Is the Ketogenic Diet Safe if you have Thyroid Problems?

Is the Ketogenic Diet Safe if you have Thyroid Problems?

If you have thyroid problems and you are considering the ketogenic diet then this it the article for you. 

In it, we are going to explore why the ketogenic diet may potentially be harmful to your thyroid, how it may potentially help your overall situation, and how to determine if it's right for you. 

Highlights from the article:

  • The ketogenic diet may help with weight loss but it may not be safe for your thyroid. 
  • Whether or not the ketogenic diet will negatively impact your thyroid depends on a number of factors. 
  • Weight loss may help improve your thyroid through weight loss and improving leptin sensitivity. 
  • It may damage your thyroid through suppressing your free thyroid hormone levels and increasing your TSH. 
  • Be cautious if you decide to use this diet and check your thyroid lab tests regularly or about every 6 weeks.

More...

The Ketogenic Diet and your Thyroid

I'm not going to spend time explaining exactly how the keto diet works (there are plenty of places where you can read about that right now), instead I want to focus on its impact on thyroid function and whether or not it is safe for thyroid patients. 

As many of you probably know, I'm not a huge fan of the ketogenic diet. 

And this is coming from someone who has done keto himself and has put a great many patients on this diet early on in my career. 

But it became apparent to me (back in 2013-2014) that this diet is certainly NOT for everyone. 

While it potentially can be used as a great tool for certain people, I don't think it should be universally recommended, especially for thyroid patients. 

ketogenic diet in the news

Because this diet has hit the mainstream, it's now common for all kinds of people to jump into this diet head first. 

This is both good and bad. 

Good in the sense that many people are losing weight, and bad in the sense that there will be a large number of people with newly diagnosed thyroid issues for the foreseeable future

When I talk about the keto diet and its impact on thyroid function, I want to talk about 2 separate groups of people. 

The first group are those who do NOT have any thyroid issues but who develop thyroid problems or thyroid lab abnormalities as a result of going on the diet. 

The second are those people who have existing thyroid disease (Hashimoto's, those without a thyroid, those taking thyroid medication, etc.) who are considering going on the diet to see if it will help with their weight loss. 

I am primarily going to focus on this group. 

And my recommendation to these people is to proceed with caution

Let's talk about why.

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My Experience with the Ketogenic Diet

I attribute much of my own personal healing to changing up my diet which included being in ketosis for several months back in 2012ish. 

While changing my diet certainly helped improve many aspects of my health, it was certainly not perfect and I ultimately had to alter the type of diet that I was using several times in order to feel completely better. 

But because I noticed that it was so effective, I began to recommend it to certain patients. 

Because most of my patients had thyroid disease, I was able to see how they responded or reacted to this diet. 

What I found was a mixed bag. 

Some people responded very well, lost weight, had increased energy, and experienced the type of outcome that most of you are looking for. 

But even more people had either no reaction or a negative reaction. 

My weight loss therapies would be considered somewhat aggressive, so when a patients weight is staying the same it's never a good sign. 

I even tested the diet on my wife (I test most therapies on my family members) and she ultimately gained around 13 pounds (she wasn't happy about this). 

Relevant to this discussion is that she suffered from high reverse T3 and thyroid resistance at the time. 

From these experiences, I adopted a better approach which is to individualize each person's dietary needs and align them with various other factors that they may be dealing with. 

But, since most of you don't have a doctor willing to do that for you, it's worth exploring the potential benefits and risks that this diet affords. 

The Potential Benefits for your Thyroid

Is the ketogenic diet all bad?

The answer is no. 

In fact, it can be a great asset and tool for many people (including some with thyroid disease). 

My goal here is not to scare you away from this diet altogether, but it is to teach you to have a healthy respect for therapies and how they may potentially impact your thyroid in a negative way. 

We'll talk more about the negatives below, but for now, let's focus on the positives and how these may positively impact your thyroid. 

#1. Weight Loss

Yes, losing weight (if done correctly) can have a positive impact on your thyroid. 

Several studies have shown that weight loss is usually associated with a decline in free T3, total T3, and an increase in reverse T3 (1), but this doesn't explain the whole picture. 

What is the "standard" way to lose weight?

It's calorie restriction.

So, all of the studies that we have which show this trend occur as a result of calorie-restricted diets. 

If you want to lose weight long-term, then this is absolutely NOT the way to do it because these types of diets WILL damage your metabolism and your thyroid. 

But what about the ketogenic diet? 

If done correctly, and if it is not associated with calorie restriction, then the ketogenic diet can help with weight loss which may positively impact your thyroid. 

In this setting, it doesn't necessarily have to be associated with a decline in free T3, total T3, or an increase in reverse T3. 

In fact, weight loss can actually promote normal thyroid function (2) as hormones such as leptin and insulin decrease. 

But, this is true only if your weight loss is not dramatic, associated with a decline in calories, and if done over a reasonable period of time. 

Dramatic drops in your weight may trigger these negative changes (discussed more below). 

#2. Leptin Sensitivity

The second way that the ketogenic diet may positively impact your thyroid is through its influence on leptin sensitivity. 

Weight gain itself is a potential cause of leptin resistance. 

The more weight that you have on your body the more likely you are to be leptin resistant. 

And leptin resistance negatively impacts thyroid function through the hypothalamus by reducing your metabolism and by reducing free T3/free T4 levels (3). 

If you can do anything in your body to sensitize your brain to leptin (assuming you have leptin resistance) then you will necessarily improve thyroid function indirectly. 

And because the ketogenic diet can help with weight loss it may also help sensitize your brain to leptin. 

This may be complicated by the fact that some studies show that the ketogenic diet may actually increase leptin levels (4). 

This may sound ideal, and it should be, but only if you are a 5-10 pounds overweight. 

Increasing leptin levels is the last thing you want to happen if you are suffering from moderate to severe leptin resistance because high leptin levels are what caused the resistance in the first place. 

Your underlying leptin status may be part of the reason why some people respond well to the ketogenic diet and why others do not. 

The Potential Harm for your Thyroid

The ketogenic diet isn't all benefits, however, and I tend to think of this diet as potentially causing more harm than good for most thyroid patients. 

The reason I feel this way is that managing and balancing your thyroid is already so tenuous, to begin with. 

Those people with hypothyroidism know how difficult it can be to get their doctors on board with newer treatments which include medications that contain T3. 

So why would you want to risk further damaging your thyroid with a diet when the consequence may be very difficult to deal with?

I'm not saying that it's impossible to repair your thyroid after you damage it, but it certainly takes a long time and you better be sure that whatever therapy you are doing is worth this potential risk. 

For what it's worth, I find that most of the time damage done to the thyroid from diets or therapies can be fixed with the right treatments or right thyroid medication. 

And most people can simply stop the offending therapy (in this case diet), to normalize their thyroid function again. 

#1. Suppressed Thyroid Hormones

The first reason you want to be careful with the ketogenic diet is that it has been shown to suppress free thyroid hormone levels in some studies (5). 

There simply aren't many studies which show the connection between thyroid function and the ketogenic diet, but what few studies we have, do show a potential negative outcome. 

This research, while done in children, mimics what I've seen in my own personal practice. 

Even in some people who 'feel well' their thyroid function seems to decline as evidenced by a drop in free t3/total T3 and a rise in their TSH

This is a classic presentation for hypothyroidism and probably represents early damage to the hypothalamic-pituitary-thyroid axis. 

If you start to see this sort of change in your thyroid lab tests while you are using the ketogenic diet then it is probably a good idea to stop as soon as possible. 

But, as I said previously, just because it happens to some people doesn't mean it will happen to everyone. 

It appears that there are some people who are at increased risk of thyroid damage when doing the ketogenic diet. 

Whether or not your thyroid lab tests will be suppressed likely depends on a number of factors including:

  • Are you eating 'healthy' fats?
  • Are you restricting your daily caloric needs?
  • How long have you been in ketosis?
  • Were you adequately treated with thyroid hormone before you started?
  • Are you also over-exercising, over-stressed or over-worked?
  • Do you have a strong family history of thyroid disease?

If you are eating unhealthy fats, if you are restricting your calories, if you've been in ketosis for a long time (6+ months), if you weren't adequately treated with thyroid medication before you started, if you are also over-stressed/over-worked, and if you have a strong family history of thyroid disease, then you are probably more likely to experience a decline in thyroid function with the ketogenic diet. 

This isn't perfect, but it is a good way to assess whether or not you should even consider the diet in the first place. 

#2. Inability for your thyroid to respond if you are on thyroid medications

Another potential issue for thyroid patients is the fact that they are taking thyroid medications

Thyroid medications help to supplement thyroid hormone in their body to replace whatever their own body can't produce naturally. 

The only problem with this is that the more medication you take the more you suppress your own native thyroid hormone production from your thyroid gland. 

This becomes an issue when you undergo things like the ketogenic diet which may influence how much thyroid hormone your body needs (or the demand on your thyroid gland). 

Because your gland is being suppressed by the medication you are taking, you aren't able to fully respond to these new demands. 

This means you MUST address your thyroid medication (either up or down) based on these new demands. 

This is only really a problem for people who have doctors who aren't willing to work with them as they undergo weight loss, new therapies, or new diets because this problem doesn't necessarily have to prohibit you from these therapies. 

So, if you find that the ketogenic diet puts an increased demand on your thyroid gland, you may need to either increase the dose that you are taking. 

On the other hand, it's also possible that the ketogenic diet may improve your thyroid function which may necessitate a reduction in your thyroid dose. 

#3. Further Hormone Imbalances

Lastly, it's also possible that using the ketogenic diet may negatively impact other hormones in your body which may have an impact on your thyroid. 

The hormones that I am referencing here include progesterone, cortisol, and estrogen. 

All three of these hormones can be positively (or negatively) impacted by the ketogenic diet. 

What you really want to avoid is further stress on your body which may cause cortisol-related issues. 

Changing your diet, even if it's causing positive changes, is still considered to be a stressor on the body. 

And if this stressor tips the balance of positive and negative stress towards the negative side of the spectrum, then it may cause further issues for your thyroid. 

It is well known that there is a connection between cortisol levels and your TSH (6) such that problems in one will drag down the other. 

Again, this isn't going to necessarily be a problem for everyone who tries the ketogenic diet, but it's something worth considering. 

Like your thyroid, you can easily test for these hormones as you undergo the diet. 

Should you Use it? 

Your decision to use the ketogenic diet should be between you and your doctor (if you have one willing to work with you) and it should not be dependent upon the results that you see other people are getting. 

Remember:

Each person is genetically unique which means that how you respond to any given therapy is different from the next person. 

My own personal experience suggests that the ketogenic diet is probably not ideal for the majority of thyroid patients, but somewhere between 20-25% may experience some benefit while using it. 

Determining if you fit into that 25% can be done through careful testing and monitoring of your symptoms. 

If you decide to use the ketogenic diet then you should be very cautious and closely monitor your thyroid lab tests on a regular schedule. 

Checking your TSH, free T3, free T4, reverse T3, and total T3 can and should be done every 6 weeks or so. 

If you find that your TSH rises, your free T3/free T4/total T3 lower, or your reverse T3 rises, then these may be early signs that your body is NOT tolerating the diet. 

You can get your thyroid lab tests at baseline BEFORE you start the diet to compare your new results to. 

thyroid metabolism reset poster for side bar

Beware, though, if you make changes to your thyroid medication during this time period then this may invalidate the effectiveness of testing your thyroid lab tests. 

If you decide to use it you should very closely monitor both how you are feeling and how

It's probably also not a good idea to stay on the keto diet long-term, even if it is working for you. 

It's important to understand that there are no long-term studies which prove that this diet is safe or effective (7) for your overall health if done for years in a row. 

In fact, many of the proponents of the ketogenic diet (those who taught me about this diet) only use it temporarily on themselves!

Going in and out of ketosis may be superior rather than staying in ketosis without any breaks. 

My personal recommendation would be to use this diet temporarily and then transition to other diets which are considered safer for your thyroid. 

This can actually be done safely because the entire goal of using the ketogenic diet is to reset insulin/leptin levels. 

Once you have done this you should be able to transition to a regular diet without any issue. 

You just better hope you don't damage your thyroid along the way, otherwise, you may gain that weight back due to metabolic damage! 

Ketogenic Diet After Thyroidectomy

Does this information apply to you if you don't have a thyroid or if your thyroid has been destroyed with radioactive iodine?

The short answer is yes. 

All of this information is still relevant to you but you should also proceed with slightly more caution than those with a functioning thyroid. 

Why?

Because, unlike them, you are 100% reliant upon thyroid medication to support the needs of thyroid function in your body. 

And people without a thyroid are generally undertreated as evidenced by the fact that most people gain weight after their thyroidectomy and suffer from the symptoms of hypothyroidism

I say proceed with caution because if you elect to use the keto diet then you must be prepared to make changes to your thyroid medication. 

Again, it's not really a reason to avoid it 100%, but you will probably need to have your doctor on board with you to help regularly check and adjust your thyroid medication as needed. 

The Low T3 Longevity Argument

Lastly, I want to spend some time on the low t3 longevity argument. 

It's been suggested that the ketogenic diet is safe to use even if it does lower your T3 levels (or thyroid function) because some studies have shown that people who have lower thyroid function tend to live longer (8). 

While it may be true that a few studies have shown this, it doesn't in any way prove that low thyroid function leads to a long life. 

In fact, even if it did lead to a long life, we have a number of studies which show that low thyroid function (especially low T3) is also associated with weight gain, fatigue, depression, and many other negative symptoms. 

So even if having low T3 did lead to a longer lifespan, the life that you would be living would not necessarily be a quality one. 

In addition, it's also just as likely that these people who have low thyroid function have other genes which improve thyroid sensitivity at the cellular level which means that they simply need less thyroid hormone than other people. 

That or any number of other explanations could potentially explain why we see that low thyroid hormone in the serum may be associated with increased longevity. 

If you are a thyroid patient already, then you can always reduce your dose of thyroid hormone temporarily to experience how you might feel with low thyroid hormone. 

If you've ever done that before please reply back here with your experience! I'm sure it wasn't a positive one. 

The bottom line?

Don't necessarily jump in on the ketogenic diet just because you feel that it will improve your lifespan. 

Conclusion

The ketogenic diet isn't all benefits without any consequences. 

If you are thinking about using this diet AND you have thyroid disease then please be cautious. 

It's possible, and probable, that undergoing this diet may negatively impact your thyroid in a number of ways. 

If, however, you've tried every other therapy and no matter what you do you can't seem to find any relief, then a trial of this diet may be in order. 

If you elect to go down this path then make sure that your doctor is on board and willing to test your thyroid lab tests regularly and adjust your medication as necessary. 

Don't just jump into the hype of the ketogenic diet, however, because you don't want to put yourself in a situation that ultimately makes your thyroid function worse. 

Now I want to hear from you:

Have you tried the ketogenic diet?

Did it work for you? 

Did it help with weight loss?

Did you notice any damage or changes to your thyroid?

Why or why not?

Leave your questions or comments below! 

References (Click to Expand)

is keto safe if you have thyroid problems?

Dr. Westin Childs

About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 45,000+ people have used them over the last 4.5 years. You can read more about my own personal health journey and why I am so passionate about what I do here.

49 thoughts on “Is the Ketogenic Diet Safe if you have Thyroid Problems?”

  1. Thank you Dr Childs for this great article bringing awareness. The keto diet, while it has its merit isn’t for everyone. I am a 37 year old female, generally healthy, in good shape, no known thyroid issues (TSH 0.987) who went on the keto diet for about 2 months in Jul 2018 to drop the “last 5 pounds from summer vacation”. I was in deep ketosis, taking in maybe 5-10 net carbs per day. Fast forward to October, lost the weight and then some, but my hair started falling out by the handfuls, extreme fatigue and body pain set in. There were days I would lay in bed and cry because of the debilitating fatigue. Finally did a thyroid & hormone panel and found TSH at 4.4, and very high TPO antibodies. Progesterone and Estrogen also completely out of whack – both too low. Was diagnosed with Hashimoto’s (no family history of it) Thyroiditis and put on Armour Thyroid and finally feel like myself again after 6 months of living hell. I am now back to a normal, balanced diet and have maintained my weight just fine. I am not saying this will happen to everyone, but it happened to me and the ONLY change in my life was going on Keto before my thyroid gave up. If you are reading this, please be measured in your approach to Keto as with any other diet…sometimes the last 5 lbs just isn’t worth losing 6 months or more of your life. I was lucky in that I found a great functional doctor who diagnosed and treated me quickly.

    Reply
    • You’re welcome and thanks for sharing your story!

      I do agree that there are plenty of people who can do just fine on the diet, but there is a small subset of people who will be worse off for even attempting the diet. Figuring out which group you fall into can be tough which is why I will usually only recommend the diet as third-line therapy.

      Reply
      • I have been following you for about a year now and value your opinion. Can you please let me know what you think I should do in this situation?
        I have been on the Keto diet now for about 3 months. I’ve lost 7 lbs. My TSH was low (.276), Free T3 low (3.49) and Free T4 low(.94).
        Now 3 months later my TSH is even lower at .074, my Free T3 is lower at 3.33 and my TSH is the same .94. Three months ago my doctor started me on 50 mcg of Tirosent once a day and 5 mcg of Cytomel twice a day. When he saw the recent labs from 5/10/21, he said to just take the Cytomel once a day now. I’m so confused. If my T3 is low why would I take less of the Cytomel? Before I lost the 7 lbs, I was seeing another doctor who only had me taking 50 mcg of Synthroid and I couldn’t lose any weight no matter what I did. What do you think about all this?

        Reply
        • Hi Karen,

          The short answer is your doctor is putting more importance on your TSH compared to your free T3 level. Most doctors care only for the TSH and he/she knows that if you reduce your dose of T3 then your TSH will increase which is what they want. Unfortunately, this is almost guaranteed to be associated with fatigue, weight gain, and more symptoms on your part.

          Reply
  2. Great article, we need more awareness. I too developed hypothyroidism because of low carbing. I was following Atkins diet and was in Ketosis for almost 2 years. In the end I was diagnosed with General (not autoimmune) Hypothyrodism. I also was stamped as pre-diabetic, which is still total mystery to me. As far as I know ketogenic diet is the first way to go to lower your blood sugar. My sugar went down after I reintroduced carbs back to my diet. I read and study a lot, experiment with thyroid medication as you advise in your articles. Study my lab results in greatest details and use your optimum ranges as guidance. I’m a big fan of your work Dr. Childs, really apréciate all work you do to educate people and spread awareness.

    Reply
    • Hi Tatiana,

      While carbs certainly play a role in treating and causing insulin resistance, there must be other factors at play as well. I frequently prescribe high healthy carb diets to patients who end up losing weight and improving their insulin/blood sugar in the process. I’ll have to write a post on that topic in the future at some point.

      Reply
  3. I have subclinical hypothyroidism. Have insulin and leptin resistance weight gain around stomach. Each doctor has different ideas I’m struggling to find correct treatment for me. After being on too high a dose of dessicated thyroid extract which brought down TSH I developed tinnitus full time. Another Dr prescribed T3 only then TSH went up. I went off T3 for seven weeks TSH went down to 4 but reverse T3 is up to 480 (we have different lab results in Australia) still just in range but getting to upper level I know that’s not right but new GP said that’s in the range. Feel they don’t know how to read results properly. Do I need an endocrinologist or integrative medical doctor who recommended T3 only? I also have MTHFR gene C677T. ENT specialist said tinnitus is related to thyroid any suggestions?
    I am interested in your information my saliva cortisol was low in 2015 but no one has tested it since. You say there is a connection there. I have taken numerous supplements with no weight loss only weight gain! I am in Australia and at a loss of what to do next. No doctor seems to put it all together to give me a good result. I did have phone consultation with naturopathic doctor in USA who gave me Biothyroid then integrative Dr here said I only need T3 Liothyrione? I feel I am sensitive to medication
    You recommend your supplements I’m guessing. Thanks for your help? Do you consult personally by email?

    Reply
    • Hi Susan,

      You listed several conditions that you are suffering from and not all of them are treated the same way. So some supplements can potentially help you, but you will most definitely require optimizing your thyroid medication, changing your diet, and several other therapies as well.

      Reply
  4. Unfortunately, I ended my experience like your wife. I’m now trying to get off the 15 lbs I gained in a year. Fortunately, my doctor has taken me off of T4/T3 and put me on T3 only. Seems like a long road back.
    I have recently enrolled in your program.

    Reply
    • Hi TM,

      Yeah! She wasn’t too happy either and I still get a little bit of flak from it to this day. Unfortunately, I tend to learn the most treating the people who are closest to me.

      Reply
  5. Thank you for this article. I wish I would have read this BEFORE I tired the Keto diet. I have Hashimotos and within 2 months of trying this diet, I was in the ER with terrible stomach pains. I was diagnosed with diverticulitis. My Dr. believes it was the radical diet change that brought this on. Now, my whole life is about managing this new diagnosis as well as Hashimotos. I am so afraid to try new things or add in foods for fear of having another flare up. I would give anything to go back to just managing my thyroid.

    Reply
    • Hi Lori,

      I don’t know if you can say for sure that keto caused the diverticulitis, but if you are feeling better off keto then it’s probably best to avoid it given the uncertainty.

      Reply
  6. I don’t feel good on a ketogenic diet, and it does NOT help me lose weight. I was doing it last spring, and I felt worse than I had in years. Fatigue, depression, brain fog, etc. I only really needed to lose 5-10 pounds to get back to my pre-pregnancy weight, and I wasn’t planning to stay on it long term. My thyroid labs were done at the end of the time I was on it, not the beginning. They looked ok, for the most part… low normal.

    Also- I’m one of the silly heads who once asked my doctor if I could wean off my Armour thyroid and he said- sure, try it. I was trying to do other things to support my thyroid. If I could have stomached the transition, I maybe could have weaned off it successfully. However, it was so unpleasant that after 3 weeks, I started the Armour again. NOT pleasant!!!

    Reply
  7. I have been on keto for a little over a month. I have been dx with insulin resistance and I have about 40 lbs to lose. I was hoping that keto would be successful when all other diets have failed. I have lost about 7lbs so far and I feel great. I am confident that this will help me. Based on your advice here, I plan on going back to Paleo once I get all of my issues resolved.

    Reply
  8. I have hypothyroidism that was diagnosed about a year and a half ago, though my ND feels that it’s been lifelong. I have carried a lot of extra weight/fat my entire life and have also been battling hormone imbalance, terrible periods (though that’s been helped immensely with addressing thyroid) and iron-deficient anaemia forever, too. I take a mix of NDT and T3 – we lowered the NDT and increased the T3 and I definitely feel better that way. Anyway, I have been doing a keto diet for quite some time and definitely feel better on it, but the version of keto I do is a whole foods one, with good fats, plenty of organic veggies. I am vegetarian, so my protein sources are a bit trickier, but I’ve been advised that have my non-gmo, organic soy away from my thyroid meds. I think the key difference to traditional keto for me in my approach: it is cyclic. Twice a week I have forms of “carb ups” – mid week dinners and one day on the weekend of no restrictions. Doing things this way, along with meds has kept my thyroid numbers stable. Weight is extraordinarily stubborn, though, but I’m hopeful that will come with hormone healing and eventual reduction in inflammation (oh hi there, elevated sed rate, hs-crp, wbc and platelets, my constant “friends”!).

    Reply
  9. Hi Dr. Childs.Thank you so much for this article. My first try of keto was less than 30 days back in 2 years ago. my 2nd try was last Autumn for 60 days including intermittent fasting and very little exercise. I lost weight from 63/5kg to 59kg. my aim was fat loss from belly & waistline which was very good. I was diagnosed with a large thyroid gland when I was 10. My Mum has a history of thyroid. I remember I was taking Levothyroxine pill between age 18-34. I also had partial removal of my gland at age 32. All the different GP doctors in the UK haven’t prescribed any medication since 2001.i have been given the simple blood tests to do all these years, except the last two years after I did lots of reading so now I have TPO ab, TG ab,…to get tested too. last year all factors were ok except TPO ab was 20.07 This year after 60 days keto I did the lab test after 2 months, my TSH 1.9, T4 6.8, T3 0.6, TG ab 25.69 and TPO ab 23.48. I just did another test last week which the result hasn’t arrived yet. Another experience with keto was my left eye was larger than before. I did a CT scan, nothing was wrong and it went back to normal size gradually. Now I am on low carb lifestyle most of the time and if I fall off the wagon, eating unhealthy occasionally with friends, I do fasting and carry on with healthy cyclical low carb diet, similar to the Mediterranean diet. I noticed that I had better sleep and more energy on keto and now if I do low carb correctly, also my skin eczema get much less on these diets. I must mention that I am 52. My pre menopause symptoms are much less with a low carb diet. Also I started 5:2 fasting in 2015 for six months but I believe calorie counting is not my cup of tea 😉 After all these years trying different diets to get rid of extra few pounds around my belly, I realized my body will be at peace if I cut sugar, restrict gluten and stay on low carb lifestyle. I would be more than happy if you could give me more guidance to stay healthy regarding Thyroid issue. Many thanks.

    Reply
  10. I have recognizable increased stress levels recently due to losing my father. With that, I had a follow up with my endocrinologist and she noticed a slight increased with my glucose but all other labs were within normal range. ( A year ago- she remarked I had such great labs and they were the pinnacle each doctor aims for !) Now, I can’t seem to budge! Can you recommend a vitamin? Btw, I recommend your blog to others that also have thyroid issues. Thank you!

    Reply
    • Hi Theresa,

      I think it’s relevant to some people, but lectins impact certain people more than others so not everyone needs to avoid them.

      Reply
  11. I won’t dare try Keto. First 2X I tried low carbing I did not feel well at all but didn’t know why so I instinctively stopped. I decided to try again when I was around 3 months postpartum. BIG MISTAKE. When ketosis kicked in I started to feel horrible fatigue, brain fog and some strange sensory symptoms. I would wake up middle of the night gasping for air. Then I noticed my neck felt lumpy. I showed my doc and she diagnosed Hashimoto’s. My TSH was 67+, my FT4 very low and antibodies way off the charts. I’ll never forget she called me to tell me about my labs – I was laying down trying to nap middle of the day. She said, “How are you even functioning? In my 20 years treating patients I’ve never seen numbers like this…” She ran the tests again just to verify.

    Reply
    • Hi Amy,

      Thanks for sharing your story. It’s helpful for others to see who are considering these types of diets.

      Reply
  12. Dr. Child’s,
    Thank you so much for bringing this diet under examination! I have Hashimotos and my Functional Med doctor is a firm believer in Keto. But when I tried it, I landed in the ER after about 6 weeks with what I thought was a heart attack but was actually a gal bladder attack. No one warns about all that fat going through the gall bladder, which can already be sluggish for people with thyroid issues. Keto diet’s recommendation of 70% of calories from fat is too much for me! Low carb with no gluten has been working for me — lots of veggies now, less protein, and only small amounts of healthy, non-dairy fats keeps my gall bladder happy. Now if only I could lose some weight!

    Reply
  13. I gained 10/15 lbs from a 90 day keto experiment and have experienced struggle losing it ever since. What is your best suggestion behind this? How did your wife lose the weight?
    Thank you.

    Reply
  14. I lost 41 pounds on Keto diet. I have hypothyroid. Before I started the diet my doctor tested my free T3 which was low with just taking T4 so my doctor take me off T4 and had me take T3 only which I will say made me feel great. I went on the Keto diet in February and lost the weight. My test taken this month still looks strange to my doctor but I tell him I feel fine. T4 free= .11, T3 free=5.4, TSH=10 that’s all my doctor will test. Took my T3 meds 3 hours before test. If I test without T3 meds the readings are T4 free=.11, T3 free=1.4, TSH=33. I am taking 30mg a day dividing them in dosages of 10mg. Do you have any advice on the dosage and should I be testing without meds or with meds.

    Reply
    • You should get the book “The Thyroid Patient’s Manual” by Paul Robinson. Look in to his YouTube videos and blogs.
      The book teaches you how to dose the meds using the T4, NDT, T3 or T4/T3 Thyroid Treatments. I am also bad converter of T4 meds to T3. Paul Robinson explains how to figure this out. I just bought his book, I will try to learn how to dose correctly myself, because my doctor has no idea how to do it. Here are some links to podcasts that he was in if you want to listen first.
      https://www.youtube.com/watch?v=0TnSDdyyME8

      Reply
  15. Hi Dr. Childs,

    It seems like most of the information here pertains to hypothyroidism. Does this mean that the keto diet would be okay or even beneficial for those with overactive thyroid?

    Thanks!

    Reply
  16. I’ve been on carnivore fir 2+ yrs. still battle with some fatigue. I’ve tried adding back in some carbs. Some are ok. Some cause bloating etc. Have decided eggs and dairy don’t like me. I have days when I feel ok but if I try to exercise and do a little more, I cam get real tired. Any idea where I can turn to tweak things? In 2003 I had saline breast implants. Had them removed 2018 after no results with AIP, keto etc. Feel like I’d tried everything. TPI went from 226 right before explanation to 66 2 mos after. It’s a huge deal. All implants have 40+ heavy metals/toxins…even saline implants. People should know. My question is: it mitochondria not getting adequate energy? I argue with my doc about being at upper limits of my thyroid tests. I’m tired of having to be the one ‘in the know’. Feel the best on carnivore. But not optimal. Thoughts?

    Reply
  17. Hi, I have Hashimoto’s and have been keto for the last 4 years, planning to stay on it for life. All good, TSH halved. My keto involves 50-65g net carbs/day and is cyclic – I have a cheat morning once a week in which I eat what I like, though gluten-free of course. Takes 2-3 days to get back in ketosis. Each day I have lots of unstarchy vegies, nuts, some fruit including berries, not high protein (don’t eat red meat) and eat to appetite. I am easily addicted to starchy carbs/sugar, diabetes in the family, but this cyclic keto means I have no addictions any more, blood sugar is beautiful. Lost about 20kg 4 years ago, put on 10kg last year (covid restricting exercise, also cheat meal every 4 days instead of 7) but am back on track, such a relief. Exercise moderately 6 days out of 7, 30-60 mins/day, rarely get ‘tired’ days anymore. Age 64.

    Reply
  18. Hi Dr. Childs,

    As for me, I’ve had hypothyroidism for 20 years. I’ve never been truly successful at losing weight. I would go on a calorie-restricted diet, lose some weight and gain it right back and then some. Yo-yo dieting. After doing this forever, I started keto in January 2021, and by April I had lost 31 pounds! I now weigh what I weighted 40 years ago! I feel great and have so much energy. I’ve just retired and work physically on my land daily. I am very thankful to have discovered clean keto. I had insulin resistance and was pre-diabetic, and now I’ve reversed all my metabolic issues. This has saved my life with no impact on my thyroid (to my knowledge).

    Reply
  19. I was taking Levo 50mg through my regular doctor for 20 years. About 5 months ago switched to bovine thyroids granular 25 mg as advised by me a holistic doctor. I did not see any difference in both medications. Still cannot lose weight. I have tried keto, intermitted fasting and others, but cannot lose an oz.
    Today, my regular doctor insists that I get back on levo as my tsh shoes 0.05mcl adn t4 Free 1.0ng.
    Do you have any advise if I should continue levo or bovine?

    Reply
  20. I’m a Hashimotos patient and have tried endless number of diets, including calorie count, rigorous workout regiment, buying a bunch of your products etc. All it ever did was me gaining more and more weight.
    Now on a keto diet- not pumping my body with fat but eating lots of avocados and olives etc- I’m down 25lbs in 2 months.

    Reply
    • Hi Eli,

      Thanks for sharing! The litmus test as to whether a diet is working is not whether or not you can lose weight quickly but whether or not you can keep that weight off long-term 🙂 Losing 25 pounds is great if it means you can keep that 25 pounds off in 1 year from now but it’s not so great if it comes at the cost of more thyroid damage as well as the regaining of that weight in 4-6 months. Time will tell if the diet is actually beneficial to your body.

      Reply
  21. Hi Dr Childs,
    my dietician put me on a ketogenic diet for 9 month and it was a big mistake. I have gained 10 pounds as well as I have lost leptin sensitivity and thyroid hormone level. Now I’m fighting to get back my hormonal imbalances for two years now, no results yet. Thank you so much for your knowledge. I wish you would teach our doctors!

    Reply
    • Hi Beata,

      I experimented with my wife on the keto diet about 7 years ago and she gained 10 pounds as well! It just doesn’t work well for some people.

      Reply
  22. Hello! I’ve had thyroid issues for the last 25 years with being diagnosed with Hashimotos and Celiacs in 2014. Over the years, I have eaten Paleo, Primal, various forms of keto, raw vegan and carnivore. But,I feel my absolute best when I do “Squeaky Clean” keto. It is also the only diet that brought my TPO(ab) down from 900+ to 216. Just recently (April 2021). My Dr also lowered my Tirosint dosage, my cholesterol is optimal and insulin levels are good, although I feel like the numbers are on the cusp of insulin resistance, they are lower than a year ago. I have recently been adding a couple of 24 hour fasts a week. Those are easier to do for me if I’m skc keto. The only number on my tests that is concerning to me is my weight, but because I have good numbers, my Dr isnt that concerned. What are your thoughts on the carnivore diet?

    Reply
  23. I have had my thyroid removed and NOTHING worked besides keto. It was still a long process, but I lost 20 pounds and I have all the energy to exercise, go on long walks, etc. Now, I am not as strict and just maintain a cyclical low carb diet, so I eat low carb and prioritize protein, fats, and non-starchy greens most of the week. When I go out, I will give myself some grace–although it is still gluten and dairy free, and I try to be mindful of sugar. Be your own lab rat and see what works for you!

    Reply
    • Hi Kennedy,

      Agreed 🙂 Do what works for you and don’t be afraid to experiment. Keto can work for some people but I personally don’t feel that it’s a great long term solution.

      Reply
  24. My doc happened to add cytomel to my levothyrox at the same time I started a Keto diet. I did well. My numbers were “too good” and doc suggested I lower dose of levo, or cancel cytomel. I hate being on any meds so I let go of the cyto, and since in my heart I’m vegan(ish) I also let go of the keto. I’m still confused. Find it nearly impossible to lose weight. The levo (now synthroid) doesn’t seem to help symptoms only the numbers, and my doc is opposed to most supplements. I feel like I am between a rock and a hard place. Don’t know where to turn and would love to be off the med.

    Reply
    • Hi Michele,

      I would strongly recommend looking elsewhere if you don’t feel like your doctor is willing to work with you or help you. I’ve seen thyroid patients waste literal decades of their lives with doctors like yours who won’t “allow” them to experiment or try new things to feel better. In my mind, it doesn’t make sense to let someone dictate what you can or can’t do, especially if they don’t live your life 🙂

      Reply
  25. I was diagnosed with hypothyroidism 20 years ago. I have been on medication for 20 years. I felt best on naturethroid but nave not been able to get it or armor thyroid for a year or more. I have not felt well, but my doctor says my labs are good. I have been on Levothyroxine. I would love to have my nature thyroid again. I have been on keto for 10 months now and have not lost a ounce. My doctor says it is because I Am 67. Thanks for your article. I may be harming my body.

    Reply
  26. What kind of diet is recommended for people with thyroid issues who also have dysbiosis?? (I’ve been reading that the two can go hand in hand.) I cried to my husband a few nights ago that I feel like I’m screwed no matter what I eat. Calorie restriction is a bad idea so if you have to maintain healthy calories you have to get them from either carbs, fats, or proteins. Well, too much fat these days is stressing out my gallbladder. If I eat too many carbs in the form of beans, bananas, potatoes, rice etc I not only gain weight but I get achy joints and constipation. Plus, I read that starches like sweet and white potatoes, wheat, rice and certain beans damage the gut lining (think GAPS or SCD diet) and feed bad bacteria. That leaves high protein which I’ve been reading is hard on the liver and kidneys and can lead to things like osteoporosis (I already have very thin bones). I’ve been diagnosed with Dysbiosis caused by yeast overgrowth and a protozoan parasite. I’m told that I need to cut carbs to starve the yeast and parasites. But I’m also told that low carb is a terrible idea for people with thyroid issues. Sooo…what DO I eat??

    Reply

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