Are carbs good for Hashimotos?
The Benefits of a Lower Carbohydrate Diet for Those with Hashimoto’s
What effect does diet have on thyroid autoimmunity? We look at a study that observes the beneficial effects of a lower-carbohydrate diet in overweight patients with Hashimoto’s thyroiditis.
If you need help with thyroid autoimmunity, click here
The Benefits of a Lower Carbohydrate Diet for Those with Hashimoto’s
The thyroid is one of the metabolism-regulating glands. Its function is to determine the number of calories the body has to burn to maintain normal weight.
Thyroid autoimmunity is when your immune system attacks your thyroid gland. Over time, as the damage worsens, it can lead to hypothyroidism.
Today, Hashimoto’s disease is the leading cause of hypothyroidism in most countries throughout the world. It is more common in women, and its incidence increases with age. Hashimoto’s thyroiditis, an acute immune condition (aggression of the thyroid gland by the body’s own immune system), generally tends to evolve toward hypothyroidism.
In the vast majority of cases, Hashimoto’s thyroiditis has an insidious onset, and thyroid hormone levels usually remain within the normal range at first, with the first symptoms appearing only after the disease has progressed toward overt hypothyroidism.
In patients with Hashimoto’s thyroiditis, anti-thyroid peroxidase antibodies (TPO Abs) are usually detectable, while a minor percentage of patients also have anti-thyroglobulin antibodies.
A recent study evaluated the effects of diet on thyroid autoimmunity. Specifically, researchers looked at a group of overweight subjects with thyroid autoimmunity and the effect of following a lower-carbohydrate diet. This was not an ultra low-carb diet, but more of a moderately low-carb diet.
The study enrolled a total of 180 patients: 84 males and 96 females, aged 30 to 45 years. Hashimoto’s disease was detected in all of the subjects. Additionally, each patient showed other autoimmune symptoms typical in Hashimoto’s disease. All the patients were monitored weekly.
The experimental group, which consisted of a total of 108 patients (44 males and 64 females), started a diet program based on the following proportions: 12% to 15% carbohydrates, 50% to 60% proteins, and 25% to 30% lipids.
These patients were instructed to eat large leafy and other types of vegetables and only lean parts of red and white meat, avoiding goitrogenic food. The following items were also excluded from the diet: eggs, legumes, dairy products, bread, pasta, fruits, and rices.
This protein-rich diet plan was implemented for 3 weeks. At the end of the 3 weeks, bioimpedance tests, body weight measurements, and blood tests were performed.
The remaining 72 patients (40 males and 32 females), who made up the control group, followed a simple, low-calorie diet without restrictions regarding the type of food to consume, but adhered to the recommended dietetic allowances, as suggested by the National Research Institute on Food and Nutrition. After 3 weeks, the same tests were performed in this group of patients as those performed in the treatment group.
Patients on the low-carb diet saw significant reductions of anti-thyroid, anti-microsomal, and anti-peroxidase markers. Most notably, the decrease in TPO antibodies was 44%. TPO is the most important marker for thyroid autoimmunity. Additionally, a reduction in body weight of 5% and a reduction in BMI of 4% were observed over the 3-week period. The untreated patients in the control group saw an increase of these thyroid markers.
A dietary plan based on the reduction of carbohydrate content and free of goitrogenic foods leads not only to a decrease in body weight, but also determines a decrease in fat mass and a significant drop of autoantibodies in those with Hashimoto’s thyroiditis.
Goitrogenic foods
Goitrogenic foods contain substances that may interfere with iodine metabolism. These substances (known as goitrogens) are found especially in products of the cruciferous family (rapeseed or canola, cabbage, turnip, watercress, arugula, radish, horseradish) and in milk produced by cattle nourished with these vegetables. Other goitrogens include soy, spinach, millet, tapioca, and lettuce. These foods can prevent iodine uptake by the thyroid gland and induce iodine deficiency, which can cause hypothyroidism.
Why is a lower-carbohydrate diet helpful?
One reason could be that when you cut out carbs, you typically cut out most gluten-containing food. We know that gluten can be a trigger for several autoimmune conditions, including thyroid autoimmunity.
Another reason could be that patients experience improved metabolic health when they reduce carbohydrate intake.
The concern of low-carb diets damaging the thyroid is invalidated as observed in this study. When people change the way they eat, they may see a shift in some thyroid levels, but that is just the body getting adjusted. There’s no thyroid damage being done. It’s simply an adjusting of hormones, and if anything, a lower-carbohydrate diet may be healthier for your thyroid gland.
By simply restricting common sources of dense carbohydrates, like breads, cereals, rices, and fruits, you can have a positive impact on your thyroid autoimmunity.
To discover more about low-carb diets and thyroid autoimmunity, click here for a short video.
If you need help with thyroid autoimmunity, click here
What do you think? I would like to hear your thoughts or experience with this.
Discussion
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Does Thyroid Medication Interfere with Ketosis?
Learn what you need to know about eating a keto diet if you take thyroid medication for hypothyroidism.
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Last updated:
1/21/2022
Written by:
Julia Walker, RN, BSN
Medically Reviewed by:
Kimberly Langdon M.D.
In this article:
- What is ketosis?
- Potential problems with the keto diet and thyroid conditions
- How does a ketogenic diet interfere with thyroid medication?
- How to use a modified keto diet for hypothyroidism
The ketogenic diet has become a buzzworthy diet in the past few years. One of the biggest successes of the keto diet is that it can help many people lose weight. For others, it has helped boost energy levels, improve cholesterol levels, and control blood sugar. However, like all diets, it is essential to talk to your doctor before trying keto, especially if you have a thyroid condition like hypothyroidism. Here’s why.
What is ketosis?
Ketosis is a metabolic state characterized by the presence of elevated ketones in your bloodstream. People can achieve a ketogenic state by severely restricting carbohydrate intake. Carbohydrates break down into a quick, useable form of energy called glucose. The digestive system pulls glucose from our food to fuel our cells. However, when we do not have enough carbohydrates to support cellular energy needs, the liver produces ketones from fat, serving as a fuel.
The ketogenic diet helps you enter a state of ketosis by limiting the amount of carbohydrates you eat. Instead, you get fuel from foods higher in fat content (like avocados) and moderate protein intake.
Eating too many carbohydrates causes your body to store unused glucose as fat. Additionally, it can also lead to insulin resistance, one of the biggest causes of type 2 diabetes and obesity.
People can see if they are in ketosis by testing their urine or blood for ketones. If you are positive for ketones, that means you are burning fat and producing less glucose. Ultimately, less glucose means you are also producing less insulin, which can be good and bad for people with a thyroid condition.
Potential problems with the keto diet and thyroid conditions
Keto diets can offer tremendous benefits for people with thyroid conditions. However, there are some concerns that you should be aware of if you are considering this diet and are taking thyroid medication.
Firstly, a reduced amount of insulin may affect your ability to convert the inactive thyroid hormone thyroxine (T4) to the active thyroid hormone triiodothyronine (T3). This conversion occurs in the liver and is necessary because it turns the thyroid hormone into its active form. When insulin levels are too low, it can inhibit the liver’s ability to convert T4 to T3, thus reducing the availability of usable thyroid hormone in the body.
Secondly, prolonged ketosis can force the body to accumulate acid, which can spur inflammation. Most people with thyroid diseases already suffer from chronic inflammation, especially if they have Graves’ or Hashimoto’s disease—two thyroid conditions caused by autoimmune processes.
Because of these two primary concerns, people with thyroid conditions who try the keto diet sometimes struggle with worsening thyroid-related symptoms like a Hashimoto’s flare-up. They may also be more prone to side effects like the keto flu, a cluster of flu-like symptoms that some people experience within the first few weeks of eating a keto diet.
Furthermore, it can be harder to regulate thyroid hormone levels, especially when you are just getting started on the diet.
How does a ketogenic diet interfere with thyroid medication?
Most people with a thyroid condition like hypothyroidism require thyroid medication to help normalize thyroid hormones. It takes several weeks to months to find the correct dose of thyroid medication for each individual. Once you find the correct dose, it is essential to stick with it unless certain factors change in your body, such as having significant weight changes or starting a new diet.
Because ketosis can decrease your liver’s ability to convert T4 to T3, some people find their thyroid hormone levels change even when they take thyroid medication. Also, because inflammation may worsen with ketosis, you may feel unwell unless you make changes to your medication regime.
People taking thyroid medication should never make changes to their dose or the type of medication they are taking without consulting their doctor first.
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