Excess thyroid hormone and carbohydrate metabolism
Abstract
Objective To review the pertinent basic and clinical research describing the complex effects of excess thyroid hormone on carbohydrate metabolism.Methods We performed a MEDLINE search of the English-language literature using a combination of words (ie, "thyrotoxicosis and diabetes," "diabetic ketoacidosis and thyroid storm," "carbohydrate metabolism and hyperthyroid," "glucose homeostasis and thyrotoxicosis") to identify key articles addressing various aspects of the thyroid's influence on carbohydrate metabolism.Results Thyroid hormone affects glucose homeostasis via its actions on a variety of organs including increased hepatic glucose output, increased futile cycling of glucose degradation products between the skeletal muscle and the liver, decreased glycogen stores in the liver and skeletal muscle, altered oxidative and non-oxidative glucose metabolism, decreased active insulin output from the pancreas, and increased renal insulin clearance. Thyroid hormone also affects adipokines and adipose tissue, further predisposing the patient to ketosis.Conclusions Thyrotoxicosis can alter carbohydrate metabolism in a type 2 diabetic patient to such an extent that diabetic ketoacidosis develops if untreated. Based on the current understanding of this relationship, all diabetic patients should be screened for thyroid dysfunction because correcting hyperthyroidism can profoundly affect glucose homeostasis. Similarly, patients presenting in diabetic ketoacidosis should undergo a thyroid function assessment.
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TH has insulin-antagonistic effects in the liver and synergistic effects with insulin in peripheral tissues.
“TH has insulin-antagonistic effects in the liver, whereas it acts synergically with insulin in the peripheral tissues.”
From Thyroid dysfunction and diabetes mellitus: two closely associated disorders (2019) · cites this paper as [134]
Thyroid hormones are major energy expenditure hormones.
“Thus, thyroid hormones are major energy expenditure hormones.”
From Interaction of the endocrine system with inflammation: a function of energy and volume regulation (2014) · cites this paper as [64]
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- Authors
- Potenza, M., Via, M. A., & Yanagisawa, R. T.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- Mount Sinai Beth Israel (US)
- Corresponding author
- Potenza, Matthew
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 2009-04
- Volume
- 15
- Issue
- 3
- Pages
- 254-262
- ISSN
- 1530-891X (ISSN-L)
- OpenAlex
- W2081136285
- Cited by
- 155
- References
- 74
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 16 · 2023: 7 · 2022: 11 · 2021: 9 · 2020: 9 · 2019: 12 · 2018: 13 · 2017: 11 · 2016: 11 · 2015: 6 · 2014: 7 · 2013: 6 · 2012: 8
- FWCI
- 5.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrine Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Keywords
- thyrotoxicosis, hyperthyroidism, carbohydrate metabolism, glucose homeostasis, diabetic ketoacidosis, thyroid storm, type 2 diabetes, hepatic glucose production, glycogen stores, insulin secretion, adipokines, adipose tissue, thyroid dysfunction screening
- MeSH terms
- Aged, Diabetes Mellitus, Type 2, Female, Humans, Models, Biological, Thyroid Hormones, Thyrotoxicosis, Diabetic Ketoacidosis, Carbohydrate Metabolism
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