A drop in T3 levels after adopting a ketogenic or low-carb diet does not automatically indicate hypothyroidism.

“you know I've got kind of private clients that I see outside of residency and occasionally I see the free t3 go down but I think that that probably has to do with tissue levels being different than serum levels because we don't see the basal metabolic rate change clearly people are not gaining weight they usually feel better and the TSH isn't going anywhere so there's not really I don't think they've become they become less t3 resistant probably we're back to that same old song I think I don't think you've heard their thyroid function at all I think their tissue now is just more sensitive and they don't need as much circulating t3”

“Anyone who claims that keto or low carb is bad for thyroid first of all I would love to see the evidence and here's a couple of things that are presented first of all people that are going to a low carb acute again enjoy you sign it let's let's see where they're at already they're usually overweight they've tried every other diet right maybe they already have a thyroid problem”

“so then a doctor might go oh they went keto there t3 drop that means they're hypothyroid does it have you asked them about their symptoms again”