Dr. Eric Westman - Adapt Your Life - Keto And Your Thyroid — Dr. Eric Westman [Live Talk]

Short Summary

Main recommendation: If you are on a keto diet and have never had your thyroid checked, get your thyroid levels tested, and if symptoms persist despite normal labs, discuss them with a doctor open to symptom-based thyroid assessment. Dr. Eric Westman says a thyroid check is the first thing to rule out when weight loss or energy is not progressing, since the thyroid sets the body's metabolic "idle speed." He notes that in his practice, keto diets rarely change a normal thyroid result, but weight loss sometimes requires thyroid medication dose adjustments in either direction.

Key Points

• Westman's first step for a patient is a half-hour to 45-minute history covering diet, weight, and medical problems, followed by a thyroid blood test if none has been done in the last 6 to 12 months, or ever.
• He describes the thyroid as the body's major metabolic rate regulator, comparable to an engine's idle speed, so a low thyroid level can make weight gain or stalled weight loss more likely.
• In his experience, repeated thyroid tests on keto rarely become abnormal, and he has not seen that happen; however, significant weight loss has prompted thyroid dose changes up or down.
• He draws on obesity medicine practice, which weighs symptoms alongside blood levels, and suggests thyroid dysregulation can exist even when results fall in the "normal" range.
• He argues that proper thyroid management combines blood tests with a symptom review, and recalls that morning basal body temperature was used before lab tests.
• He acknowledges that large-scale clinical trials measuring thyroid changes on keto do not yet exist.

Details Worth Noting

• Concrete instructions:
  • If you have never had your thyroid level checked and things are not working, ask your doctor to check it, or get it done at a lab testing company or a retail-mall testing location.
  • Dr. Westman suggests confirming that the thyroid level falls in the normal and optimal range, not only the standard normal range.
  • If you are already on thyroid medication and losing weight, ask your doctor to reconsider medications and doses, since weight loss can require adjustment up or down.
  • If you have symptoms of low thyroid (findable through online symptom checklists) despite a normal blood test, discuss them with a doctor who considers symptoms, not just labs.
  • Westman says that in his own practice, if morning basal temperature is very low and symptoms match, he would consider trying a thyroid product such as Synthroid or another formulation to see if symptoms improve.
• Westman notes that Synthroid contains only T4, while formulations such as Armour Thyroid and Cytomel combine T4 and T3, and he says endocrinologists often prefer Synthroid for manufacturing consistency.
• He states that Adapt events in Terre Haute, Indiana, and a fall southern tour (Phoenix/Scottsdale, San Antonio, Raleigh-Durham) are ways for local keto communities and doctors to connect.
• He mentions a brand of keto-friendly products under Adapt Your Life and new bars he was introduced to, to be discussed at another time.

Bottom Line

Thyroid testing is a sensible first check when keto or weight loss stalls, and a normal result from a clinician who also weighs symptoms gives the clearest picture.