I have been on levothyroxine for about 9 or 10 years and despite trying every diet going, have found it a struggle to lose weight, typically losing and gaining the same poundage, going off the diet and piling on a stone.

In desperation I tried low carb high fat with some success - down since march from a size 20-22 to 18 and visibly looking slimmer. I started lchf and then in March went onto ketogenic diet, not tracking macros. I had my macros tailored by another more experienced and well studied keto-er so that i take on less fat, only for sateity, adequate protein as a goal and carbs restricted to less than 20g per day and a calorie deficit of 1300 calories per day. I find that I reach the carbs too easy, reaching the protein and fat not so easy and today only managed to eat around 800 calories.

Is anyone else on levo and struggling like me and also doing keto ? I have been feeling really good on this way of eating and not hungry like on other diets and lots of energy too.

I am suffering extremely low mood, brain fog and lethargy which i feel is due to levo not working properly. GP not bothered to check my bloods in probably like a year ! I have to go hassling for a blood test and i really cba. Had endless arguments with nhs endo and walked out as she would not hear of NDT and instead wrote to my GP and made a big issue out of me being "non" compliant with taking levo. Yes, I have stopped taking it on occasions; longest for a month to lose some weight but had to start it again as heart rate went too low, was probs on way to killing myself i spose.

I don't need or want a lecture about eating a balanced diet; I am insulin resistant for real and have such problems with carbs and gluten and keep to green veg and the only fruit i eat in moderation are berries. Nhs diets have failed for me as there is too much gluten and carbs. I am only interested in keto continuing and advice on where i can get NDT please


21 Replies

Lectures no one needs if they are hypothyroid as weight gain is usually due to being on an insufficient dose of levothyroxine. Most need a combination of T3/T4 or an optimum dose of levothyroxine, i.e. no symptoms and feel well. It is the commonest question on the forum.

In my personal opinion, I don't see how you could have any energy with a calorie deficit like that. The whole body including thyroid needs food to make energy and for everything to function properly. Just to give you an idea, the recommended calorie requirement for a two year old is 1000 calories and they have a teeny body in comparison? Unfortunately in many of us, sustained low calorie diets can have the opposite effect and just slow your metabolism, increase fat while causing additional problems with blood sugar levels and put pressure on your adrenals which could lead to longer term issues. Additionally, you will find it hard to meet your bodies requirements in terms of all the other vitamins and minerals and micronutrients and pretty much everything as you might not be eating enough to reach the levels required. Maybe it would be worth testing your nutritional levels?

However, this is just my opinion. I'm am not suggesting that lowering calories can't help lose weight if reduced by a small amount like 250 or 500 max but considering general requirements for a female is 2000 calories, eating less than half of this cannot be good for the body. However, I know everyone is different but maybe it works for you :-)

I've done ketogenic diets in the past and feel "better" on less carbs and more fat. That said, I'm not sure if it is an optimum diet for people with thyroid or autoimmune problems. I don't do keto at the moment but make sure I eat a lot of fat; seems to stabilize my energy better. That said restricting calories should be really be avoided, your body will have plenty of stresses without adding another one to it.

Unfortunately medical advice (NHS and private) is often poor so many of us take our health into our own hands. The more you learn about your illness and ways to combat it , the more it empowers you.

I've also messaged you

Hi Mike Don;t appear to have received a PM from you

Sent now - sorry

I think the 'less fat' may be the reason you're suffering brain fog, low mood and lethargy. Instead of brain fog I just wrote brain food....but how very apt: good fat is brain food. Even a teaspoon of coconut oil will benefit you. I feel wonderful on vitually zero carbs ( vegetables not included in that) and even small amounts seem to effect me badly - I understand what you have written about not wanting the usual diet advice. However, if everyone suggests your calories are insufficient and many suggest you need more fat ( which will increase calories of course) then perhaps it would be beneficial to take that on board?

Keto diet is unadvisable for hyperthyroid patients. The problem is that the body uses glucose from carbs to convert t4 to t3, when you get to ketogenic phase the body switches from using carbs to using ketones as energy. This starves the thyroid and actually CAUSES hypothyroidism. This is a natural feedback loop present in our metabolism, it helped our ancestors to not starve in times of famine.

In the end when someone returns to a normal diet they often find themselves more hypothyridic and gain more weight.

I'm not trying to scare you, just inform you. If you're having difficulty losing weight there could be many reasons for it.

The fact that you say you are insulin resistant AND you have Hashimoto's is a pretty solid sign that you might have leptin resistance, and this is causing your weight gain. I would get this tested at your doctors or Endo, often leptin resistance is found in those with diabetes, insulin resistance, and Hashimoto's. It's characterized by high RT3 levels, resulting in low FT3 levels. Doses of t3 are needed to reverse high RT3 and leptin resistance. Those who are leptin resistant have a near impossible time losing weight no matter what.

Hi dang, you said the keto diet is not advised for Hyper thyroid patients.. I am Hypo thyroid. I have had battles with the endos and the local hospital so not willing to go that route ever again. I understand there is no way to test for insulin resistance and I have watched the videos on Youtube from Dr Jason Fung and the way he describes IR and metabolic disorder is pretty much me. My weight loss is soooo slowww. I put on and take off same 4lb and get frustrated seeing others lose heaps on keto in less time than i have been doing it. I have only been tracking since early May.

I find the fat I do eat does definitely satiate enough as I have been doing the lchf since March then went keto and tracking in May; I should have made it clearer that I feel satisfied because of the good fats and often do not meet 1300 calories as i feel satisfied and not hungry.

Have a read through this article from Chris Kresser about carbs and thyroid health. Keep in mind this article isn't aimed at those who already have Hashimoto's or hypothyroidism.

A few excerpts:

"Hypothyroidism is one of the most commonly cited medical reasons for needing to eat a moderate carb diet. The main reason why carbs affect thyroid function so directly is because insulin is needed for the conversion of the inactive T4 hormone into the active T3 hormone, and insulin is generally quite low on very low carbohydrate diets."

"If you’re experiencing symptoms of hypothyroidism or adrenal fatigue, you may be worsening them with a well-intentioned low carb Paleo diet."

As keto diet reduces conversion of t4 to t3 I would keep an eye on your FT3 levels. You may possibly need to up your medication, or start taking t3 depending on how long you intend to keep the diet.

I will warn you I went down the keto path (actually carb-restricted paleo). While I lost a ton of weight in the short 2-3 months I did it I experienced a doubling of my antibodies and also now have to take a higher dose of t4/t3 (I wasn't converting at all) I can't guarantee it's because of the carb restriction, first couple months I did well, then ended up doing very poorly.

About the insulin resistance I don't know much as I'm not diagnosed diabetic, but I was quite sure there are tests for this as well as leptin resistance. I'll try to find these, I highly recommend you look into leptin resistance, the combination of Hashimoto's with diabetes (with insulin resistance) PLUS the inability to loose weight without keto points to leptin resistance (in my opinion).

Here is the test for insulin resistance that your doctor can administer: it's called a two-hour glucose tolerance test. This will show if you are resistance to insulin or not.

Here is some info from labtestsonline, another 9 tests that are possible for insulin resistance:

Please check this link about leptin resistance it has a lot of good information:

In this link you'll understand what leptins are, and how resistance is one of the leading factors of weight gain. Low carb diets only make things worse (causing more resistance to leptin and insulin), this lowers conversion of t4 to t3 (treating resistance requires fixing conversion issues). There's information tying in insulin and thyroid, this should be very informative if you haven't seen this information yet. This could very well help you understand what is going on.

All the best!


i do low carb high fat. I have protein smoothie for breakfast (protein powder with coconut oil or avacado) lunch is eggs, mushrooms and tomatoes, dinner salmon salad or mince with broccoli and gravy, chicken breast with pesto and cream cheese and broccoli. I have fromage frais with lemon sugar free syrup mmm like cheese cake, good quality dark chocolate, snacks of cheese, brazil nuts, tuna and mayo in lettuce wraps etc i have one cup of tea with one sugar a day . I use konjac pasta zero carb/zero wheat i am never hungry keep carbs to 20-50 per day. I have lost 2.5 stone but more importantly i have lost inches off my tummy hips thighs, i have been covered in mucin for 6 years and this hypo fat is starting to go but i am also on t3. I dont find it restricting or difficult but its not for everyone. I have no trouble adding butter, coconut oil, sesame and walnut oil, avacado etc to keep fat high, i love veg and salad, eggs etc but you cant do it by skimping on oils, fats and protein and no point doing it if you dont feel well, we are all different and have to find what works for us. xx

I do well on LCHF. Flirt with keto but haven't adopted the crazy low calories yet. Occasionally get into ketosis and feel amazing. I've lost 13kg over 6 months by changing what i eat. Starting to feel energy and strength returning. I stopped taking levo after 7 years. T3 for 30 months. Way better.

The first thing you should do is to get your doctor to give you a blood test. He should do one every year. But this time get him to do Vitamin D, B12 and Folate, and Ferritin as well as the Thyroid tests. If you are low on any of those (and most thyroid patients are) it make you feel awful (low mood etc) and stops the thyroid hormones from working.

As for NDT, there are several different brands. The cheapest are thiroyd, available from Thailand, then Thyroid-S (ditto) but there is also Nature throid, ERFA (often used in the USA) and a few others. If you are on a low dose of Levothyroxine there is also Thyro Gold, which has less hormone in and comes from cattle, not pigs. Many people find NDT helps where Levothyroxine doesn't, particularly with weight loss, but you may need to start on a low dose and build it up. The main problem with taking NDT is that it skews your blood test results, so if your doctor doesn't understand or doesn't know you are taking NDT he might panic and think you are going into pituitary failure. However in your case it would probably serve him right.

I find it all confusing and overwhelming so just keep taking the levo. Interesting about pituitary. I had a microadenoma at the same time i was going through chemo after bowel cancer surgery in 2001. The endo i saw gave me tablets to shrink it down and i don't think i have had any bother from it since. Combined with the chemo It made me feel very tired and unwell and wiped out so i had to cut out the Maxalon as that stuff can make the pituitary "tumour" grow more. Going without anti-sickness meds was choice !!! not !!! I still get the odd galactorrea but I dont think my prolactin is especially raised; not that I have had that blood test in years.

The Keto Summit is on at the moment - today and last day, tomorrow.

Hi have you checked out mark sisson, or marks daily apple. Big keto fan but in a modern world way, ties it in with exercise. His blog has been going 10 years so he's learnt it all, masses of info on his site.

I have seen Mark Sisson yes but I am on a couple of uk keto groups on facebook.

Have a chat with Roderick Lane on Thyroid Care Group on FB, this is exactly the kind of thing he does.

Thank You OldC. I shall head there right now. Just had some bloods back and appear to have low ferritin levels but I have no clue how to interpret my TSH and T4 results ; it baffles me.

Hi, I came across your post when I was looking for information about the keto diet in relation to Hashimoto's hypothyroidism. I've had hypo hashimoto's for over 15 years. It took almost 5 years of having hashimotos before my tests finally showed that I had low thyroid.

Hashimotos will typically screw up your labs, making it look like your levels are fine even though you still have all of the symptoms of low thyroid while on levo (or whatever you've been prescribed. Hashimotos is an autoimmune disease, attacking your thyroid. It cannot be treated like a regular low thyroid. You should speak to your doctor about your medication as you will typically go from high to low to high doses approximately every 3 to 6 months. I personally bounce from 100 mcg to 112 mcg to 125 mcg (my current dosage). Even if the doctors can get your thyroid under control for a short period of time, you will not lose weight like a regular low thyroid patient.

I have tried numerous diets. I started off this thyroid nightmare at a slim 125 lbs that quickly morphed into my max weight of over 215 lbs a year ago. When I read about the keto diet I thought that I might as well try it since nothing else seem to work (plus I love steak!). I read just about everything I could find online and jumped into it with both feet. I watched my macros, kept my carbs around 20 grams, gave up sugar, and started losing weight--but not as drastically as the stories you hear about online. I've been on the diet for almost 8 months and went from 215 to 190 lbs. After that, it seemed that I stalled out.

I finally talked to a dietitian who was advocating the Atkins diet. If you've ever read about Atkins it's basically the same thing as the keto diet. She suggested I read "The New Atkins for a New You", which I bought that same day. In it, it suggested that the reason I stopped losing weight is because I wasn't eating enough. It was true. Because the fat kept me sated, I wasn't hungry and was eating maybe twice a day and not actual meals.

I had to force myself to eat three meals, getting in the proper amount of fat that was suggested. Since I started doing this, I've been losing again. And according to the book, the brain fog and tiredness (which can be attributed to your thyroid due to your medication) can also happen to regular folks with no thyroid problem while on a keto/atkins diet. They said drink a cup of salty broth and that will help with those symptoms and they were right. I drink a cup of broth once or twice a day and it really does improve those symptoms (when my thyroid meds are doing their job).

My advice is for you to talk to your doctor about your symptoms (get pushy if you have to) and maybe consider referencing the Atkins book that I mentioned above. Good luck to you.

Hi parkerclvs Apologies for my lack of response. Thank you for your reply. I have joined Roderick Lane's Thyroid Care group on Facebook and following his protocol and have been making and taking Kefir. It works well it seems to regulate the bowel, but I am not sure if it is going to be the cure that I hoped for. I also have New Atkins, New You Book but am too tired to read it !!! I also have Roderick Lane's book and again, too tired to read it as I am on housekeeping duties most of the day and often running around after almost 2 year old grand-daughter who lives here with her Mum, plus my husband, eldest daughter, so you can imagine the washing, drying, cleaning, cooking, shopping etc; I sit and watch soaps at 7pm to relax in a heap and often nod off without any effort. I have annoying nocturia and insomnia; sometimes i cannot get off to sleep all night and sometimes after a trip to void the bladder, cannot get back to sleep and awake all night. Today i was awake from about 3.30am grrrr !

I have been taking potassium, magnesium, ferrous gluconate, selenium drops and idiodine drops, vitamin c, but i had a relapse to low carb diet in July and a pig out on carbs over xmas and need to get my head back into keto. I hate tracking so much as i do not have time and i drive myself mad with obsessing and it is hard to cook for the family, often 3 different meals and one comes in at lunchtime too. I am trying to keep meals simple but brain fog means I run out of ideas and what one person will relish one week, they complain of the next. If i make them cook their own, the kitchen is a bombsite and its like a warzone with arguing as the kitchen is small.

There is no use in talking to my GP; he insists my bloods are fine. I have been to see endos at the hospital. No use, I locked horns with them as they would not give me T3 and was discharged to the GP to take levothyroxine. I have to monitor my own bloods as I was left a year without being called for a thyroid check; Thyroid support group say my levels are not fine and my recent anemia floored me as the GP surgery failed to let me know that I had a prescription sent over to the chemist as I was anaemic in August, it was only when the chemist wrote to me in October to pick up outstanding script that was ferrous gluconate.

I worry about patients with learning disabilities or are elderly and infirm etc as the GP surgery failed, in my case, to follow up and contact me that I was anaemic and needed treatment. It is also a big fail that I was not chased up to get a thyroid blood check done; I instigated this myself otherwise it would be 2 years ! The irony is that the surgery chases patients via letter, to have vaccinations and bp checks so they can bung you on statins and whatever else big pharma dictates to the nhs is necessary for the majority of the population !!! It would take a simple flag to send a text or letter to patients.

I feel like i am in some limboland of not knowing what to do. I am just trying to experiment with supplements etc and low carb/keto, but frankly, I am very depressed, disheartened and not really enjoying life as I should be as I am too darn tired and weary.

You may also like...