Blood sugar is one of the most universal triggers for Hashimoto’s and autoimmunity, yet it is also one of the most misunderstood. With thyroid issues, we are simply more prone to blood sugar imbalances, insulin resistance and type 2 diabetes. But the answer is not as simple as just managing your blood sugar. There is so much more going on underneath the surface.
In this episode, Inna is joined by Dr. Jason Shumard, a functional medicine practitioner with over 20 years of experience specializing in diabetes, insulin resistance and blood sugar regulation. Rather than simply managing numbers, Dr. Jason helps his patients understand why their blood sugar is elevated in the first place and what they need to do to restore true cellular function. Together, they break down the real connection between insulin, glucose, the cells, and autoimmunity, and they explain why so many people who go low carb still do not get better.
Why Blood Sugar and Autoimmunity Are So Closely Linked
Many people assume their autoimmune condition is purely genetic or simply a matter of an immune system that has gone haywire. Dr. Jason explains that while genetics can play a role, there is far more within our control than most people realize. Regulating blood sugar and insulin is one of the most fundamental ways to help stabilize the immune system.
He describes blood sugar regulation as the most basic function of the body, similar to putting gas in a car. We eat food, it gets broken down in the digestive tract, insulin is released, and that fuel gets delivered to the cells for energy. When this process becomes dysregulated, it can become a powerful trigger for autoimmunity and can keep the fire burning so that the immune attacks continue. What makes this especially relevant for Hashimoto’s is that the same triggers that drive blood sugar problems, including infections, toxins, heavy metals and mold, are the very same triggers that drive thyroid autoimmunity.
What Your Blood Sugar Labs Actually Mean
Most people only ever get a fasting glucose checked at their yearly physical, and Dr. Jason explains why that single number is not enough. Someone can have a perfectly normal fasting glucose on the day of their lab draw while their blood sugar and insulin are fluctuating all over the place the rest of the year. He has even seen people with blood sugars over 300 who feel completely fine, which shows how adaptable the body can be and how silently this problem can build.
This is why he relies on hemoglobin A1C, which reflects roughly a 90 day average of blood sugar regulation. He also explains that the term pre-diabetes is misleading. Much like there is no such thing as pre-pregnancy, pre-diabetes is really an indication that you are already moving toward a deeper problem. Beyond glucose and A1C, he looks at fasting insulin and C-peptide to get a fuller picture of what the body is actually doing.
Insulin Resistance Explained Simply
Many people have heard the term insulin resistance but do not truly understand what is happening in the body. Dr. Jason uses a clear analogy. When you eat, food is converted into glucose, which enters the bloodstream like a fuel line. The pancreas then releases insulin, a hormone that attaches to receptors on the cells like a key in a lock or a baseball in a glove. Once insulin attaches, the door opens and sugar can enter the cell to be used for energy in the mitochondria.
With insulin resistance, those receptors become closed off or desensitized, almost like a plant that has been given too much water and starts to shut down. When insulin can no longer attach, the door does not open, and sugar cannot get into the cell. So where does it go? Right back into the bloodstream, where it builds up and eventually shows up as elevated blood sugar. The crucial insight here is that this is not actually a sugar problem at all. The body is doing its job and the sugar is doing its job. The real issue is at the level of the cell.
Why the Cell Becomes Damaged in the First Place
If the true problem is at the cellular level, the natural question is what damages the cell. Dr. Jason explains that cells are very sensitive and that an injured cell replicates as an injured cell, carrying that dysfunction forward rather than simply becoming healthy again on its own.
He outlines several major drivers of this cellular damage. Poor lifestyle and processed foods filled with pesticides and herbicides are the most obvious. Beyond that, blood sugar regulation involves multiple organs and glands working in unison, including the liver, the intestinal tract, the adrenal glands, the brain, and the thyroid. Chronic inflammation acts like a fire that burns and destroys tissue. Chronic infections, including bacterial, parasitic and viral loads, add to the burden. And finally, toxins are one of the biggest contributors he sees in practice, including mold from water damaged buildings as well as from grains and coffee, environmental toxins like plastics and pesticides, and heavy metals. He notes that toxins from exposures decades ago can still be impacting the body today.
The Truth About Carbohydrates and Blood Sugar Spikes
Dr. Jason is clear that carbohydrates are not inherently bad. The problem is what happens in the body when fast-digesting carbohydrates are consumed. Foods like white rice or white potatoes convert very rapidly in the digestive tract, creating a large and sudden influx of sugar into the bloodstream. This rapid spike forces the pancreas to release a massive load of insulin to counteract it.
He compares too much insulin engulfing the cells to throwing too much water on a plant. A little is essential, but too much over years and decades begins to damage the receptors and drive insulin resistance. Fiber-rich vegetables and options like sweet potatoes break down more slowly, which softens the blood sugar response. This also explains a common source of frustration. When people remove carbohydrates, their blood sugar may drop, but the underlying cell is still broken. Lowering sugar without fixing the cell is the step so many people are missing.
How Many Carbs Should You Actually Eat
Rather than prescribing one universal number, Dr. Jason explains that carbohydrate needs depend on the individual and especially on activity level. Someone with a sedentary desk job simply does not need as many carbohydrates as someone doing physically demanding work or consistent endurance exercise.
In his practice, he finds that most patients are not lacking carbohydrates at all. They are lacking protein, often because their meals have been built almost entirely around carbs for years. He also shares his perspective on carnivore and ketogenic diets, noting that while they can offer benefits as a short term reset, much like a fast, he does not consider them sustainable long term. His overall philosophy centers on whole foods and balance rather than extreme elimination.
How to Actually Fix the Cell
Eating well creates the environment for healing, but Dr. Jason emphasizes that many people with diabetes are already eating fairly well and still have high blood sugar, which signals that something deeper is going on. This is where testing becomes essential, because it allows him to create a hierarchy and prioritize the biggest drivers first.
He typically prioritizes infections, parasites and toxins, since these create the most inflammation, and explains that the body cannot heal well while it is essentially living in a fire. Once those major stressors are reduced, he focuses on supporting the cells and the mitochondria with the proper nutrients, including B vitamins, and then moves on to supporting the organs and glands involved in blood sugar regulation. He shares a powerful reframe, that conventional medicine often tries to hold onto patients while functional medicine aims to lose them by getting them healthy enough to thrive on their own. He also offers real hope, noting that unlike the thyroid, which can sustain permanent damage from years of autoimmune attack, blood sugar regulation is something nearly everyone was able to do at some point in their life and can often return to.
Optimal Lab Ranges for Blood Sugar
Just like with thyroid labs, Dr. Jason explains that standard lab ranges and optimal ranges are not the same. For fasting glucose, he likes to see a range of 85 to 100, noting that some people feel dizzy and unwell when their levels drop too low, particularly those using insulin. He stresses that daily fluctuations are normal and that the 7 day, 14 day and 30 day averages matter far more than any single reading.
For hemoglobin A1C, he points out that the standard reference range has no real low end, which is a problem. An A1C below 5.2 can actually indicate a tendency toward hypoglycemia, which is not healthy for the cells. He considers roughly 5.2 to 5.6 to be ideal, and notes that it is common for people to swing low before they swing high. He walks through the conventional categories as well, with 5.7 to 6.4 considered pre-diabetes and 6.5 and above used for a type 2 diabetes diagnosis, while explaining why simply staying under a 7 by medication standards still leaves room for complications.
Insulin, C-Peptide and the Triglyceride to HDL Ratio
Dr. Jason explains that fasting insulin is an important marker because it reveals how hard the body is working to keep blood sugar down. In people with insulin resistance, insulin levels are often very high, and because insulin itself is inflammatory, this creates additional strain on the body. He pairs this with C-peptide, which reflects how much insulin the pancreas is actually producing. He addresses a common misconception, noting that he rarely sees a truly fatigued pancreas. More often the pancreas is working fine, and in people injecting insulin it may simply become lazy because it is not being asked to do its job.
One of the most practical takeaways is the triglyceride to HDL ratio, a marker available on standard lab work. He explains that a higher ratio is a direct indication of insulin resistance, even when glucose, A1C and insulin all appear normal. This makes it an easy and accessible early warning sign that something is developing inside the body before it shows up anywhere else.
GLP-1 Medications, Microdosing and Cycling
With GLP-1 medications everywhere right now, Dr. Jason offers a balanced and thoughtful take. He explains that GLP-1 is actually a natural peptide produced in the gut that works alongside insulin, but that chronically high insulin suppresses GLP-1 over time, contributing to metabolic syndrome and weight gain. The medications help by reducing appetite, slowing gut motility, and softening sugar and insulin spikes, which improves insulin sensitivity. However, he cautions that they do not address the toxins, inflammation and infections underneath the problem.
He compares the current GLP-1 trend to the bariatric surgery wave of years past, where weight came off but root causes were never addressed, leaving people thin but still metabolically unwell. His preference is to cycle these tools, using them for a defined window such as 90 to 120 days and then coming off for several weeks, rather than staying on them indefinitely. He applies the same cycling philosophy even to microdosing, comparing it to training the body and then allowing it to do its own job again. He also explains why these medications work beautifully for some people and barely move the needle for others, often pointing to hormones and other underlying barriers that need to be addressed.
The Critical Role of Stress on Blood Sugar
No conversation about blood sugar and the cells would be complete without addressing stress. Dr. Jason explains that stress comes in three forms. There is emotional stress, which most people think of first, but also physical stress such as inflammation, poor sleep and organs not working well, and chemical stress from the food, air and liquids we take in. He points out that we have a great deal of control over the physical and chemical stressors, which in turn gives the body more capacity to handle emotional stress before it tips over the edge.
He explains how chronic stress drives the adrenal glands to pump out cortisol, and how excess cortisol over time can affect the brain, the organs, the thyroid, the immune system and the gut, while also desensitizing insulin and driving blood sugar higher. He highlights the particular impact on women heading into perimenopause and menopause, when burnt out adrenal glands are suddenly asked to take over hormone production they simply cannot keep up with. Inna adds a powerful real world example, noting that many people see their fasting blood sugar climb in the early morning hours before eating anything at all, simply from the stress of daily life, which makes the connection between stress and blood sugar impossible to ignore.
Connect with Dr. Jason Shumard
Website: drshumard.com Instagram: @dr.jasonshumarddc
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PLEASE NOTE
All information, content, and material on this podcast is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and or medical treatment of a qualified physician or healthcare provider
