by Megha
(USA)
QUESTION: My husband has type 2 diabetes managed without medicine; his HbA1c is 6.4%. He has lost about 20 pounds in one year and now feels weak. His doctor says he has “hot” hyperthyroidism and is considering medicine or iodine testing. Can it be cured permanently, which medicine is best, and how can he regain weight?
Hyperthyroidism is treatable, but the best option depends on its cause. A “hot” thyroid nodule makes hormone independently and is usually controlled permanently with radioactive iodine or surgery; tablets can control it but generally do not remove the nodule. Graves disease may enter remission with antithyroid medicine; radioactive iodine or surgery are more definitive but may require lifelong thyroid replacement. Treating the thyroid usually improves weakness and allows lost weight and muscle to return. Do not choose a drug solely to gain weight.
Answer by Dr. Albana Greca, MD, MMedSc
Hi Megha,
An HbA1c of 6.4% in a person already diagnosed with type 2 diabetes generally indicates good current glucose control; it does not mean the diabetes has disappeared. Hyperthyroidism can increase liver glucose production and insulin resistance, so glucose may change while the thyroid is active. Review HbA1c and average glucose and keep a blood sugar log during treatment.
A “hot” or functioning nodule takes up more iodine than the surrounding thyroid and produces thyroid hormone without normal control. More than one active nodule is called toxic multinodular goiter. This differs from Graves disease, which stimulates the whole gland, and thyroiditis, which releases stored hormone temporarily.
Ask for the exact diagnosis. A thyroid uptake and scan uses a small tracer, often I-123, to show whether the whole gland or one nodule is overactive.
For a toxic hot nodule: medicine controls hormone production but does not remove the nodule, so hyperthyroidism usually returns when it is stopped. Radioactive iodine or removal of the affected thyroid lobe is commonly definitive.
For Graves disease: methimazole may be used for a course or longer. Some people enter remission, while others relapse. Radioactive iodine or surgery provides definitive control but may cause permanent hypothyroidism requiring daily levothyroxine.
For thyroiditis: antithyroid drugs generally do not help because the gland is releasing stored hormone rather than making too much new hormone. Many cases improve with time, although a hypothyroid phase may follow.
No medicine is best for everyone. Methimazole is commonly used to reduce new thyroid-hormone production when antithyroid treatment is appropriate. The dose depends on free T4, T3, symptoms, diagnosis, liver status, and follow-up results.
A beta-blocker may temporarily reduce a rapid heartbeat, tremor, sweating, and anxiety, but it does not cure the thyroid condition. Radioactive iodine or surgery may be preferable for a toxic nodule, a large goiter, compression symptoms, medication intolerance, relapse, or a need for definitive treatment.
Hyperthyroidism increases energy use and may cause loss of fat, muscle, and bone. Once thyroid levels return to normal, appetite, strength, and weight commonly improve.
Do not use high-sugar foods to force weight gain. Choose regular balanced meals with adequate protein, vegetables, whole fruit, healthy fats, and suitable high-fiber carbohydrates. Use the diabetes plate-method meal plan and foods and blood sugar guide. A dietitian can increase calories without destabilizing glucose.
Resistance exercise may help rebuild muscle after the heart rate and thyroid levels are controlled. Avoid strenuous exercise while he has marked weakness, palpitations, chest symptoms, or uncontrolled hyperthyroidism. Review exercise and diabetes safety.
The diabetes plan should be reviewed with the thyroid plan. See blood tests for diabetes and how to control type 2 diabetes.
Antithyroid medicines can rarely cause a dangerous fall in infection-fighting white cells or liver injury. Fever or a severe sore throat while taking methimazole or propylthiouracil requires immediate medical advice and a blood count; follow instructions about further doses. Yellow skin or eyes, dark urine, severe itching, marked fatigue, or right-sided abdominal pain requires urgent review.
Seek emergency care for a very rapid or irregular heartbeat, chest pain, severe breathlessness, fainting, high fever, severe agitation, confusion, repeated vomiting, profound weakness, or collapse. These can indicate thyroid storm or a heart complication. Also obtain prompt care for worsening thirst, frequent urination, dehydration, or very high glucose; review dangerous blood sugar levels.
The next step is to obtain the exact diagnosis and test results rather than selecting a medicine for weight gain. If this is a toxic hot nodule, tablets usually control but do not cure it; radioactive iodine or surgery is often definitive. A1c 6.4% is generally within the common target for many adults with known diabetes, but glucose should be monitored while thyroid function changes.
Educational safety note: This answer is for general diabetes and thyroid education only. It does not replace endocrinology care. Do not start, stop, or change antithyroid medicine, beta-blockers, diabetes treatment, iodine products, supplements, diet, or exercise without instructions from the treating healthcare team.
Last reviewed: July 2026.
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by OBJECTIVE TRUTH
(USA)
CONCERN: My sugar level test came back at 116, which I understand is high. But how high?
I have hyperthyroidism, and when my thyroid was really high (3.5), my sugar level was 65. Now that I have my thyroid under control, the sugar level is back up and I haven't done a thing differently.
Is this Diamaxol supplement worth the money?
SUGGESTIONS: Hi there,
Problems of thyroid gland are not because of diabetes, but often they occur along with diabetes.
To me, your blood sugar levels are not neither high nor too high. They are within the limits (<120 mg/dl).
If you keep your thyroid problems under control, you may be able to keep diabetes under control too.
You must understand that not only the thyroid hormones affect blood sugar levels; but there exist many other factors: from foods you eat or drink; to lifestyle habits and so on.
About Diamaxol, as far as I know it contains the extracts of some herbs which have been used for ages (and clinically proven) to lower blood sugar levels. Also it contains some vitamins and minerals which are important for diabetics, but they are in lack.
You may go to the review page or call the people there for any concern or inquiry you may have.
Remember: The secret of fighting diabetes is in what you do and what you eat. Others help when you cannot control what you eat and what you do.
Hope you had your answer! Good luck!
Dr.Alba
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