I am autoimmune underactive and gluten intolerant but also pre diabetic.
As thyroid stabilising and generally fine, I am now trying to sort the Pre diabetes and take it off the back burner.
I have been reading around this on and off for ages and never got out of the rabbit hole!
I guess I am asking how low can I go with my carbs and what experience have others had ?
Going into full ketosis is that worse than a lowish carb diet now that I am underactive thyroid.
I do not think I am a great converter of T4 to T3 and I think I understand it can interfere with this.
As I write, I am thinking of now of pushing my exercise level as well for pre diabetes.
I am reasonably active but sometimes my work and "thyroid rabbit holes" lead to periods of sedentary behaviour!
Background
(I am a bit over range on T4 and about 15% on T3 range. Jan 24 and May 23
T4 Dose reduced to 125 from 150 and T3 dose increased 6 to 12 mg T3.
I plan a full bloods test in a couple of weeks with vit B12/D /iron etc.
I did keto diet 5 years ago prior to AIUAT/gluten issues and really liked it felt really good on it for about 3 months (and again for 2 months ( great generally but a bit dull as a menu)
It say 2.5 years before gluten became a obvious problem and 3.5 years before finding I was autoimmune underactive. Otherwise healthy. Known prediabetic for say 3 to 4 years.
Slightly improved HBA1C recently 43 May was 44.
I was one of those effectively told fat and lazy when first flagged pre diabetic.
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Sleepman
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This is a difficult one as low carb diets help many health issues and a certain portion of people with thyroid issues would benefit from at least eating lower carb if not keto.
The issue is it affects conversion of T4 to T3, and when we are reliant on tablets and blood results to provide our thyroid hormone we need to be wary.
In my opinion if you have another health condition that benefits from a lower carb diet then you should try it and just be aware of the effects it can have on your conversion. Get bloods run after a while on the diet and see if any adjustments need to be made.
It would be madness to give your sole attention to one medical condition to the detriment of another.
Hi Sleepman, like you I am borderline pre diabetes. I was first diagnosed just after I was put in a three month course of steroids for inflammatory arthritis, I was taking part in a medical study and it showed up very soon after I started the steroids. I was given three months to eat my way out of it - the only advice I was given was not to eat more than one banana a day and to be careful with pineapple!!!
As luck would have it I discovered a book on how to reverse T2 diabetes with diet by a doctor David Cavan. I bought the book and a blood sugar meter and did exactly what he recommended and had reduced my HbA1c by the time I saw the nurse again. Phew!
What I discovered though was that there are carbs and carbs and that some are healthier than others so you can still eat carbs but be selective about them hsph.harvard.edu/nutritions....
I also found a good free course on the Diet Doctor website with loads of information on carbs. Interesting things like eat veg that go above ground rather than those grown underground because they store sugar.
So you don’t need to stop carbs altogether but just be more selective about your choice of carbs. Good luck with it all.
I am already a convert to "most carbs are bad for us". I used the Diet Doctor site when I went Keto 5 years ago, I will remind myself.
I can see myself swapping most of my rice for cabbage, lettuce and spring greens.
It would be nice to know if anyone has done full keto with underactive thyroid ? However non keto but lowish carbs with beans/legumes might be a better diet for me long term as I can stick to that.
Fruit and veg are carbs and are most definitely not bad for us. They are in fact essential. We’re told there are certain vegetables that those with thyroid disease should avoid but even those shouldn’t be a problem eaten in small quantities, occasionally
Low carbs doesn’t means no carbs. Carbohydrates are necessary and requirements are covered by fruit and veg (good carbs) if enough are consumed. Moderate quantities of potatoes and whole grain rice can also be eaten
Nobody actually needs flour products or cereals (bad carbs). These processed, refined products are quickly converted to sugar
This is not a lecture, I eat bread and chocolate occasionally. It’s merely a reminder that fruit and veg are good carbs and should be consumed, even when starting a low carb way of eating which, btw, only good things can come of ditching bread, any pastry goods, pasta, noodles, cereals
Again, this isn’t a lecture, I love all those things
I do a low carb diet. Stick to under 20! carbs a day (mostly, apart from days when I have wine then it's probably 25g!). I've got Hasimoto's and an underactive thyroid. I went completely gluten free 3 years ago, and have been vegetarian for 40 years. I am also on T3 only medication.
For me, it's the only thing that works to control my weight. It stopped working early on in my thyroid journey, but to cut a very long story short I found it started working again when I started adding in T3 (at that point I was taking levo as well, but it just didn't do anything for me so over a long period of time I lowered my dose of levo until I was completely off it, and upped my T3 dose).
I don't feel hungry when I low carb (don't get me wrong, I could eat, but unlike when I'm eating 'normally' with full carbs I'll feel starving, and I just don't get that on low carb, which makes it much easier).
I do tend to come off it for holidays and special events (birthday, Christmas etc), just because it makes life easier. Trying to be low carb, gluten free and vegetarian on holiday would be an absolute nightmare (GF and veggie is tricky enough!).
I've been low carbing now for probably 8 years on and off (mostly on). To my knowledge, it's had no adverse effects, and it keeps my weight far more stable, which is a good thing (I cannot stick to a normal diet, and have a tendency to completely overeat). And I can indulge my love of cheese on the diet, so it doesn't really feel like a diet if that makes sense?
Toasted low carb roll with cottage cheese for breakfast (husband bakes the rolls). I absolutely love cottage cheese and have to stop myself eating the whole pot! Husband has raspberries and clotted cream.
Homemade low carb crackers and cheese with a spoonful of coleslaw for lunch. Sometimes I'll have a big salad with boiled eggs and cheese or an omelette just to change it up.
Couple of sugar free Werthers during the afternoon (they're pretty much no carb due to the polyols).
Dinner obviously varies. Last night was homemade broccoli and cauliflower soup. We have things like veggie sausages with cauliflower mash and mangetrout, lasagne made with Quorn mince and using slices of gouda instead of the pasta layers, bolegnese with Quorn mince and a low carb pasta we buy, halloumi bolgnese with veggies rather than mince, spinach and ricotta cannelloni made with low carb wraps (homemade) as the cannelloni tubes, calzone and salad (using something called fathead dough which is low carb) etc etc.
At around 8pm we'll have a homemade low carb treat. At the moment it's bakewell tart (each piece is around 1.5g carbs). All the homemade treats involve using ground almonds as the 'flour', and we have 4 or 5 different ones that he rotates through making.
My husband eats meat whereas I don't, but he is totally happy to eat veggie meals with me. At weekends he'll treat himself to bacon and eggs in the morning in a low carb roll, and on days when he's in the office he'll take tuna mixed with grated cheese and mayo.
I'm very lucky as he loves to cook, so he makes everything and I just enjoy the lovely food he makes!
Really appreciate you sharing your experiences it is really helpful to know it has worked for someone. Under 20g carbs is really tough!
I agree totally about low carb and not feeling hungry from when I did keto some time ago. It is a strange voodoo like sensation. Cheese nuts and natural yogurt and frozen berries whisky and wine we all fairly free. Actually, I think the grog made me nibble more.
I did sort of feel keto sort of cleaned your body up somehow. Fasting in some religions must sort of tap into this too ?
I have also been gluten free for 3 years and it does make travel tougher, but gluten makes me ill for a week. I lost my sweet tooth 5 years ago when on keto. Dark chocolate is a nice treat though - grated.
From where I am at the moment, I think a massive reduction in rice/spuds/corn stuff and increase in greens and beans might be enough to sort my blood sugar issues as first stage. I have a monitor patch on for 2 weeks to understand it a bit more.
I think it is stable and not too bad/over range.
I find GF breads, pasta and cake generally yucky so not hard to give up.
Apples, bananas and oranges would be tough to loose/reduce if going full keto.
I don't strictly measure, we tend to rotate the same meal options we've got, and know what the carbs are in those, so that makes it easier. When coming up with new meal ideas we work out the carbs in them, so know that we're always around 20 g ish for the day.
You mentioning berries, my husband has 50g of raspberries with 50g of clotted cream for breakfast on weekdays and loves it!
I do know that I was in ketosis, as I was admitted to hospital in December with a bowel obstruction (due to adhesions from previous surgeries), and went from being low carb to not eating at all from the day I fell ill, and for a full week after that. Hospital were pumping me full of fluids as my kidneys were failing. Anyway, after surgery I was in intensive care for a couple of days, and they were doing constant blood tests. One of them was because of the ketones in my blood, and after a while in my dazed state I realised it was probably because I'd been low carbing, so let them know. The nurse told me I was clearly doing it right!
Fasting in some religions must sort of tap into this too ?
I'm not sure that e.g. people strictly observing Lent would go into ketosis.
Have you considered "intermittent" fasting - there are many variations but essentially the idea is to initially leave the stomach empty for a minimum of twelve hours e.g. breakfast 10.30am, main meal 4pm and apart from maybe a small snack, nothing after 9pm. I've being doing that for years and eat exactly what I want during my chosen "window". That includes daily red wine.
I generally do not eat after 8 ish till 12 the next day for probably a couple of years now. Pre diabetes /weight thing were reasons I think.Wine makes me nibbly and I try to keep to weekends now and also I think it makes insulin control harder for the body? I had periods of half a bottle a day though.
A year ago my blood sugar was still high in a mornings.
I posted last weekend as my blood sugar went very low.
Hi, I’ve been low carb for months now. Being treated by Dr Sarah Myhill who insists everybody does Paleo Keto. I haven’t yet managed despite trying to get low enough to be Keto. I think my hypo metabolism is sluggish & resents the change to Keto. The doctor says she can only eat 19grams of carb to stay in ketosis. She knows I’m hypo so presumably it’s ok.
I was eating low carb for 2 months before Christmas as I was taking T3 only & my blood sugar readings were increasing every time I tested. High T3 is known to raise blood sugar & with 2 diabetic parents I thought I’d switch to combined T4 & T3,
I ate some brownies, a little chocolate & some honey & nut clusters at Christmas & in January my HbA1C test jumped from 38 to 42! I had blood taken for another test last week (no results yet) & the nurse said that a low carb diet can produce that big jump if you then eat a little extra. Very frustrating.
For a couple of years I used a Berberine supplement to keep blood sugar level. I think it did help but I didn’t want to use it for ever as it can have side effects.
Another helpful thing to do apparently is to leave as long as possible between your supper & the first meal next day. It’s a form of intermittent fasting & helps with regulating blood sugar. The 5/2 diet is also effective. I might try that if the low carb becomes too tedious & ineffective for me.
I tend to do that. We eat fairly early in the evening so from seven at the absolute latest unless we are eating out and it might be later we never eat anything after our evening meal which means I don’t eat until breakfast at around 8.00 next day. Unfortunately I still need to work on losing weight ☹️
I know quite a bit about nutrition, having read a lot over the years, training and trying a lot of food regimes out.I'm hypothyroid and I've done Keto and low carb. Although I lost weight on both I actually wouldn't advise you do either one with thyroid issues.
Keto: I lost a lot of weight on Keto, was on very low calories/sugar. However, long term it really screwed my digestive system up. I had stomach acid issues afterwards and ended up in hospital having developed intolerance to things like any kind of spice, caffeine or aspirin.
The other downside to Keto is one that not a lot of people will talk about and thats staying on it. Its just not physically possible. The minute you come off it, you will inevitably eat more and the weight will go straight back on.
Also, because weight comes off with Keto quickly, it's not great on your body. You should never lose weight quickly, it's just not good for your metabolism, that also takes a hit on Keto and can get screwed up once you're off it.
Having done it, I would never do it again.
Low Carb: This is slightly better than Keto, but again, really get the benefits from it you need to go for 50gms of carbs MAX per day. This is a pretty low limit to induce weight loss and the biggest obstacle here, is that (as I found out later) Thyroid health needs carbs to work properly. Low carb can screw up the conversion of various thyroid hormones (T4 - T3) so it will actually work against you.
With energy being low due to the thyroid condition, the last thing you'll want is even lower energy, which is what you'll get from low carb.
Again, I lost weight, not as quick as Keto and a bit more sustainable, but forget doing any long term exercise with low carb. You'll be able to do it for a few weeks, but it will catch up with you and energy will slump. Don't listen to healthy people who don't have thyroid issues, tell you that it's fine doing low carb and exercise. It is for them, but it won't be for you.
I was exercising 5 days a week on low carb, mainly cycling, but energy levels would suffer and so would immunity.
So what's the solution? Well luckily, there is one. It's the Mediterranean Diet.
Trust me. If you want to exercise, which I would definitely recommend, and you want to lose weight, then the Med diet is the best middle ground. You won't lose weight as quickly as Keto, but then you really don't want to lose it quickly. But you will lose weight for LONGER if you stick with a Med diet.
The pros of a Mediterranean diet are that.
1. You still eat carbs in terms of wholemeal breads (so doesn't screw up your thyroid conversion) just not the processed ones.
2. You eat more protein (fish, meats etc) that are more filling and promote muscle building.
3. You eat more fruit, nuts, which contain more vitamins and minerals.
4. You eat more healthy fats (olive oil, avocados).
5. You won't risk energy slumps in the same way that you will with Keto or Low Carb. Especially if you aim to exercise.
Knowing what I know now, from years of doing this, I would recommend the Mediterranean diet every time. Especially coming from a thyroid issue background.
It won't screw up your thyroid function, it's filling, it's easier to stick to, it's easier to exercise on.
Thank you so much for taking the time to share your experience.
My T4 conversion is low and and I am adding a little T3 to assist it - so your bad experience with low conversion and low carbs is very interesting. Do you get by just on T4 ?
My weight is not too bad, I am trying to sort out the fact I am prediabetic mainly. I can't take gluten, I am probably not that far off Mediterranean diet already.
I have a continuous glucose monitor on at the moment to try and understand it some more.
3 days in looks better than I had hoped really. I seem to be not far off normal.
I think timing my meals well and away from bedtime and walking after dinner might sort me ... as well as keeping an eye on carbs - which I have been doing for quite a while. Reduce wine and drink earlier with food to reduce effect on blood sugar.
No problem.Yes, at the time I was purely on T4. My conversion to T3 was OK, but not great. Since then I have been taking T3 on top of my T4 and I do feel a whole lot better.
I've exercised (Road cycling) for over a decade and got into it for the same reasons. Improve my health, lose weight (I've always been stocky, rugby player build and had trouble losing weight) and as I mentioned, Keto worked the best but couldn't train whilst on that. Low carb was the better out of the two, but going low carb messed with my thyroid and energy levels. I would be exhausted and getting colds literally after 2 weeks of regular exercise and that never changed even if I reduced the amount of times I exercised.
Now I stick to the Mediterranean diet and I've found that sustainable and I can exercise on that without getting run down. The other advantage to the Med diet (although I don't like the term 'diet', it's more a way of life) is that if you have a meal out or go to a dinner party etc, and eat things you wouldn't, it won't mess up your normal eating routine or make any difference to what you want to achieve from it.
Whereas if you're low carb or in particular, Keto. Just a few meals can mess up the whole way it's working in your system. With Keto, you'll come out of Keto stasis and then have to start again.
Keto is fine for a week, maybe 2 (with a thyroid condition) to kick start things, but it's not sustainable long term and not good for your metabolism.
Just as a side note, being a cyclist I've followed Pro Cycling for years and around 8-10yrs ago, Team Sky (now called Ineos) were all for low carb whilst training. Well a few months ago they have now changed their stance on that and gone completely the other way because of the long term effects of being on low carb for too long.
Sounds like you're finding the right level though. So good luck with it all.
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