Abstract
Hypothyroidism is one of the most prevalent endocrine disorders in the world, with a sharp rising incidence. The evaluation of recurrent hypoglycemia in the light of hypothyroidism still remains a major diagnostic challenge for most clinicians. We report a rare case of hypothyroidism presenting as recurrent hypoglycemia with relative adrenal insufficiency. Blunting of hypophyseal–pituitary–adrenal axis, pituitary dysfunction, delayed gastric emptying, decreased production and effect of glucagon on hepatocytes, reduced insulin clearance, gluconeogenesis, and glycogenolysis in patients with hypothyroidism may be the plausible mechanisms of hypoglycemia in such individuals. This will enable clinicians to consider thyroid dysfunction while evaluating causes of hypoglycemia in individuals without diabetes mellitus or treating unexplained hypoglycemic episodes in individuals with diabetes.
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