Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones. This can lead to a variety of symptoms including fatigue, weight gain, feeling cold, and constipation. Many people with hypothyroidism find that they are sensitive to carbohydrates and feel better when they reduce their carb intake. However, there are mixed opinions on whether people with hypothyroidism need to completely avoid carbs. Here is an overview of the key considerations around hypothyroidism and carbohydrate intake.
What is hypothyroidism?
The thyroid gland is located in the front of your neck and produces hormones that regulate your metabolism. The main hormones are triiodothyronine (T3) and thyroxine (T4). These hormones affect nearly every cell in your body. They impact how quickly calories are burned and how fast or slow a person’s heart rate is.
When the thyroid does not produce enough hormones, it causes the metabolism to slow down. This can lead to a variety of symptoms:
- Fatigue
- Weight gain or difficulty losing weight
- Feeling cold
- Constipation
- Dry skin and hair
- Depression
- Impaired memory
- Muscle weakness
- Joint pain
- Heavy menstrual periods
- Slowed heart rate
The most common cause of hypothyroidism is Hashimoto’s disease, which is an autoimmune disorder where the body’s immune system attacks the thyroid gland. Other causes can include thyroid surgery, radiation treatment, and certain medications.
Hypothyroidism is typically diagnosed through blood tests that measure levels of thyroid hormones. The main treatment is taking thyroid hormone replacement medication to raise hormone levels back to normal. With proper treatment, most people with hypothyroidism are able to manage their symptoms and feel well.
Do carbs impact hypothyroidism?
Carbohydrates are one of the main macronutrients found in food, along with protein and fat. Carbs include sugars, starches, and fiber:
- Sugars – Found naturally in foods like fruits or added to foods like sweets, sodas, etc.
- Starches – Found in grains, potatoes, corn, peas, and some other vegetables.
- Fiber – The indigestible part of plant foods like vegetables, fruits, whole grains.
For people with hypothyroidism, there are several reasons why carbs may need to be controlled:
Blood Sugar Levels
Eating lots of refined carbs and sugars can cause spikes and crashes in blood sugar levels. The thyroid hormones help control insulin production, so blood sugar regulation can be disrupted in hypothyroidism. Limiting carb intake to foods with a low glycemic index can help maintain steady blood sugar.
Gut Health
A healthy gut microbiome promotes good immune system functioning. An imbalance of gut bacteria is common in autoimmune thyroid disorders. Limiting sugar intake and eating more fiber can help improve gut health.
Inflammation
Hypothyroidism often goes hand-in-hand with inflammation. Refined carbs and sugars promote inflammation. Whole, high fiber carbs tend to reduce inflammation.
Weight Loss
Since hypothyroidism slows metabolism, it can be very hard to lose weight. Reducing carbs can help reduce insulin resistance, decrease fat storage and make it easier to lose those extra pounds.
Energy Levels
Eating lots of refined carbs and sugars leads to energy crashes. People with hypothyroidism already struggle with fatigue, so stabilizing blood sugar is important for maintaining consistent energy.
So in summary, there are good reasons for people with hypothyroidism to be mindful of their carbohydrate intake. However, carbs don’t necessarily need to be avoided altogether.
Should you avoid carbs completely?
While being aware of how carbs impact hypothyroidism is wise, completely avoiding all carbs is not necessarily the best approach. Here are some things to consider:
Carbs Are Your Body’s Preferred Fuel Source
Carbohydrates are your body’s main and preferred source of energy. Very low carb diets can leave you feeling tired, weak and unable to think clearly. Extremely restricting carbs can also cause cravings, lead to binges, and be hard to sustain long-term.
Healthy Carbs Provide Important Nutrients
Carbohydrates in their natural, whole food form provide vitamins, minerals, antioxidants and fiber. Cutting carbs can mean missing out on these valuable nutrients.
Blood Sugar Extremes Are Not Ideal
Severely limiting carbs can result in blood sugar dropping too low between meals. Hypoglycemia comes with its own set of symptoms like dizziness, anxiety and headaches. Stable blood sugar levels are ideal for optimal health.
Fiber Is Especially Important
Fiber is a special type of beneficial carb that supports gut health and helps regulate blood sugar. Fiber slows digestion, allowing for a slower release of glucose into the bloodstream. Getting adequate fiber (25-30g per day) can be challenging on very low carb diets.
Social and Lifestyle Factors
Avoiding all carbs can isolate you socially and create stress around food. Dietary restrictions can develop into disordered eating if taken to the extreme. For most people, a moderate, balanced approach to nutrition is preferable over the long-run.
An optimal carb intake for hypothyroidism
Given the points above, it’s clear that some carb restriction can benefit hypothyroidism, but going to extremes is likely unwise and unnecessary.
An optimal carbohydrate intake focuses on the quality and amount of carbs:
Quality
Choose whole, minimally processed carb sources like:
- Non-starchy vegetables – broccoli, spinach, kale, carrots, tomatoes, zucchini, etc.
- Moderate starchy vegetables – sweet potatoes, winter squash, beets, etc.
- Low sugar fruits – berries, grapefruit, peaches, plums, etc.
- Whole grains – oats, brown rice, quinoa, buckwheat, etc.
- Legumes – lentils, beans, peas, peanuts, etc.
Limit refined grains (white bread, pasta, etc.), added sugars, and highly processed carb-rich snacks.
Amount
A moderate carb diet contains around 26-45% of total calories from carbs. To determine your optimal range:
1. Estimate your calorie needs. Online TDEE calculators can help with this.
2. Multiply your total calories by 0.26 and 0.45 to get a carb gram range.
For example, someone needing 2000 calories per day would aim for 130-225 grams of carbs.
Spread these carb grams over 3-5 meals and snacks eaten every 3 to 4 hours to maintain stable blood sugar.
Adjust your intake based on your own tolerance, health goals and activity levels. Higher activity demands more carbs for fuel.
Sample lower carb meal plan for hypothyroidism
Here is a sample one day meal plan with around 150g of carbs:
Breakfast
- 2 eggs scrambled with 1 cup spinach and 1 oz cheddar cheese
- 1⁄2 cup oatmeal cooked in water with 1 Tbsp almond butter and 1⁄4 cup blueberries
- 1 cup green tea
Morning Snack
- 1 medium apple
- 1 stick part-skim mozzarella string cheese
Lunch
- Tuna salad made with 3 oz tuna, 2 Tbsp plain Greek yogurt, lettuce, diced cucumber, tomato
- 10 whole grain crackers
- 1 cup vegetable soup
- 1 cup unsweetened iced tea
Afternoon Snack
- 1⁄4 cup hummus with celery sticks
- 10 unsalted almonds
Dinner
- 3 oz grilled salmon
- 1 cup quinoa
- 1 cup roasted broccoli
- Green salad with 2 Tbsp balsamic vinaigrette
Evening Snack
- 1 cup plain Greek yogurt mixed with 1⁄4 cup raspberries and 1 tsp honey
Guidelines for managing carbs with hypothyroidism
Here are some key tips to find your optimal carbohydrate intake with hypothyroidism:
- Choose whole, fiber-rich carb sources and limit refined grains, sweets and processed carbs
- Spread carb intake evenly over 3-5 meals and snacks throughout the day
- Aim for a moderate intake of 26-45% calories from carbs based on your needs
- Adjust carb intake up if you are very active or down if trying to lose weight
- Focus on getting at least 25-30 grams of fiber per day
- Stay well hydrated and eat enough protein at meals
- Listen to your body and tweak carbs based on your energy, cravings and symptoms
- Allow room for some whole grain treats in moderation
With a balanced, tailored approach, most people with hypothyroidism can include carbs as part of a healthy diet while still managing their symptoms. Avoiding carbs completely is likely unnecessary for most. Work with your healthcare provider to find the right carbohydrate intake for your individual health needs.
Conclusion
Hypothyroidism can make people more sensitive to the effects of carbohydrates. Limiting intake of refined grains, added sugars and processed foods may help manage weight, energy levels, blood sugar and other symptoms. However, eliminating all carbs is usually not beneficial long-term. Following a moderate, nutrient-rich carb diet spread over several meals can allow people with hypothyroidism to enjoy carbs while optimizing health. Finding your personal carb tolerance and sticking with whole food choices are the keys to success. With the right dietary approach, you can manage hypothyroidism while still including a variety of delicious and healthy carb options.