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This post is adapted from a chapter in my best-selling Essential Thyroid Cookbook. Enter your name and email to the left (scroll down a bit) for a sample cookbook.

Being overweight and weight loss resistant is one of the biggest complaints of hypothyroid sufferers. Perhaps you may have greatly restricted carbohydrates in your efforts to lose those extra pounds, but I’m guessing your efforts backfired? Maybe it worked for a while and then you found yourself putting on weight once again?

For those with hypothyroidism, carbohydrates are critical. I’ve seen too many people crash and burn on a low-carb diet—and lose a ton of hair. Or they’ve beaten themselves up because they didn’t have the “willpower” to stick to primarily protein and fat. It’s often not about willpower, it’s what going low-carb does to the brain. See #10 below.

According to naturopathic physician and women’s health expert, Dr. Lara Briden, “A diet of only meat and non starchy vegetables is great in theory, and great for many people. But it does not work for everyone. It does not work for the poor young women who tell me that they have valiantly avoided rice with dinner, only to collapse with tears and ice cream in the evening.”

Paleo and AIP diets

The Paleo or AIP (autoimmune protocol) diet is often recommended for those with autoimmunity and proponents are generally in favor of low-carb diets. That said, this isn’t so much the case anymore—many who’d beaten the low-carb drum for some time have softened their views on carb restriction, largely because of what many of us have known all along—that a low-carb diet is an especially bad idea for those with hypothyroidism, Hashimoto’s, the adrenal dysfunction that almost always accompanies low thyroid function, and those suffering from hair loss.

To be clear, many Paleo proponents have clearly stated that Paleo isn’t necessarily synonymous with low-carb, as they feel that some starchy vegetables are acceptable.

There are three macronutrients: carbohydrates, fat, and protein. None of them should be vilified, as they’re all critical for good health.

Back in the day, I watched with distant interest as the Paleo craze took hold. I read how Paleo proponents knocked carbs—but I was incredibly skeptical. I sat back and observed, sure this would eventually blow over, knowing that this advice was unfortunately going to backfire on those in the hypothyroid community.

Sure, it’s not a good idea to overload our diet with grains and/or legumes, which I believe is true for everyone. But I had a particularly difficult time hearing the claim that starchy vegetables (sweet potatoes, yams, pumpkin, squash, parsnips, etc.) were off limits. I thought, “Here we go again, just as with ‘goitrogenic’ vegetables, we’re denigrating healthful foods.”

One caveat with starchy vegetables is potatoes. They’re in the nightshade family—nightshades can be inflammatory triggers for some with autoimmunity.

Not all carbs are created equally

The role and benefit of carbs has been fervently debated in the functional nutrition world and it’s important to make the distinction between carbs from whole foods such as fruits, vegetables, tubers, and starches (gentle carbs) and carbs from sugar, grain flours, and highly processed and refined foods (junk carbs). Common sense tells us that foods in their whole state don’t have a negative effect on the body like processed and refined junk does. One exception is fruit juice. I’m not anti-fruit, but concentrated fructose is a jolt of sugar.

[You can learn about healthful fat, protein, and carb sources, how to easily balance these macronutrients, and the distinction between simple and complex carbs in my ebook, Balance Your Blood Sugar, Balance Your Life.]

It’s true that some do well on a low-carb diet. In fact, it can be therapeutic for those with polycystic ovary syndrome (PCOS) and epilepsy (many with epilepsy adhere to a ketogenic diet with great results). But for most people, a low-carb diet can be just that—a therapy, not meant to necessarily be adhered to long-term. Even those with PCOS don’t need to be low-carb forever, especially given that PCOS is said to be a temporary condition.

I’m not advocating excessive carb intake. And if weight is an issue, you may want to consider a moderate-carb diet, but definitely not a carb-restricted diet.

Below are reasons why a low-carb diet is a bad idea. For each of these points, I’m of course referencing whole foods carb sources, not junk carbs from sugar, processed foods, and grain flours, not that grain flours are all bad.

1. A low-carb diet tends to be low fiber, which is bad all around. Go here for my post, Low-Fiber: A Low-Carb Casualty.

2. A low-carb diet can lower T3, your active thyroid hormone, and increase Reverse T3 (RT3), which acts against thyroid hormone production. Low-carb diets force the body to break down fat for energy. So yes, you can lose weight on a low-carb diet, until your RT3 increases and your weight loss efforts backfire.

3. Caloric restriction incites a stress response (think famine), which is compounded when carb intake drops. More stress means higher RT3 production and decreased circulating thyroid hormones. See #1.

4. Many with hypothyroidism have a difficult time with thermo-regulation—they’re frequently cold. Carbs help with cold tolerance and better overall body temperature.

5. The primary hormonal imbalance with adrenal dysfunction is overproduction of the stress hormone, cortisol. Low-carb diets contribute to high cortisol. 

6. For those prone to high stress, carbs help improve the cortisol response.

7. Adrenal dysfunction and a high protein diet often lead to low GABA—a calming neurotransmitter. Carbs help to raise GABA.

8. Insulin is generally low on a low-carb diet and insulin is required for T4 (inactive thyroid hormone) to T3 (active hormone) conversion.

9. Low-carb diets are often lacking in potassium, a mineral that helps support the adrenals and nervous system and helps to support mood and energy.

10. A carb-restricted diet is usually protein-heavy, which can cause brain fog and can leech calcium from the bones.

11. Carbs are the primary fuel source for many of the body’s vital organs, including the central nervous system, kidneys, heart, and brain. The brain is a glucose hog, and this is why many low-carb dieters become tired, angry, depressed, spaced out, and tense. Research has shown that carb-restrictive dieters tend to become depressed about two weeks into their diet, about the time their serotonin levels (a neurotransmitter and feel-good brain chemical that elevates mood, suppresses appetite, and has a calming effect) have dropped due to decreased carb intake.

12. A low-carb diet can cause hair loss. Obviously, this is a double-whammy for those already losing hair due to low thyroid function and/or alopecia. The combination of caloric and nutritional restriction often present with a low-carb diet puts a significant amount of stress on the body, which can cause telogen effluvium, or stress-induced, diffuse hair loss. In fact, my hairdresser said that many women who go on low-carb diets end up with hair extensions.

I can’t go a day on a low-carb diet—I start to feel spaced out and have trouble focusing. Many of my clients have said the same and are so relieved to hear that I’m not an advocate of eating this way. Again, I don’t recommend going on a carb bender, but reasonable and moderate amounts of carbs are part of a balanced diet.

As many have said, “Carbs ground me” and I couldn’t agree more.