Adults with pharmacoresistant epilepsy who follow the modified Atkins diet experience a modest decrease in thyroid hormone levels, particularly if they already have low thyroid hormone levels or are...
Mechanism
Synthesis from 1 study
When the body gets very little sugar from food, it makes less of the active thyroid hormone and breaks down more of what's left. This effect is stronger if someone already has low thyroid hormone or takes medicines that do the same thing.
Most probable mechanism
When the body runs on very little sugar from food, it shifts how it uses energy, which lowers the production of active thyroid hormone and changes how the body converts the inactive form into the active one. This effect is stronger if the person already has low thyroid hormone or takes medicines that do the same thing.
Low carbohydrate intake reduces insulin secretion and increases glucagon signaling, leading to decreased hepatic conversion of thyroxine (T4) to triiodothyronine (T3)
Reduced T3 production increases the activity of type 3 deiodinase in peripheral tissues, which inactivates T4 and T3 into reverse T3 and other metabolites
Lower circulating T3 levels reduce negative feedback on the hypothalamus and pituitary, but thyroid-stimulating hormone (TSH) remains unchanged due to concurrent suppression of thyrotropin-releasing hormone sensitivity
Pre-existing low thyroid hormone levels or concurrent use of antiseizure medications that inhibit deiodinase or thyroid hormone binding proteins amplify the reduction in bioactive thyroid hormone
Evidence from Studies
Supporting (1)
Community contributions welcome
Effects of modified Atkins diet on thyroid function in adult patients with pharmacoresistant epilepsy.
Contradicting (0)
Community contributions welcome
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