Diabetes refers to a group of conditions characterized by a high level of blood glucose, commonly

referred to as blood sugar. Too much sugar in the blood can cause serious, sometimes life-threatening
health problems. There are two types of chronic diabetic conditions:
type 1 diabetes and type 2 diabetes

A. T1DM and TMD2

-WHAT IS HAPPENING
Type 1 Diabetes is an Auto-immune disease in which the T-cells, a part of the imuune system, attack the
pancreatic B-cells(beta cells). Our pancreas produces insulin. Insulin is a hormone produced by beta cells
of the pancreas and is necessary for glucose absorption in the cell as a source of energy. If beta cells are
destroyed, then there is low production of insulin, making glucose stay in the bloodstream instead of
being absorbed by various insulin-responsive tissues like muscle cells and adipose tissue.

In type 2 diabetes, the pancreas produces enough insulin but the cells that will absorb it becomes less
sensitive to insulin, mainly because of the build up fat (due to sedentary and unhealthy lifestyle) in the
insulin receptors which makes insulin won't bind with the receptors therefore leaving the glucose on the
bloodstream. When cells don’t respond to insulin, this is called insulin resistance.

-RISK FACTORS
T1DM

Risk factors for type 1 diabetes are less clear than risk factors for type 2 diabetes.

- Family history: People with a parent or sibling with type 1 diabetes have a higher risk of
developing it themselves.
- Age: Type 1 diabetes can appear at any age, but it’s most common among children and
adolescents.

T2DM

You’re at risk of developing type 2 diabetes if you:

● have prediabetes, or slightly elevated blood sugar levels

● are carrying excess weight or have obesity
● have a lot of belly fat
● are physically active less than 3 times a week
● are over age 45
● have ever had gestational diabetes, which is diabetes during pregnancy
● have given birth to a baby weighing more than 9 pounds
● have an immediate family member with type 2 diabetes
● have polycystic ovary syndrome (PCOS)

-SYMPTOMS

Type 1 and type 2 diabetes share common symptoms. They are:

​ going to the toilet a lot, especially at night

​ being really thirsty
​ feeling more tired than usual
 ​ losing weight without trying to
​ genital itching or thrush
​ cuts and wounds take longer to heal
​ blurred vision.

4Ts of T1DM

​ Toilet – going for a wee more often, especially at night. 

​ Thirsty – being constantly thirsty and not being able to quench it.
​ Tired – being incredibly tired and having no energy.
​ Thinner – losing weight without trying to, or looking thinner than usual.

-MANAGEMENT

T1DM
If you have type 1 diabetes, you’ll need to take insulin to control your blood sugar levels. You’ll also need
to test your blood glucose levels regularly.

T2DM
Management of:
Blood sugar
Blood pressure
Cholesterol

Meal plans:
● Lean proteins: Proteins low in saturated fats include chicken, eggs and seafood. Plant-based
proteins include tofu, nuts and beans.
● Minimally processed carbohydrates: Refined carbs like white bread, pasta and potatoes can
cause your blood sugar to increase quickly. Choose carbs that cause a more gradual blood sugar
increase such as whole grains like oatmeal, brown rice and whole-grain pasta.
● No added salt: Too much sodium, or salt, can increase your blood pressure. Lower your sodium
by avoiding processed foods like those that come in cans or packages. Choose salt-free spices
and use healthy oils instead of salad dressing.
● No added sugars: Avoid sugary foods and drinks, such as pies, cakes and soda. Choose water or
unsweetened tea to drink.
● Non-starchy vegetables: These vegetables are lower in carbohydrates, so they don’t cause blood
sugar spikes. Examples include broccoli, carrots and cauliflower.

People with type 2 can also be prescribed insulin.

-CURE AND PREVENTION

Unfortunately, there’s currently no permanent cure for either type 1 or type 2 diabetes.

But there’s evidence that some people with type 2 can put their diabetes into remission by losing weight.
Following a very low-calorie diet under medical supervision, or having surgery are some ways you can put
your type 2 diabetes into remission.

B. HYPOTHYROIDISM and HYPERTHYROIDISM

-WHAT IS HAPPENING
 Hypothyroidism is a common condition where the thyroid doesn’t create and release enough
thyroid hormone into your bloodstream. This makes your metabolism slow down. Also called
underactive thyroid, hypothyroidism can make you feel tired, gain weight and be unable to tolerate
cold temperatures. The main treatment for hypothyroidism is hormone replacement therapy.

What is hypothyroidism? In short, your thyroid gland can’t make enough hormones to function
well. The thyroid gland controls every aspect of your body’s metabolism. In hypothyroidism, the
gland’s hormone production slows. This, in turn, slows your metabolism, which can lead to weight
gain. Few of the causes of hypothyroidism is Hashimoto’s Thyroiditis which is caused by
autoimmune inflammation of the thyroid gland, and Iodine Deficiency.

As its name suggests, hyperthyroidism occurs when your body makes too much of the thyroid
hormones, thyroxine (T4) and triiodothyronine (T3), and becomes overactive. If you have hyperthyroidism,
you may experience a fast heartbeat, increased appetite, anxiety, sensitivity to heat, or sudden weight
loss. Hyperthyroidism most commonly occurs in three ways:

● thyroiditis, or
an inflammation of the thyroid
● a thyroid nodule
that produces too much T4 hormone
● an autoimmune
condition known as Graves’ disease

In hyperthyroidism, an irritation of your thyroid known as thyroiditis allows too much thyroid hormone to
enter your blood.

The Differences Between Hypothyroidism and Hyperthyroidism

Hypothyroidism causes symptoms like slowed metabolism, tiredness, and weight gain. Having an
underactive thyroid can decrease or slow down your bodily functions.

With hyperthyroidism, you may find yourself with more energy, as opposed to less. You may experience
weight loss as opposed to weight gain. And you may feel anxious as opposed to depressed.

The most common difference between the two diseases relates to hormone levels. Hypothyroidism leads
to a decrease in hormones. Hyperthyroidism leads to an increase in hormone production.

-RISK FACTORS

Although anyone can develop hypothyroidism, you're at an increased risk if you:

● Are a woman
● Are older than 60
● Have a family history of thyroid disease
● Have an autoimmune disease, such as type 1 diabetes or celiac disease
● Have been treated with radioactive iodine or anti-thyroid medications
● Received radiation to your neck or upper chest
● Have had thyroid surgery (partial thyroidectomy)
 ● Have been pregnant or delivered a baby within the past six months

Risk factors for hyperthyroidism, include:

● A family history, particularly of Graves' disease

● Female sex
● A personal history of certain chronic illnesses, such as type 1 diabetes, pernicious anemia
and primary adrenal insufficiency

-SYMPTOMS
The signs and symptoms of hypothyroidism vary, depending on the severity of the hormone
deficiency. Problems tend to develop slowly, often over a number of years.

At first, you may barely notice the symptoms of hypothyroidism, such as fatigue and weight gain. Or you
may simply attribute them to getting older. But as your metabolism continues to slow, you may develop
more-obvious problems.

Hypothyroidism signs and symptoms may include:

● Fatigue
● Increased sensitivity to cold
● Constipation
● Dry skin
● Weight gain
● Puffy face
● Hoarseness
● Muscle weakness
● Elevated blood cholesterol level
● Muscle aches, tenderness and stiffness
● Pain, stiffness or swelling in your joints
● Heavier than normal or irregular menstrual periods
● Thinning hair
● Slowed heart rate
● Depression
● Impaired memory
● Enlarged thyroid gland (goiter)

Hyperthyroidism can mimic other health problems, which can make it difficult for your doctor to
diagnose. It can also cause a wide variety of signs and symptoms, including:

● Unintentional weight loss, even when your appetite and food intake stay the same or
increase
● Rapid heartbeat (tachycardia) — commonly more than 100 beats a minute
● Irregular heartbeat (arrhythmia)
● Pounding of your heart (palpitations)
● Increased appetite
● Nervousness, anxiety and irritability
● Tremor — usually a fine trembling in your hands and fingers
● Sweating
● Changes in menstrual patterns
● Increased sensitivity to heat
● Changes in bowel patterns, especially more frequent bowel movements
● An enlarged thyroid gland (goiter), which may appear as a swelling at the base of your neck
● Fatigue, muscle weakness
 ● Difficulty sleeping
● Skin thinning
● Fine, brittle hair

-MANAGEMENT
Important Nutrients to Watch in Hypothyroidism

Are there any foods I can eat to help my hypothyroidism?

Most foods in western diets contain iodine, so you do not have to worry about your diet. Iodine is a
mineral that helps your thyroid produce hormones. One idea is that if you have low levels of thyroid
hormone, eating foods rich in iodine could help increase your hormone levels. The most reliable way to
increase your hormone levels is with a prescription medication from your healthcare provider. Do not try
any new diets without talking to your provider first. It’s important to always have a conversation before
starting a new diet, especially if you have a medical condition like hypothyroidism.

Foods that are high in iodine include:

● Eggs.
● Dairy products.
● Meat, poultry and seafood.
● Edible seaweed.
● Iodized salt.

Calcium

Some foods that are high in calcium can inhibit the absorption of levothyroxine, a synthetic hormone
commonly prescribed to treat hypothyroidism. Watch for calcium in unexpected places like chewable
antacids. Because of the effects of calcium, doctors generally recommend taking levothyroxine on an
empty stomach. If that causes stomach upset, the gel and liquid forms are known to reduce interactions
with calcium and other nutrients.

Fiber

Excessive amounts of fiber have been known to inhibit the effectiveness of synthetic thyroid hormones
including levothyroxine. If you maintain a healthy diet that includes fruit and vegetables, fiber supplements
are generally not recommended.

Iodine

Iodine is essential for a functioning thyroid and the production of the hormone thyroxine. Iodine
supplements are unnecessary for anyone with hypothyroidism taking levothyroxine, a synthetic version of
thyroxine. But if you have an overactive thyroid (hyperthyroidism), taking iodine can make your symptoms
worse. Those who have hypothyroidism as a result of iodine deficiency can benefit from an adequate
intake of dietary iodine, which your doctor can help you determine.

Iron

Iron is another mineral that can lower the effectiveness of levothyroxine. Check with your doctor before
boosting iron intake. It’s recommended to take the levothyroxine at least two hours before or after taking
any iron supplements, including multivitamins with iron.

Seaweed/kelp

Kelp contains naturally high levels of iodine and should be avoided by anyone with hypothyroidism.

Selenium

Another nutrient that’s been credited with contributing to thyroid health is selenium—found in beans,
Brazil nuts, eggs, sardines, and tuna. But too much selenium is not a good thing, and so supplements are
not recommended.

Soy

Soy is another food product that can inhibit levothyroxine absorption. Again, it’s best to take the hormone
a few hours before or after ingesting soy. Some brands of soy milk can contain iodine, so check labels.

Vitamin D

It has long been known that vitamin D helps regulate calcium and phosphorus to protect the health of your
bones and teeth. But more recent studies have indicated that vitamin D can also be involved with
endocrine conditions including diabetes as well as hypothyroidism and Hashimoto’s disease.

Some research has found a mild link between people with hypothyroidism and low vitamin D levels, but it
could be coincidental because the vitamin deficiency is so common.

Preliminary studies have pointed toward a potential benefit from vitamin D supplements for thyroid
conditions, but more rigorous research is needed on safety and efficacy, according to the British Thyroid
Foundation.

Zinc
Zinc is commonly found in legumes (beans), beef, chicken, and shellfish and is thought to be another
helpful mineral for thyroid health.

Since it’s best to get vitamins and minerals through foods, always check with a doctor or pharmacist
before taking any supplements. Taking more than the recommended dose of vitamins can be harmful and
lead to inaccurate thyroid blood tests. And if you are taking any medication for hypothyroidism, be sure to
check the package insert for any contraindications.

Foods to Avoid While Taking Levothyroxine

People with hypothyroidism are commonly prescribed the synthetic hormone levothyroxine. There are
several foods and drinks that can lower the effectiveness of the drug, although any unfavorable
interactions can generally be avoided by timing and method of intake.

Some evidence shows a decrease in absorption of levothyroxine when taken with foods containing
calcium, fiber and iron. If taking calcium, iron, or fiber supplements, do so at least four hours after taking
levothyroxine, to avoid poor absorption.

It is generally recommended to take levothyroxine tablets on an empty stomach and 30 to 60 minutes

before or after drinking coffee or other caffeinated beverages.

The interaction with food or drinks can also be lessened by taking the gel or liquid form of levothyroxine
instead of in a tablet.

Lifestyle Remedies for Hyperthyroidism

It’s a good idea to watch your iodine intake if you’ve been diagnosed with hyperthyroidism, since high
levels of iodine consumption can worsen the condition. Look for ways to limit iodine in your diet by cutting
back on iodine-rich foods such as fish, seaweed, shrimp, dairy products, and grain products (like cereal
and bread). Check with your doctor before taking any medications or supplements with iodine.

Sodium can also contribute to edema (swelling), which is common with Graves’ disease, so you’ll also
want to watch your salt intake.

While there is no particular hyperthyroidism diet, there are foods that can give you a bit of a boost. Since
some symptoms can sap your energy, eating lots of fresh fruits and vegetables can provide a steady
supply of the vitamins and minerals your body needs. Berries are a smart choice because they’re high in
antioxidants, while cruciferous veggies like broccoli, cauliflower, and cabbage have compounds called
goitrogens that can actually decrease the thyroid hormone produced by your body.
In addition, take steps to reduce stress and relax. Slowing down is key, even if it feels counterintuitive with
all the “sped up” effects of hyperthyroidism. The Graves’ Disease & Thyroid Foundation (GDATF)
recommends practices such as yoga, Tai Chi, self-hypnosis, and meditation.

Foods to eat if you have hyperthyroidism

Low-iodine foods

The mineral iodine plays a key role in making thyroid hormones. A low-iodine diet helps to reduce thyroid
hormones. Add these foods to your daily diet:

● non-iodized salt
● coffee or tea (without milk or dairy- or soy-based creamers)
● egg whites
● fresh or canned fruit
● unsalted nuts and nut butters
● homemade bread or breads made without salt, dairy, and eggs
● popcorn with non-iodized salt
● oats
● potatoes
● honey
● maple syrup

Cruciferous vegetables

Cruciferous vegetables and other types may stop your thyroid from using iodine properly. They may be
beneficial for hyperthyroidism:

● bamboo shoots
● bok choy
● broccoli
● Brussels sprouts
● cassava
● cauliflower
● collard greens
● kale
● mustard
● rutabaga

Vitamins and minerals

Several nutrients are essential for thyroid health and to balance thyroid hormone production.

Iron
Iron is important for many vital bodily functions, including thyroid health. This mineral is needed for blood
cells to carry oxygen to every cell in your body.

Low levels of iron are linked to hyperthyroidism. Get plenty of iron in your diet with foods such as:

● dried beans
● green leafy vegetables
● lentils
● nuts
● poultry, such as chicken and turkey
● red meat
● seeds
● whole grains

Selenium

Selenium-rich foods may help to balance thyroid hormone levels and protect your thyroid from disease.
Selenium helps to prevent cell damage and keep your thyroid and other tissues healthy.

Good food sources of selenium include:

● Brazil nuts
● couscous
● chia seeds
● mushrooms
● tea
● meat, such as beef and lamb
● rice
● oat bran
● poultry, such as chicken and turkey
● sunflower seeds

Zinc

Zinc helps you use food for energy. This mineral also helps keep your immune system and thyroid
healthy. Food sources of zinc include:

● beef
● chickpeas
● cocoa powder
● cashews
● mushrooms
● pumpkin seeds
● lamb

Calcium and vitamin D

Hyperthyroidism causes weak and brittle bones. Bone mass may be restored with treatment. Vitamin D
and calcium are necessary for building healthy bones.

Calcium-rich foods include:

● spinach
● collard greens
● white beans
● kale
● okra
● calcium-fortified orange juice
● almond milk
● calcium-fortified cereals

Vitamin D is found in these low-iodine foods:

● vitamin D-fortified orange juice

● vitamin D-fortified cereals
● beef liver
● mushrooms
● fatty fish

Healthy fats

Fats that are from whole foods and largely unprocessed may help reduce inflammation. This helps to
protect thyroid health and balance thyroid hormones. Nondairy fats are important in a low-iodine diet.
These include:

● flaxseed oil
● olive oil
● avocado oil
● coconut oil
● sunflower oil
● safflower oil
● avocado
● unsalted nuts and seeds

Spices

Some spices and herbs have anti-inflammatory properties to help protect and balance thyroid function.
Add flavor and a dose of antioxidants to your daily meals with:

● turmeric
● green chilies
● black pepper
Foods to avoid if you have hyperthyroidism

Excess iodine

Eating too many iodine-rich or iodine-fortified foods may lead to hyperthyroidism or worsen it in some
cases.

According to the National Institutes of Health (NIH), a teaspoon of iodized salt contains 304 micrograms
(mcg)

Trusted Source

of iodine.

Seafood has the most iodine. Just 1 gram of seaweed contains 23.2 mcg

Trusted Source

, or .02 milligrams (mg), of iodine.

The recommended daily dose of iodine is about 150 mcg

Trusted Source

(0.15 mg), according to the NIH. A low-iodine diet requires even less.

Avoid the following seafood and seafood additives:

● fish
● seaweed
● prawns
● crabs
● lobster
● sushi
● carrageen
● agar-agar
● algae
● alginate
● nori
● kelp

Avoid other foods high in iodine such as:

● milk and dairy

● cheese
 ● egg yolks
● iodized salt
● iodized water
● some food colorings

Some medications also contain iodine. These include:

● amiodarone (Nexterone)
● cough syrups
● medical contrast dyes
● herbal or vitamin supplements

Gluten

In some people, gluten may harm the thyroid by causing inflammation. Even if you don’t have a gluten
allergy or intolerance, it may be beneficial to restrict or limit gluten.

Check food labels for gluten-containing ingredients such as:

● wheat
● barley
● brewer’s yeast
● malt
● rye
● triticale

Soy

While soy doesn’t contain iodine, it’s been shown to interfere with some treatments for hyperthyroidism in
animals. Avoid or limit foods with soy such as:

● soy milk
● soy sauce
● tofu
● soy-based creamers

Caffeine

Foods and beverages that contain caffeine, such as coffee, tea, soda, and chocolate, can exacerbate the
symptoms of hyperthyroidism and lead to increased anxiety, nervousness, irritability, and rapid heart rate.

If caffeine has this effect on you, avoiding or limiting your intake may be a good option. Try replacing
caffeinated beverages with natural herbal teas, flavored water, or hot apple cider.
-CURE AND PREVENTION

How is hypothyroidism treated?

In most cases, hypothyroidism is treated by replacing the amount of hormone that your thyroid is no
longer making. This is typically done with a medication. One medication that is commonly used is called
levothyroxine. Taken orally, this medication increases the amount of thyroid hormone your body produces,
evening out your levels.

Hypothyroidism is a manageable disease. However, you will need to continuously take medication to
normalize the amount of hormones in your body for the rest of your life. With careful management, and
follow-up appointments with your healthcare provider to make sure your treatment is working properly,
you can lead a normal and healthy life.

Can hypothyroidism be prevented?

Hypothyroidism cannot be prevented. The best way to prevent developing a serious form of the condition
or having the symptoms impact your life in a serious way is to watch for signs of hypothyroidism. If you
experience any of the symptoms of hypothyroidism, the best thing to do is talk to your healthcare
provider. Hypothyroidism is very manageable if you catch it early and begin treatment.

Can hyperthyroidism be cured?

Yes, there is a permanent treatment for hyperthyroidism. Removing your thyroid through surgery or
destroying your thyroid through medication will cure hyperthyroidism. However, once your thyroid is
removed or destroyed, you’ll need to take thyroid hormone replacement medications for the rest of your
life. Your body still needs thyroid hormones, just not at such high levels as you have in hyperthyroidism.
Though you'll need to take the medication and check in with your healthcare provider regularly, this is a
manageable form of thyroid disease.