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The Impact of Alcohol Use on Thyroid Function

Why you might limit or abstain from alcohol if you have hypothyroidism.
The Impact of Alcohol Use on Thyroid Function
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If you have a thyroid condition like hypothyroidism, you likely want to make healthy decisions to support it. Among many things, you might wonder if alcohol affects your thyroid functioning. The short answer is yes, and the long answer is a bit more complicated. 

Alcohol and general health

According to the USDA's dietary guidelines, alcohol consumption is perfectly acceptable in moderation. They define moderation as up to one drink per day for women and up to two drinks per day for men. Of course, this definition does not apply to pregnant women, people under 21-years old, people with Alcohol Use Disorder, or those on medication that adversely interacts with alcohol. While some studies suggest that people who drink moderately have longer lifespans, follow-up studies could not confirm this benefit.


The CDC cites several studies as they warn about the many risks of drinking more than a moderate amount of alcohol as defined by the USDA. Heavy drinking and binge drinking can lead to an increased chance of high blood pressure, heart disease, stroke, liver disease, various cancers, learning and memory problems, depression, anxiety, and alcoholism, among other physical and social issues. Research shows that the damage of alcohol use may extend to the endocrine system. 


Alcohol and hypothyroidism

There are few human studies on current alcohol drinkers, as many studies happen in detox or rehab programs. So, much of the research on the relationship between alcohol and hypothyroidism relates to excessive alcohol use. 

The effect of heavy alcohol use on the hypothalamic-pituitary-thyroid axis— also known as thyroid homeostasis—is significant. Most significantly, heavy alcohol use reduces the thyroid hormones—T4 and T3—and blunts the thyroid-stimulating hormone (TSH) response to thyrotropin-releasing hormone (TRH) from the hypothalamus gland.

Overview of the hypothalamic-pituitary-thyroid axis or thyroid homeostasis
Overview of the hypothalamic-pituitary-thyroid axis

In addition to reducing T3, T4, and TSH values, alcohol may also reduce thyroid volume—the sum of the volumes of both lobes of the thyroid gland. This reduction is due to alcohol's direct toxic effect on thyroid cells. 

However, the toxic effect of alcohol on thyroid volume may also be a protective element against the development of goiter—an abnormal enlargement of the thyroid gland. In fact, some treatments for thyroid nodules use ethanol ablation therapy—a minimally invasive radiology treatment that destroys tumors by using alcohol.

Impact of alcohol on hypothyroid symptoms

Alcohol may have an impact on your hypothyroid-related symptoms, as well.

Common symptoms of hypothyroidism include:

  • Constipation
  • Hoarseness
  • Muscle weakness
  • Elevated blood cholesterol level
  • Muscle aches, tenderness and stiffness
  • Slowed heart rate
  • Impaired memory

For example, given the connection between mood disorders in alcoholism and mood disorders with hypothyroidism, researchers theorize that this may explain the increased occurrence of mood disorders in alcoholism. It's possible that the thyroid levels in withdrawal may change hormonal properties in the brain, increasing withdrawal and increasing craving, which may affect abstinence. 

An older study of rats found that rats with hypothyroidism experienced 16% less sleep after alcohol consumption. While this doesn't necessarily mean the same is true for humans, people with hypothyroidism might want to avoid or limit alcohol if they notice it affects their sleep or other symptoms.

Impact of alcohol on the immune system

We know now that alcohol affects the function of the thyroid gland. Furthermore, it can also affect your immune system, cause chronic inflammation, and damage your liver, critical to thyroid hormone conversion.

Part of the liver's job is to filter everything that enters your body like food, drinks, and medicine. After your intestines break down things that you eat or drink into their component parts, your liver is responsible for separating the good from the bad. The good stuff gets sent into the bloodstream for your body to use, and the bad stuff gets discarded. A congested liver prevents your body from effectively converting the inactive thyroid hormone T4 to the active hormone T3, so it's crucial to keep it in tip-top shape.

Alcohol can also interfere with how the body processes estrogen. If your liver can't effectively process estrogen, it can build up in your tissues, causing estrogen dominance. Estrogen dominance can activate your body's stress response and perpetuates the cycle of stress, hormone disruption, and hypothyroid symptoms.

What's more, alcohol use causes a direct increase in intestinal permeability—also known as leaky gut. Leaky gut is a digestive condition in which bacteria and toxins can "leak" through junctions that keep the cells that line the gut together to form the intestinal wall. Alcohol essentially creates little holes between these cells and allows toxins into the bloodstream, causing inflammation.


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So, what's the verdict?

Moderate alcohol consumption may have some health benefits like reducing the risk of heart disease, reducing the risk of developing type II diabetes, or preventing Alzheimer's disease. Drinking in moderation is safe for many people.

However, suppose you have a thyroid condition. In that case, it might be in your best interest to either limit or abstain from alcohol.  If you have an autoimmune disease, you more susceptible to developing a leaky gut and should avoid anything that increases intestinal permeability, like alcohol.

How to manage your alcohol use

An excellent place to start to determine if alcohol is a trigger for your Hashimoto's symptoms is the autoimmune protocol (AIP) diet. This diet is a temporary elimination-style diet protocol that consists of two phases: an elimination phase followed by a slow and intentional reintroduction phase. This diet is not permanent, but rather a tool to better understand how your body reacts to dietary and environmental triggers to manage your Hashimoto's disease.

Ahead, some suggestions to limit your alcohol use:

  • Out of sight, out of mind. If someone in your home uses alcohol, move wine, beer, or liquor bottles out of your line of sight or environment. 
  • Identify your triggers. Perhaps you choose alcohol for the taste, an emotional reason, social acceptance, or other. Ask yourself, What do you enjoy about drinking alcohol? Maybe it's fun to be social with friends, unwind after a long day, or feel carefree while cooking. What are some of the ways you can think of to replace those positive feelings without drinking alcohol?
  • Prepare for social situations. Often gatherings like dinner parties, concerts, happy hour, and weddings have one thing in common—alcohol. Try a substitute for alcohol so you can still have a drink in your hand!
  • Practice saying "no." It can be hard to explain your choices to other people. "I'm taking a break from alcohol, I'm driving, or I'm good with water," are all appropriate ways to say no, politely.
  • Try substitutes for alcohol. We like carbonated water with a slice of lime and mint leaves or coconut water with berries.

A note from Paloma Health

Many nutritional factors play a role in optimizing thyroid function. Always, we recommend making intuitive choices that make you feel your best. Paloma Health offers you the opportunity to work with a nutritionist in collaboration with a physician to determine nutritional status for optimal thyroid health.

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Katie Wilkinson

Katie Wilkinson, previously serving as the Head of Content and Community at Paloma Health, fervently explores the nexus between healthcare and technology. Living with an autoimmune condition, she's experienced firsthand the limitations of conventional healthcare. This fuels both her personal and professional commitment to enhancing patient accessibility to superior care.

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