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Fasting and Thyroid Conditions: Is it Possible?

There are two things I know when it comes to achieving and maintaining good health: fasting is second to none, and having a healthy thyroid function is a must! Can fasting and thyroid conditions coincide?

Fasting and thyroid conditions can be compatible, if done correctly. The thyroid is a small, but extremely important gland in the human body. The National Institute of Health (Diabetes, Digestive and Kidney Diseases division) describes the thyroid as “a 2-inch-long, butterfly-shaped gland weighing less than 1 ounce. Located in the front of the neck below the larynx, or voice box, it has two lobes, one on either side of the windpipe. The thyroid is one of the glands that make up the endocrine system. The glands of the endocrine system produce and store hormones and release them into the bloodstream. The hormones then travel through the body and direct the activity of the body’s cells.” Can we fast with thyroid conditions? Let’s take a closer look. 

Thyroid conditions can have a tremendous impact on a person’s health and are on the rise: Autoimmune thyroid affects millions, and oftentimes goes undiagnosed. According to the National Cancer Institute, there were 53,990 estimated new cases of thyroid cancer in 2018, with rates for new cases rising on average 3.1% each year over the last 10 years. Death rates have been rising as well, 0.7% each year over 2006-2015.1

According to the National Institute of Diabetes and Digestive Kidney Diseases, other thyroid conditions are problematic as well: approximately 4.6 percent of the U.S. population ages 12 and over has an underactive thyroid (hypothyroidism)2, and 1 person out of 100 in the U.S. have an overactive thyroid (hyperthyroidism)3. 

When thyroid function is negatively impacted, it has ramifications for every system of the body. That makes thyroid conditions one of the most misdiagnosed conditions in the United States. This is where fasting comes into play. We often hear that we can’t fast with a thyroid condition. However, fasting and thyroid health can work extremely well.  

The Power of Fasting and Thyroid Health

When it comes to battling many of today’s health issues, the entire premise of modern medicine is incorrect. In the past, diseases like cholera and smallpox could be treated with medicines like penicillin and other antibiotics, but times have changed. Yellow fever has been replaced by heart disease, Type II Diabetes, thyroid issues and other diseases that are more dietary in nature. In other words, instead of looking for the latest drug, the best form of treatment is to fix cellular dysfunction and incorporate ancient healing strategies such as fasting.

While modern medicine hasn’t embraced fasting as a viable health option (yet), the practice has been around since the beginning of time. Fasting is known to rejuvenate and revitalize the body. Even animals will fast when they are stressed, ill or feel unease. The refusal to eat is a form of self-preservation to remove waste products and promote healing of the body. Fasting and thyroid health go hand in hand: fasting makes us more responsive to our hormones, thus improving thyroid function. 

Today, the philosophy on eating is the polar opposite of the ancient practice of fasting: We are now in a constantly fed state. We have gone from an average of eating three meals a (day, breakfast, lunch, and dinner) to eating five to six meals a day: breakfast, a snack, lunch, snack, dinner, and another snack. This change in eating habits has had a detrimental effect on our health. 

Fasting and Thyroid Conditions: Fixing the Thyroid

I’m always asked, “Can these thyroid conditions be reversed?” Absolutely. Get rid of the cause and the body reverses them. Contrary to popular belief, the doctor doesn’t do it, the body does. When you get rid of the causes through my multi-therapeutic approach (including fasting), the body can do amazing things. 

Here’s a common scenario for many thyroid patients: you’re taking the thyroid medication that your doctor prescribes, and your blood work looks normal. However, you’re still losing your hair, your skin is still dry, and you have no energy. You’ve even gained 20 pounds. You’re doing everything the doctor suggested, but it’s not working. Why? We haven’t gotten to the exact cause of the thyroid condition.

Most doctors simply address thyroid conditions without an understanding of the cell’s ability to receive the messages needed to function properly. This is where fasting and thyroid health fit together. Fasting makes the body more responsive to the hormones we are producing. Therefore we start to feel better. 

Fasting and Thyroid Health: Check Your Hormones

There are three important hormones that are key to thyroid health: TSH, T3, and T4. These hormone levels can appear normal when checked, but they hold the key to potential thyroid conditions. All of these can be altered for the better through the art of fasting:

  1.     T4 doesn’t convert to the active hormone T3. T4 hormone must be converted to T3 active hormone. If this conversion does not take place or is shunted into another direction (as in times of stress), then the message to the cell will never get through.  ONLY active T3 can be used in the cell.
  2.     Active T3 can’t be used in the cell because its receptors on the cell are blunted. An important point that I teach is that hormone problems are not necessarily problems with hormones themselves, but rather the receptor to the hormone. This is similar to Type II Diabetes, where the diabetic has plenty of insulin but the receptors to the insulin are blunted and unable to “hear” the message in order to allow the glucose in the cell.  Therefore, the glucose cannot get into the cell to produce energy. A similar situation occurs with the thyroid and T3.
  3.     You could potentially have an autoimmune condition called Hashimoto’s.  It is estimated that 80% of thyroid conditions are an autoimmune related condition known as hashimotos. What people may not realize is that most thyroid conditions are autoimmune related. Most of these conditions also go undiagnosed, because most doctors do not run the correct blood work to check for autoimmune hypothyroid. Many are hesitant to check because the treatment is the same, whether you are hypothyroid or autoimmune hypothyroid.

All of these potential reasons for thyroid dysfunction can be helped through fasting.

Fasting and Thyroid Conditions: Decrease Inflammation

Fasting is the quickest way to decrease cellular inflammation, because it allows the body to direct all of its energy towards healing. I say this with confidence because it has changed my life and made a greater impact on improving my cellular health than any other strategy.

In one study conducted on laboratory mice, researchers note that nuclear T3 levels are maintained at relatively normal levels in the pituitary of the fasted animal and fractional T3 receptor occupancy may actually increase.4

Another study comparing the levels of thyroid levels between impaired fasting glucose and impaired glucose tolerance found that fasting subjects had higher levels of F3, while those who were glucose impaired had lower levels of F3. Researchers concluded that the difference in thyroid hormone levels may play an important role in the different pathological mechanisms of IFG and IGT.5

As a person gets accustomed to fasting, the body gets more and more efficient with every subsequent fast. Fasting on a consistent basis can help reduce or even eliminate many of the ailments in today’s society: cells become more efficient at utilizing fat, which burns cleaner than glucose. The body becomes more responsive to hormones. Brain fog dissipates, weight loss is easier, and most hormonal problems may be eliminated, and that includes thyroid conditions. 

Fasting and Thyroid Health: Will going too “low carb” affect my ability to make adequate thyroid hormone?

This is where I will introduce my concept of “Diet Variation”.

Our ancestors varied their diet based upon what was available. Insulin carries many roles in its relation to other hormones, especially regarding the hormone convergence. Hormone convergence means hormones need to be converted from one form to another for active use. One of the best examples of this conversion is thyroid hormone. Thyroid hormone T3 is the active form of the hormone that helps our body (cells) use fat for energy.  Active Free T3 has many other functions as well, such as the overall health of our skin and hair, and even daily energy. Therefore, if your cells don’t get enough of the message, you will not feel well or burn fat efficiently. T4 is the inactive form that must be converted to the active T3. If the conversion is hindered in any way, the lack of T3 will affect how you feel and use fat as energy.

Fasting and Thyroid Health: Vary the Diet!

Insulin is needed for this conversion to take place. Therefore, if insulin is low too long the lack of active T3 can become a problem. Those on a low carb diet for long periods can develop very low insulin. This impacts not only fat loss and muscle loss but can affect other hormones as well. People that already have hormone challenges are even more sensitive to this potential problem, and respond the best to the what I refer to as “monthly diet variation.”

Feasting for one week a month (as described below) not only helps the conversion of T4 to T3, but other hormones like estrogen and testosterone as well. The week before a woman’s period is what we have discovered is the best time to drive the insulin up to assist in the many hormonal needs that take place at that time.

Think about how smart the body is. That is the time that most women would say they get the cravings for carbs and sugar. Simply listen to your body, but reach for the healthy carbs like fruits, sweet potatoes, yams, ancient grains, ground vegetables, etc. Men this has been a proven strategy for you as well just from a variation strategy to remind your body it has plenty and not starving, and from the variation of the increased carbs or protein drives a pathway called mTor which is an anabolic pathway for growth. This pathway is referred to by the low calorie, low protein and plant-based diet enthusiasts as a destructive pathway that can lead to premature aging and disease, however, clinically we find that short-term stimulation of this pathway from high carbs, protein or calories can have a healing effect and improve the hormones and metabolism.  

Diet Variation: 3-2-2 (great for anyone struggling with thyroid conditions)

Each week:

Pick 3 days of Intermittent fasting days:

Although it may sound complicated, intermittent fasting is actually a very simple concept. It’s eating in a 4-6, maybe 8 hour window. Maybe you start with a 10 hour window. I personally have been at it so long, I love to go at least 18-24 hours. Therefore, my eating window is typically 4 hours. However, I don’t recommend beginning with a long fast right away. You have to work up to that efficiency in the cells, which is why we I created this program. Be patient and work your way up. As you get more fat adapted, you will burn more fat for energy, and you will be able to fast for longer periods. The idea is to do a short daily fast, only eating during certain hours of the day.

Pick 2 days of famine: 

Famine means just water for 24 hours

Pick 2 days of feasting:

Do not limit your intake of food or water, eat throughout the day.

**Tips to remember:

  • We want to see glucose dropping, and ketones rising, even when varying and cycling the diet!  
  • As we see that happening, then increase fast days per week.
  • Don’t forget about the feast days, which are just as important.
  • Wait until you are in ketosis to start the feast famine cycle.
  • If you are coming off the water fast, you don’t have to wait, go right into feast famine cycle.
  • Monitor glucose levels! Autophagy will still keep going, as long as glucose isn’t rising. You have to look at the glucose.

Diet Variation: Monthly 

7 carb loading days/month:

Listen to your body: Do the carb day when needed.

  • Add in 1 carb loaded week, where ever you have the most moodiness and carb cravings. For females, this is typically the week of menstruation.
  • Remember, low carb for a long time keeps insulin low. However, chronically low insulin (especially for those who are hormonally challenged) will start to slow down the conversion of some hormones.
  • T4 hormone (the non-active thyroid hormone) has to convert to the active form of T3, which is the kind that has to go into the cell receptors in the mitochondria and talks to the receptors.
  • This conversion requires insulin.
  • Really healthy people can get their insulin down to 2 and below, and can still make that conversion. However, for those with hormone conversion trouble already, when the insulin gets too low will start to slow down this conversion, and not make the active form.

We need insulin to make many hormone conversions.

Once a month adding in these carbs (through diet variation), we magically start converting our hormones and feeling better! This applies to the rest of the month. This is imperative for those people with thyroid conditions. Fasting and diet variation are both great ways to increase your thyroid health, in conjunction with my multi-therapeutic approach to healing.

Reference:

1. Cancer Stat Facts: Thyroid Cancer. https://seer.cancer.gov/statfacts/html/thyro.html

2. Hypothyroidism (Underactive Thyroid). https://www.niddk.nih.gov/health-information/endocrine-diseases/hypothyroidism

3. Hyperthyroidism (Overactive Thyroid). https://www.niddk.nih.gov/health-information/endocrine-diseases/hyperthyroidism

4. Comparative Study Of Pituitary-Thyroid Hormone Economy In Fasting And Hypothyroid Rats.  1985 Feb;75(2):679-88.

5. Different Levels Of Thyroid Hormones Between Impaired Fasting Glucose And Impaired Glucose Tolerance: Free T3 Affects The Prevalence Of Impaired Fasting Glucose And Impaired Glucose Tolerance In Opposite Ways.  2014 Jun;80(6):890-8. doi: 10.1111/cen.12384. Epub 2014 Jan 16.

Reader Interactions

Comments

  1. Great article. I suffer from thyroid condition Hashimoto but also have low bone density (Osteoporosis). I am on Keto diet now as I am following the Cellular Healing diet. Would the above strategy of Diet Variatuon with 3-2-2 work for both my thyroid and bone density. Kindly advise.

    Reply

  2. Nicolette

    You state: “Monitor glucose levels! Autophagy will still keep going, as long as glucose isn’t rising. You have to look at the glucose.”

    What are the glucose levels we should be mindful of?

    And as a nursing mother (baby is 3.5 months), would you say to follow this same recommendation?

    I’m 35, have Hashimoto’s-diagnosed last November…finally-, haven’t touched anything gluten in almost a year, I’ve been low carb since my second trimester, I feel great as far as my eating is concerned, and have managed to have a full fast day (going from eating one evening till not eating again until two days later-mid day with no struggle). I eat most days anywhere from 2-4pm till about 10pm, I don’t have a hard and fast rule but that’s when I tend to get hungry. My milk supply is not suffering at all, but I have to admit my energy is awful, as always. My lack of energy has been my problem for about 10 years now, and I am so tired of it! I wonder if your plan will help that. I just don’t know what to do anymore. I’d love your input.

    Reply

  3. Merina

    Great article and provides answers to questions I’ve been having about hormones and fasting. How would this work for menopausal women and the myriad of hormonal issues that are at issue?

    Thanks!

    Reply

    • Hello Merina,

      The hormones associated with menopause would still fall into the line of general hormones. Fasting has the ability to help balance menopausal hormones as well!

      Reply

  4. Lynn

    I understand what you’re conveying and it seems really important. However, any time one ups the carbs it seems like cravings would ensue. Is there a way to do this to minimize cravings?

    Reply

    • Hello Lynn,

      When adding in a feast day, you would want to do so after you have become fat-adapted to prevent the glucose imbalance. This one feast day a week is to remind the body that it isn’t starving!

      Reply

  5. Great advice Dr. Pompa! I was previously strictly low carb for quite some time, not quite ketosis, but still wasn’t feeling 100%. I then introduced intermittent fasting about 5-6 days a week (8 hr eating window), and carb loading a couple days of the weak. My thyroid related symptoms have now improved greatly; more energy, stopped hair loss, no mid day crashes, etc. Now on day 3 of a 5 day fast (mostly water, tea twice a day, no sugar), and it feels great. Day 2 the hardest for sure.

    Thanks for all you do!

    Reply

  6. Amanda

    This is so informative, thank you! I have hypothyroid, low insulin and HPA Axis dysfunction. I have been working up my fasting hours since July and some days easily do 18-20hours and feel fantastic, but the next day or two I will be exhausted and the constant ringing in my ears is even louder. Do I need to take this even slower? I’m so encouraged reading that fasting can indeed help with thyroid issues yet want to do it the most helpful way. Thank you

    Reply

      • Amanda

        Thank you very much for your reply and thoughts Celina! I appreciate your time and am looking both concepts up now on Dr.Pompa’s site. In six years and seeing four functional medicine practitioners, no one broached the subject of possible metal toxicity with me.

        Reply

        • Carla Hines

          Amanda, I have hashimoto’s and believe the cause to be the heavy toxins I was exposed to for 30 years in my sign shop. i’m about to begin a serious metal detox program. Good luck!

          Reply

  8. Good morning. I watched your interview on the fasting summit. You explained fasting clearly especially the sinking ship comparison. It’s important to understand the science behind the results. I’ve been fasting 16/8 for a while and feel fantastic. However I drink two black coffees and water in the mornings during the fast. Is this sabotaging my results?

    Reply

    • Hello Margot,

      We have many people who consume coffee while intermittent fasting. But, if you are doing an extended fast (such as a water fast), I would stick to water only.

      Reply

    • Hello Vicki,

      I would suggest reading about diet variation and how it affects hormone sensitivity. I would also learn about the True Cellular Detox program to get to the root cause of the imbalance.

      Reply

  10. Dacie

    Are we supposed to alternate from feast to famine daily? This article made sense to me until i thought about implementing it and got confused where to start, and what a week would like look.
    It also says not to incorporate the feast famine cycle until you are in ketosis. I feel like my body has an aversion to ketosis. I don’t have a gallbladder. I was only in ketosis once and it was on the 3rd day of a fast, but I really dont want to do a long fast like that again. It truly wasnt helpful and only stressed my body out.
    I’ve been alternating keto and the cellular healing diet for quite some time. And was doing cellular detox protocol for 1 year with a nutritionist. The heavy metals test only showed slightly elevated lead levels.
    Thank you for any advice!

    Reply

    • Hello Dacie,

      It is important to remember that with each phase, comes further improvement and hormone sensitivity. Once in ketosis, you would have one feast day a week. The elevated lead levels are from detoxing. From what you mentioned, you have very high lead levels and it is going to take more time for you to bring those levels down.

      Reply

    • Holly

      Did you figure out a good system? I have the same question. It made sense until I thought about implementing it.

      Reply

  11. Juliana

    Hi,
    I’m researching about fasting, but I had my thyroid removed a few years ago. I take T4 daily since pure T3 isn’t available where I live. Is fasting recommend for me? I constantly few my energy low and craving for sugar. Also I’m very active with sports.
    Pls give me some light cause it seams that a condition where you don’t have the thyroid at all is being completely forgotten.
    Thanks in advance and congratulations for your great article

    Reply

  12. Christie

    Hello,
    I am a little confused on how to start this….would it be intermittent fasting for 3 days in a row, followed by the 2 days of famine, and then 2 days of feasting in a row? Since being diagnosed with Hashimoto’s a year ago, my levels have been up and down with various dosages of medication and never as good as they were before I started taking them. I am looking for alternative ways to manage this. Thanks for your help!

    Reply

    • Hello Christie,

      Most people do a 5-day water fast and consume only water over those 5 days, however, there are many ways to do fasting such as intermittent fasting, block fasting, partial fasting, bone broth fasting, etc. If you are unsure of how to complete a fast with your thyroid condition, I would suggest finding a coach at http://www.drpompacoaching.com.

      Reply

      • Jennifer Benson

        But to answer her question (I have the same question): for the 3-2-2 – how is it implemented? It is 3 days in a row of intermittent fasting followed by 2 days in a row of 24 hours fasted followed by 2 feasting days?

        Reply

        • Ashley Smith

          No, you don’t need to keep the blocks grouped. Just be sure though you you don’t follow the water fasting days with feast days.

          Reply

  13. Anna Chiarenza

    A recent blood test has showed that I have hypoparathyroid. I read a lot about the thyroid but not much about the parathyroid. Is it treated the same way? What information do you have on the parathyroid. Thank you!

    Reply

    • Hello Anna,

      The parathyroids are glands located within the thyroid gland. These glands work with calcitonin that balances blood calcium levels which is important to numerous processes. Too little parathyroid hormone can lead to decreased concentration of calcium leading to painful muscles spasms and convulsions. Oftentimes, it is an autoimmune condition that causes this decreased activity. If you are interested in finding a coach or practitioner, please visit http://www.drpompacoaching.com.

      Reply

  14. Mary

    I have been intermittant fasting and following the TCD diet for 4 months and feel great. For the last month i did 4-2-1 and by the last week i was doing great on the 2 fasting days. My question is : can i continue into 3–2 -2 fasting now and start the prep phase of the cellular detox? Or should i complete the 5 day water fast before starting the prep phase ? Or iis it to be done after all the 3 phases are iover? Thanks!

    Reply

  15. Jamie Heaton

    I have only one thyroid after having one removed.I am not in any medication right now as my last labs came back normal and it is not needed.I am thinking of fasting.would this effect my thyroid in a negative way or cause it to crash?

    Reply

    • Ashley Smith

      I would recommend working with a highly trained practitioner. Healing through fasting is possible, but I’d suggest you don’t go at it alone.

      Reply

  16. Laurie

    I have only done intermittent fasting 6-7 days for a year now with low carbs, except vege’s – I eat fish and eggs, no meat. I have high T4 and low T3 and in post menopause. On podcast Dr. P mentioned a 5 day high carb before period to correct this? Not sure how that applies to me?

    Reply

    • Ashley Smith

      Incorporating a high carb block of around 5 days before (and during) your cycle can be very beneficial. Since you are in post-menopause, this still applies. Choose a week that works well for you. Dr. Pompa speaks about Diet Variation as the key to balancing hormones. You can check out many videos in his Facebook Group, Fasting For A Purpose.
      Note of course, this is still conscious eating, high quality carbs, and a moderate balance of fat and protein.

      Reply

  17. Allen

    Hi. Great article

    I take a desiccated bovine natural thyroid supplement twice a day. If I wake up and I’m going to fast that day, wouldnt taking that supplement be sorta like taking a little capsule of “beef”? (Food)? So should I wait until my feeding window ? Or is that little capsule (standard size) too small to worry about, food wise, and could perhaps help me through the fast (T3 wise) ? (Keeping energy levels up). I’m sure anyone who is hypothyroid has questioned this to themselves. And if not, now they will. Lol. 🙂

    Reply

    • Ashley Smith

      Just fasting for a day, it’ll be ok to skip your supplements. You are correct, a food based supplement will break your fast.

      Reply

  18. linda

    whats a good fasting routine for hashimotos,, refuse to take meds,,, i have gained 13 pounds in 2 weeks after i stopped fasting,, i fast regularly and was short about 20 pounds to my goal , i usually do water fast for days at a time then carb refeeds for a bit then back at it. I switched it up to omad 2 weeks ago, still with carbs as part of refeed and gained 13 pounds in two weeks now 🙁 uggg so instead of losign or maitaning i gained but i was feeling to eat as n can feel thryoid pain again and swelling in throat area again. So that’s why i had to do some refeeeds, but now instead of needing to lose 20 i need to lose 33 lbs, what do you type of fasting do you suggest for this? Im desparate to acheive my weight loss goal along with correcting my thryroid issue, thank you so much .

    Reply

  19. drew

    What about those who fast, but have hyperthyroidism? Is it advise to practice since we “burn” our food intake at higher rate?

    Reply

  20. Anita Vaughn

    Hello Dr. Pompa!
    I am 57 years old, post menopause and was diagnosed with hypothyroidism while doing a weight loss program probably 9 or 10 years ago. I was put on Armour Thyroid but later changed insurance and my doctor now will not prescribe anything but Levothyroxin. The problem now is that I have done everything to lose weight, I’m 14-20 pounds heavier and miserable! I work out, eat healthy and drink lots of water. I even tried low carb eating 2 years ago along with Intermittent Fasting and dropped 10 pounds. Now nothing seems to be working. My primary care doctor thinks I’m crazy because my thyroid levels are normal and has referred me to a endocrinologist who I can’t see until next month. I do not feel right because something is wrong! Can you help me?

    Reply

  21. Darren M Chaves

    My wife had her thyroid removed 11 years ago and takes synthroid every morning. I am a huge advocate of fasting and a low carb/diet variation way of eating. What would be a healthy strategy for my wife without her thyroid, and dependance on synthetic thyroid hormones?

    Reply

  22. ANNMARIE

    Years ago, I was diagnosed with an Iodine deficiency so I started adding 150 mcg Iodine a day. I have all the symptoms of hypothyroid problem but my dr says it not treatable until it reaches TSH 5.0. It is at 4.5 I was thinking about doing a water fast the is June with the group. I believe and heard of people adding salt to the fasting water. With that said, how much salt should I add during the day for this 5 day fasting with a purpose fast?

    Reply

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