Keto and Hypothyroidism

Newcomer introductions, personal anecdotes, caregiver issues, lab results, and n=1 experimentation.
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Yobetty
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Keto and Hypothyroidism

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Last summer, I decided to double down on the keto. Went very low carb, high'ish fat consumption. Didn't really change my protein intake. Overnight fasting stayed the same - 12 to 14 hours. I started feeling sluggish, overwhelmed, and moody by the end of the summer. I attributed it to stress related to the final stages of building a new house. I was due for routine labs in early Oct. My doctor's office called me the next week and said the doctor wanted to speak to me right away - always a bit disconcerting. My thyroid had crashed - the worst it's been since I learned I had a thyroid issue ~25 years ago. Neither of us had any idea why it happened. Fast forward to January - thyroid hormone levels were corrected, but I still had very low energy. So, I started researching. I found that our liver, which converts T4 (the storage form of thyroid hormone) to T3 (the usable form of thyroid hormone), needs glycogen to do the conversion of T4 to T3. Essentially, with no glycogen present in my liver, I had no way to access the thyroid hormone I take. It's like putting a crimp in the gas intake for your car engine. You may have a full tank, but your engine is just not going to run. I did feel a little better, but there was something obviously still wrong.

I corrected this by drinking a couple of ounces of orange juice at night before bedtime and again in the morning 30 minutes after taking my thyroid meds. I also started eating more carbs - like strawberries, sweet potatoes, small servings of legumes (pressure cooked to avoid lectins).

OK - here's my dilemma. How do I achieve any level of keto without risking a thyroid crash? I just cannot wrap my head around this. I am due for a checkup with my doctor in May and we'll discuss it in depth at that time, Meanwhile, I'd love to hear from anyone who has solved this for themselves or who may have helpful ideas.
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Julie G
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Re: Keto and Hypothyroidism

Post by Julie G »

Welcome, Yobetty! Many of us use a low carb approach (combined with fasting & exercise) to create ketones without experiencing a thyroid "crash." I assume that you're using ketosis for brain and overall health? If so, are you measuring your BHB? I can eat a pretty high number of carbs and still be in ketosis because I fast for a very extended period. By testing you can find your sweet spot.

That said, it is normal for thyroid function to decrease a bit with a low carb approach. BHB is a cleaner burning fuel than glucose. When using that as your primary source of fuel, your "engine" simply idles more slowly because it's easier to burn. Because of this slow down, I began using a very small dose of a natural thyroid medication for a while. I recently started low dose naltrexone (for my immune system) and my thyroid function completely normalized. It's a known side effect. Some people take it specifically for that reason. Have you ever had your thyroid antibodies tested to rule out Hashimoto's? Many folks use LDN for that too. Just a thought.
mike
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Re: Keto and Hypothyroidism

Post by mike »

Yobetty wrote:I corrected this by drinking a couple of ounces of orange juice at night before bedtime and again in the morning 30 minutes after taking my thyroid meds.
This will knock you straight out of ketosis. OJ is the suggested remedy for low blood sugars for diabetics who go too low. It is pure sugar. It will also spike your insulin levels, which is not great for ADs. Instead of extra fat, you might try upping your protein...
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Yobetty
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Re: Keto and Hypothyroidism

Post by Yobetty »

Julie G wrote:Welcome, Yobetty! Many of us use a low carb approach (combined with fasting & exercise) to create ketones without experiencing a thyroid "crash." I assume that you're using ketosis for brain and overall health? If so, are you measuring your BHB? I can eat a pretty high number of carbs and still be in ketosis because I fast for a very extended period. By testing you can find your sweet spot.

That said, it is normal for thyroid function to decrease a bit with a low carb approach. BHB is a cleaner burning fuel than glucose. When using that as your primary source of fuel, your "engine" simply idles more slowly because it's easier to burn. Because of this slow down, I began using a very small dose of a natural thyroid medication for a while. I recently started low dose naltrexone (for my immune system) and my thyroid function completely normalized. It's a known side effect. Some people take it specifically for that reason. Have you ever had your thyroid antibodies tested to rule out Hashimoto's? Many folks use LDN for that too. Just a thought.
Hi Julie - thanks for the reply. I do have Hashimoto's and have been on LDN (4.5) for a while - several years. It has taken my antibodies down from ~750 to ~50. Because of this, I had a hunch it was something other than the autoimmune condition or an immune response. Thus, the confusion on my part - what could crash my thyroid if not for an immune issue? This is why I dug into other things. My TSH was 12.5, so this was a significant change after years of relative stability - it was real and not borderline.

Great explanation for the metabolic slow down. I've wanted to avoid that at all costs, but I can see where it may be a reasonable expectation. I have not measured my BHB. Admittedly, I've been "winging it" and I've probably known better. I will add this to my list of things to explore as I figure out (with my doctor) on how to move forward. She is not a fan of extreme diets of any kind, so she would certainly agree with you to continue to eat carbs - especially the nutrient dense ones. I'll make sure to discuss expectations of metabolic changes based on MILD ketosis with her (I won't go to the extreme end of that again).

Thanks for your input. I really appreciate it.
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