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Keto Diet and Hypothyroidism

How does the keto diet impact hypothyroidism?
Keto Diet and Hypothyroidism
Last updated:
4/23/2024
Medically Reviewed by:

The Big Picture

In this article

With so many different diets available for hypothyroidism and general health, it can be hard to navigate which one is best. 

It's critical to remember that each of us is unique with individual sensitivities, and there is no "one size fits all" method of eating. Work with a knowledgeable, trustworthy care team to create a personalized meal plan for your thyroid, including modifications for food sensitivities and your health conditions. 

Ahead, what is the keto diet, and what can it do for your health?

What is a ketogenic diet?

A keto or ketogenic diet is a low-carb, moderate protein, higher-fat diet designed to help you burn fat.

When we consume more carbs than needed for our body mass, our body produces glucose and insulin for energy. Once all energy needs are met, the body stores what's remaining as fat. Too much glucose available in the body can lead to insulin resistance, meaning that the body stops clearing the glucose and blood sugar from the body. 

The thinking behind a keto diet is that while you eat far fewer carbs, you maintain moderate protein intake and increase your fat intake. This reduction in carbohydrates puts your body in a metabolic state called ketosis.

Ketosis is a metabolic state that is characterized by elevated levels of ketones in the body. When you don't have enough insulin in your body to turn sugar into energy, the liver produces ketones from fat. These ketones, a type of acid, then serve as a fuel source for the body and the brain.

On a ketogenic diet, it becomes easier to access your fat stores to burn them off. 

Is a keto diet safe for hypothyroidism?

Thyroid hormones play a significant role in glucose metabolism. So, while it's generally advisable to cut down on carbs, too little insulin can impair the liver's ability to convert the inactive thyroid hormone thyroxine (T4) to the active form triiodothyronine (T3). 

Another concern for hypothyroid patients may be that when the body remains in ketosis too long, accumulated acidity can lead to inflammation. Many people with hypothyroidism already struggle with chronic inflammation, and adding an overly acidic diet can be like adding gasoline to a fire. 

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Modified keto diet for hypothyroidism

The keto diet does offer many benefits, but as mentioned, there is no "one-size-fits-all" solution. With some modifications, the keto diet may be helpful for you. 

Combine anti-inflammatory diet with a keto diet

Leafy green vegetables are great for reducing inflammation and assisting the body in becoming more alkaline. Besides adding them to each meal, consider adding kale, spinach, and other leafy greens to smoothies. Increasing Omega-3 fatty acids and vitamin D will also help with reducing inflammation in the body.

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Identify dietary triggers

The more dietary stress you put on yourself, the more likely you are to experience inflammation that worsens your autoimmune reactions or interferes with your thyroid function. The most common culprits are gluten, dairy, soy, eggs, corn, nuts, shellfish, and preservatives. Understanding your nutritional triggers will help you know the best method of eating for you.

Increase water consumption

Drinking water has a considerable impact on your weight, energy, mental clarity, and whole-body health. Aim for half of your body weight (pounds) in ounces of water every day. And if you have a coffee, alcohol, or sweat for 30 minutes, have an extra 8-ounce glass. 

Improve stress management

Stress affects thyroid function. When the body is stressed, the adrenal glands produce cortisol. Studies suggest that elevated levels of thyroid-stimulating hormone are associated with high levels of cortisol. Cortisol, along with other stress hormones glucagon and adrenaline, work together to increase blood sugar levels. High blood sugar levels may interfere with entering a state of ketosis. Consider daily stress management techniques like eating a healthy thyroid diet, getting adequate sleep, connecting with people who are important to you, and finding ways to relax. 

Reduce environmental toxins 

Endocrine disruptors are chemicals that interfere with the hormone systems and may cause adverse developmental, reproductive, neurological, and immunological effects. Something to consider for your diet is that conventional produce is sprayed with numerous pesticides and herbicides that may affect your hormone balance.

Consider the health benefits of intermittent fasting 

Fasting intermittently on a ketogenic diet may offer some health benefits and metabolic improvements. Talk to a trustworthy doctor to determine if intermittent fasting is safe for you.

A note from Paloma Health

As with any diet, you should discuss the best options for your health with your doctor and nutritionist. Work with a thyroid nutritionist to find the right solution for you.


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Julia Walker, RN, BSN

Clinical Nurse

Julia Walker, RN, BSN, is a clinical nurse specializing in helping patients with thyroid disorders. She holds a Bachelor of Science in Nursing from Regis University in Denver and a Bachelor of Arts in the History of Medicine from the University of Colorado-Boulder. She believes managing chronic illnesses requires a balance of medical interventions and lifestyle adjustments. Her background includes caring for patients in women’s health, critical care, pediatrics, allergy, and immunology.

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