Thyroid, Diabetes & Keto-Green

Thyroid, Diabetes & Keto-Green

This OB-GYN turns the traditional Keto diet into a diabetes and thyroid twist.

Written by Anna Cabeca, Triple Board Certified OB-GYN

If you thought diabetes was an irreversible condition that you would just have to live with, then I have some good news for you. The diagnosis of Type 2 diabetes isn’t set in stone! In fact, there are lots of ways you can improve symptoms and reverse the effects of this illness.

Now, as a doctor, my first inclination is always to give you the medical reasons or the statistics. But as someone who has lost both parents to diabetes, I want to also say that you can change the way you eat. You can change your exercise routines. You can alter your lifestyle, making it more healthy. It just takes a bit of information and some effort. And it’s so worth it. 

My mother died at age 67. The older I get, the more I realize that 67 isn’t old at all. She should have lived another 20 years. Imagine all the fun and memories we would have made. So I want you to get on the road to better health, so you’ll be around to make those memories with your own family. First, let me explain what diabetes is.

What is Type 2 Diabetes?

Type 2 diabetes develops when your cells resist the standard effects of insulin. The normal process is for glucose to move into your body’s cells providing energy so you can get up, go out and live your life. With Type 2 diabetes, this process gets derailed. This is called insulin resistance. Your body ceases to properly process glucose, causing glucose levels to become too high. Once this occurs, it can result in damage to your blood vessels and your nerves. If it continues, it can lead to kidney failure. 

One of the most common developments is the interference of blood circulation to the legs and feet. Many people that suffer with this illness develop neuropathy. This condition in itself can be very troubling. You’ll experience numbness and tingling in your hands and feet. This can be painful and even scary for many people. Plus, it’s very uncomfortable to live with this condition.

Often, all it takes is just waking up one morning and saying, “Hey! I’ve got a lot of living left to do and I want to be healthy throughout the course of my life.”

Know Your Number

The number I’m talking about is hemoglobin A1C (HbA1c), the “heads up” early warning marker for blood sugar issues and for developing insulin resistance, prediabetes, and diabetes.    

Using a simple blood test, you measure the average percentage of red blood cells saturated with glucose. This should be done over a period of two or three months. This will tell you if you’re developing insulin resistance. The higher the number, the more at risk you are for developing diabetes.

Below is a brief explanation of the numbers:

  • Under 5.3 is optimal
  • Between 4 and 5.6 percent is normal 
  • 6.5 or higher indicates diabetes
  • 5.7 to 6.4 points to prediabetes

Go Keto-Green

My Keto-Green plan is a combination of ketogenic and alkaline eating. The keto part involves lowering your carbohydrate intake to 40 grams daily or under while increasing healthy fats. Limiting carbs is vital if you have type 2 diabetes because carbohydrates convert to sugar causing scary blood sugar spikes. Replacing dietary carbs with fats can reduce blood sugar levels and prevent this.

Almost 90 percent of those with type 2 diabetes are also overweight or obese. Losing weight with Keto-Green affects blood sugar levels and balances insulin. It can make a powerful difference in your body. It works to perform a number of important tasks:

  • Reverses insulin resistance 
  • Helps you shed pounds quickly
  • Restores you to a healthy insulin-sensitive state
  • Lessens diabetes symptoms and can even reverse the disease

Stay Alkaline

When we stay alkaline, our bodies can function the way they were intended. We can go out and live our lives from day-to-day. That’s what is so important to me … and probably you feel the same way. We want to stay healthy and happy so we can live a good, long life. 

Too many people these days are walking around in an acidic state. Their diets and lack of exercise have caused this condition. Reversing this condition is possible and not all that difficult. And once you do, you’ll have energy, you’ll feel good and you’ll look better.

Keto-Green is an alkaline diet that helps you change your body from an acidic state to an alkaline one. Our bodies have a pH (power of hydrogen) level and this number is between zero and 14. Zero means your body is totally acidic. 14 means it’s completely alkaline. For optimum health, our body pH should be neutral – around 7.

Keto-Green prevents acidity. It’s packed with foods that overturn the acid load. These are healthy foods like cruciferous vegetables, green leafy veggies, and healthy fats like avocados and coconut oil. This eating plan contains high-fiber vegetables, which help with glucose and insulin control. They even help to regulate those hunger hormones.

Practice Intermittent Fasting

Intermittent fasting is a key part. It involves going without food between dinner and breakfast the next day, overnight, for a total of 12 to 16 hours.

Science shows that intermittent fasting resolves insulin resistance – plus prevents it. Intermittent fasting is such an easy way to get insulin to work properly, because you do it mostly overnight while you’re sleeping!

There’s more to report: Intermittent fasting kick-starts “autophagy.” This is a process by which the body gets rid of cells that have a greater risk of becoming infected or even cancerous. These are cells that also lead to type 2 diabetes, accelerated aging, and Alzheimer’s disease.

Keto-Green and Thyroid Issues

There’s some conflicting information out there as to whether a ketogenic diet improve symptoms for women having thyroid disease, or whether it makes symptoms worse.

Because my Keto-Green program has a ketogenic element to it, I thought I’d talk about keto and thyroid.

Is Keto-Green something a woman with thyroid disease might want to try?

The short answer is yes!

The long answer? You may need to try it to see how it works for you over a period of time. We’re all unique when it comes to our chemistry, genetics and overall health challenges, so any given diet or health program may or may not be the best fit for you. I always say that if someone tells you they have the perfect diet that works for everyone all the time, don’t listen any further! In particular, if you have a thyroid issue and need to gain weight, keto may not be the right fit for you, especially long-term.

The standard ketogenic diet helps control blood sugar spikes and reduces insulin. But does it reduce the insulin to where the liver can no longer make adequate T3 and T4? I believe that if the TSH levels don’t increase and you continue to feel well, then there’s no reason not to try Keto-Green. And remember, this is a 16-day eating plan. You don’t stay on this diet all the time. You get on it, reap the benefits and then get off for a while.

In most cases, the benefits outweigh any potential lowering of T3 levels. But it is important to monitor your own thyroid levels. As I mentioned before, everyone is different. Our bodies and health issues are unique.

And please…always discuss any change in your diet with your doctor!

A typical ketogenic diet does not consistently provide women with the support they truly need to both feel healthy and be successful on low-carb dietary restrictions. It doesn’t provide the detox support, gut healing and adrenal support that most women need; it isn’t anti-inflammatory when sustained over time; nor does it provide the interventions necessary to ensure overall hormone balance.

Thyroid-Friendly Keto-Green

These differences make Keto-Green more thyroid-friendly. They also address many of the common barriers such as keto-flu, which make many women simply give up on keto-based diets early-on. More importantly it prevents going “keto-crazy”. That’s what I call the irritable (using a nice word) state that many women experience on these diets.

The first major difference is that a woman doesn’t just dive into the ketogenic diet day one. Start by developing a healthy foundation that includes:

  • An alkaline diet and lifestyle – Achieving an alkaline pH is a core difference of my Keto-Green program over strictly ketogenic diets. The issue with ketogenic-only diets is that women stay in ketosis too long and become acidic, which actually creates inflammation which forces your body to hold on to its fat stores…more inflammation is bad for your thyroid, and you won’t lose weight (if that is your goal). We want to see an overall net alkaline producing diet versus the typical Western net acid producing diet; it is also important to note that this net effect is impacted by many non-dietary elements! Alkalinity is a core component of my Keto-Green program. It is anti-inflammatory and hormone balancing.
  • Removing inflammatory food sensitivities – Most ketogenic diets focus on just lowering gluten intake but do not require the removal of gluten as well as other inflammatory foods. I have found that women in particular do better on a diet that excludes the top inflammatory foods such as gluten, dairy, sugar and processed foods. All the vices need to be cut back on as well, such as alcohol and caffeine.
  • Removing environmental toxins from foods (no hormones, chemicals or GMOs), personal care products, and the home. Most ketogenic diets do not include this as an initial step; but women have found this to be a key aspect to their achieving alkalinity as well as hormone balance.
  • Incorporating important lifestyle changes that directly support our two thyroid-impacting regulatory hormones, cortisol and insulin. This includes:
    • Stress management (cortisol effectively puts the brakes on your digestion, immune processes and thyroid metabolism!) Many women can’t get into ketosis until they learn better stress management techniques. We can’t always get our stressors out of the picture, but we can definitely reduce our cortisol to healthier levels!
    • Improving the quality and quantity of sleep. Our circadian rhythm is critical to hormone production and over overall health and mood.
    • Resolving adrenal dysfunction with adrenal adaptogens. Too much stress burns out your adrenals; your adrenals normally focus on mundane things such as metabolizing nutrients and producing needed hormones!
    • Addressing gut dysfunction that is common with thyroid disease. We support thyroid/keto digestion issues (leaky gut, low stomach acid, malabsorption of key nutrients such as zinc, Vitamin D, selenium; constipation due to slow metabolism, etc.) with probiotics and digestive enzymes, and we incorporate natural detoxification strategies and you should too.

Without this foundation a ketogenic diet will in many cases not be successful for most women over 50. Without this focus, women – especially those with thyroid or other underlying inflammatory conditions and going through menopause – will often feel sick with keto-flu when going on a ketogenic diet, will find it difficult to adhere to, and will likely not stick with it or get optimal results. I’ve seen this time and time again.

Once this foundational work is underway we begin with a slightly modified ketogenic “plate”:  Keto-Green focuses on “clean” and organic foods. It consists of a slightly reduced percentage of fats (56-70%) from most ketogenic plates but with a very specific focus on healthy fats (omega-9 fatty acids, omega-3 fatty acids, healthy saturated fats). Protein (20%) also needs to be clean and organic…we don’t want to introduce hormones and other toxins onto our plate. The same goes for carbs (5-10%)…remember, not all carbs are equal! My plate consists of only slow-burning carbs such as green veggies (organic, please). You have to eat a lot of those to remain alkaline too. This also provides fiber benefits (important for those with thyroid issues – who may become sluggish).This percentage of carbs typically equates to 20-35 grams of carbs per day.

I’m a proponent of intermittent fasting with a 15/9 or 16/8 window or less, or as close as you can get to that on a regular basis. This means I will fast 15 hours between dinner and breakfast, sometimes longer, and sometimes not… and then eat two good Keto-alkaline meals and possibly one light meal or protein shake in the 9-hour window, and no snacking. I do not support the prolonged 24 hour type of fasting especially for those having thyroid or other underlying health issues as it puts too much stress on the body. People with underlying issues relating to glucose and insulin should discuss intermittent fasting with their doctor.

My Keto-Green program assumes an 80-10-10 philosophy. I’ve seen some thyroid clinicians state that staying in ketosis too long isn’t healthy for those with thyroid issues given that it may lower thyroid T3 levels. But frankly, women on my program don’t stay in ketosis for weeks at a time, not even days at a time in many cases. We bounce in and out as there are many dependencies beyond carbs that affect ketosis (such as stress level!). For optimal results I like for women to stay Keto-Green about 80% of the time, fast about 10% of the time (so do some periodical periods of intermittent fasting, but don’t live with those restrictions each and every day), and feast about 10% of the time. Yes! Feasting is important as it is typically time we bond with family and friends…and we all need to treat ourselves from time to time.

Most people need to be at 20-40 grams of total carb per day to get into ketosis. For some people they may need less, some can go more…this is a general rule of thumb, it will depend on all of the things we’ve already discussed here! Women who are under serious chronic stress may not be able to get into ketosis at all, as one example, no matter how restricted the carbs. In talking with clinicians focused on thyroid disease and working with ketogenic diets for their patients and clients, most would say not to go lower than 20 grams of total carb per day, in conjunction with their thyroid hormone medication. But most will also say women may need to try it out and adjust their level of carbs as they go. In my Keto-Green program we don’t really look at the number of daily carbs, we look at the percentage of one’s daily food intake or “plate”. It is much easier and intuitive to do this! So we target 5-10% of the “plate” to be healthy, slow-burning carbs (and this equates to generally around 20-35 grams of carbs).

Stock Your Fridge

About Anna Cabeca, DO, FACOG

Dr. Anna Cabeca is an Emory University trained gynecologist and obstetrician, a menopause and sexual health expert, international speaker and educator, and author of the USA Today bestseller. In a survey of more than 500 women following her Keto-Green program 94.95% felt that their energy levels had improved. And while blood testing isn’t part of the program, many women who did have testing improved their numbers – including their thyroid and blood sugar levels.

Order your copy of Keto-Green 16 at any bookstore for a limited time, and get these FREE gifts: A Keto-Green Quick Start Guide, an additional 3-day meal plan with recipes, Keto-Green Recipe Videos (watch recipes being made!), and more recipes to help you “feast” healthfully.


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About Dana Trentini

Dana Trentini founded Hypothyroid Mom October 2012 in memory of the unborn baby she lost to hypothyroidism. This is for informational purposes only and should not be considered a substitute for consulting your physician regarding medical advice pertaining to your health. Hypothyroid Mom includes affiliate links including the Amazon Services LLC Associates Program.


  1. Hi all, I believe I have hypothyroidism . I’m really frustrated because I have had blood work to see if I do have it. It all came back normal. I want to get more in depth tests and that is what I am working on now. I will be seeing my primary soon. I have so many symptoms and I keep gaining weight. I am so scared about gaining even more weight. I really want my doctors to take me seriously. Any advise is welcomed. Thanks.

    • Deb bajada says

      Go see an integrative doctor.
      I have been going to regular doctors for three years now about my thyroid issues and they treat me for other symptoms that are a result from my under active thyroid but say my thyroid levels are ok. But when I Goto an integrative doctor they tell me my levels are so low they have to put me on a high dosage.

    • Most doctors will do “blood work” and tell you your thyroid is normal. But they don’t generally do a full thyroid panel, where it checks all the possible thyroid hormones. Most regular GP’s and Endocrinologists don’t go far enough. You need to find a provider that specifically specializes in women’s hormone health, that knows thyroid tests need more than the basic work up that most MD’s do. For example, in testing thyroid, you need to make sure they test for the following: thyroid stimulating hormone (TSH), Free T3 (triiodothyronine), Free T4 (thyroxine), total T3, reverse T3 (reverse triiodothyronine), TGab (thyroglobulin antibodies), thyroid peroxidase antibodies, thyroid stimulating immunoglobulins, and sex hormone binding globulin. Finally, have the doctor do an ultrasound of your thyroid. My thyroid was reading “normal” too, on the basic labs, but I felt awful. I’m a nurse, and I knew that I just didn’t feel the same as I normally do. I was on my late 30’s and didn’t think I should feel so run down that early in life. My labs were on the low side of normal. But I tried a different doctor, who ran all these tests, and I found out that I have several nodules on my thyroid, plus Hashimotos and Graves’ disease. So, be your own advocate and request those labs. All of them. Plus have your female hormones checked. A decrease in testosterone and progesterone often happens in women in middle age, and those hormones, if they’re low, can also affect a thyroid that might be on the “low side of normal”. Good luck!

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