What Really Impacts Thyroid Health Part 1

Like all other hormone issues, there’s quite a bit of confusion when it comes to thyroid health. Some people say low carb is good for those with hypothyroid, while others say it’s going to exacerbate your symptoms. Some women do really well on thyroid meds, while others don’t get any relief from their symptoms. So what’s the deal? There are many different areas of our health that impact thyroid hormone production and usage in the body. That’s what we will cover in this two-part series. To start, let’s dig into nutrition!

Macronutrients & Your Thyroid

Protein, fat, and carbs are all important for thyroid health. When it comes to eating for thyroid health, it’s honestly not very complicated. My best piece of advice is to avoid extremes. Dieting extremes like the ketogenic diet that increases fat and lowers carb and protein and low carb diets are often recommended for those that struggle with their thyroid health. The issue with these extremes is that they can slow down certain thyroid functions. Protein, for example, is essential for thyroid function. Our bodies breakdown protein into amino acids, which fuel many activities in the body, including liver function. The liver is where much of our thyroid hormone conversion occurs. A lack of protein in the diet has been shown to lead to poor thyroid hormone conversion and higher TSH levels (indicating a sluggish thyroid).

Carbohydrates are also essential for healthy thyroid function since our livers require glucose to convert thyroid hormone. A lack of protein and carbs balanced in the diet typically leads to blood sugar imbalances and increases in cortisol. These can all contribute to insulin resistance, making it difficult for our bodies to absorb nutrients and lead to thyroid dysfunction.

Essential Micronutrients For Thyroid Health

Micronutrients are the true allstars when it comes to thyroid health and function. Not only to minerals help us make thyroid hormone in the first place, but they also help us convert it and get it inside the cells. Without adequate levels of vitamins and minerals, our thyroid would not be able to make or use thyroid hormone. Here are some of the most important:


Copper stimulates the production of the thyroxine hormone T4 and helps to maintain optimal thyroid function by supporting energy production in the body. Copper also regulates iron, which is important for thyroid hormone conversion.


Protects against oxidative stress and inflammation which damages the thyroid gland. Essential for making ATP that powers the sodium-iodide symporter to transport iodine into thyroid cells.


Helps initiate the creation of thyroid hormones, activates thyroid hormones, and helps to convert T4 to T3. It also helps to support the recycling of iodide to make more thyroid hormone and protects against damage by reducing oxidative stress and heavy metal contamination.


Transports iodide into thyroid cells in order to make thyroid hormones via the sodium-iodide symporter. Also supports insulin sensitivity, which can impact micronutrient status and thyroid function.


Iron helps to convert inactive T4 into active T3. Iron deficiency also disrupts thyroid hormone creation by reducing thyroid peroxidase activity–this relies on heme, which we need iron to make.


Zinc is important for converting T4 to T3. Supplementing with zinc has been shown to improve thyroid hormone conversion; however, excess zinc has also been shown to cause hyperthyroidism.


Iodine works with sodium to fuel the sodium-iodine symporter, which helps to make thyroid hormones and get them inside our cells.

Blood Sugar & Thyroid Health

Keeping blood sugar levels balanced is another important factor when assessing nutrition needs for thyroid health. When blood sugar drops, the body releases cortisol, which will then lead to a breakdown of glucose from the liver and a release of insulin. The more this happens, the more cortisol and insulin are released, and eventually it can lead to insulin resistance.

When we are eating low carb or following a ketogenic diet, this leads to lower levels of insulin, which leads to an increase in loss of minerals in our urine. Whether we are dealing with high cortisol and insulin or low insulin this can contribute to depletion of important minerals for thyroid function like sodium, potassium, and magnesium. Balancing meals with protein and carb as well as eating regularly throughout the day (see below) is the best way to support balanced blood sugar. We also have a blog post that goes into more detail here. 

Meal Timing & Thyroid Function

There is a lot of controversy around whether you should eat more frequently, only eat three meals and a snack, never snack, or do full-on intermittent fasting. My general recommendation for most people is to eat every 3 to 4 hours. However, I want to emphasize that the number of meals an individual should consume daily is individualized. No two people are the same. Meal frequency depends on the individual. When considering meal frequency, several different factors look at including current hormone health, digestive health, body temperature and pulse, stress level, and appetite.

Women that struggle with thyroid function often do better with eating a little more frequently since they tend to have imbalances in blood sugar. Reducing these fluctuations by eating balanced meals more often helps to reduce stress. Less stress leads to more balanced hormones, a better functioning thyroid, and better liver glycogen stores (leading to better, uninterrupted sleep).

What happens when you have no appetite at all? If you are waking up with zero appetite, that means you have been using other energy sources for fuel (AKA keeping your blood sugar balanced) while you have been sleeping. Under normal circumstances, you should wake up hungry, which means you were using your liver’s stored energy while you were asleep. Having no appetite in the morning is not a good sign. It tells you that while you were sleeping, your body was using muscle and/or fat tissue and turning it into glucose needed to keep your blood sugar balanced. If you have no appetite, forcing yourself to eat more frequently will not be pleasant. I always recommend starting with just one additional meal. Try eating breakfast and see how you feel. Most of my clients begin to get hungry sooner and notice they are getting more hunger/fullness cues. They have better energy throughout the day and less brain fog.

The number of times you should eat in a day depends on you and your current hormone health, digestive health, body temperature and pulse, stress level, and appetite. Increasing meal frequency can be beneficial to some who experience thyroid dysfunction and slow metabolism. Read my full blog post on meal timing here. 

You can learn more about the thyroid mineral connection in my free webinar and here is a great podcast episode from the Are you menstrual? podcast that helps you understand even more how to support an optimal thyroid.

reminder: i’m currently taking on 1:1 clients. if you’d like to explore what it would be like to work together and if we are a good fit, fill out this form to get more details!​

Amanda Montalvo

Amanda Montalvo is a women's health dietitian who helps women find the root cause of hormone imbalances and regain healthy menstrual cycles.

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