Jacqueline Rizk, Contributor
Thyroid Nation

Are carbs really the enemy?

TTAC-IQQuiz-ads-300X250v2Low-carb diets are de rigueur these days. Because they are all the rage, most celebrity nutritionists have some version of the low-carb diet in their tool belt.

I totally understand the lure of the low-carb diet. If you have low thyroid function, a stressful lifestyle, insulin resistance (or Diabetes) and/or a hormonal imbalance and are putting on weight, it is really easy to point a finger at carbohydrates as the sole reason for that weight gain. A low-carb diet is often the natural antidote to that weight gain.

What do low-carb diets do?

Low-carb diets generally cause rapid weight loss and most people claim to feel amazing, energized, and have that “no sugar glow” on these diets. There are some, such as those with severe metabolic syndrome/insulin resistance or Diabetes which benefit from these diets long term.

Lower-carb diets do increase insulin sensitivity extremely well especially since metabolic syndrome is caused by chronically overeating carbohydrates which causes hyperglycemia (high blood sugar). To break down metabolic syndrome let’s look at hyperglycemia. When carbohydrates (which break down into glucose) are present in the bloodstream the pancreas secretes insulin to shuttle blood sugar into the cells where it can be used as energy.

Cells have insulin receptors, like little keyholes, with insulin being the keys. This is normally a physiological and biochemical process. Where this becomes problematic is when there is much more glucose than can be utilized by those cells (or moved to the liver to be stored as glycogen). More and more insulin is secreted as the concentration of glucose in the blood stays high and, the cells block the receptors from being utilized by insulin. The cells essentially cannot take on or utilize as much glucose as insulin tells the cells it wants to move into the cells so the cells stop listening to insulin. Some studies even show the possibility that the numbers of receptors on the cells are reduced as insulin resistance increases.

It should be noted that researchers like Broda Barnes, Lita Lee and Ray Peat have also alerted us to the probability that polyunsaturated fats have a hand in increasing insulin resistance. Since most people with metabolic syndrome have not eaten bowls full of sugar (rather cheap processed carbs full of PUFAs), in my view and what I have learned from my studies, there is validity to these claims, but that is an entirely different article.

Those with metabolic syndrome have a tendency towards low thyroid function and, because no system functions in a vacuum, many also have autoimmune inflammatory conditions. I find that discovering which came first, the chicken or the egg, is helpful in treatment.

Many health care practitioners, at the first hint of metabolic syndrome, immediately prescribe a low-carbohydrate diet to every patient that presents those symptoms. The issue with this is that many of these very accomplished experts prescribe very low-carb diets (under 20 grams) and many still prescribe “Bariatric weight loss” shakes and “meals” which are both low in carbohydrates and loaded with unfermented soy protein which is goitrogenic and has definite antithyroid properties.

How many carbs are allowed in a low-carb diet?

I should note that there are varying degrees of low-carb diets. Low-carb, for the sake of argument in this article, is defined as under 50 grams of carbohydrates in a day or the “ketogenic” state for a largely sedentary person. There are those who thrive with relatively low levels of carbohydrates ranging between 50-150 grams per day. With this in mind, it is no wonder that the average person with normal thyroid function and relatively normal hormonal balance and inflammatory markers, can maintain weight at about 150 grams of carbohydrates a day and will lose weight when restricting carbs to under 100 grams a day. The Standard American Diet (SAD) weighs in at 300+ grams of carbohydrates a day, and for a sedentary person, this is (more often than not), way too much glucose for the body to utilize in a day.

But what happens to the body over time when following a VLCD (very low carb diet)?

Well, at first the body is doing a little happy dance. As blood sugar falls the body overproduces stress hormones such as adrenaline, cortisol, and norepinephrine. Let’s face it, these stress hormones make you feel very good. They give you abundant energy, clarity, and even increase circulation. This is, unfortunately, often touted as that “Sugar-free Glow”.

Remember, adrenaline is released when your “fight or flight” response is triggered by cortisol. If there is a tree that falls on your child and you suddenly have superhuman strength, that’s adrenaline. Cortisol is also released to counter adrenaline release and is responsible for triggering insulin release to handle blood sugar maintenance and helps keep blood sugar regulated. It plays a part in the regulation of the inflammatory response and immune modulation. It is also responsible for blood pressure regulation. It’s not the villain it is made out to be, unless it is released at the wrong times or is elevated constantly.

Bear in mind that because of the OAT (Ovarian Adrenal Thyroid) Axis, the thyroid plays a part in both the production and secretion of stress hormones.

Also bear in mind that the body really does require some glucose for cellular metabolism and without enough of it, metabolic and energy production rates fall, body temperatures drop, active T3 levels fall, (with or without an elevation of T4), reverse T3 levels rise. Depending on the root causes of low thyroid function, high estrogen levels can also be observed, which are often driven higher still by the suppression of progesterone (which is needed to oppose estrogen). This creates an estrogen dominance scenario. Estrogen dominance causes the liver to release a protein called Thyroid Binding Globulin which binds thyroid hormone. This scenario is very prevalent in those with autoimmune disorders that attack the thyroid. TBG elevation lowers thyroid function even more.

So, you are on 20, maybe 30, grams of carbs a day, you feel amazing thanks to all those stress hormones trying to eke out usable energy for your cells, and your insulin sensitivity is falling. That’s fantastic.

What happens next?

Adrenaline has a function in your body: to keep you safe and alive. Cortisol has a lot of functions we have detailed above. Cortisol should be high in the morning to help wake you up and tell you to go hunt for food to energize your body. It should be low in the evening to help your body unwind and get the rest you need for your body to rejuvenate. There are many biochemical processes involved in this process that I detail on The Detox Diva quite a bit.



Thyroid function and the perils of a low-carb diet

There are very definite times and amounts in which these stress hormones are beneficial for the body. When you are on a very low-carb diet and these stress hormones are being overproduced to counteract not having enough glucose to feed your cells, this is where the trouble begins.

Your stress hormones will, inevitably, fail to be able to keep up with the demands of the bodily functions. There is such a thing as cortisol resistance. When your body is resistant to any given hormone, that’s a very bad thing. Remember when we talked about estrogen dominance causing TBG elevation? A VLCD causes chronic stress to the body which causes chronic cortisol release which decreases the liver’s ability to clear excess estrogen which raises levels of TBG.

Nourish&FlourishIf you are hypothyroid, you will have a tendency towards blood sugar handling issues, and if you have blood sugar handling issues you will, more than likely, put on weight at which point you will be tempted to do a VLCD which will, inevitably, make these issues so much worse.

If you have metabolic syndrome and need to increase insulin sensitivity, a low-carb diet can be a good thing for a relatively short time. You will lose weight and the lower your weight, the greater your insulin sensitivity.

But here’s the rub. A VLCD should be utilized for a very short time only and raising your carbohydrate level to above 50 grams and preferably above 100 grams a day is much more thyroid protective than trying to maintain “ketosis” for longer than the body can sustain. Don’t worry. If you have excess weight to lose, it will be more beneficial to do so from a standpoint of your organs being supported to function properly rather than stressing the body.

There is a very compelling reason that, in my practice, when my clients start with a cup of orange juice with a pinch of salt they often shed weight and feel energized upon careening off of a VLCD! The right carbs (unprocessed in the right ratios to other macronutrients and in the right amount) truly should be your ally in healing your thyroid and giving you the healthy slim body you desire and deserve.

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About the Author

Jacqueline-RizkJacqueline Rizk, DSc., CCN, HHC  is the fierce and fabulous clinical nutritionist, Integrative Health Specialist, Functional Medicine practitioner and transformational health consultant behind The Detox Diva. She helps passionate women take charge of their lives and health with customized strategies, and pret-a-porter treatment plans. Drop by, say bonjour, and shop at the chic services over at Be sure to follow her on Facebook, Twitter, and Instagram.

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Questions or anything to add about low-carb diets? We want your thoughts, please. You might just help someone else in need.