HYPOTHYROIDISM: Diet & Exercise Regime

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Written by Hayleigh Bennett 

Eat Run Lift's HIIT and female weight loss specialist. Hayleigh is exclusively available as an online coach.
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Exercise and Nutrition for Hypothyroidism

Hypothyroidism is a hormone disorder where the thyroid does not make enough thyroid hormones – leading to an under-active thyroid. The disease affects 1-2% of people worldwide and is 10 times more likely to affect women.

The most common type of hypothyroidism (in the United States) is Hashimoto’s Thyroiditis. Causes may include iodine deficiency, a genetic disorder, taking certain medication, or surgery where part of the thyroid gland has been removed. Having an under-active thyroid disrupts the ability for growth, repair and metabolism.



·      Slower metabolism
·      Gradual weight gain
·      Feeling cold year round
·      Muscle weakness
·      Joint and muscle pain
·      Sadness or depression
·      Tired/Fatigue
·      Pale, dry skin
·      Slow heart rate
·      Heavy menstrual bleeding



It may feel like a vicious cycle - the symptoms of fatigue, achy joints and weight gain causes muscle weakness, which in turn can make exercise feel like a chore. It can be difficult to find the energy to exercise due to a slow metabolism however it is vital to establish a routine to help elevate metabolism, improve energy and relieve depression.

Moderate or high intensity cardio including fast-paced walking, running, hiking or rowing where the heart and lungs are working >50% can help to alleviate symptoms. Exercising 150 minutes per week split as 30-60 minutes over 5 days can help to boost mood, ease constipation, promote muscle and joint flexibility and help manage weight.

If you are new to exercise begin with stretching and weight bearing exercises – you can find our free stretch guide here! You can begin to increase weights and intensity as your tolerance grows. Avoid pushing through fatigue as this will trigger exhaustion and make exercising less desirable.


Diet & Nutrition

Although food won’t cure hypothyroidism, consuming the right combination of nutrients and medication can help restore function and minimise symptoms. Iodine (seaweed, fish, dairy, eggs), selenium (antioxidant, brazil nuts, tuna, sardines, eggs, legumes) and zinc (oysters, shellfish, beef, chicken) assist in activating the thyroid hormones and are preferably consumed as wholefoods rather than supplements unless otherwise prescribed by your health practitioner.


Avoid goitrogens in the case of iodine deficiency, or eat in moderation, ideally cooked, as these may interfere with normal function of the thyroid. Goitrogens include soy foods (tofu, tempeh, edamame), cruciferous vegetables (cabbage, raw kale), fruit and starchy plants (sweet potato, cassava, peaches, strawberries), and nuts/seeds (millet, pine nuts, peanuts).

"What about a high protein diet?"

Higher protein diets can increase the speed of metabolism; consider 1.5-2g per kilogram of body weight. This will also assist in muscle recovery and growth.  It is important to consume a healthy diet of eggs, lean meats, fish, vegetables (cruciferous in moderation, cooked), fruits, gluten-free grains and seeds, and dairy. It would be suitable to consider a low to moderate carbohydrate diet.

"SHOULD I DO A Low Carb / Ketogenic Diet?"

Thyroid hormones are essential to maintain and regulate the metabolism of energy and carbohydrates. Energy (glucose) that we get from carbs is required to fuel production of thyroid hormones – carbohydrates influence the conversion of T3 from T4 which is important for hypothyroidism as T3 is the active thyroid hormone that needs to be increased. When carbohydrate intake is reduced the conversion declines. Prolonged calorie restriction or fasting reduces T3, which slows down metabolism (ultimately leading to weight gain).

A low carb diet without ketosis is unlikely to influence thyroid levels, whereas keto can cause other hormonal imbalances (particularly in women) that which would be unnecessarily risky. It is not recommended to follow a very low carb or ketogenic diet if you have hypothyroidism


Eleise Britt (nutritionist), Is Low Carb Bad for Hypothyroidism, Diet VS Disease, retrieved from [https://www.dietvsdisease.org/low-carb-hypothyroidism/]

Thyroid Disease, Office on Women’s Health, retrieved from [https://www.womenshealth.gov/a-z-topics/thyroid-disease]

Authority Nutrition,  Best Diet for Hypothyroidism; Foods to Eat, Foods to Avoid, Health Line, retrieved from [https://www.healthline.com./nutrition/hypothyroidism-diet#section9]

Greene, C. 2013 The Permanently Beat Hypothyroidism Diet & Exercise Shortcuts Cookbook, Createspace Independent Publishing.



Low Carb vs Keto - What's The Difference?

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Low carbohydrate and ketogenic diets are often confused, perhaps in part because a ketogenic diet is, by default, also a low carbohydrate diet. That said, there are several important distinctions that set ketogenic diets apart from more generic low carbohydrate diets. Let's look a little more closely at each of those distinctions, so you can better understand why someone might wish to pursue a ketogenic diet.

So, what's a low-carb diet?

Okay, so here's where the greatest confusion generally comes in. A low-carbohydrate diet focuses on limiting carbohydrate intake. A ketogenic diet does the same. So how are they different?

The difference is like that between a doctor and a surgeon. The surgeon is still a doctor but may be far more specialized. Keto diets, similarly, are specialized low-carb diets. So let's look at the generic—the low-carb diet—first.

First, it's important to note that “low” in this case is pretty subjective. There's no clear consensus on how many carbs one can eat before a diet is no longer low-carbohydrate, for instance.

In general, though, the idea here is to be more selective than the standard western diet. Often this means fruits, vegetables, and beans are still acceptable parts of the diet; while grains, baked goods, and processed sugars are either completely eliminated or drastically reduced.

As a result of shifting from carbohydrate-dense foods in your diet, to more low-density foods, the daily carbohydrate quantity you intake is significantly cut.

The subjectivity of the diet, however, can be problematic. For instance, if you were consuming 300 grams of carbohydrates daily, and cut it to 200 grams per day, this is a lower-carbohydrate diet. If you don't replace the lost calories, you may still lose weight, and technically, you could consider this a low carb diet, as you lowered your carbohydrate intake. Conversely, though, if you replace those lost calories with extra proteins or fats, you may have very different outcomes.

As a result, this subjectivity makes it hard to determine whether or not low-carbohydrate diets are effective, as they're not very well defined, and as such, cannot be very well judged.

Then what's the ketogenic diet?

The two biggest differences between low(ish)-carb diets and ketogenic diets are these:

  • Low-carbohydrate diets are imprecise; everything in a proper ketogenic diet is measured.
  • Low-carbohydrate diets are predicated by cutting back on a single macronutrient (carbohydrates), whereas ketogenic diets require very precise balances of all three.

In short, a successful ketogenic diet is high-fat, moderate-protein, and low-carbohydrate. When done correctly, it allows your body to shift from burning carbohydrates (or glucose) to burning fat in the form of ketones and fatty acids.

In fact, in order for a diet to truly be ketogenic, it has to pursue nutritional ketosis; if it isn't done properly, however, it can go very badly, and leave you feeling terrible—without any of the benefits ketogenesis can provide.

So, how should ketogenesis work?

When ketogenic diets are balanced correctly and appropriately, that carbohydrate restriction should result in increased ketone production. Ketones, which are a byproduct of fat distillation and produced in the liver, can actually be measured (via blood or urine), so if you are a ketogenic diet, you can test progress.

A few guidelines: Traditional western (high-carbohydrate) diets generally result in blood ketone levels between 0.1-0.2 millimoles (mmol), and even moderate-carbohydrate diet (which some may confuse for low-carbohydrate diets, as discussed above) will generally fall in this same range. A truly effective ketogenic diet, however, will result in much higher blood ketone levels, generally above 0.5millimoles but safely as high as 5.0 millimoles. This higher ketone level is a sign that your body has reached a state of “nutritional ketosis,” and shows that the ketogenic diet is working.

But what does this look like as a diet?

For an effective ketogenic diet, consider the following guidelines a starting point for each of the three most major macronutrients.


Standard western diets are frequently between 40-70 percent carbohydrates, by calories. Most research studies equate low-carbohydrate diets as gaining less than 30 percent of their calories from carbohydrates (generally in a range of 50-100 grams per day).

Ketogenic diets, however, often suggest as few as 5-10 percent of your total caloric intake comes from carbohydrates, which is generally in the 25-30 gram range. Many ketogenic plans offer a little more leeway, but almost all suggest a maximum intake of 50 grams on any given day, as keeping carbohydrate intake below that threshold seems necessary for triggering nutritional ketosis, in which your body begins relying on fat for fuel.


This is where ketogenic diets show the greatest range, depending on the goals of the ketogenic diet. If weight loss is the aim, for instance, the plan may suggest moderate to high protein intake, in order to maintain muscle, strength, and satiation, so you aren't left feeling hungry.

Consider the following basic divisions: High-protein diets may recommend 0.7-1 grams per pound of body weight (2 grams per kilogram) or more; moderate-protein diets generally recommend between 0.6-0.7 grams per pound of body weight (1.3-1.5 grams per kilogram); low-protein diets may recommend less than 0.35 grams per pound (0.9 gram per kilogram) of body weight.

One note of caution: As Dr Jacob Wilson, director of the Applied Science and Performance Institute, notes, high-protein diets can make achieving nutritional ketosis impossible. (As a result, he recommends no more than 1.5 grams per kilogram as an upper limit.)

The science behind this is based on a process called gluconeogenesis, by which the body, in a carbohydrate-limited state, breaks down proteins to create glucose, thereby bypassing the aims of ketogenesis, which requires the body not have access to glucose, so that it instead will create ketones for fuel.


 When it comes to low-carbohydrate diets, you still need a moderate amount of fat, because otherwise, the only way to get calories is through an overabundance of protein. In a low-carbohydrate diet, though, you're still mostly burning the carbohydrates you're still consuming, so this is less important.

In a ketogenic diet, however, fat is what you're burning. As a result, you want 70 percent or more of your daily calories to come from fat, as fat is your new fuel source.


For many people, this is the hardest change to accept when looking at a ketogenic diet. After all, isn't it fat which contributes to obesity? The truth is, the research on high-fat diets are inconclusive at worst, whereas as plenty of evidence suggests that the real culprit for so many health issues is the combination of high-carbohydrate and high-fat diets, or what we might consider a standard western diet.