Low Carb & Hypothyroid ~ Healthy?

It is very difficult to find peer review studies on thyroid function and the effects of a low carbohydrate diet.  I've found a few short term studies, but nothing long term.  It would be nice to have longer term studies on VLC, but there's just not a lot of people going to be willing to follow such a diet for a matter of years in a study.  So if anyone is aware of any studies that might be relevant, please do provide links in comments.  What I'm particularly interested in is the second half of the first year - e.g. months 7-12 - and beyond.  Because anecdotally, this is the time frame when hypothyroids seem to react rather poorly to a VLC diet.  Far more material is available on health and nutrition related sites.  While I prefer not to rely on such sources, I think the information available from reasonably reliable sources demonstrate that carbohydrate restriction reduces T3, reduces T4-to-T3 conversion and increases reverse T3 (rT3).  The latter happens with all diets but the T4-to-T3 conversion differences I've seen reported are reductions in the 25-35% range with VLC diets.

I've been somewhat befuddled with the number of hypothyroids who go on long term VLC diets to begin with knowing this - or perhaps they don't know.   Lots of threads with lots of hypothyroids on Low Carb Friends for example.    I'm even more befuddled when I read that their thyroid goes out of whack as time progresses, yet they continue with the diet and increase their thyroid meds.

I don't think you'll find a higher concentration of thumb-your-nose at conventional wisdom and medical establishment types than in LC circles.  Especially where diabetics are concerned, because Bernstein says it, so many will avoid insulin or other available meds at all costs.  Metformin is acceptable, though.  Now obviously a diabetic of either type should not be mainlining Coke and trying to "cover it" with insulin.   But too many will have raging hyperglycemia eating the smallest amount of carb but will not use insulin.  And yet diabetes is ultimately an insulin insufficiency disease at some point - so why wouldn't you consider supplementing insulin secretion?  Folks seem to have no issue with supplementing an underperforming thyroid with hormones.  Why not the underperforming pancreas?

So I went off on a little tangent there, but my main point being hypothyroid low carbers do not apply the same standard to their thyroid treatment.  Part of my issue with the "low carb is inherently healthy" mantra is that I see a lot of people report on discussion forums, and contact me via email or in the comments here, some serious health complications.  The hypothyroids will report having symptoms of low thyroid and run to the doctor to get their meds increased.

To me this seems like the wrong approach.  It is certainly evidence of what folks often complain about going into too much of the science or looking at this stuff at the academic level rather than "in practice".  If I've heard once, I've heard it a thousand times, that who cares if Atkins was wrong, his diet works so it doesn't matter that his original ketone theories held up to the test of time.  I'm fine with that, just don't perpetuate the gimmickry.  If something works for you who really cares how or why, right?

I'm not in the business of giving out medical advice here, but on a personal level I would only encourage those with thyroid issues who experience worsening of those issues with low carb dieting to consider this:  Is the diet working for you?  There's more to diet than weight loss.  If you are having worsening symptoms or needing to increase medications, I would suggest not.  I'd even go so far as to suggest that the diet is not a healthy one for you.

And I would give the same advice as regards the trends of intermittent or longer term fasting, and, what I consider a very dangerous trend of using those HCG injections in conjunction with a very-low-calorie diet for rapid weight loss.  I'm sure there are others doing this that aren't low carbers, but it's disturbing to me the degree to which I'm seeing, mostly women who've hit the plateau on LC, go that route.