If you live with hypothyroidism, then you most likely are aware of how this condition can make managing your weight and energy levels a challenge. Naturally, many people turn to diets like keto for help, but when you have a thyroid condition, it’s important to fully understand the potential impact of dietary changes such as this one. The keto diet, known for its high-fat, low-carb approach, has shown promise for some metabolic conditions, but its effect on thyroid health isn’t as clearcut.
In this article:
What is hypothyroidism?
Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones. These hormones, namely thyroxine (T4) and triiodothyronine (T3), play crucial roles in regulating metabolism, energy production, and overall bodily functions. Common symptoms of hypothyroidism include:
Individuals with hypothyroidism typically require lifelong management, often through hormone replacement therapy (levothyroxine) and lifestyle adjustments, including diet.
What is the keto diet?
The ketogenic diet is a high-fat, moderate-protein, and very low-carbohydrate diet. A typical keto diet involves:
- 70-80% fats (from sources like avocados, butter, olive oil, and fatty cuts of meat)
- 15-20% protein (such as meat, fish, and eggs)
- 5-10% carbohydrates (mostly from non-starchy vegetables and some dairy)
The goal of the keto diet is to put the body into a metabolic state known as ketosis, where it burns fat for fuel instead of glucose (sugar). Normally, your body relies on glucose from carbohydrates for energy. When carbs are drastically reduced, the liver converts fat into ketones, which are used as an alternative energy source.
This switch in fuel sources has shown benefits for weight loss, improved insulin sensitivity, and other metabolic health markers. But the main question here is: how does this low-carb, high-fat approach affect thyroid function?
What are the potential benefits of the keto diet for individuals with hypothyroidism?
1. Improved insulin sensitivity
Hypothyroidism, like hyperthyroidism, is often associated with insulin resistance, which makes it harder for the body to utilize glucose effectively. The keto diet, by reducing carbohydrate intake, can help stabilize blood sugar levels and improve insulin sensitivity, which can be beneficial for those with hypothyroidism.
2. Weight management
As mentioned earlier, one of the key challenges for individuals with hypothyroidism is weight gain or difficulty losing weight. The keto diet’s focus on burning fat for energy can help with weight loss, a major concern for many hypothyroid patients. Studies have shown that the ketogenic diet may lead to significant weight loss, especially when paired with physical activity.
By reducing insulin levels, this diet also encourages the body to use stored fat for energy, which may help people with hypothyroidism achieve weight loss that can be difficult to manage with a slow metabolism. Here’s how it works. With fewer carbohydrates in the diet, the pancreas secretes less insulin. Insulin is a hormone that promotes fat storage, so lowering its levels allows the body to access fat stores more readily.
Additionally, reducing carb intake often leads to a reduction in water retention, which can result in quick initial weight loss.
3. Inflammation reduction
Hypothyroidism, especially when caused by Hashimoto’s thyroiditis, is linked to inflammation. The keto diet is known for its anti-inflammatory properties, in part, due to its emphasis on whole, unprocessed foods and healthy fats like omega-3s from fatty fish, nuts, and seeds. An anti-inflammatory diet is therefore vital in supporting better thyroid function and overall health in hypothyroid patients. Some studies have shown that a ketogenic diet might help reduce inflammation particularly by decreasing inflammatory markers, which may support immune function and reduce thyroid gland damage.
What are the risks of the keto diet for individuals with hypothyroidism?
1. Reduced thyroid hormone levels
Some studies have indicated that very low-carbohydrate diets, like keto, may reduce the levels of active thyroid hormone (T3). This is because carbohydrates are necessary for the conversion of T4 to T3, and drastically reducing carbs may interfere with this process. A dramatic reduction in carbohydrates may lead to increased production of reverse T3 (rT3), an inactive form of the thyroid hormone that can block the action of active T3. This can ultimately lead to exacerbated hypothyroid symptoms.
2. Stress on the adrenal glands
A very low-carb diet can place additional stress on the adrenal glands by increasing the production of cortisol (the primary stress hormone) because the body has to work harder to maintain blood sugar levels and to convert fat and protein into energy. This can negatively impact thyroid function and potentially worsen hypothyroid symptoms over time.
3. Nutrient deficiencies
The restrictive nature of the keto diet may lead to deficiencies in important thyroid-supporting nutrients like iodine, selenium, zinc, and magnesium. These nutrients are crucial for proper thyroid function, and individuals on a keto diet must be careful to include foods that provide these nutrients or consider supplementation.
4. Potential worsening of symptoms
Hypothyroidism already reduces energy levels, and the keto diet may initially cause “keto flu,” characterized by fatigue, dizziness, and brain fog as the body adapts to burning fat instead of carbohydrates. Ultimately, each individual’s response to the diet can vary based on their specific thyroid condition and overall health.
What are some tips for following a keto diet safely while managing hypothyroidism?
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.
Key takeaways
- The typical macronutrient breakdown is around 70-80% fat, 15-20% protein, and 5-10% carbohydrates.
- The keto diet can offer benefits such as weight loss, improved insulin sensitivity, and reduced inflammation for individuals with hypothyroidism. However, it also poses risks, including the potential to lower thyroid hormone levels and increase cortisol.
- For those with hypothyroidism, it’s essential to approach the keto diet cautiously, ensuring proper nutrient intake, regular monitoring of thyroid levels, and staying mindful of how the diet impacts overall health.
- As always, consult your healthcare provider before making any significant changes to your diet, especially when managing a condition like hypothyroidism.
- People with certain medical conditions, such as type 1 diabetes or advanced liver disease, should approach the diet cautiously.
