People with a thyroid condition generally want to make safe, healthy choices to support their bodies. Indeed, if you have experienced hypothyroidism symptoms, you know how good it is to feel, well, good.
The USDA Dietary Guidelines for Americans advises on what to eat and drink to meet nutrient needs, promote health, and help prevent chronic disease. The guidelines indicate that drinking alcohol in moderation is considered safe in most people. Two drinks or less per day in men and one drink or less daily in women is generally safe. However, if you have a thyroid condition, moderate consumption may impact your thyroid function test.
Research understands very little about how alcohol affects your thyroid health. The studies available are primarily on individuals with hypothyroidism who are in substance rehabilitation facilities. Thus, there is little information on how little to moderate drinking affects the thyroid.
From studies on people who excessively drink, we know that heavy drinking affects thyroid hormone production in your brain via the hypothalamic-pituitary-thyroid axis (HPT axis) and in your circulatory system.
Within your brain, your pituitary’s response becomes less sensitive to thyrotropin-releasing hormone (TRH) secreted from your hypothalamus. Thus, your pituitary does not release enough TSH to signal the thyroid to produce enough thyroid hormone. Therefore, heavy alcohol use decreases T4 and T3 concentration in your bloodstream.
Alcohol can also shrink the size of the lobes of your thyroid gland, which may be a protective mechanism to prevent enlargement of the thyroid gland—called a goiter.
While there is little information about how alcohol affects the thyroid directly, we know that alcohol can trigger an immune response.
Alcohol can cause inflammation in the body. Most notably, it can inflame the liver, which plays a crucial role in the conversion of thyroxine (T4) to triiodothyronine (T3)—the usable form of thyroid hormone for your cells.
Remember, the liver is responsible for filtering your body of all toxins. On its most basic level, a toxin is any compound that has a harmful effect on your body. We're exposed to toxic substances every day, which can pose a risk to our health.
Our bodies naturally filter out toxins from the body through the liver and kidneys. These organs continually filter our blood and allow toxins to leave the body via urine.
Toxic and other adverse effects of alcohol on the body are primarily a consequence of its chemical breakdown. Two of the most common pathways that metabolize alcohol involves two enzymes—alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH)—which help break apart the alcohol molecule, making it possible to eliminate it from the body. First, ADH metabolizes alcohol to acetaldehyde, a highly toxic substance, and a known carcinogen. Then, acetaldehyde metabolizes further to a less active byproduct called acetate. Acetate then breaks down into water and carbon dioxide for easier elimination.
Suppose your liver is too busy processing and ridding your body of alcohol. In that case, it may not be as effective at converting thyroid hormones. When you regularly expose your liver to alcohol and other toxins, it can cause liver inflammation (called hepatitis).
To add further insult to your body, alcohol increases intestinal permeability. Also called leaky gut, this widening between the cells in your intestinal lining allows for more toxins to leak from your digestive tract triggering your immune system. As hypothyroidism is often the result of Hashimoto's disease, an autoimmune process, this may further aggravate your system and cause more inflammation to your thyroid
Drinking too much alcohol can lower your T4 and T3 lab results, especially with frequent heavy use. Additionally, it may also lower your TSH and make you feel more symptomatic.
People who drink only moderate amounts of alcohol, as defined by the USDA Dietary Guidelines, will likely not see a significant impact on their lab results. However, there is a bit of a gray area here. Keep in mind, alcohol can flare up your immune system, and some people are more sensitive to alcohol than others. Thus, where one person may not be affected by a glass of wine in the evening, another may have a flare-up of their symptoms.
If you are curious how alcohol affects your thyroid, it may help to eliminate alcohol temporarily through the Autoimmune Protocol (AIP) diet. However, people with a thyroid condition should limit alcohol or avoid it altogether to optimize their thyroid.
While it would seem to make sense to abstain from any not-so-great habits before having a thyroid blood test, it is probably best to assess your thyroid under normal conditions for you. If you drink alcohol each day, it is best not to alter that pattern if you plan to continue drinking this amount after your test.
You want to stick with your regular habits because you need to understand how your thyroid functions in your everyday life. Of course, you also need to let your doctor know how much you drink on average each day or week so they can take that into account when reviewing your labs.
Aside from alcohol, several other factors can also skew your thyroid lab results. For example, the time of day you take your labs may have subtle influences on your thyroid labs, which can be problematic if you have subclinical hypothyroidism and are working with your thyroid doctor to decide if you need treatment.
Also, women who are not menopausal may experience subtle shifts in their thyroid hormones depending on where they are in their cycle.
To avoid discrepancies between current and past lab results, it is advisable that each time you test your thyroid, test around the same time of day, in the same phase of your menstrual cycle, and follow your usual daily habits.
How you prepare for your thyroid blood test depends on the laboratory that is conducting your test—some require that you fast or discontinue medication or supplements. Here at Paloma Health, our lab uses a specialized assay and there is no need to delay your medications or supplements. You may also take our thyroid blood test with or without regard to food, so no need to fast beforehand!
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