with Type 1 diabetes and 2 to 4% have Graves or hyperthyroidism in addition to Type 1 diabetes. Both of these diseases affect the thyroid, an endocrine gland, that involves the production of thyroid hormones and therefore regulates many metabolic processes. The thyroid gland is in the front of the neck and shaped like a butterfly and releases the thyroid hormone into the bloodstream. Its function is regulated by a feedback loop that involves the brain; when thyroid hormone is low in the bloodstream, the brain releases thyroid stimulating hormone (TSH) into the bloodstream which, true to its name, stimulates the thyroid gland to release thyroid hormone. In Hashimotos thyroiditis, the immune system attacks the thyroid directly. Because it is being attacked, the thyroid may be compromised and becomes unable to release sufficient the thyroid hormone. This can cause hypothyroidism, which is also known as an under-active thyroid. Women are 8 times more likely than men to develop Hashimotos, and most commonly presents between the ages of 40 and 60, frequently earlier in individuals with Type 1 diabetes. Goiter, or enlarged thyroid, which may cause a feelin Continue reading >>

The Relationship Between Type 2 Diabetes Mellitus And Related Thyroid Diseases

The Relationship Between Type 2 Diabetes Mellitus And Related Thyroid Diseases

Go to: 1. Introduction The role of hyperthyroidism in diabetes was investigated in 1927, by Coller and Huggins proving the association of hyperthyroidism and worsening of diabetes. It was shown that surgical removal of parts of thyroid gland had an ameliorative effect on the restoration of glucose tolerance in hyperthyroid patients suffering from coexisting diabetes [1]. There is a deep underlying relation between diabetes mellitus and thyroid dysfunction [2]. A plethora of studies have evidenced an array of complex intertwining biochemical, genetic, and hormonal malfunctions mirroring this pathophysiological association [2, 3]. 5′ adenosine monophosphate-activated protein kinase (AMPK) is a central target for modulation of insulin sensitivity and feedback of thyroid hormones associated with appetite and energy expenditure [3]. Hypothyroidism (Hashimoto's thyroiditis) or thyroid over activity (Graves' disease) has been investigated to be associated with diabetes mellitus. A meta-analysis reported a frequency of 11% in thyroid dysfunction in the patients of diabetes mellitus [4]. Autoimmunity has been implicated to be the major cause of thyroid-dysfunction associated diabetes mellitus [5–7]. Unmanaged pro diabetes, both type 1 and type 2, may induce a “low T3 state” characterized by low serum total and free T3 levels, increase in reverse T3 (rT3) but near normal serum T4 and TSH concentrations [8]. The relation between T2DM and thyroid dysfunction has been a less explored arena which may behold answers to various facts of metabolic syndrome including atherosclerosis, hypertension, and related cardiovascular disorders. T2DM owes its pathological origin to inappropriate secretion of insulin, due to defective islet cell function or beta cell mass. Continuous consump Continue reading >>

Graves’ Disease Overview

Graves’ Disease Overview

Graves’ disease is named for the doctor who first described it in Ireland—Robert J. Graves. He noticed it in a patient in 1835. The disease is also referred to as Basedow’s disease—named after a German, Karl Adolph van Basedow, who described the disease in 1840. He didn’t know that Graves had described the same disease just a few years earlier. The term Basedow’s disease is more commonly used in continental Europe; in the United States, it’s called Graves’ disease. Graves’ disease is a type of autoimmune problem that causes the thyroid gland to produce too much thyroid hormone, which is called hyperthyroidism. Graves’ disease is often the underlying cause of hyperthyroidism. Autoimmune problems—of which there are many different types—develop when your immune system causes disease by attacking healthy tissues. Researchers do not completely understand what causes autoimmunity, although there seems to be a genetic connection, as cases of Graves’ disease tend to run in families. For unknown reasons, like many autoimmune diseases, Graves’ is also more likely to affect women than men. In Graves’ disease, your immune system creates antibodies that cause the thyroid to grow and make more thyroid hormone than your body needs. These antibodies are called thyroid-stimulating immunoglobulins (TSIs). The TSIs bind to thyroid cell receptors, which are normally “docking stations” for thyroid-stimulating hormone (TSH—the hormone responsible for telling the thyroid to produce hormones). The TSIs then trick the thyroid into growing and producing too much thyroid hormone, leading to hyperthyroidism. The early symptoms of Graves’ disease may be confused with other conditions and make diagnosis a challenge. Some of the more common symptoms include: Weig Continue reading >>

Thyroid Disorders And Diabetes

Thyroid Disorders And Diabetes

Thyroid disorders are very common in the general U.S. population, affecting up to 27 million Americans, although half that number remains undiagnosed. It is second only to diabetes as the most common condition to affect the endocrine system — a group of glands that secrete hormones that help regulate growth, reproduction, and nutrient use by cells. As a result, it is common for an individual to be affected by both thyroid disease and diabetes. Since the thyroid gland plays a central role in the regulation of metabolism, abnormal thyroid function can have a major impact on the control of diabetes. In addition, untreated thyroid disorder can increase the risk of certain diabetic complications and can aggravate many diabetes symptoms. Luckily, abnormal thyroid function can easily be diagnosed by simple blood tests, and effective treatment is available. For all of these reasons, periodic screening for thyroid disorder should be considered in all people with diabetes. What is the thyroid? The thyroid is a butterfly-shaped gland located in the neck, just below the Adam’s apple and above the collarbone. It produces two hormones, thyroxine (T4) and triiodothyronine (T3), which enter the bloodstream and affect the metabolism of the heart, liver, muscles, and other organs. The thyroid gland operates as part of a feedback mechanism involving the hypothalamus, an area of the brain, and the pituitary gland, which is located within the brain. First, the hypothalamus sends a signal to the pituitary through a hormone called TRH (thyrotropin-releasing hormone). When the pituitary gland receives this signal, it releases TSH (thyroid-stimulating hormone) to the thyroid gland. Upon receiving TSH, the thyroid responds by producing and releasing the two thyroid hormones (T3 and T4). The Continue reading >>

Graves' Disease | Niddk

Graves' Disease | Niddk

Graves' disease is an autoimmune disorder that causes hyperthyroidism , or overactive thyroid. With this disease, your immune system attacks the thyroid and causes it to make more thyroid hormone than your body needs. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control how your body uses energy, so they affect nearly every organ in your bodyeven the way your heart beats. The thyroid is a small gland in your neck that makes thyroid hormones. If left untreated, hyperthyroidism can cause serious problems with the heart, bones, muscles, menstrual cycle, and fertility. During pregnancy, untreated hyperthyroidism can lead to health problems for the mother and baby. Graves disease also can affect your eyes and skin. Graves disease is the most common cause of hyperthyroidism in the United States. The disease affects about 1 in 200 people.1 Who is more likely to develop Graves' disease? Graves disease usually affects people between ages 30 and 50, but can occur at any age.2 The disease is seven to eight times more common in women than men.3 A persons chance of developing Graves disease increases if other family members have the disease. People with other autoimmune disorders are more likely to develop Graves disease than people without these disorders. Conditions linked with Graves disease include rheumatoid arthritis , a disorder that affects the joints and sometimes other body systems pernicious anemia , a condition caused by a vitamin B12 deficiency lupus , a chronic, or long-term, disorder that can affect many parts of your body vitiligo , a disorder in which some parts of the skin are not pigmented What other health problems could I develop because of Graves disease Without treatment, Graves disease can cause some serious heal Continue reading >>

Low Thyroid Hormone Raises Risk For Type 2 Diabetes

Low Thyroid Hormone Raises Risk For Type 2 Diabetes

People with prediabetes and low thyroid function were more than twice as likely to progress to full-blown type 2 diabetes compared to those with normal thyroid-hormone levels in a new study1 published September 30 in the journal BMC Medicine. For the study, researchers from the Erasmus Medical Center in the Netherlands followed 8,492 adults, ages 54 to 74, for nearly eight years. At the start, 1,338 had prediabetes and 7,114 had normal blood sugar levels. After 7.9 years, 798 had developed type 2 diabetes. Overall, low thyroid function—even in the low-normal range—increased risk for diabetes by 13%. But among those with prediabetes, the risk for progressing to type 2 diabetes ranged from 15% for those with normal thyroid function to 35% for those with signs of low function. Even “low normal” thyroid functioning increased risk. It’s the first large study to track low and low-normal thyroid function and diabetes risk. “There are no other studies addressing the relation between diabetes and thyroid function in the euthyroid range or in individuals with prediabetes,” the researchers note. Lead study author Layal Chaker, MD2 a Research and Curriculum Fellow at the Harvard T.H. Chan School of Public Health and a research fellow in the Department of Endocrinology and Epidemiology at the Erasmus Medical Center told EndocrineWeb that its too soon to recommend thyroid screening tests for people with prediabetes. And while treating low thyroid can help people with type 2 control their blood sugar, it’s not known whether treatment could prevent or delay it. “Our findings suggest that screening in people with prediabetes could be considered for further research,” Dr. Chaker said. “There are many ways in which low thyroid hormone levels can increase the risk of Continue reading >>

Graves Disease Causes

Graves Disease Causes

As with most autoimmune disorders, its hard to pinpoint the exact cause of Graves diseasethe most common cause of hyperthyroidism . When you have an autoimmune disorder, such as Graves disease, your immune system mistakenly turns against your body. Although researchers know very little about autoimmune diseases, heres what we do know about what happens to your immune system when you have Graves disease: Your immune system creates antibodies called thyroid-stimulating immunoglobulins (TSIs). These antibodies cause your thyroid gland to produce more thyroid hormone than your body needs. TSIs attach to thyroid cell receptorsdocking stations for thyroid-stimulating hormone (TSH). TSH is a key thyroid hormone. Its responsible for telling the thyroid to create thyroid hormones. But when you have Graves disease, the TSIs trick the thyroid gland into over-producing thyroid hormone, which causes hyperthyroidism. Although researchers are still investigating what triggers this autoimmune response, some researchers think that the cause of Graves disease may be tied to your family history. Because Graves disease may have a genetic link, that means if you have a family member with Graves disease, then youre more likely to develop it, too. Another risk factor that makes you more prone to developing Graves disease is your gender. As with other autoimmune conditions, Graves disease is more likely to affect women than men. Graves is most common in women older than 20 years old. However, people of any ageincluding mencan have Graves disease.1 Research On Other Possible Causes of Graves Disease As for other causes of Graves disease, researchers are working hard to determine other possible causes of this condition. For example, researchers are looking to identify the specific genes involve Continue reading >>

Thyroid Disease And Diabetes

Thyroid Disease And Diabetes

Diabetes and thyroid disease are both endocrine, or hormone, problems. When thyroid disease occurs in someone with diabetes, it can make blood glucose control more difficult. The thyroid is a butterfly-shaped gland in your lower neck just beneath your skin. It regulates your body’s metabolism, the processes of using and storing energy, by releasing a substance called thyroid hormone. If it produces too much thyroid hormone, your metabolism quickens (hyperthyroidism), too little and your body functions slow down (hypothyroidism). Hyperthyroidism Symptoms Pounding heart Quick pulse Increased sweating Weight loss despite normal or increased appetite Shortness of breath when exercising Muscle weakness or tremors Trouble concentrating Change in menstrual periods Thick skin on the knees, elbows, and shins Hypothyroidism Symptoms Sluggishness Depression Feeling of being cold even when others feel warm Constipation Weight gain unrelated to increase in eating Low blood pressure Slow pulse Effects on Diabetes Hyperthyroidism. When your metabolism quickens, your medicines go through your body quicker. Your blood glucose level may rise because your usual dosage does not stay in your body long enough to control it. Hyperthyroidism and low blood glucose can be hard to tell apart. If you are sweating and having tremors from hyperthyroidism, you may think you have low blood glucose and eat extra food, causing your blood glucose to rise. Using your glucose meter to verify low blood glucose levels can help you avoid this problem. Hypothyroidism. When your metabolism slows, your blood glucose level may drop because your diabetes medicine doesn’t pass through your body as quickly as usual and so stays active longer. In hypothyroidism, it is often necessary to reduce your dose of diabet Continue reading >>

Thyroid Disorders And Diabetes Mellitus

Thyroid Disorders And Diabetes Mellitus

Copyright © 2011 Mirella Hage et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Studies have found that diabetes and thyroid disorders tend to coexist in patients. Both conditions involve a dysfunction of the endocrine system. Thyroid disorders can have a major impact on glucose control, and untreated thyroid disorders affect the management of diabetes in patients. Consequently, a systematic approach to thyroid testing in patients with diabetes is recommended. 1. Introduction Thyroid diseases and diabetes mellitus are the two most common endocrine disorders encountered in clinical practice. Diabetes and thyroid disorders have been shown to mutually influence each other and associations between both conditions have long been reported [1, 2]. On one hand, thyroid hormones contribute to the regulation of carbohydrate metabolism and pancreatic function, and on the other hand, diabetes affects thyroid function tests to variable extents. This paper demonstrates the importance of recognition of this interdependent relationship between thyroid disease and diabetes which in turn will help guide clinicians on the optimal screening and management of these conditions. 2. Frequency of Thyroid Disorders in the General Population and in Patients with Diabetes Thyroid disorders are widely common with variable prevalence among the different populations. Data from the Whickham survey conducted in the late 1970s in the north of England revealed a prevalence of 6.6% of thyroid dysfunction in the adult general population [3]. In the Colorado Thyroid Disease Prevalence study involving 25,862 participants attendin Continue reading >>

The Connection Between Thyroid Disease And Diabetes

The Connection Between Thyroid Disease And Diabetes

It's not uncommon for someone to have both thyroid disease and diabetes. In fact, if you have type 1 diabetes , type 2 diabetes , insulin resistance , or metabolic syndrome , this doubles your risk of developing thyroid disease. And thyroid disease increases your risk of developing metabolic syndrome or type 2 diabetes. This association is even stronger if you are overweight or obese. It's important, then, to make sure you undergo routine screening for diabetes if you have thyroid disease, and vice versa, to ensure early detection and timely treatment. When one of the conditions is poorly controlled, it can make management of the other condition and reducing your risk of complications more difficult. There are also few steps you can take to help reduce your risk of this double diagnosis. Your thyroid gland and thyroid hormones play a major role in regulating many of your body's biological processes, such as growth, development, and metabolism. Because thyroid disease interferes with metabolism, it can alter your blood sugar. This increases your risk of developing diabetes, and it makes it harder to manage your blood sugar if you already have diabetes. Hyperthyroidism, which is overactive thyroid hormone, and hypothyroidism, which is underactive thyroid hormone, are both associated with mild hyperglycemia (elevated glucose levels). You might not experience obvious symptoms of thyroid-induced hyperglycemia if you do not have diabetes because your insulin can regulate your blood sugar to get it near optimal levels. It is believed that the chronically high blood sugar that can be induced by thyroid disease may contribute to the development of metabolic syndrome, a pre-diabetic state. Untreated metabolic syndrome can progress to type 2 diabetes. Diabetes can cause alteratio Continue reading >>

How To Eat Well When You Have Graves Disease

How To Eat Well When You Have Graves Disease

How to Eat Well When You Have Graves Disease Berries, Dairy, and Protein for Graves Disease Theres really no such thing as a Graves disease diet. Its more about filling your plate with healthy foods that wont aggravate Graves disease symptoms.In addition to watching what you eat, youll most likely need a combination of treatments, such as medications and radioactive iodine, as part of your overall Graves disease treatment plan. Graves disease is actually the most common cause of hyperthyroidism when your thyroid gland over-produces thyroid hormone. Although Graves disease cant be prevented or treated through diet alone, certain foods can help ease Graves disease symptoms. This article walks you through the foods you should choose to help manage the symptoms of Graves disease. However, because everyone has unique dietary needs, you should also talk to your doctor or registered dietitian about creating a meal plan. Berries: Berries, such as blackberries, blueberries, and raspberries, are brimming with antioxidants. These antioxidants help keep your immune system strong. Graves disease is an autoimmune disorder, which means that your immune system attacks healthy tissues in your body. Eating berries cant prevent Graves disease, but they can help protect your overall health.How much you need to eat: 1 or more servings a day Dairy Products: Untreated Graves disease can cause bone loss (which can lead to osteoporosis), but once Graves disease is treated, you need calcium to rebuild those bones. Get plenty of calcium from dairy foods, such as cheese, milk, and yogurt. If youre lactose intolerant, you can get your calcium from fortified foods, such as fortified orange juice, soy milk, whole grain cereals and breads.How much you need to eat: 3 servings daily Cruciferous vegetab Continue reading >>

Thyroid Disease And Diabetes

Thyroid Disease And Diabetes

CLINICAL DIABETES VOL. 18 NO. 1 Winter 2000 PRACTICAL POINTERS Thyroid Disease and Diabetes By Patricia Wu, MD, FACE, FRCP Thyroid disease is common in the general population, and the prevalence increases with age. The assessment of thyroid function by modern assays is both reliable and inexpensive. Screening for thyroid dysfunction is indicated in certain high-risk groups, such as neonates and the elderly. Hypothyroidism is by far the most common thyroid disorder in the adult population and is more common in older women. It is usually autoimmune in origin, presenting as either primary atrophic hypothyroidism or Hashimoto's thyroiditis. Thyroid failure secondary to radioactive iodine therapy or thyroid surgery is also common. Rarely, pituitary or hypothalamic disorders can result in secondary hypothyroidism. Approximately 4 million people in the United States are hypothyroid and receive thyroxine replacement therapy. By contrast, hyperthyroidism is much less common, with a female-to-male ratio of 9:1. Graves' disease is the most common cause and affects primarily young adults. Toxic multi-nodular goiters tend to affect the older age-groups. Diabetic patients have a higher prevalence of thyroid disorders compared with the normal population (Table 1). Because patients with one organ-specific autoimmune disease are at risk of developing other autoimmune disorders, and thyroid disorders are more common in females, it is not surprising that up to 30% of female type 1 diabetic patients have thyroid disease. The rate of postpartum thyroiditis in diabetic patients is three times that in normal women. A number of reports have also indicated a higher than normal prevalence of thyroid disorders in type 2 diabetic patients, with hypothyroidism being the most common disorder. Table Continue reading >>

The Relationship Between Diabetes And Thyroid Disorder

The Relationship Between Diabetes And Thyroid Disorder

At the clinic today, a patient came in for an initial assessment for Diabetes Self-Management Education. She was taking thyroid medication along with her diabetes and other medications. She was not the first patient that I have seen lately who is taking thyroid medication. I was aware of the link between diabetes and thyroid disease, and had some basic information. I thought it would be interesting to look into the dynamics a little further. After all, the pancreas and the thyroid both fall within the endocrine system. Now let’s take a look at why people with diabetes often seem to have thyroid disorder, and the reasons behind it. What is thyroid disease? In order to understand the relationship between diabetes and thyroid disease, it is helpful to understand what thyroid disease is. At the front of your neck, just under your Adam’s apple is where you will find the thyroid gland. Thyroid disease is a problem that happens when the thyroid gland either under produces or over produces the thyroid hormones. Thyroid hormones are responsible for regulating the body’s metabolism. From research, the percent of the population that will develop thyroid disease is 7 percent. The percentage of people with diabetes who have thyroid disease is greater than the general population. We will dig in a little deeper to find the reasons why, and examine the link between the two. Note from Kirk and Health Institute: A high percentage of low thyroid is “Hashimoto’s”, which like Graves disease is an auto-immune in origin and most often creates low thyroid symptoms. To address Hashimoto’s and Graves affectively you must focus on the immune system, medication can be supportive but does not address the cause. Autoimmune conditions are best managed by change in diet and reducing infl Continue reading >>

Hyperthyroidism And Diabetes

Hyperthyroidism And Diabetes

Hyperthyroidism can make blood glucose control difficult, so proper diagnosis and treatment are important. People with type 1 diabetes are at a high risk for hyperthyroidism, a condition caused by the overproduction of thyroid hormones. This excess of hormones speeds up the metabolism, the rate at which the body uses energy. Hyperthyroidism is usually associated with poor blood glucose control and a need for additional insulin. A increased metabolism “clears” insulin from the system at a faster rate, and an increased production and absorption of glucose can raise blood sugars. All of this can lead to insulin resistance – where cells are unable to respond to insulin in order to use glucose for energy. In extreme cases, this can lead to dangerously high blood sugars and diabetic ketoacidosis. Hyperthyroidism can also aggravate diabetic heart conditions. It can cause a rapid heart rate as well as arrhythmia (an irregular heartbeat). People with type 1 diabetes are particularly vulnerable to developing hyperthyroidism because thyroid disorders often result from problems with the immune system. The most common cause of hyperthyroidism in people under 40 is Graves’ disease, an autoimmune disorder. People with type 2 diabetes can also be affected by hyperthyroidism. However, people with type 2 are more likely to have hypothyroidism, a condition where the body produces too little thyroid hormones and the metabolism is slowed. What is Hyperthyroidism? The source of the problem is the thyroid, a butterfly-shaped gland located in the front of the neck below the larynx or voice box. The thyroid consists of two lobes, one located on either side of the windpipe. The job of the gland is to store hormones and release them into the bloodstream, where they circulate throughout th Continue reading >>

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