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Keto and Hypothyroidism: Safety and Tips

author avatar Dr. Eric Berg 12/13/2024

The connection between keto and hypothyroidism offers a promising avenue for those seeking to promote their thyroid health. 


While concerns exist regarding low-carb diets disrupting thyroid function, a carefully planned Healthy Keto® approach can support a healthy thyroid gland and improve overall well-being.


Learn how Healthy Keto helps support thyroid function and discover practical tips for safely incorporating keto into your lifestyle. 


Thyroid gland concept

What is hypothyroidism?


Hypothyroidism is a common endocrine disorder characterized by the thyroid gland's inability to produce enough thyroid hormones to regulate the body's metabolism.


The thyroid, a butterfly-shaped gland located in the neck, is responsible for producing and releasing essential thyroid hormones, including triiodothyronine (T3), thyroxine (T4), and calcitonin.


These hormones help control and regulate vital physiological functions, including energy metabolism, body temperature, and mood regulation.


Because thyroid hormones play a critical role in various biochemical processes and metabolic pathways, hypothyroidism can lead to a wide range of health issues. 


Common symptoms of hypothyroidism include:

  • Chronic fatigue

  • Weight gain 

  • Difficulties losing weight

  • Intolerance to cold temperatures 

  • Dry, flaky skin

  • Hair loss

  • Weak muscles

  • Depression

  • Brain fog

  • Constipation


If left untreated, hypothyroidism can progressively worsen, disrupting critical bodily functions and increasing the risk of severe health complications.


Hypothyroidism has been linked to an increased risk of various serious health problems such as:

  • Heart disease 

  • High cholesterol 

  • Heart failure

  • Insulin resistance 

  • Infertility

  • Pregnancy complications

  • Nerve damage

  • Cognitive decline

  • Goiter


While iodine deficiency and environmental factors such as radiation exposure can trigger hypothyroidism, around 90 percent of all cases are caused by Hashimoto’s thyroiditis, also known as autoimmune thyroiditis.


This autoimmune condition occurs when the immune system mistakenly attacks the thyroid gland. This triggers inflammation and tissue damage, which reduces the thyroid's capacity to produce hormones.


Watch the video below to learn why keto can help manage Hashimoto’s symptoms.

Hashimoto's Disease (Hypothyroid) and Keto (Ketogenic Diet)

What is the keto diet?  


The ketogenic diet is a low-carb diet that shifts the body’s metabolism from burning glucose to generating energy to utilizing fat as a primary fuel source.

This metabolic state is known as ketosis, during which the liver converts fatty acids into ketone bodies, or
ketones, which serve as a highly efficient alternative fuel when glucose is limited.


Ketosis can be achieved by restricting carbohydrate intake to no more than 50 grams of net carbs daily while obtaining the majority of calories from healthy fats.

By limiting carbs, keto helps normalize blood sugar levels and improve insulin sensitivity, which is critical for hormonal balance and metabolic health, both key factors for managing hypothyroidism.  



The ketogenic diet, originally developed in the early 1900s, has since undergone several adaptations, leading to various approaches to this high-fat diet.


Healthy Keto® is an optimized version of the standard keto diet that utilizes the same macronutrient structure with added emphasis on food quality and nutritional value.


This nutrient-dense, low-carb diet can be particularly beneficial for individuals with hypothyroidism as it helps prevent nutrient deficiencies and reduce exposure to inflammatory foods and ingredients that can adversely affect thyroid function.


Good news from the doctor

Keto and hypothyroidism: is it safe?


Some people are concerned that a low-carbohydrate diet might negatively impact thyroid function, worrying that changes in insulin balance could inhibit thyroid hormone production.


However, when done correctly and under careful supervision, the metabolic changes in response to a ketogenic diet are unlikely to impact hormone production and may actually help improve symptoms of hypothyroidism.


According to research published in Plos One, the ketogenic diet can have advantageous effects on thyroid function, as the authors report that a high-fat diet led to more weight loss than a high-carb, low-fat diet without adverse consequences on thyroid health. 


While active thyroid hormone levels decreased on the keto diet, resting metabolic rate (RMR) remained stable. This is noteworthy, as reduced T3 levels typically correlate with a slower metabolism, yet keto appears to maintain the body’s metabolic rate.

This suggests that under certain conditions, such as nutritional ketosis, the body adapts metabolically to maintain energy balance without relying as heavily on T3 for metabolic regulation.


Additionally, thyroid-stimulating hormone (TSH) levels remained stable, indicating that the thyroid gland continued to function normally.


However, the type of ketogenic diet you choose is crucial. Many standard keto diets rely on low-quality, ultra-processed keto-friendly products, which can increase inflammation, contribute to weight gain, and aggravate hypothyroidism symptoms.


Without proper nutritional guidance, reliance on these processed products can result in nutrient deficiencies and increased cravings, making it difficult to maintain a healthy diet needed to support thyroid function. 


This emphasizes the importance of following Healthy Keto, which educates dieters about avoiding low-quality foods and focuses on achieving the right nutrient balance for overall health.


Given the complexity of thyroid health, it’s essential to review any information related to hypothyroidism, including lifestyle changes, with a healthcare provider to determine suitability based on individual health needs.


Grilled salmon on a platter

The best foods on keto for hypothyroidism


Incorporating foods that support thyroid health is crucial when following keto for hypothyroidism.


Wild-caught fish such as salmon, mackerel, and sardines are excellent sources of omega-3 fatty acids. These healthy fats help reduce inflammation in the thyroid gland and support overall hormone balance by increasing cellular sensitivity to thyroid hormones.


Beef liver, fish, and eggs are excellent sources of vitamins D and A, which are crucial for immune function, improved mood, and energy levels. These nutrients also support healthy adrenal glands by helping regulate cortisol levels, which plays a critical role in thyroid function.


Selenium-rich foods such as Brazil nuts, yellowfin tuna, sardines, beef steaks, nutritional yeast, eggs, and cottage cheese are also highly beneficial for individuals with hypothyroidism.

Selenium is a vital trace mineral that plays a critical role in thyroid hormone production as it’s an enzymatic cofactor needed to convert T4 into its active form, T3. 


“In addition to its role in thyroid hormone production, selenium decreases antibodies that attack proteins involved in thyroid hormone production, which are often elevated in thyroid conditions such as Hashimoto’s,” explains Dr. Berg.


Sea vegetables such as sea kelp, nori, and chlorella are natural sources of iodine, which is vital for thyroid hormone synthesis.

The word gluten in grains

Foods to avoid for hypothyroidism


Certain foods can exacerbate hypothyroidism symptoms by interfering with thyroid hormone production and thyroid gland function.


Here are foods that can worsen hypothyroid function and should be avoided. 


1. Gluten-containing grains

Gluten-containing grains, such as wheat, barley, and rye, are especially problematic for thyroid health, particularly for those with autoimmune Hashimoto’s thyroiditis. 


Gluten contains a protein that has a similar structure to a protein found in thyroid tissue, and gluten intake can mistakenly activate the immune system to attack the thyroid in an attempt to eliminate gluten from the body.


2. Ultra-processed foods

Additionally, ultra-processed foods such as ready-made meals, fast foods, and fried foods should be avoided. 


These food products are typically packed with refined starches, added sugars, and unhealthy seed oils that can disrupt insulin balance, promote inflammation, and worsen hypothyroidism symptoms. 


3. Goitrogenic foods 

Goitrogens are naturally occurring compounds that can interfere with thyroid hormone production by blocking iodine absorption. 


Foods high in goitrogens include cassava, lima beans, sorghum, sweet potato, flax seed, millet, soy, and onions.


While cruciferous vegetables also contain goitrogens, cooking significantly reduces their likelihood of impacting thyroid function. 


Cooking methods, such as steaming, boiling, or sautéing, can deactivate many of the goitrogenic compounds, making these highly nutritious vegetables safe in moderation for those with thyroid concerns.


Intermittent fasting clock healthy food

Tips for doing keto if you have hypothyroidism


Adopting a ketogenic diet while managing hypothyroidism can offer several benefits, but it’s essential to approach it cautiously to avoid exacerbating thyroid symptoms.

Here are some tips to help you incorporate keto safely if you have hypothyroidism.


1. Gradually lower carbohydrate intake 

Hypothyroidism can make your body more sensitive to sudden metabolic changes. Instead of abruptly cutting carbs, gradually decrease your intake over a few weeks.


Gradual carb reduction can help your body transition smoothly into ketosis while minimizing the risk of triggering stress responses, such as increased cortisol production, which can suppress thyroid function.


2. Ensure adequate caloric intake 

Ensure you’re consuming enough calories to support your basal metabolic rate (BMR), which is the energy your body requires to maintain vital functions such as breathing, circulation, and cell repair.

Undereating can slow your metabolism, a risk already heightened in hypothyroidism, which can further suppress thyroid hormone production and reduce energy levels.

Use a
BMR Calculator or KETO Calculator to better understand your energy expenditure and ideal macronutrient levels. 


Sportswoman drinking water

3. Stay hydrated and replenish electrolytes

Keto can initially lead to increased water and electrolyte loss, resulting in dehydration and nutrient imbalances that can exacerbate hypothyroid symptoms.

Stay well-hydrated by drinking plenty of water, and ensure your body gets essential electrolytes like sodium, potassium, and magnesium. 


A well-planned keto diet rich in nutrient-dense foods can help maintain electrolyte levels, and incorporating a sugar-free electrolyte powder can further promote mineral balance. 


4. Practice intermittent fasting 

Intermittent fasting can complement a keto lifestyle by promoting insulin sensitivity and autophagy, a natural regenerative state in which the body recycles and repairs damaged cellular material. 


However, if you have hypothyroidism, start gradually to avoid potential disruptions to thyroid function. Begin with shorter fasting windows and listen to your body’s responses. 


Consulting a healthcare provider familiar with both hypothyroidism and intermittent fasting can help you tailor a safe and effective approach.


Thyroid health concept

Key takeaways


Keto and hypothyroidism can safely coexist through a nutrient-focused approach, such as Healthy Keto®. 


When implemented correctly, a Healthy Keto diet, combined with adequate hydration, electrolyte replacement, and intermittent fasting, may help improve thyroid hormone balance, increase energy levels, and assist in weight management. 


In addition, those with hypothyroidism should avoid processed foods, gluten-containing grains, and goitrogens, which can interfere with thyroid function.


FAQ


1. Are keto and hypothyroidism a bad combo?

No, when done correctly, a Healthy Keto® diet can support thyroid health by reducing inflammation, improving essential nutrient intake, and promoting hormone balance.


2. Is a keto diet safe for hypothyroidism?

Yes, a well-planned Healthy Keto diet can safely support hypothyroidism. However, it’s critical to consult your healthcare provider before making significant dietary changes, especially if you are taking medication.


3. Can keto cause hypothyroidism?

There’s no solid evidence linking a ketogenic diet to the development of hypothyroidism.


However, nutrient deficiencies and extreme carbohydrate restriction can affect thyroid hormones, and it’s crucial to follow a nutritious diet to support thyroid health.


4. Which diet is best for hypothyroidism?

The best diet for hypothyroidism is a nutrient-dense, whole-food approach such as Healthy Keto, which supports thyroid health by promoting thyroid hormone balance and reducing inflammation. 


It's also essential to focus on key nutrients such as iodine, selenium, and vitamin A while avoiding processed foods that can trigger inflammation and contribute to nutrient deficiencies.


5. Can you reverse hypothyroidism with diet?

While diet alone may not reverse hypothyroidism, proper nutrition can support thyroid function, help individuals lose weight, improve energy levels, and potentially reduce other hypothyroidism symptoms.


6. Are ketones good for thyroid health?

Yes, ketones provide a steady energy source, reduce inflammation, and calm the sympathetic nervous system, all of which benefit thyroid health.


7. Can I do fasting with hypothyroidism?

Yes, fasting can be beneficial for those with hypothyroidism, as it helps reduce inflammation and supports balanced immune responses. 


However, it’s crucial that those with hypothyroidism discuss fasting with a medical professional to ensure it suits their individual health needs.



Source


  1. https://pmc.ncbi.nlm.nih.gov/articles/PMC9165850/
     

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