As I've been looking into this disease more and more, it has become more and more apparent that high blood sugar may, to some degree, be intentional, meaning intentionally regulated to that. So when I say intentional here I mean an intentional process by the body to maintain what it considers to be an optimal range under the circumstances.
So while high blood sugar to some degree is pathological, an inappropriate adaptation to hormonal imbalances for instance, and that's a big deal actually, there does seem to be a component here that appears to be much more adaptive.
So in other words, let's say that our blood sugar when we don't eat is in the range of 130-140. We would look at this and say well that's too high, but it actually may not be, and it actually may be what it is required to be in order for us to function more properly.
So if we need it at this level for proper glucose metabolism, in our present state, then lowering it artificially, by increasing insulin for example, might be against our best interests, and this isn't even accounting for any potential longer term side effects of doing this, increasing insulin resistance for example.
It might be a bad idea, right now. So I've had discussions in the past about there being a certain set point where our blood sugar appears to be, and this can be a pretty tight range in some of us, and it does appear that this range is preferred by our body even. We may even feel our best in this range, and we do know that people can feel worse when they reduce their blood sugar below what their set point may be, and this would involve being in a glucose deprived state actually, and the symptoms they tend to get match this diagnosis.
So this obviously involves metabolism, and by the way I'm not saying here that it is better to have a certain blood sugar even though it might be high, what I am saying instead is that there is almost certainly some underlying factors at the level of cellular metabolism that may play a role in all this.
We understand our type of diabetes as not being sensitive enough to insulin, and that certainly does play a big role in things, but it also may be that it takes more insulin to do the job because our cellular metabolism is downregulated.
The idea of this post actually came up during a recent discussion of diabetes and hypothyroidism, and we know that low thyroid function and insulin resistance are very much linked. The downregulation of cellular metabolism that reduced thyroid function causes definitely decreases insulin sensitivity, as there is less demand for glucose, and there is less peripheral uptake of glucose in both conditions.
Thyroid hormone, T3 specifically, is a double edged sword when it comes to diabetes. It can both cause glucose intolerance in excess, and cause glucose intolerance at the cellular level if deficient.
Can we have both going on at the same time though? Well it seems we can, and the reason for this is that if we convert too much T4 to reverse T3, we can develop what we could call T3 resistance, where we may have lots in the blood but not enough can enter our cells, due to its being blocked by reverse T3.
Too much reverse T3 can be a big problem in fact, and what can happen with this is that free T3 can pool up in the blood, much like insulin does with insulin resistance, and the levels can be normal or even high, and this can increase hepatic glucose production, or liver dumping.
So you don't have enough glucose going into the cells, from reverse T3 blocking that, and now you have more glucose being put into the blood from the T3 that is supposed to be going into the cells but is blocked, and we can get into a real mess with this.
This is why anyone who knows what they are doing at all will look at not just free T3 levels in the blood, and not just look at levels of reverse T3 as well, they will look at the ratio of them, how much free T3 you have versus reverse T3.
This can give us insight into what may be going on here, although the best test of what's going on at the cellular level, which none of these tests measure by the way, is still probably the basal temperature test, where you measure your oral temperature upon waking in the morning, and if it is over 97.5 you are fine, and the more below this you are, the bigger of a thyroid hormone issue you have.
An assessment of symptoms is important as well, if you are asymptomatic then there's probably no real need to worry here, although people with lower basal temperatures tend to run low throughout the day and tend to feel colder than others for one thing, so there often are symptoms present that are associated with reduced thyroid function, and in this case the basal test would be confirming the symptoms.
This is all a very interesting topic and thyroid function and diabetes are probably even more correlated than we generally think, and it's not just that diabetics are prone to this, it's likely that people with reduced thyroid function are more prone to diabetes. It doesn't cause it but it surely influences it.
For those who are up to reading some science on this, here's an article for you from the Journal of Thyroid Research called "Why Can Insulin Resistance Be a Natural Consequence of Thyroid Dysfunction?"
I'll definitely be talking about this topic more as we go, but I needed to at least provide an introduction to some of this to get the point of this article across better.
So here's the interesting part. Aside from thyroid imbalance causing greater liver dumping, it may be that the body is seeking homeostasis by keeping our blood sugar higher on account of lesser glucose metabolism and the insulin resistance that this is associated with. We already can reason that insulin resistance itself does this, as the higher one's blood sugar is, the less you need insulin to uptake it into your cells, but this adds another twist to this.
So what it may come down to is getting ourselves to burn glucose more efficiently, to upregulate our metabolism, and if our metabolism is downregulated by reduced thyroid hormone function, if we look to reverse that, and in particular reverse the higher conversion of T4 to reverse T3, then we can not only burn more of the excess glucose in our blood, we may also be able to alter our body's perception that we aren't getting enough, and see an easing in the extra that is thrown in there for good measure since we don't seem to be doing that well without it, and in fact we often don't.
So in conclusion, reduced thyroid metabolism may be behind not only our higher insulin resistance but our body's perceived higher need to elevate our blood sugar by overregulation.