Should People With Thyroid Problems Avoid Artificial Sweeteners?

Sugar substitutes are linked to autoimmune hypothyroidism

Artificial sweeteners linked to Hashimoto's disease
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People affected by hypothyroidism will be typically advised to manage their intake of sugar. This is because the thyroid gland is meant to regulate blood sugar levels. If your blood sugar levels are too high, you can develop insulin resistance. If they're too low, you can develop hypoglycemia.

Given these facts, it may seem reasonable to reach for a packet of artificial sweetener as a sugar substitute, right?

Think again. According to a report presented at the 2015 International Thyroid Congress, the use of artificial sweeteners appears to be linked to the development of Hashimoto's disease, an autoimmune disorder which frequently causes hypothyroidism. So striking were the results that investigators advised against the use of any such sweeteners in people living with the disease.

How Sugar Affects the Thyroid Gland

The research, conducted by investigators at Mount Sinai Hospital in New York, evaluated 100 people who had been positively diagnosed with Hashimoto's thyroiditis.

What they found was that the use of artificial sweeteners within this population — primarily aspartame (Equal, NutraSweet) and sucralose (Splenda) — correlated with elevated levels of thyroid stimulating hormone (TSH). An increased production of TSH is indicative of a thyroid slowdown, or hypothyroidism.

Among the study participants, 53 percent reported using the equivalent of 3.5 packets of artificial sweetener per today, four times the rate seen in people without Hashimoto's (12 percent).

Within this cohort of individuals, two of every three who had subsequently stopped using artificial sweeteners had a complete reversal of their Hashimoto's. Their thyroid antibodies gradually returned to normal, and they were even able to stop their hormone replacement medication.

Other Adverse Effects of Artificial Sweeteners

This is not the first time that artificial sweeteners have been linked to thyroid dysfunction.

What research has shown us is that certain sweeteners interfere with physiological functions that either give rise to or exacerbate conditions like Hashimoto's. For example:

  • Some sugar substitutes are known to change the balance of bacteria in the gut, known as the gut microbiome, as well as the pH level of the stomach and intestines. Imbalances in the gastrointestinal tract often act as a trigger for immune dysfunction and autoimmune disease.
  • Sucralose is chlorinated. Chlorine exposure has also been linked to autoimmune disorders as it can destroy much of your intestinal flora and cause a contradictory immune response.

Even when it comes to one of its primary uses — to control calories and lose weight — artificial sweeteners come up short. While they are certainly able to mimic the sensation of sugar, they don't trigger the same physiological response.

This is because the presence of sugar in the blood causes a biochemical reaction that effectively turns off that region of the brain believed to control appetite. Artificial sweeteners don't do this, and most studies have concluded that their use is not associated with weight loss. In some cases, it has been just the opposite.

A Word From Verywell

As compelling as the research is, it shouldn't suggest that sweeteners are "off the table" if you have non-autoimmune-related hypothyroidism.

It is only among persons with Hashimoto's that this adverse response is seen. As such, moderation is key when it comes to the use of any sweetener, whether it be artificial or natural.

If, on the other hand, you do have Hashimoto's, avoid artificial sweeteners and minimize your sugar intake, as well. You should avoid also processed foods, which are often packed with sugar, and steer your way clear of diet products that contain sugar substitutes.

Sources:

Samechi, P. and Kim, P. "The Association Between Sugar Substitutes and Hashimoto's Thyroiditis (HT)." 15th International Thyroid Congress; Lake Buena Vista, Florida; October 19-23, 2015; abstract SCP 28.

Suez, J.; Korem, T.; Zeevi, D.; et. al. “Artificial sweeteners induce glucose intolerance by altering the gut microbiota.” Nature. 2014;  514;181-186.

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