Expert Advice

How to Balance Blood Sugar When You Have Hypothyroidism

Acella Pharmaceuticals, LLC., is partnering with Nicole German Morgan, RDN, LD, CLT to bring greater awareness to the importance of thyroid care and education. This post is sponsored by Acella Pharmaceuticals and should not be construed as medical advice. Please talk to your doctor about your individual medical situation.

Disclaimer: The information provided is for educational purposes only and does not substitute professional medical advice. Consult a medical professional or healthcare provider before beginning any exercise, fitness, diet, or nutrition routine.

Blood sugar imbalances are a common complaint among hypothyroid patients. When thyroid hormone is not properly balanced, the symptoms may be more noticeable. However, research is conflicted on whether or not hypothyroidism causes low blood sugar or if hypothyroidism is correlated with blood sugar imbalance.1

Today I’ll review symptoms of what to look for and how to better balance blood sugar with diet and lifestyle.

Symptoms of Blood Sugar Imbalance

These are a few symptoms related to both high and low blood sugar:2

• Shakiness or weakness
• Hunger
• Fatigue
• Headache
• Dizziness
• Irritability or anxiousness
• Increased thirst or dry mouth
• Increased urgency to urinate
• Blurred vision

If you can identify with a few of these symptoms, you may want to schedule a time to speak with your doctor and to consider a few of the tips and tricks below.

5 Tips to Balance Blood Sugar with Diet and Lifestyle

1. Manage stress. Stressors may contribute to adrenal fatigue and exacerbate hypothyroid-related symptoms and blood sugar imbalance.3 Find a stress reducer that works best for you – exercise, meditation, reading, listening to music, a relaxing bath, talking to a friend or something else. The key is to practice your stress reduction technique daily to form a new healthy habit.

2. Balance diet. The key is to balance the portion of carbohydrates at each meal or snack and to combine your carbohydrate with a little protein or healthy fat. This combination helps slow the absorption of carbohydrates and leads to a more stable blood sugar level and improved energy.

3. Start the day with a protein source. Yes, this means eating breakfast every day! Consistent meal and snack timing will help support better blood sugar control. You may need to set timers to remind you of your new eating schedule. In addition, when you start the day with a protein such as eggs, Greek yogurt, any type of nuts or seed, or a protein smoothie, this helps to balance the typical carbohydrate-heavy breakfast and support the health of hormones.

4. Improve your sleep. Research shows that adding 30 minutes to 60 minutes of sleep per night, without going over nine hours of sleep total, may improve blood sugar control.4 Start small and work on adding 15 minutes to 30 minutes of sleep per night to see if this improves how you feel.

5. Pack a snack. If you are prone to blood sugar imbalance, always carry a snack with you. Over time, this habit may help support healthier blood sugar levels. The snack choice should be something that contains a little bit of carbohydrate paired with a healthy fat or protein. For example, try fresh fruit with nuts, a protein bar, a boiled egg with a side of fruit, hummus and whole grain crackers, avocado and baked chips or whole grain crackers, trail mix or a little leftover food from a meal in a snack-size container.

Overall, it is better to speak with your doctor if you have concerns about your blood sugar levels. Your doctor can perform a fasting blood glucose test or other tests to better determine if you are at risk for low or high blood sugar. In addition, you may want to inquire about testing your thyroid hormones to see if they are healthy. If you find there are imbalances, you can speak with a registered dietitian to help determine how to balance your diet and lifestyle.

REFERENCES: 1. Kalra S, Unnikrishnan AG, Sahay R. The hypoglycemic side of hypothyroidism. Indian J Endocrinol Metab. 2014;18(1):1-3. doi:10.4103/2230-8210.126517. 2. Bobroff, Linda B. "Symptoms and Treatment of Low Blood Sugar: FCS8749/FY521, 7/2002."EDIS 2002.2 (2002). 3. Kamilaris TC, DeBold CR, Pavlou SN, Island DP, Hoursanidis A, Orth DN. Effect of altered thyroid hormone levels on hypothalamic-pituitary-adrenal function. J Clin Endocrinol Metab. 1987;65(5):994-999. doi:10.1210/jcem-65-5-994. 4. Spaeth AM. Additional Sleep Duration Associates with Improved Blood Sugar Regulation. Sleep. 2015;38(5):663-664. doi:10.5665/sleep.4648.


Note that DTE products, including NP Thyroid®, have not been reviewed by the FDA for safety or efficacy.

Important Risk Information

Drugs with thyroid hormone activity, alone or together with other therapeutic agents, have been used for the treatment of obesity. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects.
  • NP Thyroid® is contraindicated in patients with uncorrected adrenal insufficiency, untreated thyrotoxicosis, and hypersensitivity to any component of the product.
  • In the elderly and in patients with cardiovascular disease, NP Thyroid® should be used with greater caution than younger patients or those without cardiovascular disease.
  • Use of NP Thyroid® in patients with diabetes mellitus or adrenal cortical insufficiency may worsen the intensity of their symptoms.
  • The therapy of myxedema coma requires simultaneous administration of glucocorticoids.
  • Concomitant use of NP Thyroid® with oral anticoagulants alters the sensitivity of oral anticoagulants. Prothrombin time should be closely monitored in thyroid-treated patients on oral anticoagulants.
  • In infants, excessive doses of NP Thyroid® may produce craniosynostosis.
  • Partial loss of hair may be experienced by children in the first few months of therapy but is usually transient.
  • Adverse reactions associated with NP Thyroid® therapy are primarily those of hyperthyroidism due to therapeutic overdosage.
  • Many drugs and some laboratory tests may alter the therapeutic response to NP Thyroid®. In addition, thyroid hormones and thyroid status have varied effects on the pharmacokinetics and actions of other drugs. Administer at least 4 hours before or after drugs that are known to interfere with absorption. Evaluate the need for dose adjustments when regularly administering within one hour of certain foods that may affect absorption.
  • NP Thyroid® should not be discontinued during pregnancy, and hypothyroidism diagnosed during pregnancy should be promptly treated.


NP Thyroid® (thyroid tablets, USP) is a prescription medicine that is used to treat a condition called hypothyroidism from any cause, except for cases of temporary hypothyroidism, which is usually associated with an inflammation of the thyroid (thyroiditis). It is meant to replace or supplement a hormone that is usually made by your thyroid gland.

NP Thyroid® is also used in the treatment and prevention of normal functioning thyroid goiters, such as thyroid nodules, Hashimoto’s thyroiditis, multinodular goiter, and in the management of thyroid cancer.
Revised 10/2023