Thyroid Meds And Keto: A Good Match?

The ketogenic diet is a low-carb, high-fat diet that triggers the body's natural metabolic process, ketosis. While the keto diet is beneficial for people with epilepsy or insulin sensitivity, it is not recommended for people with hypothyroidism, or an underactive thyroid. This is because the keto diet can suppress thyroid hormone production, increase inflammation, cause micronutrient deficiencies, and elevate cortisol levels.

Carbs are needed to make thyroid hormones work

The thyroid gland produces two primary hormones, triiodothyronine (T3) and thyroxine (T4), with T3 being the more biologically active form. The production of thyroid hormones depends on a constant energy source. Restricting carbohydrate intake can decrease the thyroid's ability to produce and secrete thyroid hormones.

Carbohydrates, commonly called "carbs", are sugar (glucose). After eating, your body breaks carbs down into individual sugar molecules. Your cells use this sugar as their primary energy source. Without an energy source, your cells have a hard time functioning.

Not all carbohydrates are created equal. There are two main types of dietary carbs: simple and complex. A simple carbohydrate is a straight-up sugar, like the sugar you put in your coffee or found in regular soda and processed foods. But simple sugars are also found naturally in fruits, vegetables, and milk. Complex carbohydrates are formed from many simple sugar molecules.

When you restrict carbohydrates, you are limiting your body's primary energy source. This can decrease your thyroid's ability to produce and secrete thyroid hormones, leaving you feeling more tired or sluggish.

Your body needs a constant energy source to convert the inactive T4 hormone into the active T3 hormone. Restricting carbohydrates can reduce the activity of the enzyme that performs this conversion, resulting in low levels of T3 production.

Carbohydrates also trigger the release of insulin, a hormone that regulates blood sugar levels by moving sugar into your cells. If your body does not get enough carbs over time, this can impact how your cells respond to insulin, known as insulin sensitivity. A decrease in insulin sensitivity means your cells can't move sugar into your cells, impacting how they function. In the case of your thyroid, the outcome would be a lack of thyroid hormone production.

The keto diet is a high-fat, low-carbohydrate diet. It can be beneficial for managing hypothyroidism, but it may not be suitable for everyone. The keto diet may affect thyroid hormone production and circulation. Small, short-term studies have found that a ketogenic or other low-carbohydrate diet resulted in increased levels of T4 and decreased levels of T3. More research is needed to determine whether a keto diet could have a lasting effect on thyroid hormone production.

While the keto diet may help with weight loss and improving heart health, it is generally not recommended for people with underactive thyroids. When considering if a keto diet is good for hypothyroidism, it’s essential to understand how the thyroid works. The thyroid is an important endocrine gland that controls metabolism, or how the body uses energy. Hypothyroidism occurs when the thyroid doesn't produce and release enough thyroid hormones.

Keto puts you in fight or flight, which is bad for your thyroid

The keto diet is a low-carb, high-fat diet that triggers the body's natural metabolic process, "ketosis". This process involves the body using stored fat as fuel instead of glucose, its natural fuel source. While this process can be beneficial for people with epilepsy, diabetes, Alzheimer's, Parkinson's, and cancer, it may not be suitable for those with hypothyroidism.

Hypothyroidism is when the thyroid gland does not produce enough thyroid hormone, which affects metabolism, brain function, heart function, muscles, hair, and skin. The keto diet may not be recommended for people with hypothyroidism due to the following reasons:

Decreased Thyroid Hormone Production

The keto diet involves consuming less than 20-50 grams of carbs per day, which is the same as less than 10% of your total energy intake. Carbohydrates are broken down into glucose, which is necessary for the production of thyroid hormones. The decrease in glucose levels due to a low-carb diet can lead to a decline in the conversion of T4 to T3, the active thyroid hormone.

Increased Inflammation

Prolonged ketosis can force the body to accumulate acid, which may encourage inflammation. People with thyroid diseases, especially Hashimoto's disease and Grave's disease, already suffer from chronic inflammation. Adding more inflammation on top of existing inflammation may worsen symptoms.

Potential Micronutrient Deficiencies

Diets that restrict carbohydrates, like keto, may affect the quality of your diet, especially when micronutrients become limited. Eliminating fruits, vegetables, whole grains, and legumes while increasing animal product consumption may result in a lack of important antioxidants and other beneficial micronutrients.

Elevated Cortisol Levels

Chronic stress can lead to elevated cortisol levels, which can cause havoc on the thyroid and worsen hypothyroidism symptoms. Cortisol is a steroid hormone produced when the body is stressed, and it can suppress the hypothalamic-pituitary-adrenal (HPA) axis, leading to decreased production of thyroid hormones.

Additionally, the keto diet may be a major strain on the adrenals, leading to decreased thyroid hormone levels and increased cortisol levels. This can further decrease thyroid function and cause more adverse effects on the body.

In conclusion, while the keto diet may be beneficial for some people with specific conditions, it may not be suitable for those with hypothyroidism due to the potential negative impacts on thyroid function and overall health. It is essential to consult with a healthcare professional before starting any new diet, especially if you have a medical condition.

Micronutrient deficiencies

Two specific micronutrients to consider are potassium and vitamin C. Potassium is needed to support the kidneys, heart, muscles, and nervous system, and people with hypothyroidism tend to have low potassium levels. The best way to get enough potassium is to eat plenty of fruits and vegetables, especially root vegetables like potatoes, sweet potatoes, and squashes.

Vitamin C is a water-soluble vitamin that acts as an antioxidant, reducing inflammation in the body and helping to regenerate other antioxidants like vitamin E. It is also involved in protein metabolism and the creation of connective tissue and some neurotransmitters. Vitamin C can also help with the absorption of thyroid medication and improve thyroid function by reducing TSH and increasing blood levels of T3 and T4.

It is important to note that a "food first" approach is recommended by some registered dietitians, who suggest getting as many essential nutrients from natural sources rather than supplements. However, in some cases, supplementation may be warranted, and it is always best to consult with a healthcare professional to determine the best approach for your individual needs.

Elevated cortisol levels

When you experience stress, your body produces a steroid hormone called cortisol. If you experience chronic stress, your body may produce elevated levels of cortisol, which can wreak havoc on your thyroid. This is because the hormone suppresses the hypothalamic-pituitary-adrenal (HPA) axis, which is the connection between stress and physiological responses. The HPA axis acts as a communication system between the hypothalamus, pituitary, and adrenal glands. An increase in HPA axis activity can cause dysfunction, leading to decreased production of thyroid-stimulating hormones (TSH), thyroxine (T4), and triiodothyronine (T3).

Chronic stress can provoke hypothyroidism by overworking the adrenal glands, which produce stress hormones such as cortisol. When you experience stress, your body slows down processes that are unnecessary for overcoming the stressor, including thyroid hormone production. This can lead to a state of adrenal fatigue, where the flooding and eventual plummeting of stress hormones cause thyroid activity to come to a halt.

It's unsustainable

The keto diet is a high-fat, low-carb diet that triggers the body's natural metabolic process known as "ketosis". While the keto diet has been proven to be beneficial for people with epilepsy, insulin sensitivity, and diabetes, it is not recommended for people with underactive thyroids. Here are four reasons why the keto diet may not be sustainable, especially for those with thyroid issues:

• Decreased thyroid hormone production: The keto diet emphasizes consuming less than 20-50 grams of carbs per day, which is crucial for maintaining and regulating energy metabolism. The glucose derived from carbohydrates is essential for producing thyroid hormones. When carb intake is drastically reduced, as the keto diet requires, the conversion of the inactive thyroid hormone (T4) to the active form (T3) declines. Hypothyroidism is already associated with decreased insulin sensitivity, which may further affect the body's ability to convert T4 to T3.
• Increased inflammation: Prolonged ketosis can force the body to accumulate acid, which may encourage inflammation. Many people with thyroid diseases, such as Hashimoto's disease and Grave's disease, already suffer from chronic inflammation. Adding more inflammation on top of existing inflammation may only worsen the symptoms.
• Potential micronutrient deficiencies: Diets that restrict carbohydrates, like keto, may significantly impact the quality of your diet, especially when micronutrients become limited. Eliminating fruits, vegetables, whole grains, and legumes while increasing the consumption of animal products may result in a lack of essential nutrients and antioxidants that help combat thyroid disease.
• Elevated cortisol levels: Chronic stress can lead to elevated cortisol levels, which can wreak havoc on your thyroid. Elevated cortisol levels may worsen hypothyroidism symptoms by suppressing the hypothalamic-pituitary-adrenal (HPA) axis, decreasing cellular sensitivity to thyroid hormones, and reducing the conversion of T4 to T3.

While the keto diet may be beneficial for some, it is not a one-size-fits-all solution. It is essential to consult with a healthcare professional before starting any diet, especially if you have a medical condition like hypothyroidism.

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