Hypothyroidism Diet Guide + Weight Loss Guide (Foods to Eat & Avoid)
Diet is one of the most important parts of treating your hypothyroidism.
Not only can it help you lose weight, diet also plays an important role in reducing symptoms.
That means eating the right foods and avoiding the wrong ones can impact how much energy you have, your waistline and help you to feel better.
And before you ask:
Diet by itself isn't the ONLY thing you need to do to treat your thyroid, but it is a great first place to start.
Not only that, but it's something within YOUR control.
You can't control what medication you take or what your dose is, but you CAN control what you put in your mouth.
Let me walk you through how I approach patients with Hypothyroidism in my clinic with this Hypothyroidism Diet Guide...
Will Changing my Diet Help with Weight Loss?
You are in the right place if you are looking for any of these benefits:
- Lose weight by changing your diet
- Feel better by increasing your energy, mood, etc.
- Reduce your symptoms of hypothyroidism
- Learn how to get started with the best diet for YOUR body
- Understand how your diet impacts thyroid function
- Find a place to get started (without feeling overwhelmed with all the information out there)
Now that we are both on the same page, let's jump in...
One of the main issues that patients bring up with me is their inability to lose weight.
By the time most patients see me, they have already tried and failed multiple diets and have been unsuccessful in weight loss.
So let me get this out of the way early:
Diet CAN help with weight loss if you have hypothyroidism but it's only a small part of an overall treatment plan.
So how do you know if changing your diet will lead to weight loss in YOU?
Generally, patients who fall into the following categories tend to gain the most from changing their diet:
- Patients who are still eating the standard American diet (1) (that means they are still eating out, drinking soda and not avoiding foods like gluten or grains)
- Patients who don't have a history of chronic and recurrent yo-yo dieting (2)
- Patients already taking thyroid medication like Natural Desiccated thyroid, Cytomel or combinations of T4 + T3
- Patients who don't have multiple medical conditions (If you suffer from insulin resistance, Diabetes, immune problems or chronic illness diet is still important but you will need more to feel better)
Basically the more complex your history is the less likely diet is to help you by itself.
Don't get me wrong:
It's still VERY important and you should absolutely consider changing your diet if you fall into any of the categories above, but alone it's not likely to have a huge impact on changing your weight if used by itself.
So let's jump right into diets that you should be considering if you have Hypothyroidism.
Diets that may Help with Weight Loss
Remember that there is no specific "Thyroid Diet" you should be following.
Instead, you should be looking at YOUR body and what YOU need.
Everyone is unique which means that they will react to certain foods that others won't, they are more likely to develop hormone imbalances, etc.
It can seem overwhelming, but I've broken it down to a simple approach to get you started.
Below I listed several types of diets that MAY help you feel better and lose weight, but it will require trial and error on your part to figure out what you need.
Low Carb or Atkins Type Diet
By now I'm all sure you've heard of this diet, but if not let me explain...
The low carb diet is exactly how it sounds - reduce the total amount of carbs you eat to help your body burn fat and lose weight (3).
The basis for the diet is that reducing carbs will help lower your blood sugar and help your body burn fat, thus resulting in weight loss.
This diet was previously demonized by the media and medical establishments because it was felt that the saturated fat in these foods was dangerous to your heart.
That has since been shown NOT to be true (4) so don't freak out about eating higher fat foods thinking it will cause weight gain or damage your heart.
Instead, focus on the MANY studies that have shown a low carb diet can actually help with weight loss (5).
The main question really is this:
Should hypothyroid patients go on a low carb diet?
And that's where things can get a little bit tricky...
The general idea is that not everyone does well or loses weight on a low carb diet.
Special considerations should be taken if you have significant and heavy fatigue related to adrenal function or other conditions.
In these situations, a low carb diet can actually make your symptoms worse.
In addition to feeling worse, some patients can actually gain WEIGHT on a low carb diet.
In general, I recommend you consider using the low carb or Atkins type of diet if you fall into the following categories:
- You have insulin resistance, high blood sugar or diabetes
- You have lost weight and felt great in the past using this diet
- You get bloated with carbs/rice/grains/pasta
- You have failed losing weight with other diet plans
If you fall into any of these categories then a trial of a low carb diet might be worth it.
For additional info use this pros/cons table below:
- May help with weight loss
- Lots of recipes and diet guides on the internet
- Helpful in patients with gas/bloating to carbs
- May be helpful in lowering blood sugar levels
- May make certain patients feel worse
- May cause weight gain in certain patients
- Easy to eat high protein instead of high fat
Nutritional ketosis (6) is like the low carb diet but on steroids.
In this diet, you remove almost ALL sources of carbohydrates (including even low glycemic fruits and vegetables) to put your body into a state of ketosis.
Ketone bodies are a breakdown product of fat metabolism so the idea is that while in a state of ketosis your body is burning mostly fat as your primary source of energy.
Sound pretty good right?
You can use certain markers in the blood and urine to make sure these ketone bodies are present and that your carbs are low enough to allow your body to enter into this "state".
Nutritional ketosis should be differentiated from Diabetic ketoacidosis which is definitely NOT a healthy state to be in.
These are two entirely different beasts, so please don't confuse them.
Nutritional ketosis has been shown to help with weight loss (7), lower triglycerides, lower LDL cholesterol and raise HDL cholesterol.
Should hypothyroid patients go into Nutritional Ketosis?
Unfortunately, nutritional ketosis isn't for everyone.
And as you might guess hypothyroid patients may not tolerate nutritional ketosis for the same reasons they don't always tolerate low carb diets.
So before you jump head first into this diet I generally recommend you try a lower carb diet first to make sure that your body is able to tolerate a lower amount of carbs before you almost always take them away.
How to find out if you should consider this diet:
- Have you failed losing weight with other diets?
- Do you have gas bloating, SIBO or yeast overgrowth?
- Do you suffer from Insulin resistance or Diabetes?
- Do you suffer from conditions like depression, anxiety or other mental health issues?
If you answered YES to any of the above questions then nutritional ketosis would be worth considering.
For additional info see the list of pros/cons below:
- May help with weight loss (more than low carb diets)
- Helpful in patients with SIBO/SIFO
- May be helpful in lowering blood sugar levels and insulin levels
- Helpful in patients with depression/anxiety
- Can cause weight gain
- May make cholesterol levels worse
- Very strict diet
- May need to monitor ketone levels with urinary sticks
- May make fatigue worse in certain patients
By now I'm sure you know what the paleo diet (8) is so I won't focus on that.
Yes, it helps with weight loss (9).
Yes, it can help with autoimmune diseases.
Yes, it can help patients feel better.
(Otherwise, why would I even bring it up?!)
The main question is:
Should hypothyroid patients use the Paleo Diet?
As I've tested diets on hundreds of patients I've found that using a paleo type of diet is probably one of the better and easier places to start.
That doesn't mean it will solve all of your problems or fix your weight, but because there are SO many resources online (including recipes and guides), it's relatively easy to get started with.
Not only that but it can be tweaked and fixed to match your body type.
You can add more carbs to it, add more fat, use less protein, etc.
And that makes it very powerful for hypothyroid patients.
That doesn't mean it's right for everyone, but it's a great starting place.
For more info see the pros/cons list below:
- May help with autoimmune conditions
- Can be tweaked to fit your needs
- Can be more restrictive or less restrictive
- Lots of resources online for help
- May help with weight loss
- Great starting point
- Still may include foods that certain patients react to
- May not be enough by itself for everyone
- May be difficult to follow for certain patients
- Still requires grass-fed/organic based foods
The elimination diet can be VERY powerful especially if you find yourself reacting to multiple different food groups (10).
The idea is that sensitivities and reactions to certain food groups can cause inflammation and result in weight loss resistance and a multitude of other negative side effects.
By removing these inflammatory foods from your diet you allow your body to "cool" off and put it into a state where weight loss is possible.
It works in 2 different ways:
1) By testing your blood with a delayed IgG food sensitivity test and then proceeding to remove the foods you react to.
2) By systematically removing the most common food allergens.
If you choose to eliminate foods without testing then you simply reintroduce food groups back 1 at a time after 90-120 days and see how your body reacts.
Based on my practice I think either option can work depending on the person and how badly they are reacting.
For more complex patient cases I prefer to order the test FIRST, but in other patients, it's generally ok to start with the systematic elimination of certain foods.
Should hypothyroid patients use the Elimination Diet?
Just like the other diets listed above, the elimination diet shouldn't be used for EVERY patient.
I find more value in using this approach if patients have any of the following:
- Long list of food allergies or sensitivities
- Unknown symptoms that can't be attributed to medications or supplements
- History of post nasal drip or chronic sinus problems
- History of hives, facial swelling or itching of the skin
- History of eczema or asthma
- History of not feeling better on diets like paleo, AIP or others
If you fall into any of these categories then the elimination diet may be a good place to start.
You can see some studies in elimination diets based on serum testing for IgG antibodies helping patients with asthma control their symptoms here (11).
For more info see the list of pros/cons below:
- Helpful for those with multiple food allergies
- Helpful for people who are highly sensitive to foods, supplements and medications
- May improve symptoms and improve food tolerance
- Can also be used in conjunction with testing to identify triggers
- May not work for everyone
- May be overly restrictive
- Difficult to maintain for some individuals
Do I need to be eating Certain foods?
When people look into diets they are generally looking for a complete step-by-step guide to help them.
In the case of hypothyroidism, it's not quite that easy, but you can use some general guidelines to help.
While there aren't certain foods that will help reverse your disease or improve your thyroid function by themselves, certain foods can help your body function properly and indirectly affect these elements.
As an example:
Let's say you eat a diet filled with inflammatory fats that are nutritionally depleted, or that you completely avoid fruits and vegetables.
Now imagine this on a larger scale and over multiple nutrient deficiencies.
This is how many patients start to feel REALLY poorly on the standard American diet.
For a full list of nutrient deficiencies that may make thyroid function worse please see this post.
Foods to should be eating with Hypothyroidism
While there aren't certain foods you should be eating there are some guidelines you can follow to help reduce and prevent nutrient deficiencies that can lead to poor thyroid function.
If you aren't already then I strongly recommend you make these changes to your diet:
- Eat organic foods
- Eat grass-fed meats
- Eat real, whole foods
- Drink up to 120 ounces of water per day
- Add more healthy fats into your diet: Coconut oil, avocados, olive oil, olives, etc.
- Have 2 huge servings of vegetables per day (at least half your plate) - enjoy a salad in the afternoon and steamed veggies for dinner
- Have at least 2 fruits per day (preferably organic)
Making these small changes can have a HUGE impact on your overall health and thyroid function and they aren't VERY hard to make.
Having said that, eating healthy foods isn't enough...
You also need to make sure you are avoiding certain foods as well:
Foods to avoid that may make your thyroid function worse
Why are certain foods bad for your thyroid?
Certain types of food promote inflammation either because you have a sensitivity to them or because they are highly processed.
The point here is that poor quality foods will promote high levels of inflammation (14) which has been shown to lower T4 to T3 conversion and may, therefore, decrease thyroid function.
In addition, inflammatory foods also damage your intestinal tract causing inflammation and a further reduction in thyroid function (15).
Your intestinal tract is where all of the nutrients that you consume must be absorbed. Small damage to the intestinal lining may promote nutrient deficiencies and lead to worsening thyroid function in a vicious cycle.
So now that we understand WHY these foods can be bad we need to know which foods to avoid:
- Any and all processed foods - If it has more than 3 ingredients then you should NOT be eating it
- Refined and added sugars - That means looking at the ingredient label for "added sugars"
- Grains, pasta, cereal, and breads - These highly insulinogenic foods increase blood sugar, promote inflammation and lead to weight gain
- Sodas - Including diet sodas which still promote weight gain through the incretin effect (16)
- Non-organic and hormone filled dairy and soy products
- Excessive use of alcohol on a daily basis
None of these should really come as a shock to you, and it might surprise you just how many of you "think" you are eating healthy but you really aren't.
As a quick check just see how many of the "approved" foods you consume and how many of the "foods to avoid" you are actually consuming.
If you spent the time to read through this and you are serious about improving your health then consider these guidelines as a line you shouldn't cross.
Hypothyroidism, Treatment & Weight Loss
As I mentioned above:
Changing your diet is only part of the weight loss equation if you have hypothyroidism.
So what else do you need to know to lose weight?
It's worth spending a few minutes on this topic because weight loss with Hypothyroidism can be very tricky if it isn't approached correctly.
Hypothyroid patients are more likely to have certain hormone imbalances that can make weight loss VERY difficult and almost impossible if you don't find someone to treat and address these imbalances.
It is definitely NOT as simple as getting on the right medication and changing your diet...
Having said that, I've compiled some resources for you to get started with if weight loss is your goal:
- Finding the right diet for your body (See our previous discussion and if you have Hashimoto's check out this post for more info)
- Making sure your hormones are in balance - that means checking insulin levels, leptin levels and reverse T3
- Getting on the RIGHT dose of thyroid medication - This usually means using T3 in some form like NDT and/or Cytomel/Liothyronine
- Managing your stress levels - You can't necessarily avoid stress altogether but you can help your body handle it
#1. The Right Type of Diet
We just spent the majority of this post discussing how to get on the right diet for YOUR body, so consider this a reminder that the first step to weight loss is changing your diet.
For weight loss, I generally recommend starting with a paleo-esque type of diet and changing the number of fats/carbs your body needs to promote weight loss but still maintain energy levels.
For most patients this, begins around 20-40% of carbs as calories in your diet.
You can then adjust your carbohydrates based on your energy and activity level.
The more active you are the more carbohydrates you will probably need to consume.
#2. Balancing other Hormone Levels
When it comes to hypothyroidism the majority of weight gain comes from hormone imbalances.
And I'm NOT talking about your thyroid.
Hypothyroidism sets the body up to develop multiple hormone imbalances:
- Insulin resistance
- Leptin resistance
- Estrogen dominance
- Low testosterone levels
- Adrenal dysregulation
And unfortunately, once you replace the lost thyroid hormone these other imbalances don't always self-correct.
In addition weight gain from hypothyroidism usually only amounts to an extra 10-15 pounds of weight gain.
That means if you lost some weight initially once you got on thyroid medication you aren't likely to lose much more by adding or changing medications.
Which means finding a doctor to help correct these hormone imbalances is critical to losing weight.
#3. The Right Medication
We can't have a discussion about weight loss without mentioning thyroid medication.
Because so many patients out there are being undertreated, under medicated or treated with the wrong type of thyroid medication.
To prove the point let me share with you a few studies:
If you are deficient in thyroid hormone and it isn't being replaced correctly your metabolism will REMAIN slow and that will promote weight GAIN, not weight loss.
And before you tell me your labs are "normal", I recommend you read this post which shows you why thyroid lab tests are usually inaccurate when testing your "levels".
Getting on the right medications usually means using medication like Natural desiccated thyroid (Armour thyroid, WP thyroid or Naturethroid) or combinations of T4 only medications + T3 (Like cytomel or liothyronine).
#4. Managing your Stress
I've included stress here because it is often one of the most overlooked lifestyle changes that thyroid patients believe they should make for weight loss.
That means it's a great opportunity for you to fix!
Managing your stress may help lower cortisol levels, lose weight and decrease symptoms of anxiety and depression (19).
Managing your stress includes sleeping for at least 8 hours per night.
One of my favorite ways to reduce stress and calm down the mind is by using guided meditation.
The use of certain tones can influence brain wave activity and seriously calm down the body.
See the tracks below as examples:
To get the benefits simply listen to them and follow the prompts.
You can do it right before bed or multiple times throughout the day.
#5. The Right Supplements
Lastly, you will also want to make sure you are taking the right supplements to help manage your thyroid.
Taking supplements for your thyroid isn't very difficult but there are certain types of supplements that you should focus on...
- Supplements to help reduce inflammation
- Supplements to promote cortisol regulation and to treat adrenal related problems
- Supplements to promote thyroid hormone production
- Supplements to endorse T4 to T3 thyroid hormone conversion in peripheral tissues
- Supplements to balance and promote proper gastrointestinal health
Using supplements directed at the right place can produce dramatic results.
Supplements should always be used with other therapies to increase their relative effectiveness.
I do not recommend the use of supplements without both diet and lifestyle changes!
You can learn more about supplementing to boost thyroid production here.
Hypothyroidism Diet Plans + Recipes
If you want to get started on some diet plans I've included several below which ALSO include recipes:
Just remember that these are resources that you can use, but it still requires you to use the information I've listed above to help guide you.
Remember that diet is something in YOUR control and you should take full advantage of that fact.
Spend time figuring out what your body needs and what you do best on...
It just might be the best thing you can do for your health.
Diet is a critical part of weight loss in patients with hypothyroidism.
Not only can it help you lose weight, it can also help improve your energy levels and boost thyroid function.
There is no "perfect" diet for hypothyroid patients, instead, there are several diets that MAY be beneficial depending on the medical conditions that YOU have.
If you aren't sure where to start, or you are overwhelmed with all the information then consider making small changes at first like eating organic real whole foods and avoiding sugar/carbs/grains/etc.
Be mindful while making changes to your diet and keep track of how you are feeling and what you notice with different food groups.
Another great place to start is with the paleo diet. You can adjust up or down the number of carbs you need based on your symptoms.
If you are interested in weight loss don't forget that diet alone is usually not enough. Instead, you need to focus on a combination of managing your thyroid medication, hormone imbalances, nutrient deficiencies and stress levels.
Now it's your turn:
Has your diet helped you feel better or lose weight?
Which diets have you tried and which worked the best?
Leave your questions or comments below!