Ketogenic Diet and Thyroid Hormones

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I don’t really pay much attention to the ketogenic niche out there on the internet, or the low carb one for that matter.  Once in a while though someone gives me a link to an article preaching or defending this dietary practice, and some of them are quite amusing.

Yesterday one of my readers shared this one, from a keto blogger, and this one honestly is quite a piece of work.  There are some people who are drunk with ketogenesis, some more so than others, and it also seems that they will go to any length to look to defend their beloved way of eating, even well beyond what is necessary.

So one of the things that some people worry about is the way that a ketogenic diet, and to a lesser extent a low carb diet, downregulates thyroid function.  This very often isn’t a concern, if one’s thyroid metabolism is fine to start with, and this often allows them to tolerate the downregulation and stay within acceptable limits.

Proper thyroid function is very fundamental to one’s health and even feeling well and when this is off, you can certainly tell, and it will present itself with some rather obvious symptoms.  Even if one already is seriously afflicted with this, one will notice getting worse when one gets worse.

We know that low carb diets can reduce thyroid function, even our friend admits that, but some people see such things as an attack upon their fort and their passion in defending it may know no bounds,  and I’ve read some pretty silly things said here, but this one is a real jaw dropper actually.

We can learn from the most ridiculous things though, so I picked this article to do a blog post about even though it’s pretty absurd.  It’s written by an internet blogger who says she is just presenting her thoughts and allowing us, her readers, to judge for ourselves, so that we shall do.

If I were defending the ketogenic diet, I would simply state that decreased thyroid function is often not perceived as an issue by the user, and this is the sort of thing that does present itself rather clearly.  There is not a diet that is one size fits all, some strategies of carb reduction will work better for some rather than others, and we must always look to individual performance to judge them.

So we may come up with certain definitions and guidelines, this is what a ketogenic diet is, and so on, and one may try these diets, but one must also seek to find what’s best for them.  Some people may find that a ketogenic diet does not make them feel their best and may make them feel rather unwell.  This is not when we want to say, damn the torpedoes, if the idea is better outcomes and we see worse outcomes, unless we are idiots, we will seek to adjust our strategy to come up with one more suitable.

At one time I put myself on a ketogenic diet for several months, and it turned out pretty ugly.  I did stay the course for a lot longer than I should have, but I wanted to be sure this wasn’t for me.  In the end I became painfully sure it wasn’t.

One of the classic symptoms of low thyroid function is the loss of the outer third of your eyebrows.  I ended up losing the outer two thirds.  My other thyroid symptoms all got a lot worse, I was so weak it wasn’t funny, standing up for more than a few minutes was more than I could handle.

My TSH was perfect by the way although that’s only one thing to look at here, our thyroid gland can function exactly as it should but there can be problems downstream.

Many people were convinced I was dying, and I felt like it as well.  I eventually said Uncle and got off of this and adjusted my carbs up, and got a lot better.  I still practice carb restriction but a lesser form.  So I’ve experienced the dark side of the ketogenic diet, but I still encourage anyone who wants to try this to give it a go, because it does work with some people and there’s only one way you can know if it is for you or not.

So let’s have a closer look at this article.  She starts out by claiming that we can’t say that ketogenic diets cause hypothyroidism because it is defined as a lack of hormonal secretion by the thyroid gland, and all that happens with ketogenic diets is that your free T3 goes down.  So this isn’t hypothyroidism.

The first question we should be asking her, if we could, is why does it matter if our thyroid gland undersecretes?  Is it a bad thing in itself, the only bad thing, to have low levels of the inactive form of thyroid hormone, or is the concern that this will lead to lower levels of the active form?

So how is it even possible that levels of the active form, T3, do not matter? This is where her argument leads, and when we get there, sure enough this is what she claims.  Not only does low T3 not matter, it is desirable in her mind, as low as you can go it seems.

You can indeed look up hypothyroidism and see it defined as a problem with the gland itself, undersecretion.  However, this is only a problem because you end up with reduced thyroid metabolism.  Thyroid hormone actually does its work in the cells, so when you have reduced cellular function of it, that’s called something, and it not only matters but it’s the only thing that matters.

Now we don’t want too much T3 entering our cells either, and the body has several protective mechanisms for this, binding up T4, not converting T4 to T3, and also converting T4 to an inactive form of T3 called reverse T3, and this is all to protect us from getting too much T3.

In the end though, we also need enough, and when something goes wrong along the way, and the body may adjust for a number of reasons, that’s your dysfunction right there, T3, at the cellular level.

This is where our metabolism gets overregulated, with too much, underregulated, with not enough, or gets the right amount of regulation.  This is a lot like the Goldilocks story, and all hormones work that way, we need them in a fairly tight range or there will be problems, being too high or too low.

So hypothyroidism is indeed a lack of free T3.  Some distinguish this as primary hypothyroidism, issues with secretion, or secondary, issues with conversion, but it doesn’t matter.  I prefer the term thyroid hormone dysfunction to describe all of it, to avoid any confusion.

So if someone has issues on the low side of this already, and further reduces thyroid metabolism, well that’s called worsening a disease, and you want to improve diseases, not worsen them.

She points out that symptoms can be confounded, and this is certainly true, however one can just do a basal temperature test, and if you flunk that, no matter what else is going on, your thyroid metabolism is dysfunctional.

If one gets undesirable symptoms consistent with low thyroid function from a ketogenic diet, and they persist past what is considered to be the adaptation period, one has not adapted, one is not doing well, and it does not even matter why.

Within the normal range, lower T3 may be associated with longevity, but not so much when one suffers from a disease state.  To suggest that we look to lower T3 as much as possible because it’s healthy to do so is one of the all time gaffes, right up there with the most ridiculous things ever said about human health that has come out of the mouths of conventional practitioners, such as the body has spare parts that we don’t really need, they are spare because we haven’t looked into what they are for, like the appendix.

It is only prudent to approach low carb dieting with some degree of prudence, and not just look to join a cult, and give thanks to the masters and persevere no matter how bad this may make you feel, that’s just plain stupid.  At least her article is a step up with what they usually do, which is to pretend this stuff never happens, and if you keep the drapes closed all the time and stay inside, the sun will never be too bright for your eyes I guess.

It’s really a shame that some keto worshippers go too far with their claims, as this has worked out to be a fabulous diet for many people, although I don’t really think that the ketosis part is really necessary, taking low carb to such extremes.  However if one feels great on this, who is to argue.  If people do not, if they feel worse, that surely can’t be the goal.

So this does bear paying attention to in spite of any drunken reasoning that may be out there to claim otherwise.

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