1. Consult your doctor first

Before starting any new diet, especially if you have a medical condition like hypothyroidism, it’s essential to consult with your healthcare provider. They can help you monitor thyroid hormone levels and adjust medications as needed.

2. Prioritize nutrient-dense foods

Ensure that your keto diet includes foods rich in thyroid-supporting nutrients, such as seafood (for iodine), Brazil nuts (for selenium), and leafy greens (for zinc and magnesium). You can also consider supplementation if needed, but always consult with a healthcare provider first.

3. Don’t drastically cut carbohydrates

For some individuals with hypothyroidism, a slightly higher intake of carbohydrates (closer to 50-100 grams per day) may be beneficial to ensure adequate conversion of T4 to T3. You may want to consider starting with a more moderate low-carb approach or following a cyclical keto diet (where carbohydrates are reintroduced periodically) to minimize any negative impact on thyroid health.

4. Incorporate anti-inflammatory foods 

Include foods rich in omega-3 fatty acids, like fatty fish (salmon, mackerel), to reduce inflammation and support thyroid health. Also, consider adding low-carb, non-goitrogenic vegetables like leafy greens, bell peppers, and zucchini to ensure a diverse nutrient intake.

5. Hydration and electrolyte balance

The keto diet often leads to increased urination, which can deplete electrolytes such as sodium, potassium, and magnesium. This can result in symptoms like fatigue, dizziness, and muscle cramps, which may overlap with hypothyroid symptoms. Make sure to stay hydrated and replenish electrolytes through foods or supplements.

6. Listen to your body

The keto diet may not work for everyone with hypothyroidism. Pay close attention to how your body responds, and if you notice worsening symptoms, consult your healthcare provider and consider adjusting your diet.

A diet low in magnesium-rich foods is a primary cause of magnesium deficiency. Studies suggest that nearly 50% of the U.S. population may not be getting enough magnesium from their diet. There are a few possible reasons for this, one of which is soil depletion. This may be due to modern agricultural practices that have resulted in many crops containing lower magnesium levels than they did decades ago. Processed foods, which dominate modern diets, also often lack essential nutrients like magnesium. Over time, inadequate dietary intake can lead to significant magnesium deficiency.

Even if you consume magnesium-rich foods, certain health and lifestyle factors can deplete magnesium levels, including:

1. Chronic stress: High stress levels trigger the release of cortisol, a hormone that can increase the excretion of magnesium through urine. Chronic stress can therefore contribute to a gradual depletion of magnesium levels, affecting various bodily functions, including thyroid health.
2. Medications: Certain medications can interfere with the absorption or increase the excretion of magnesium. For instance, diuretics (often used for high blood pressure) and proton pump inhibitors (used for acid reflux) are known to reduce magnesium levels. Additionally, antibiotics and some chemotherapy drugs can also contribute to magnesium deficiency.
3. Gastrointestinal disorders: Conditions that affect nutrient absorption, such as Crohn’s disease, celiac disease, and irritable bowel syndrome (IBS), can impair the body’s ability to absorb magnesium from food. This malabsorption can lead to deficiencies, which may also impact thyroid health.
4. Alcoholism: Excessive alcohol consumption can interfere with magnesium absorption and increase urinary excretion. Over time, alcohol abuse can lead to significant deficiencies, affecting multiple organ systems, including the thyroid.
5. Aging: As people age, their ability to absorb and retain magnesium decreases. Older adults are more likely to suffer from magnesium deficiency due to factors such as reduced dietary intake, medication use, and decreased digestive efficiency.
6. Increased physical activity: While exercise is beneficial for overall health, intense physical activity can lead to magnesium loss through sweat and urine. Athletes and individuals who engage in strenuous exercise need to ensure they are replenishing their magnesium levels through diet or supplementation.

Sensitivity to caffeine can vary widely among individuals. Thyroid patients, however, may be particularly susceptible to the stimulating effects of caffeine. People with thyroid disorders—whether hypothyroidism or hyperthyroidism—can experience symptoms that overlap with those triggered by caffeine, such as fatigue, anxiety, palpitations, or nervousness.

For instance, hyperthyroidism can already make the body feel as if it’s in a heightened state of stress. Adding caffeine to the mix can amplify this feeling, leading to more anxiety, jitters, and a sense of being constantly “on edge.” It therefore makes sense why sensitivity to stimulants like caffeine is often higher in these hyperthyroid individuals.

In contrast, individuals with hypothyroidism might turn to caffeine to combat feelings of fatigue and sluggishness. However, while caffeine may provide a temporary energy boost, relying on it excessively can lead to energy crashes and interfere with sleep, which can further exacerbate symptoms of hypothyroidism. This creates a cycle of dependency that may complicate the management of one’s thyroid health.