(re-)started keto ... feeling great but blood test shows 9 TSH - continue?

(Joey) #21

Well put.

But I too shall read the link as we all keep open minds, live and learn.

In particular I’d want to understand how eating carbs might help lower cortisol in any healthy way?! Based on a quick glimpse at the paper cited above, it doesn’t seem to touch on that presumption.

(Bacon is a many-splendoured thing) #22

If eating carbohydrate were an effective treatment for hypothyroidism, then surely all those people following the dietary guidelines would have healthy thyroids, lol!

(Bacon is a many-splendoured thing) #23

I just looked up iodine on WebMD. It says that animal foods, eggs and liver in particular, are the best sources of iodine.

Although I’m not sure how trustworthy the article is, because there is a line in it, stating that because the body cannot manufacture iodine, it is therefore an essential micronutrient. Since the human body is not a nuclear reactor, that is equally true of every other element the body needs.

I wonder, since our body can’t manufacture arsenic, either, does that make arsenic an essential micronutrient, too? Also, so far as I know, the body can’t manufacture sucrose, either, which must be why people seem to feel they need to supplement with such large quantities.

(Joey) #24

Love this. Epidemiology in action!

(Betsy) #25

Check here.


Right, Chris Kresser - see my citation from Tucker Goodrich below.

Source Dr. Dominic D’Agostino:

"When the body senses low thyroid hormone levels, the hypothalamus will release Thyrotropin Releasing Hormone (TRH) to stimulate the release of Thyroid Stimulating Hormone (TSH) from the pituitary gland. TSH binds to the thyroid gland, and stimulates the release of thyroxine (T4; inactive thyroid hormone); TSH is in control of circulating levels of T4…

“Carbohydrate-restriction and the ketogenic diet can cause a drop in active thyroid hormone (T3), when calories are restricted and even when calories are kept at maintenance. However, a drop in T3 does not automatically mean you have an under-active thyroid or that you are on the path to hypothyroidism. Hypothyroidism is characterized not only by a drop in T3 but a drop in resting energy expenditure/metabolic rate, abnormally high TSH levels (body’s way of asking for more T4, to make more T3), and abnormally low T4 levels…”

Source Stephen Phinney Virta Health

"… reduction in active thyroid hormone (called T3) has been taken as evidence that carbohydrate restriction impairs thyroid function. Some have opined that carb restriction should never be maintained below 100 grams per day in order to prevent this effect. Others advocate that people on a low-carbohydrate, high fat (LCHF) diet take intermittent ‘holidays’ from carb restriction to boost thyroid function back up to ‘normal.’

“An alternative explanation for these changes in thyroid hormones when one is weight stable on a LCHF diet is that the body becomes more responsive to these hormones due to beneficial changes in cell structure and function when in nutritional ketosis. As a result, it can function normally at lower T3 levels. Put another way, a ketogenic diet seems to result in improved thyroid hormone sensitivity (i.e., it takes less hormone to produce the same effect), which, if anything, puts less of a burden on thyroid hormone (T4) production in the thyroid gland and its conversion to T3 in the liver.”

Source Amber O’Hearn

“There is no evidence that we are aware of indicating that ketogenic diets cause hypothyroid, or negatively impact thyroid function. The fact that T₃ is lower in ketogenic dieters is probably part of the mechanism that protects lean mass when fat is being lost. Moreover, low T₃ may possibly even be an indicator of a life extending effect, an effect we have suggested elsewhere when examining the cortisol profile of ketogenic dieters.”

Source Tucker Goodrich

“… two of the top low-carb nutritional health researchers in the world — Dr. Stephen Phinney and Dr. Jeff Volek — say this phenomenon with low thyroid while on a low-carbohydrate diet promoted by people in the Paleo community like Kresser and Paul Jaminet is “a myth” and has not manifested itself in any of the research subjects in their numerous studies of people who are properly following a well-formulated low-carb diet with adequate calories over the past three decades.”

Source Sophie Laura Certified Nutrition Coach

“Decreasing carb intake dramatically, moderating protein and increasing fats increases tissue sensitivity to T3, and due to this, serum T3 levels go down all the while the psychological response to T3 remains normal. In this scenario, both the thyroid and the liver have far less work to do in order to maintain a normal thyroid physiological response – which is what we want!”

Source Thyroid Nutrition Resource Guide:

“There were only two studies showing negative thyroid outcomes in a ketogenic diet. Both focused on children and possible pre-existing thyroid conditions…”

Note: this is from a very long and detailed explanation of thyroid function in a ketogenic condition. Well worth the time to read and learn. :smirk:

PS: In the Tucker Goodrich Source cited above he discusses several related studies/analyses of how thyroid function/hormones assist insulin to clear glucose. The relationship of insulin, TSH, T3 and T4 to glucose management is well worth the read.

(Michael) #27

I am of the opinion that insulin signaling is the issue, and carbs can get the signal the easiest, but large protein intakes can accomplish the same thing. Spreading out a low carb low calorie over a day would not however, achieve sufficient insulin signaling.


@Naghite See the PS in my reply above.

(Michael) #29

Will do, tomorrow :grinning:

EDIT: @MattWisti good link, really liked it. I thought the bit on lowering body temperature might be applying to me in a big way


@betsy2 from the Tucker Goodrich piece I’ve cited above:

"Now it’s entirely possible that if you’re marginally hypothyroid, and you reduce glucose production, therefore reducing thyroid hormones further, you may have additional problems. And this may be what Kresser and Jaminet are seeing in the people they refer to, although the Rosedale/Westman study mentioned above was not a study of healthy people, but sick ones

"But what I suspect is happening, is that people who are more carbohydrate dependent do worse initially on a low-carb diet, and may be underconsuming calories, leading to the hypothyroid-like symptoms. The thyroid reduces metabolic rate in the absence of food, to reduce the body’s need to metabolize its tissues, thereby lengthening the time one can go without food. This has clear evolutionary advantages, obviously.

"But I’ve not found any indication that carbohydrates are required or even beneficial for thyroid health, as the role of the thyroid, in partnership with the pancreas where insulin is produced, is in disposing of glucose.

“Both Kresser and Jaminet recommend increasing “safe” carbohydrates consumption a bit for people who seem to have hypothyroid conditions on a low-carb diet, and while this is likely effective in resolving symptoms, it may not resolve the underlying condition. But if that’s where you are, it’s worth a shot, as they both advocate a minimal increase well within the bounds of what I’d consider a reasonable level of carbohydrates.”

(KM) #31

I got lazy and skimmed, sorry If I missed this. Could it be possible that it’s the reaction to the carbs / bad diet from July '22 onward which caused the rise, and that your keto diet will now bring it down, rather than the keto diet recently started being the culprit raising the level?

(Arie1985uk ) #32

Perhaps, I don’t know, I don’t feel like my body or I as a person want to stop the keto diet now, I keep on losing weight and have more energy during the day … I did read the sources above but not sure what they mean in the bottom line…

Matt - I am trying to read your “criticism” of Chris Kresser, you’re quoting a lot of “Chinese” for me - can you do it with a bottom line post, explain why are you criticizing what Betsy2 posted from Chris Kresser, and why in your opinion what he said is wrong in simple words, please?

(Arie1985uk ) #33

What is the underlying condition then?

(Joey) #34

My interpretation is that, for individuals who suffer from hypothyroidism to begin with, reducing carbs may bring this condition of an under-active thyroid to the fore. But it is not the cause - so eating carbs is not the solution.

Hypothyroidism is a fairly easy/safe condition to address through properly regulated Rx. But it takes time and lots of follow up testing to determine the right dosage for any individual - which can also be a moving target over time.

Changes in diet and changes in weight are very likely to skew things around for a while. So best to let that play out and stabilize … then get thyroid function tested and make determinations as to what might still be appropriate in terms of medication/dosage.

In short: the underlying condition of hypothyroidism is an under-active thyroid gland. Again, not a crisis. And well worth giving it a chance to stabilize when significant metabolic changes are being made.

I imagine that “safe” carbohydrate levels are amounts that don’t mess you up over time. Clearly, according to the FDA there are “safe” doses of pizza, ice cream, Doritos, fried rice, french fries, … If that’s what you’d like to feed you body, I imagine they’re “safe” for a while. The cumulative effect is what we see in our Western populations today. :roll_eyes:

(Arie1985uk ) #35

Yes, I toally agree.

Right now I have, thank god, no side effects, nothing, so would just “ignore” this blood test for now, and would check 2-3 months, and would then hopefully report here how it goes.


@arie1985uk I think the thrust of Goodrich’s commentary is as follows.

The primary role (or at least one of the primary roles) of both the thyroid and the pancreas is to regulate glucose. The functions of the hormones generated by both these organs stimulate the use and/or storage of glucose in order to clear it from the blood stream as quickly as possible. In practical terms this means in a healthy metabolism we can expect to see both insulin and the thyroid hormones rise and fall in response to glucose or its lack. The various ‘paleo pundits’ that Goodrich cites (Colpo, Lewis, Kresser and Jaminet) do not understand this. Therefore, their recommendations regarding ‘low thyroid hormones’ is incorrect because based on ignorance.

Consider this. For at least 4+ million years our paleolithic ancestors ate a primarily fat/meat diet. Evidence? Australopithecus afarensis (aka ‘Lucy’) dating to 3.9 million years. We evolved eating fat and meat, not carbs. In fact, during the Pleistocene even the possibility of deriving more than a mere pittance of nutrients from plants was nil. Even in central Africa.

Therefore, our metabolisms evolved dealing with very low levels of blood glucose produced exclusively by gluconeogenesis. For the last 8-10 k years (.0025% of our evolutionary timeframe), we have flooded our metabolisms with exogenous glucose in the form first of ‘grains’ then ‘fruits’ then ‘vegetables’. It doesn’t take scientific genius to figure out that’s going to cause problems.

(Rossi Luo) #37

My suggestion is that you should do more blood testing to test your blood glucose! I am 66 kg, and I have a device to test blood glucose at home in the morning after fasting, and I found that the blood results fluctuate for unknown reason sometimes! For example, last week I got a blood result of 7.1 mmol/L in the morning (quite high), and two days later, I got a result of 6.1 mmol/L. And I found that my blood result is usually 6.1 mmol/L, the 7.1 was an exception due to unknown fluctuation. So I suggest you to buy a device (I think 40 $ is the price) to monitor your blood glucose more frequently.

(Arie1985uk ) #38

Thanks for the advice, is there a way to test your TSH by yourself without having to go to do the doctor?