Hashimoto’s, Blood Sugar, and Diabetes 

Most of us are aware by now that diabetes is a major public health problem, affecting 30.3 million Americans, or as many as 9.4 percent of the general population. But, did you know that diabetes affects up to 30 percent of people with Hashimoto’s? Many autoimmune conditions share a common root cause and can be co-occurring — and diabetes and Hashimoto’s are no exception.

I’ve long had an interest in diabetes awareness. In fact, before I wrote my first book on Hashimoto’s, I was certified in Diabetes Management and helped to set-up diabetes education clinics around the state of Illinois. The clinics offered support on understanding the condition, with a large focus on medications, as well as some aspects of nutrition. We were always excited when patients were able to reverse their diabetes, but most patients required multiple medications and still had trouble losing the excess weight.

After my own Hashimoto’s diagnosis, I began to dive deeper into diet and lifestyle interventions to reverse my autoimmune condition. As my health improved, and I became more educated on the role that diet plays in healing, I was convinced that many of the same interventions that work to reverse thyroid disease, can reverse type 2 diabetes as well!

In this article, we’ll talk about the link between type 2 diabetes and Hashimoto’s and explore:

• The common forms of diabetes
• How to test for diabetes
• The connection between type 2 diabetes and Hashimoto’s
• Conventional & therapeutic treatments for type 2 diabetes
• How to address the root cause of type 2 diabetes

What is Diabetes?

Diabetes occurs when the body does not produce or receive insulin — the hormone that regulates blood sugar. Blood sugar (blood glucose) is the body’s primary fuel source and enters the bloodstream through the small intestine, after carbohydrates are consumed. Without the proper dose of insulin, the body’s blood glucose levels remain elevated and, over time, create a cascade of symptoms in the body, such as heart-attack, stroke, and kidney damage, that can become life-threatening.

There are several types of diabetes, including type 1, type 2, gestational, LADA, MODY, double, type 3, steroid induced, brittle, secondary, insipidus and juvenile diabetes. The most common forms of diabetes in Hashimoto’s are type 1 and type 2 diabetes. This article will focus on type 2 diabetes, which is generally thought to be “lifestyle induced.” Type 1 diabetes is autoimmune in origin, and while lifestyle also contributes to autoimmunity, type 1 diabetes is beyond the scope of this article.

As of 2015, diabetes impacted 30.3 million Americans. Unfortunately, only 23.1 million of these people know that they have it, while 7.2 million people are undiagnosed. Even more shocking, 84.1 million Americans are living with prediabetes — a condition that will lead to type 2 diabetes if not addressed. This is a growing pandemic with massive ramifications for the public’s health.

However, through proper medical treatment and a healthy lifestyle, diabetes is a condition that you can live with and perhaps even reverse!

Type 2 Diabetes

Though it is also thought to have a genetic component, type 2 diabetes is usually lifestyle-induced. It does not happen overnight, and usually takes years to manifest. People who have one or more of the following are at risk for type 2 diabetes:

• Obesity
• Unhealthy diet (high in sugars and processed foods)
• Physically inactive
• Close relatives with type 2 diabetes
• High blood pressure or raised cholesterol
• Smoking

Type 2 diabetes occurs when the body is unable to process the insulin it produces, or when the body is unable to produce enough insulin. Think of insulin as the hormone train. It loads up the sugar in your body and sends it to areas that need energy. Essentially, if your body is insulin resistant, then there is a backup of glucose (sugar) in your bloodstream, and areas that need energy get depleted.

Symptoms of type 2 diabetes include:

• Increased thirst
• Increased hunger (especially after eating)
• Dry mouth
• Frequent urination
• Rapid changes in body weight
• Fatigue
• Blurred vision
• Headaches
• Slow-healing sores or cuts
• Itching of the skin (usually around the vaginal or groin area)
• Frequent yeast infections
• Velvety dark skin changes of the neck, armpits, and groin, called acanthosis nigricans
• Numbness and tingling of the hands and feet
• Decreased vision
• Erectile dysfunction

I want to quickly explain the difference between type 1 and type 2 diabetes, because they do have very similar names, with very different root causes. Type 1 diabetes develops due to having an autoimmune disease, whereas type 2 diabetes results from insulin resistance (remember the glucose train backing up and getting dumped in the bloodstream?). Type 1 diabetes is generally seen to develop earlier in life, usually in childhood; whereas, for the most part, type 2 diabetes develops later in life, mostly from lifestyle factors, although rates of type 2 diabetes are increasing in children and teens.

For the scope of this article, and due to the vast amount of information on each type of diabetes, we will be focusing on the connection between Hashimoto’s and type 2 diabetes. In a later article, we’ll explore how autoimmune type 1 diabetes relates to thyroid disease.

Prediabetes

If you’ve been diagnosed with prediabetes, it means that your blood sugar levels are higher than normal (see below), but not high enough to be considered diabetes. Prediabetes is often referred to as a diabetes “wake up call.” It is almost always a precursor to a diabetes diagnosis, but when addressed, it can oftentimes be reversed before blood sugar levels reach the diabetes level.

But how do you reverse prediabetes? Generally, diet and lifestyle, as well as some supplements, may help to reverse prediabetes. I’ve included a list of the most common supportive foods and supplements for diabetes below, that you can also incorporate in your daily routine if you have been diagnosed with prediabetes.

Testing for Prediabetes and Type 2 Diabetes

There are several tests that a doctor may perform if a person shows signs of type 2 diabetes, or prediabetes.

• A1C Test: This blood test measures your average blood glucose levels over 2-3 months. If your AC1 level is greater than 6.5 percent, diabetes is diagnosed. Numbers between 5.7 percent and 6.4 percent are considered prediabetic, while 5.7 percent and lower is considered normal.

• Fasting Plasma Glucose: For this test, the doctor will ask a person to fast during the night and will take a blood sample the next day. If blood sugar levels are less than 100 mg/dL (5.6 mmol/L), the person’s fasting plasma glucose is considered normal. If levels are between 100 and 125 mg/dL (5.6 to 6.9 mmol/L), the person will be considered prediabetic. If two separate tests show 126 mg/dL (7 mmol/L), diabetes will be diagnosed.

• Oral Glucose Tolerance: With this test, a person fasts overnight before arriving at the doctor’s office the next day for testing. Once there, a sugary liquid is consumed, and blood sugar levels are tested several times over the course of two hours. If blood sugar levels read less than 140 mg/dL (7.8 mmol/L), they are considered normal. If numbers are between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L), a person is deemed to be prediabetic. If, after two hours, numbers are as high as 200 mg/dL (11.1 mmol/L), then diabetes is diagnosed.

In functional medicine, it is generally advised to keep blood glucose levels between 85 and 99 mg/dL. Results over 100 mg/dL signify insulin resistance, which is when the body’s cells turn off their receptors for insulin, so that neither insulin nor glucose can get into the cells, resulting in an accumulation of sugar in the bloodstream. Interestingly, while the fasting insulin test is usually one of the first tests that used to be traditionally ordered to diagnose diabetes, researchers found that fasting insulin is the marker that changes last when a person has diabetes. Postprandial insulin spikes, (or the increases of insulin after eating), are an earlier indication that one has diabetes. Thus, many people may have diabetes or pre-diabetes, that may not have been caught.

How are Type 2 Diabetes and Hashimoto’s Connected?

A lot of people don’t realize that there is a strong tie between thyroid disorders and type 2 diabetes. We know that thyroid disorders are very common in the general population — in fact, depending on the study you reference, they seem to affect anywhere from 10-20 percent of the general population. With around 30 percent of people with thyroid disease being diagnosed with diabetes, the risk for thyroid disease increases to almost double in people who have diabetes.

People with both type 1 or type 2 diabetes often have unknown thyroid problems, and typically have low thyroid function. We usually see that the T3 hormone is low in people with blood sugar problems, or dysglycemia. Thyroid hormone has both pro-insulin as well as anti-insulin effects on different organs. Low thyroid hormones can break the equilibrium, leading to altered carbohydrate metabolism, which in turn can result in imbalanced blood sugar levels.

A Polish study found that 50 percent of people with low thyroid function also had impaired carbohydrate metabolism. When someone has low thyroid hormone levels, the body will produce more insulin to maintain normal blood sugar levels. Thyroid hormone also stimulates the liver to make more glucose, and low thyroid hormone can lead to dysglycemia.

We know that all autoimmune diseases have an underlying root cause (or multiple root causes), and oftentimes, the same root cause will manifest as more than one autoimmune condition in the same individual. Hashimoto’s may be triggered by food sensitivities, a blood sugar imbalance, stress, or a leaky gut (among many others). These same factors may be triggers for diabetes as well.

Everyone with diabetes should have their thyroid hormone levels evaluated. TSH is the basic screening test for thyroid problems and the test used to dose medication. In many cases, TSH can be very misleading. Most people seem to feel and function their best when TSH is between 0.5 and 2.0 μIU/mL.

Conventional Treatment for Type 2 Diabetes

Whether you choose to work with a conventional or functional doctor, both will usually recommend a combination of lifestyle adjustments and medication to manage diabetes.

Conventional doctors typically prescribe patients that are healthy enough to exercise, a regimen of cardio pumping activities like bike riding, walking, running, or swimming. You’ll find that as you work out, your body will need less insulin to transport the sugars. Working out will also lower your blood sugar. It’s a win-win. You can burn off stress, refresh, sweat it out, and support your insulin and blood sugar needs.

When diet and lifestyle are not enough to support insulin and glucose sensitivity in type 2 diabetes, practitioners will usually prescribe other modalities in the form of medication and insulin therapy. I will go through the different types of medications and insulin therapies, but I also want to mention some therapeutic foods and supplements that can help aid western medicine prescriptions. I will mention this again as we go through these items, but it’s imperative that you are under the guide of your prescribing practitioner when taking additional supplements and therapeutic foods, because they can greatly affect blood sugars (usually for the better!), and medications may need to be adjusted.

Medication

Medication is often prescribed to encourage the pancreas to produce more insulin, while other medications are created to limit the amount of glucose released from the liver. When this happens, your body needs less insulin. Additional medications are prescribed to stop stomach and intestinal enzymes from breaking down carbohydrates, preventing sugars from being absorbed into the bloodstream.

Commonly prescribed medications for type 2 diabetes include:

• Metformin: This medication (Glucophage, Glumetza) is usually the first one prescribed for type 2 diabetes. It works by lowering glucose production in the liver and improving your body’s sensitivity to insulin. Nausea and diarrhea are possible side effects.

• Sulfonylureas: These medications help your body secrete more insulin. Examples include glyburide (DiaBeta, Glynase), glipizide (Glucotrol) and glimepiride (Amaryl). Possible side effects include low blood sugar and weight gain.

• Meglitinides: These medications — such as repaglinide (Prandin) and nateglinide (Starlix) — work like sulfonylureas by stimulating the pancreas to secrete more insulin, but they’re faster acting, and the duration of their effect in the body is shorter. They also have a risk of causing low blood sugar and weight gain.

• Thiazolidinediones: Like metformin, these medications — including rosiglitazone (Avandia) and pioglitazone (Actos) — make the body’s tissues more sensitive to insulin. These drugs have been linked to weight gain and other more serious side effects, such as an increased risk of heart failure and anemia.

• DPP-4 inhibitors: These medications — sitagliptin (Januvia), saxagliptin (Onglyza) and linagliptin (Tradjenta) — help reduce blood sugar levels, but tend to have a very modest effect. While they don’t cause weight gain, they may cause joint pain and increase one’s risk of pancreatitis.

• GLP-1 receptor agonists: These injectable medications slow digestion and help lower blood sugar levels. Their use is often associated with weight loss. Possible side effects include nausea and an increased risk of pancreatitis. Exenatide (Byetta, Bydureon), liraglutide (Victoza) and semaglutide (Ozempic) are examples of GLP-1 receptor agonists.

• SGLT2 inhibitors: These drugs prevent the kidneys from reabsorbing sugar into the blood. Instead, the sugar is excreted in the urine. Examples include canagliflozin (Invokana), dapagliflozin (Farxiga) and empagliflozin (Jardiance). Side effects may include vaginal yeast infections, urinary tract infections, low blood pressure, and a higher risk of diabetic ketoacidosis (when the body breaks down fat at a rapid rate).

• Insulin therapy: Some people with type 2 diabetes will need insulin therapy. In the past, insulin therapy was used as a last resort, but today it’s often prescribed sooner because of its benefits. Low blood sugar (hypoglycemia) is a possible side effect of insulin.

In addition to diabetes medications, your doctor might prescribe low-dose aspirin therapy, as well as blood pressure and cholesterol-lowering medications, to help prevent heart and blood vessel disease.

Each medication comes with its own set of drawbacks and benefits, so it’s important to work with a doctor to determine the right medication for each individual situation.

Insulin Therapies

While type 1 diabetes patients will need insulin to merely survive, type 2 patients are prescribed on a case-by-case basis, depending on pancreatic function. There are a variety of ways to receive insulin, including via a syringe, insulin pen, or a pump. Insulin can also be administered orally.

A doctor will work with each individual to determine the right form of administration, which often depends on their lifestyle and activity level. For example, some people like having a pump that allows them to add insulin to the bloodstream easily, without too much interruption to daily activities. However, the needle for this pump can come out, so if you are involved with highly active contact sports, this might not be your best option.

Blood Sugar Monitoring

If you have diabetes, your doctor will ask you to monitor your sugar levels with a glucose meter. This will be done a few times a week or even a few times a day, depending on the patient. Keep in mind that blood sugars can spike intermittently, so it’s important to keep an eye on them.

You may experience blood sugar swings, or you can also experience hypoglycemia and hyperglycemia. Hypoglycemia is a condition characterized by very low levels of blood sugar. It can stem from eating too much sugar or skipping meals. It can even result from too much insulin, so it’s important to know how much you’re injecting if you are using supplemental insulin.

Symptoms of Low Blood Sugar Levels (Hypoglycemia)

• Anxiety
• Muscle weakness
• Dizziness
• Mental confusion
• Feeling “hangry” (hungry + angry)
• Racing pulse
• Abnormal sweating
• Feeling shaky/trembling

On the flipside, high blood sugar levels, or hyperglycemia, result when there is too much glucose in the blood, and not enough insulin to convert it into energy. It’s important to eat a well-balanced diet, administer appropriate amounts of insulin, and take the necessary medications prescribed by your doctor, to keep high blood sugar in check.

Symptoms of Hyperglycemia 

• Constant thirst
• Blood sugar detectable in urine
• High blood glucose readings
• Frequent urination
• Headaches
• Blurred vision
• Sudden weight loss

Addressing the Root Cause

If you’ve been following me for a while, you’ll know that I’m a big proponent of lifestyle changes. Sometimes lifestyle changes can completely reverse a health condition.

One of my mentors, a pharmacist and certified diabetes educator, has always said:

“There are six broken organs in diabetes: the brain, the liver, muscles, the digestive tract, the pancreas, and lipids. Although we have many medications that treat diabetes, none of them fix all of these organs. Lifestyle changes fix all of these organs. Medications are an adjunct.”

While medications may sometimes be a necessary treatment in advanced cases of diabetes, they do not address the root cause of the problem, and can have serious side effects. In the case of type 2 diabetes, addressing a few dietary issues and supporting the stress response can oftentimes prevent, and even reverse, the condition.

In order to do so, we must our balance blood sugar levels.

Balancing Blood Sugar

Blood sugar abnormalities are present for most people with Hashimoto’s, and many people develop hypoglycemia (low blood sugar) in the early stages. This is an early risk factor for developing diabetes; and exacerbates Hashimoto’s, as well as other autoimmune conditions.

My own blood sugar was around 50 mg/dl (very low) right before I got diagnosed with Hashimoto’s, and I often used to feel lightheaded, faint, and anxious. My hair loss, anxiety, lightheadedness, and antibody levels greatly improved after I stabilized by blood sugar. In fact, stabilizing blood sugar is one of the very first interventions (along with going gluten and dairy free) that I recommend for people with Hashimoto’s.

What are Blood Sugar Imbalances?

As mentioned above, the pancreas produces insulin to help keep blood sugar levels in check after carbohydrates are consumed. It then converts excess glucose to glycogen, and sends it to the liver for storage. Blood sugar imbalances occur when our blood sugar swings out of a normal, steady range, usually from consuming high carbohydrate foods that spike blood sugar levels before they drop quickly, like a rollercoaster.

When we consume large amounts of sugar, the pancreas has to release larger amounts of insulin to bring the levels of sugar in the blood back down. These surges in insulin can cause blood sugar levels to drop too low, which then causes cravings for more carbohydrate-rich foods. This starts the cycle all over again as blood sugar levels swing high and low, creating stress in the body.

Common symptoms of imbalanced blood sugar levels include:

• Hormonal issues
• Fatigue
• Depression
• Anxiety
• Insomnia
• Poor brain function
• Chronic pain

How Do We Balance Blood Sugar?

Choosing foods that have a low glycemic index is the most effective way to balance blood sugar levels. The glycemic index is a measure of how quickly food becomes assimilated into our bodies. It can also be referred to as the “burn” rate — how quickly we burn the fuel we receive from these foods. Focusing on low glycemic index (GI) and low glycemic-loaded (GL) foods, which burn slower, can really help with balancing blood sugars.

Foods with a glycemic index of less than 55 are considered to have a low glycemic index. These include most non-starchy vegetables, meats, nuts, seeds, and some whole grains. Fruits with less fructose (“sour” fruits such as grapefruit, lemons, limes, and cranberries) also have a low glycemic index.

Foods with a glycemic index above 55 are considered high glycemic index foods and include processed grains, sugar, starchy vegetables like potatoes, and sweet fruits like watermelon.

The Importance of Protein

Protein is an essential macronutrient and helps us to build up our body to ensure that all vital processes are taking place. Many people may not get enough protein and can be at risk for protein deficiency, which can lead to blood sugar imbalances. Therefore, it is crucial to ensure that you are including adequate amounts of protein in your diet. For general health purposes, you should be consuming about 0.45-0.55 grams of protein per day, for each pound that you weigh.

Instead of loading up on carbs, I recommend increasing your intake of proteins (along with health fat), as it has a slower burn rate and becomes assimilated into our bodies in a slower and more gradual manner. Combining carbohydrates with protein can slow down the glycemic impact of the carbohydrates you consume. If you do consume some carbohydrates, I recommend a ratio of no larger than two servings of carbohydrates to one serving of protein. (For example, if you are having 4 ounces of steak, you should have a maximum of 8 ounces of potatoes.)

Include fat and protein with every meal — good sources include eggs, nuts, seeds, fish, and meat. Protein powders are another great way to get protein in your diet! You can read about the safest protein powders for Hashimoto’s here.

Address the Stress Response

Adrenal dysfunction (an impaired stress response) oftentimes goes hand-in-hand with Hashimoto’s. In fact, I would estimate that 90 percent of the people with Hashimoto’s that I work with, have adrenal dysfunction as well.

Impaired adrenals can be a root cause for Hashimoto’s, a co-occurring condition, or a symptom. Unstable blood sugar levels can have a major impact on the adrenals, as a constant rollercoaster of high and low glucose levels creates enormous amounts of stress in the body.

In people with diabetes who have unbalanced blood sugar, we often observe a common occurrence of high lipid levels (fat content in the blood), which could mean they have low T3 (thyroid hormone) levels. There are a few different root causes for low T3, and taking a T3-containing medication can be helpful in the short term. However, it’s also important to look for reasons why these individuals are not making enough T3. Frequently, stress is a factor because it causes us to make more reverse T3. I like to think of T3 as the “go” hormone, and the reverse T3 as the one that says “stop.” When stress levels are heightened, reverse T3 becomes elevated, T3 is lowered, and blood sugar becomes more unbalanced.

There’s often a connection between the thyroid and diabetes, especially type 2 and insulin resistance, and I believe the adrenals are the common denominator. The adrenal glands release hormones such as cortisol and adrenaline. These “stress hormones” impact many important functions throughout the body. They help establish your stress tolerance, tame inflammation, regulate blood sugar and body fat, control potassium and sodium levels (impacting blood sugar), and influence sex drive and anti-aging… among other things.

You may have heard that the stress hormone cortisol is “bad.” This is misleading — while high levels of cortisol are problematic, what could be equally problematic is having low levels of cortisol, especially when it comes to having an autoimmune disease.

Cortisol is a hormone that is required for life — we could not live without it, and it is an important anti-inflammatory hormone. In fact, it gets released whenever we have inflammation, to cool things down.

When your body is stressed, it leads to inflammation in the body. Often, an autoimmune disease is triggered by stress or traumatic events. Sources of stress vary, but it can range from poor sleep, to having a new baby, stressful jobs, family tragedies, or trauma. These events put an overwhelming burden on the adrenals to keep up with the cortisol production. From there, things begin to fall apart.

Chronic stress leads to bodily inflammation, as well as the need for high levels of cortisol to calm it down. Cortisol also helps us manage our blood sugar, and a lot of times when we have low levels of cortisol, we also see blood sugar swings. In my opinion, that’s the biggest connection between the stress response, adrenals, thyroid, and endocrine system. It’s too much of a burden on our poor little adrenals as they try to manage inflammation in our body.

Addressing stress levels by balancing blood sugar and focusing on lifestyle changes can have a big impact on Hashimoto’s and diabetes. A few additional ways to lower your stress response include:

1. Yoga
2. Pilates
3. Low-impact cardio exercise
4. Journaling
5. Reading
6. Resting
7. Meditation
8. Discovering what brings you joy

You can learn more tips about how to lower your stress response in my article on adrenal dysfunction.

Nutrient Deficiencies in Type 2 Diabetes

Studies have shown that people with type 2 diabetes may be deficient in certain key vitamins and minerals. Addressing these nutrient deficiencies may, in some cases, reverse many of the effects of diabetes and help restore proper blood sugar response. Below, I’ve listed the most common supplements that are used to address diabetes, but there are more out there — you would want to speak with your primary care practitioner to see which supplements (including these) would be best for you.

If you are currently taking medication to treat diabetes, please speak with your prescribing practitioner prior to taking any supplements, as they may have an effect on lowering your blood sugar:

• Vitamin D – Vitamin D deficiency is common in those with type 2 diabetes. Studies hypothesize that vitamin D is related to the action of insulin. A study conducted in 2012 – 2013 showed a decrease in HBA1c (average blood sugar) levels in those who took 4000 IU of vitamin D daily, compared to the group that took a placebo. It’s important to test vitamin D levels when supplementing.
• Magnesium – A deficiency in magnesium has been found to result in insulin resistance as well as glucose not being utilized properly and efficiently in the cells. There is also oxidative stress and inflammation present, which results in more free radicals throughout the body, which then damage cells.
• Myo-inositol – Myo-inositol may help lower blood glucose levels after consuming a meal due to its insulin sensitizing activity. Aside from diabetes, it has also been shown to be helpful for women with PCOS (polycystic ovary syndrome), a condition that greatly affects insulin sensitivity. Myo-inositol may also assist with relief from diabetic neuropathy (peripheral nerve dysfunction), as neuropathy reduces stores of myo-inositol.
• Chromium – Chromium (an essential trace mineral) can help those with type 2 diabetes and those with insulin resistance, by assisting in the attachment of insulin to cell receptors, which then increases the uptake of glucose into that cell. Symptoms of long-term chromium deficiency include severely impaired glucose tolerance, weight loss, peripheral neuropathy and confusion.
• Alpha lipoic acid – Alpha lipoic acid (an antioxidant) is very effective for diabetic neuropathy (peripheral nerve dysfunction). When neuropathy is present, glutathione (another important antioxidant produced by the body) stores are decreased as a result. Alpha lipoic acid helps diabetic neuropathy by increasing reduced glutathione stores.
• Glutamine – Used to treat diabetes and curb carbohydrate cravings, this essential amino acid helps suppress insulin levels and stabilize blood glucose. Research has shown glutamine to be effective in restoring insulin response in diabetics, so glutamine supplementation may be helpful in addressing blood sugar issues in those with Hashimoto’s. You can find glutamine in the form of L-glutamine in bone broth, as well as in supplements like L-Glutamine Powder by Pure Encapsulations.
• Vitamin C – A recent study found that taking 500mg of vitamin C twice daily can help those with type 2 diabetes by lowering elevated blood sugar levels throughout the day and reducing spikes in blood sugar after meals.
• Carnitine – Carnitine is an amino acid that is naturally produced in the body. It helps transport fatty acids into the mitochondria, where they can be burned up and used as fuel. Studies in both humans and animals have shown that carnitine supplementation resulted in an improvement of glucose tolerance, in particular during insulin-resistant states. I recommend Rootcology’s Carnitine Blend, which contains the acetyl-L-carnitine form, for its unique properties in supporting brain function and reducing mental fatigue.
• Glutathione & Cysteine – Glutathione, an antioxidant composed of amino acids, protects B-cells (immune cells) in the body, which are particularly sensitive to oxidative stress. Type 2 diabetics typically have lowered antioxidants, and supplementing with the glutathione precursor cysteine helps restore antioxidant status.
• Zinc – Zinc is crucial to the process of synthesizing, storing, and secreting insulin. It helps to protect the B-cells in the pancreas from damage, and has even been studied for its ability to affect the expression of genes that are linked to diabetes.
• Vitamin B12 – Critical to many bodily functions, including making DNA and red blood cells, vitamin B12 has been found to be deficient in many people with diabetes, as Metformin (commonly prescribed diabetes medication) depletes B12 from the body.

Therapeutic Herbs and Foods

There are some foods and herbal supplements that can be used therapeutically to compliment any current treatments for diabetes. As with anything, starting low and going slow is your best bet. If you do plan to incorporate any of these foods, be sure to start with just a little bit so you can see how you do, and slowly work your way to adding more into your diet. Again, it is important to check with your practitioner before taking any herbal supplements that may interact with medications you are taking.

• Bitter Melon – Grown in Asia and India, this vegetable is generally used in curry dishes. All parts of the vegetable can be used (fruit for consumption and leaves for tea), and have been shown to possibly increase the release of insulin from the pancreas. It has also been found to oxidize glucose in red blood cells and adipose (fat) cells. This, in turn, helps those with type 2 diabetes to better manage their sugars by decreasing blood glucose levels, creates better tolerance for glucose, and may also decrease HbA1c levels. For the most part, bitter melon is generally tolerated; however, gastrointestinal upset may occur. There have been two cases (dating back to 2013) where two children experienced adverse effects from bitter melon tea, so please speak with a practitioner prior to having children consume it.
• Cinnamon spice – There are different forms of cinnamon, but the one that is studied for decreasing blood sugars is Chinese cinnamon, also known as cassia. The Latin name for this type of cinnamon is Cinnamomum aromaticum. Cinnamon may work by enhancing insulin activity, which in turn, improves blood sugar control. Although well tolerated, over consumption of cinnamon may cause hepatotoxicity (liver damage) in humans and animals.
• Chia seeds – High in alpha linolenic acid, omega-3 fatty acids, as well as a good dose of fiber, chia seeds may help lower blood glucose levels after a meal. Adding these seeds to a morning smoothie, like my Root Cause Green Smoothie, can help you incorporate these little powerhouses daily, and they are tolerated by most people.
• Holy Basil (Tulsi) Tea – Tulsi, or Holy Basil tea, is popular in Ayurvedic medicine. Aside from the relaxing and calming effect of the tea, Holy Basil has also been known to help lower blood glucose levels after a meal. Although unknown as to which constituent is responsible for the effect, researchers have come to theorize that the reason for the glucose-lowering properties may be due to improved pancreatic beta-cell function, which leads to increased insulin secretion.
• Stevia – You may be surprised to see stevia on the list! I know there may be some concern with stevia use, but through my research, I’ve come to the conclusion that stevia may be helpful for those with diabetes. A study done in March 2015 suggests that it is “good for diabetic patients because it is calorie-free, non-toxic and cannot be oxidized.” In this study, diabetic rats were given different doses of stevia. Those given the higher dose had lower blood glucose levels over time. Stevia increases insulin secretion without any glucose being introduced to the bloodstream. This allows for the insulin to reduce high glucose levels. This will also help lower complications for people with diabetes.
• Aloe – Several studies have shown that aloe vera gel, taken orally at a dose of 15 mL twice per day, can decrease fasting glucose levels in those with type 2 diabetes. Selecting a high-grade aloe supplement, like Rootcology Aloe, will ensure that you are getting adequate amounts of the beneficial properties of aloe. Supplements that contain the outer leaf may cause issues such as diarrhea and electrolyte loss due to its laxative effect.
• Berberine – Berberine, a chemical found in several different plants, is used for diabetes to help control HbA1c (average blood sugar) levels. Compared to the drug Metformin, berberine produced similar results when a study was reported in 2009. HbA1c levels, blood glucose levels (fasting and post meal), and triglyceride (a type of fat in the blood) levels were all reduced as a result of using berberine.
• Milk Thistle – Silymarin (one of the compounds in milk thistle) may work similarly to some diabetic medications by helping to improve insulin sensitivity and decrease blood sugar. A recent analysis found that people routinely taking silymarin saw a significant reduction in their fasting blood sugar levels. The antioxidant and anti-inflammatory properties of milk thistle may also be useful for reducing the risk of developing diabetic complications, such as kidney disease.
• Black Cumin Seed (Nigella Sativa) – This spice (which can be used as a seasoning for food) has been used for medicinal purposes for thousands of years. Studies have shown that black cumin seeds may lower blood sugar levels by stimulating the release of insulin from the pancreas and raising glucose absorption by muscular tissue. Diabetes patients in one recent study lowered their fasting glucose levels after consuming 2 grams of black cumin seed every day, for four to six weeks. This supplement has recently been shown to help Hashimoto’s as well (article coming soon). It can be taken in powder (seed) or liquid form, added to a smoothie, or taken as a supplement in pill form.

Additional herbal remedies that are being used by complementary medicine practitioners to treat diabetes include:

• Agaricus mushroom: may decrease insulin resistance when combined with Metformin
• Banaba: decreases blood sugar levels
• Bilberry: has blood glucose, triglyceride, and cholesterol-lowering properties
• Fenugreek: can lower post-meal blood sugar levels when mixed with food
• Ginseng (Asian & American): may decrease carbohydrate absorption
• Glucomannan (konjac): enhances glycemic control by slowing gastric emptying
• Gymnema: reduces intestinal absorption of glucose
• Prickly pear cactus: slows carbohydrate absorption and lowers blood glucose levels
• White Mulberry: slows the digestion of carbohydrates, decreasing blood glucose and insulin levels

Takeaway

While there is a genetic component to all types of autoimmune conditions, including diabetes, I always like to remind people that your genetics are not your destiny! Lifestyle changes can have a huge impact on regulating your blood sugar and bringing type 2 diabetes into remission. Addressing the stress in your life, focusing on eating a blood-sugar-balancing diet, addressing nutrient deficiencies, and incorporating healing foods and herbs into your diet, can work together to bring your diabetes under control. Many people will even find that they can get off of their diabetes medications and feel better than ever, once they do so.

It’s important to consult with your doctor before making any changes to your medications and diet, but I encourage everyone with Hashimoto’s to get their blood sugar checked and begin making the lifestyle changes that will put them in control of their health!

As always, I wish you the best on your own health journey!

P.S. You can download a free Thyroid Diet Guide, 10 thyroid-friendly recipes, and the Nutrient Depletions and Digestion chapter of my first book for free by signing up for my newsletter. You will also receive occasional updates about new research, resources, giveaways and helpful information. For future updates, make sure to follow us on Facebook!

Resources

1. Gierach M, Gierach J, Skowrońska A, Rutkowska E, Spychalska M, Pujanek M, et al. Hashimoto’s thyroiditis and carbohydrate metabolism disorders in patients hospitalised in the Department of Endocrinology and Diabetology of Ludwik Rydygier Collegium Medicum in Bydgoszcz between 2001 and 2010. Endokrynol Pol. 2012;63(1):14-7.
2. National Institute of Diabetes and Digestive and Kidney Diseases. Adrenal Insufficiency & Addison’s Disease | NIDDK. NIH. https://www.niddk.nih.gov/health-information/endocrine-diseases/adrenal-insufficiency-addisons-disease. Published May 2014. Accessed February 25, 2018.
3. Rates of new diagnosed cases of type 1 and type 2 diabetes on the rise among children, teens. National Institutes of Health. https://www.nih.gov/news-events/news-releases/rates-new-diagnosed-cases-type-1-type-2-diabetes-rise-among-children-teens. 2017. Accessed June 27, 2019.
4. L Dvorkin Camiel, Goldman-Levine J. Herbal Products for the Treatment of Type 2 Diabetes. Practical Diabetology. 2013; 25-30.
5. Teoh S, Lai N, Vanichkulpitak P, et al. Clinical evidence on dietary supplementation with chia seed (Salvia hispanica L.): a systematic review and meta-analysis. Nutrition Reviews. 2018; 76(4):219-242. doi:10.1093/nutrit/nux071.
6. Agrawal P, Rai V, Singh RB. Randomized placebo-controlled, single blind trial of holy basil leaves in patients with noninsulin-dependent diabetes mellitus. Int J Clin Pharmacol Ther. 1996 Sep;34(9):406-9.
7. Scragg R. Vitamin D and type 2 diabetes: are we ready for a prevention trial? Diabetes. 2008;57(10):2565–2566. doi:10.2337/db08-0879
8. Barbagallo M, Dominguez LJ. Magnesium and type 2 diabetes. World J Diabetes. 2015;6(10):1152-1157. doi:10.4239/wjd.v6.i10.1152.
9. Mancini M, Andreassi A, Salvioni M, Pelliccione F, Mantellassi G, Banderali G. Myoinositol and D-Chiro Inositol in Improving Insulin Resistance in Obese Male Children: Preliminary Data. Int J Endocrinol. 2016;2016:8720342. doi:10.1155/2016/8720342
10. Vallianou N, Evangelopoulos A, Koutalas P. Alpha-lipoic Acid and diabetic neuropathy. Rev Diabet Stud. 2009;6(4):230–236. doi:10.1900/RDS.2009.6.230
11. Yin J, Xing H, Ye J. Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism. 2008;57(5):712–717. doi:10.1016/j.metabol.2008.01.013
12. DiNicolantonio JJ, Bhutani J, OKeefe JH, Crofts C. Postprandial insulin assay as the earliest biomarker for diagnosing pre-diabetes, type 2 diabetes and increased cardiovascular risk. BMJ Journals. http://dx.doi.org/10.1136/openhrt-2017-000656

Note: Originally published in March 2015, this article has been revised and updated for accuracy and thoroughness.