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February 25, 2023 10 min read

For many years, the debate of whether or not to include carbs in our diets has been a hot topic. With low-carb diets becoming increasingly popular in recent years and promising quick results, it's no wonder why many people with hypothyroidism try cutting out carbs in an effort to lose weight. But is it really good for your thyroid health?

When it comes to the relationship between carbs and hypothyroidism, things can get confusing. As it turns out, low-carb diets aren't always the best choice if you have an underactive thyroid. That's right – despite the bad rap carbs often get,this macronutrient is actually beneficial to your thyroid health

Let's dive into the connection between thyroid health and carbohydrates and why you need to eat more carbs than you think.

Carbs 101

Carbohydrates, often called carbs, are the main source of energy that keeps your body's cells, tissues, and organs running properly. Your digestive system breaks them down into blood sugar or glucose, which is absorbed by your bloodstream and used to fuel your body. Glucose can be used right away or kept in the liver and muscles for later use when needed.

Along with protein and fats, carbs are macronutrients – nutrients your body needs in larger amounts in order to stay healthy. 

You can find carbohydrates in a wide range of foods, both healthy and unhealthy, such as beans, bread, cookies, corn, and milk. However, they are often grouped into three types: sugars, starches, and fiber. Sugars are often called simple carbohydrates, while starches and fiber are complex carbohydrates.

Simple carbohydrates digest quickly in the body. This means they provide a quick burst of energy but can cause blood sugar levels to spike if consumed in excess. Complex carbohydrates, on the other hand, take longer to digest, so they don't cause blood sugar levels to rise as quickly or drastically as simple sugars do. They also contain more nutrients, such as vitamins and minerals, so they provide your body with more sustained energy throughout the day.

Are low-carb diets really good for thyroid health in the long run?

A low-carb diet is just what it sounds like – a dietary plan that limits the amount of carbohydrates you consume. It focuses on foods high in the other two macronutrients, protein and fat.

Going low on carbs is a popular way to lose weight because it helps shed stored fat. However, the quick weight loss comes at a cost. It suppresses your resting metabolism in the long run, breaks down your own tissues, burdens your liver, and puts stress on every cell in your body. This happens because when your body is low in carbohydrates, your blood sugar levels drop. According to Ray Peat, Ph.D., decreased blood sugar is a basic signal for the release of adrenal hormones. 

Here's how:

The drop in blood sugar level causes your body to get stressed and turn to backup fuel sources so it can make up for the lack of energy. Two processes help make this happen. The first one is called lipolysis. It happens when an adrenal hormone called adrenaline, along with other lipolytic stress mediators, signal your body to release fatty acids from stored fat. This way, your body uses the stored fat for energy, leading to weight loss.

The second process is called gluconeogenesis, a process by which your liver converts non-carbohydrate sources, such as acids from proteins, into glucose. This process is necessary to maintain healthy blood sugar levels and fight inflammation. Cortisol, another adrenal hormone, stimulates this process. It's also released in response to the stress your body is experiencing.

Excess adrenaline and cortisol can have a negative impact on your thyroid

Adrenaline and cortisol are important hormones in your body, but too much of a good thing can be bad. This is why while going low carb can initially help you lose weight and make you feel better, it can leave your thyroid gland worse off than before.

It's worth noting that hypothyroid patients usually have problems with storing carbohydrates in the liver. After taking a dose of thyroid hormone replacement medication that contains T3, such as natural desiccated thyroid (NDT), your body will instantly increase the demand for glucose. Therefore, you'll need to consume foods that are high in carbohydrates within at least an hour after you take your medication. If you don't get enough carbs in your food, your body will quickly experience the lipolysis and gluconeogenesis processes.

The effects of excess adrenaline and lipolysis

Lipolysis, the process where fatty acids are released from stored fat, often results in the release of polyunsaturated fatty acids (PUFAs). This can suppress your thyroid and its ability to regulate your metabolism. PUFAs may also cause water to accumulate in your cells and make you look "puffy."

High levels of adrenaline can make your heart race, increase your blood pressure, and make you sweat more than normal. It can also cause insomnia, nervousness, tingling, anxiety, dizziness, and shakiness. Over time, excess adrenaline can increase your risk of a stroke or heart attack. 

Sometimes, high adrenaline levels are confused with hyperthyroidism. This misdiagnosis may lead your doctor to lower your thyroid hormone replacement medication. Some doctors may also give you medications for blood pressure,such as Propranolol to combat the symptoms of high levels of adrenaline. 

These medications work by blocking the effects of adrenaline, which may provide temporary relief. However, the root cause of the problem, excess adrenaline, can be easily solved by incorporating more nutritious carbohydrates into your diet. Moreover, taking blood pressure medications like Propranolol can have negative long-term effects for those with hypothyroidism, as these medications may have slight antithyroid properties.

High adrenaline, digestion, and liver

Adrenaline has the ability to slow down or even stop your digestion. Thus, it can lead to problems with the absorption of nutrients and elimination of waste. This can result in the buildup of harmful substances in the gut, known as endotoxins. When these toxins are not eliminated, they can enter the bloodstream and cause a range of health problems, such as decreased immune function, inflammation, and oxidative stress.

Your liver plays a vital role in keeping your body healthy by eliminating harmful substances. When there are too many endotoxins, it has to work harder to detoxify them. But it’s not just the endotoxins; high adrenaline levels can also burden your liver. This is because your liver is responsible for balancing and removing the hormone from your body, so when there’s an excess of it, your liver has to work extra hard. If this goes on for too long, it can stress and damage your liver.

And if your liver is under stress or has been damaged, the process of converting T4 (an inactive thyroid hormone) to T3 (an active thyroid hormone) may be hindered, leading to a further imbalance of thyroid hormone. This will cause you to feel a lot worse. In fact,a study has shown that cutting back on carbs significantly decreased the conversion of T4 to T3.

The effects of excess cortisol and gluconeogenesis

One of the key effects of cortisol is to make you more insulin resistant. This is a survival mechanism that helps your body conserve its limited supply of carbohydrates. Cortisol also works to convert both the protein in your food and in your tissues into carbohydrates through a process called gluconeogenesis. This is because when carbohydrates are in short supply, your body needs to find a way to stop digesting itself too quickly.

If the tissues used to make carbohydrates contain amino acids cysteine or tryptophan, your thyroid can get suppressed even further. Tryptophan, in particular, is likely to be converted into serotonin, which lowers metabolic efficiency and further increases cortisol, perpetuating a state of stress, inflammation, and edema. Your body may slow the metabolic rate during chronic stress, so it doesn't run out of fuel sources too quickly in emergency situations. 

Excess cortisol itself can impact your body negatively. For example, it decreases immune function, contributes to belly fat and thinning skin, leads to loss of muscle (your metabolic motor), and affects bone health.

Other side effects of low carbs diet on your health

High levels of adrenaline and cortisol may accelerate aging

Adrenaline and cortisol are hormones produced in response to emergency situations. When adrenaline and cortisol are at balanced levels, they promote the production of anti-aging hormones like DHEA, T3, progesterone, and pregnenolone. Aside from slowing down your aging process, these hormones also improve the optimal functioning of your immune system, digestion, and detoxification processes.

On the other hand, when the body is low on carbohydrates, adrenaline, and cortisol levels can become elevated, and these hormones may be used more frequently to provide energy to the cells. Overuse of these hormones can place a strain on the body and potentially accelerate the aging process.

Insulin resistance can still occur even if you eat 0 carbohydrates

Insulin is a hormone produced by the pancreas that helps regulate blood sugar levels by allowing glucose to enter the cells for energy or storing it in the liver and muscles for later use. Limiting carb intake is believed to reduce the amount of insulin circulating in the body, helping people reduce insulin resistance. But this is not always the case. 

Your body will still produce insulin even if you eat 0 carbohydrates. This is becauseprotein is insulinogenic, which means that it stimulates the release of insulin. Moreover, consuming a diet low in carbohydrates and high in protein can lead to increased levels of insulin. 

It's important to note that high insulin levels increase the demand for glucose. If this demand is not met, it can cause a stress reaction leading to spikes in cortisol and adrenaline, which, again, can cause damage to internal organs over time. 

The belief that carbohydrates are solely to blame for insulin resistance may not be entirely accurate. In the past, Southeast Asians regularly ate large amounts of rice at every meal, yet still had low instances of diabetes. However, as they began consuming more meat and fried foods (fried in PUFA-rich oils), the incidents of diabetes rose. This suggests that other factors aside from carbs may play a role in the development of insulin resistance.

Oxidation of large amount of fat suppress oxidation of sugars (the Randle Cycle)

The Randle Cycle, also known as the glucose fatty acid cycle, refers to the competition between fat and sugar metabolism in the body. When there’s a high amount of fat in your blood, it may suppress the oxidation of sugar. This leads to problems like diabetes, heart failure, and aging. If your body has enough sugar, on the other hand, it may suppress the oxidation of fat.

Supporting sugar oxidation and avoiding excessive fat metabolism is important in order to prevent or treat age-related diseases. Moreover, estrogen and stress have the ability to increase the levels of free fatty acids in the blood, causing a negative impact on your body and leading to various degenerative diseases. To avoid these negative effects, a balanced diet is important as it can improve glucose oxidation by lowering the amount of free fatty acids in your body.

The further suppression of glucose oxidation is why low-carb diets can be harmful for hypothyroid patients.

Production of sex hormones suffers without enough carbs

Without enough carbohydrates in your diet, your body won’t be able to produce certain sex hormones, such as progesterone and testosterone. This can result in hormonal imbalances that can negatively impact your health, such as reducing libido, decreasing muscle mass, and increasing the risk of various health conditions. Moreover, low levels of hormones like progesterone and testosterone can disrupt the delicate balance of hormones in your body, which contribute to the development or the worsening of hypothyroidism.

It's not always how much carbs you eat, but what type of carbs you choose

For many of us, our health is a top priority. In the pursuit of good health, many have turned to low-carb diets as a weight loss solution. But for those struggling with hypothyroidism, these restrictive diets may actually be doing more harm than good. As explained above, low-carb diets could have serious side effects on thyroid health in the long term. Therefore, these diets might not be the best option for hypothyroid patients in need of a healthy and sustainable diet plan.

So what should you do if you want to lose weight and keep your health in tip-top shape?

Well, when it comes to getting into shape without compromising your thyroid health,the type of carbs you eat matters more than the amount. Not all carbs are created equal; some will provide more benefits than others. 

Experts usually divide carbs into "good" and "bad."The good ones—like oats, sweet potatoes, legumes, and whole grains like brown rice—are the kind that your body needs and loves. 

On the other hand, bad carbs are those refined carbohydrates like white bread and pasta that aren't doing your health any favors. These bad carbs are digested quickly, spiking blood sugar levels and triggering the release of stress hormones like cortisol and adrenaline. 

But here's the thing: Good carbs don't just taste better; they also help you stay fuller for longer because they take their sweet time to digest. This means that when you munch on them instead of a few slices of white bread or a muffin with your morning coffee, you're less likely to feel the need for an afternoon snack attack.

Avoid ultra-processed foods

If you want to reduce your bad carbohydrate intake, the first thing you want to cut out is ultra-processed foods. These include cookies, white bread, pastries, and candy. You might also want to avoid beverages sweetened with high fructose corn syrup (HFCS), such as sodas. These foods are high in undisclosed starches and highly fattening, making them a major contributor to weight gain and insulin resistance. Plus, they increase your risk of diabetes and heart disease.

Sweet, ripe fruits are the best source of carbohydrates

The healthiest sources of carbohydrates are unprocessed or minimally processed fruits, vegetables, and whole grains. Not only do they promote good health by supplying your body with vitamins, minerals, and fiber, but they are also a host of essential phytonutrients.

However, for people with hypothyroidism, starchy veggies, and grains are often difficult to digest and could cause bloating. Overconsumption of fiber or any indigestible carbohydrates like vegetables might ferment in the intestines, leading to the production of serotonin and harmful toxins (endotoxin) by gut microorganisms. These toxins then place added stress on your liver, which is tasked with removing them. Again, when the liver is overwhelmed with extra work, it may not properly convert T4 into the active thyroid hormone T3, leading to a worsening of symptoms of hypothyroidism

Therefore, the best source of carbohydrates for people with hypothyroidism is sweet, ripe fruit that is easy to digest. Additionally, fruits provide many of the same vitamins found in vegetables.

A balanced diet is the answer

Controlling carbohydrates through a low-carb diet may seem like an attractive option to many hypothyroid patients. But it’s better to eat meals with carbohydrates, protein, and a little bit of saturated fat as it will help slow digestion and gently release energy. Some people may also feel better with some starch in their meal, such as white rice.

In addition to a well balanced diet, daily intake of thyroid hormone replacement like VitaliThy, a natural desiccated thyroid you can buy online, is the real answer to help you lose weight, feel energetic, and live a healthy life with hypothyroidism.

Wojciech Majda
Wojciech Majda

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