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Watch for these signs that keto may be worsening your thyroid function: Increased fatigue or sluggishness Worsening brain fog Unexplained hair loss Weight gain despite dietary changes Increased cold intolerance That said, a modified keto approach, maintaining at least 50 grams of carbohydrates per day rather than the strict 20-30 gram threshold, has shown no adverse effects on thyroid hormone production

J Lipid Res 55(4):645658 Lee CH, Kang K, Mehl IR et al (2006) Peroxisome proliferator-activated receptor delta promotes very low-density lipoprotein-derived fatty acid catabolism in the macrophage

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