Vol. 7, Issue 1, Part A (2025)

Thyroid dysfunction encompassing both hypothyroidism and hyperthyroidism, represents a significant global health burden affecting millions of individuals worldwide. Thyroid hormones play a pivotal role in regulating metabolism including glucose homeostasis making their dysregulation a potential contributor to metabolic complications such as hypoglycemia. Despite the well-documented effects of thyroid hormones on glucose metabolism the interplay between thyroid dysfunction and hypoglycemia remains underexplored, particularly in specific populations. This retrospective cohort study investigates the correlation between thyroid dysfunction and hypoglycemia, focusing on differences between hypothyroid and hyperthyroid patients. A total of 200 patients (100 with hypothyroidism and 100 with hyperthyroidism) were analyzed using clinical records, laboratory tests and symptom assessments. Key findings revealed that hypothyroid patients exhibited a higher prevalence of hypoglycemia (45%)compared to hyperthyroid patients(30%).Severe symptoms such as dizziness and sweating were more common in hypothyroid patients, while tremors and palpitations were more frequent in hyperthyroid patients. These findings align with the physiological roles of thyroid hormones in glucose metabolism:  hypothyroidism impairs hepatic gluconeogenesis and glycogenolysis, leading to reduced glucose production during fasting, whereas hyperthyroidism accelerates glucose metabolism but may cause reactive hypoglycemia due to rapid glucose utilization or hyperinsulinemia. Logistic regression analysis identified several predictors of hypoglycemia, including age ≥50 years, suboptimal treatment, and hypothyroidism itself. Older patients and those with suboptimal levothyroxine dosing were at heightened risk, underscoring the importance of individualized treatment strategies. This study highlights the critical link between thyroid dysfunction and hypoglycemia, emphasizing the need for early diagnosis, tailored treatment approaches, and regular glucose monitoring in high-risk groups. By integrating clinical evaluation, laboratory tests, and symptom monitoring, healthcare providers can optimize diagnostic accuracy and management strategies for patients with thyroid dysfunction. These findings advocate for multidisciplinary interventions to mitigate the risk of hypoglycemia and improve patient outcomes, particularly in vulnerable populations such as older adults and those with suboptimal treatment adherence.