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Hypothyroidism, Metabolic Syndrome, and Time-Restricted Eating

If you are hypothyroid and have metabolic syndrome, time-restricted eating is a promising approach to improve your overall health.
Hypothyroidism, Metabolic Syndrome, and Time-Restricted Eating
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Do you have hypothyroidism and metabolic syndrome? If so, you know how difficult it can be to manage your symptoms and maintain a healthy lifestyle. But what if there was a way to improve your health without drastically changing your diet or lifestyle? Enter time-restricted eating – a form of intermittent fasting – a powerful strategy that could potentially help you take control of your health. In this article, we’ll discuss this strategy’s potential benefits for people with hypothyroidism and metabolic syndrome.

Before we delve into the potential benefits of time-restricted eating for these conditions, let’s briefly understand metabolic syndrome and its connection to hypothyroidism.

What is metabolic syndrome?

Metabolic syndrome is a group of conditions that occur together. These conditions include:

  • Elevated blood pressure – consistently above 130/80 mm Hg.
  • High blood sugar – consistently above 100 mg/dL when fasting or above 140 mg/dL after eating.
  • Excess body fat around the waist –  more than 40 inches in men and more than 35 inches in women.
  • Abnormal cholesterol or triglyceride levels – high LDL cholesterol (the “bad” cholesterol) and triglycerides, as well as low HDL cholesterol (the “good” cholesterol).

Metabolic syndrome is diagnosed with a combination of a clinical examination and several tests. The evaluation includes:

  • Measurement of waist circumference.
  • Calculation of body mass index  (BMI). If BMI is 30 or higher, it’s a risk factor for metabolic syndrome.
  • Glucose tolerance test, Hemoglobin A1C, and/or fasting plasma glucose levels to identify insulin resistance and elevated blood sugar levels
  • Blood pressure check
  • Lipids panel – blood tests for cholesterol and triglycerides

It’s crucial to identify and treat metabolic syndrome because this condition increases your risk of heart disease, stroke, and type 2 diabetes.

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What is the link between hypothyroidism and metabolic syndrome?

There are no definitive statistics, but the research clearly shows a relationship between metabolic syndrome and hypothyroidism. One study published in Clinical Diabetes and Endocrinology found that 31.9% of metabolic syndrome patients also have an underlying thyroid condition, primarily subclinical or borderline hypothyroidism. A study published in Scientific Reports found that patients with metabolic syndrome were at a 21% excess risk of developing subclinical hypothyroidism. Another study reported that around 40% of the hypothyroid people studied also had metabolic syndrome. And it’s estimated that 95% of newly diagnosed hypothyroid patients have increased cholesterol levels, and 5% have high triglycerides, two key risk factors for metabolic syndrome.

Why are these two conditions connected? Thyroid hormone has an impact on metabolic functions in the body. Specifically, thyroid hormones play a crucial role in regulating the body’s metabolism, which includes how your body uses energy, burns calories, and processes nutrients. When you have a deficiency of thyroid hormone, as in hypothyroidism, your metabolism slows down, leading to weight gain, high cholesterol levels, and insulin resistance, all of which are key components of metabolic syndrome.

Research has shown that insulin resistance is a significant factor in developing metabolic syndrome, and hypothyroidism can contribute to insulin resistance. Insulin is a hormone that helps regulate blood sugar levels by allowing cells to take in glucose and use it as energy. When the body becomes resistant to the effects of insulin, as is the case in insulin resistance, blood sugar levels rise, leading to high blood sugar levels and an increased risk of developing type 2 diabetes. Hypothyroidism can interfere with insulin sensitivity, making the body less responsive to insulin and increasing the risk of insulin resistance and metabolic syndrome.

Furthermore, hypothyroidism can also lead to an increase in LDL cholesterol levels, commonly known as “bad” cholesterol, and a decrease in HDL cholesterol levels, known as “good” cholesterol. This imbalance in cholesterol levels is a characteristic of metabolic syndrome and can contribute to the development of cardiovascular diseases such as heart disease and stroke.

What is time-restricted eating (TRE)?

Time-restricted eating (TRE) –  a form of intermittent fasting – involves restricting the window of time when you eat. TRE is based on the idea that our bodies can better digest and metabolize food when we eat within a consistent window of time each day. The most common form of TRE involves eating all meals within an 8–10 hour period, such as between 8 am and 6 pm or 10 am and 8 pm. This allows for 16–18 hours of prolonged overnight fasting while still providing plenty of time for meals throughout the day.

This approach allows the body to have prolonged periods of fasting, which appears to have positive effects on both hypothyroidism and metabolic syndrome.

One key benefit of time-restricted eating is its potential to improve insulin sensitivity. Insulin resistance is a hallmark of metabolic syndrome, and studies have shown that TRE can enhance insulin sensitivity, leading to better blood sugar control.

A study on obese volunteers found that time-restricted diets reduced visceral fat, improved abdominal obesity, lowered lipids, and controlled high blood pressure.

Another study on time-restricted eating (TRE) in adults with metabolic syndrome found that TRE led to weight loss and improved cardiometabolic risk factors. The study highlighted the potential of TRE as a dietary intervention for managing metabolic syndrome and improving blood pressure outcomes.

Time-restricted eating has also been found to aid in weight management, another critical aspect of both hypothyroidism and metabolic syndrome. By limiting the eating window, TRE can naturally reduce caloric intake, promote fat burning, and prevent excessive weight gain. Maintaining a healthy weight is essential for individuals with hypothyroidism, as it can help alleviate symptoms and improve overall thyroid function.

Additionally, research suggests that time-restricted eating may support overall metabolic function, including the regulation of the thyroid gland. The thyroid hormones play a vital role in controlling metabolism, and any disruption in their production can lead to various health issues. While more studies are needed to establish a direct link between TRE and thyroid function, early research shows promising results.

Can time-restricted eating improve thyroid function?

There is also evidence that apart from improving metabolic syndrome, TRE can help improve thyroid function itself.

One study showed that TRE can lead to a significant drop in thyroid–stimulating hormone (TSH) levels, which suggests improved thyroid function. Another study showed that early time-restricted feeding improved thyroid function in men with prediabetes, including significantly lowered TSH levels and increased free thyroxine (T4) levels, which suggests improved thyroid function.

A fall 2023 poster presentation at the American Thyroid Association Annual Meeting also reported that TRE improves thyroid function in patients with metabolic syndrome. The study evaluated cardiac enzymes and a full panel of thyroid hormone levels, including antibodies. Compared to patients following a low-carbohydrate diet alone, patients who followed an 8-hour time-restricted eating plan, with or without a low-carbohydrate diet, had improved thyroid levels and cardiac enzymes.

How can you get started with time-restricted eating?

If you’re hypothyroid and are at risk of – or diagnosed with – metabolic syndrome, here are some steps to get started with time-restricted eating:

Start by consulting with your healthcare provider to ensure it’s safe for you. Once you get the okay, you can then gradually adjust your eating schedule.

Begin making that adjustment by reducing the number of hours that you eat each day and increasing the amount of overnight fasting time until you reach your desired goal (e.g., 8–10 hours of eating and 16–18 hours of fasting). It’s best to start slowly when you’re new to time-restricted eating. Begin by shortening your eating window by an hour or two each day until you reach your desired window.

The next step is to plan your meals, focusing on nutrient-dense, whole foods like fruits, vegetables, legumes, nuts/seeds, lean proteins, and healthy fats to ensure you get the nutrients your body needs.

Remember to stay hydrated throughout the day by drinking plenty of water, herbal tea, or other non-caloric beverages.

You should also get regular physical activity, which can help support weight loss and improve your overall health.

Finally, it’s useful to keep track of your progress by weighing yourself regularly and tracking your food intake. This can help you stay motivated and make adjustments as needed.

A note from Paloma

In conclusion, the emerging approach of time-restricted eating holds promise in managing both hypothyroidism and metabolic syndrome. By incorporating this eating pattern under professional guidance, individuals may experience improvements in insulin sensitivity, weight management, and metabolic function. However, it is essential to remember that time-restricted eating should be approached cautiously and in conjunction with a comprehensive treatment plan.

For optimal care for your hypothyroidism, consider becoming a Paloma Health member. Paloma is an online medical practice designed to meet all your hypothyroidism care needs. With our team of experienced physicians and practitioners, you’ll receive personalized and comprehensive care from the comfort of your own home. With Paloma’s online platform, you can schedule appointments, get state–of–the–art home thyroid blood tests, receive expert advice and treatment plans, and even have your medications delivered right to your doorstep. You can also schedule a nutritional consultation to help finetune your diet. Our thyroid–savvy nutritionists have the knowledge and experience to help you develop a personalized nutrition plan. You’ll better understand how your diet impacts your condition and discover strategies and practical advice to optimize your nutrition for better thyroid function. Take the first step today towards a more convenient, streamlined, and effective approach to managing your hypothyroidism.


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Khatiwada S, Sah SK, KC R, Baral N, Lamsal M. Thyroid dysfunction in metabolic syndrome patients and its relationship with components of metabolic syndrome. Clinical Diabetes and Endocrinology. 2016;2(1). doi:–016–0021–0–016–0021–0

Chang CH, Yeh YC, Caffrey JL, Shih SR, Chuang LM, Tu YK. Metabolic syndrome is associated with an increased incidence of subclinical hypothyroidism – A Cohort Study. Scientific Reports. 2017;7(1). doi:–017–07004–2–017–07004–2

Sutton, E.F., Beyl, R., Early, K.S. et al. Early Time-restricted Feeding Improves Thyroid Hormone Profile in Prediabetic Men: A Randomized Crossover Trial. Sci Rep 10, 19710 (2020).–020–76738–9.

Ogbera AO, Kuku S, Dada O. The metabolic syndrome in thyroid disease: A report from Nigeria. Indian J Endocrinol Metab. 2012 May;16(3):417–22. doi: 10.4103/2230–8210.95688. PMID: 22629511; PMCID: PMC3354852.

Che, T., Yan, C., Tian, D. et al. Time-restricted feeding improves blood glucose and insulin sensitivity in overweight patients with type 2 diabetes: a randomised controlled trial. Nutr Metab (Lond) 18, 88 (2021).–021–00613–9–021–00613–9

Yixuan Zheng, Mingqian He*, Bingyin Shi. POSTER 406, Disorders of Thyroid Function Clinical Poster, “Time-restricted Eating with or without Low Carbohydrate Diet Improves Thyroid Functions and Cardiac Zymograms of Metabolic Syndrome Individuals. Thyroid, Vol. 33, No. S1. American Thyroid Association 2023 Annual Meeting. Meeting Program and Abstracts. DOI: 10.1089/thy.2023.29156.abstracts

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Mary Shomon

Patient Advocate

Mary Shomon is an internationally-recognized writer, award-winning patient advocate, health coach, and activist, and the New York Times bestselling author of 15 books on health and wellness, including the Thyroid Diet Revolution and Living Well With Hypothyroidism. On social media, Mary empowers and informs a community of more than a quarter million patients who have thyroid and hormonal health challenges.

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