Thyroid Health is Dependent on the Liver

author avatar Dr. Eric Berg 08/31/2023

Let’s talk about how to improve your thyroid by fixing your liver. I’m talking, specifically, about fixing thyroid issues by addressing fatty liver.

The short version? Improving thyroid health by addressing the liver is possible - and it’s not as difficult as you may think.

In this article, I will cover:


The Basics: Thyroid Function, Hypothyroidism, and Fatty Liver

There’s a huge, significant link between hypothyroid conditions and a fatty liver.

First, let’s understand the basics of each condition.

Thyroid Function and Hypothyroidism

Healthy Thyroid Function

Let’s start by talking about normal thyroid function and how it all works.

Endocrine system negative feedback loop

The thyroid is ultimately controlled by the hypothalamus, a small structure in the brain that’s responsible for:

  • Releasing hormones

  • Regulating body temperature

  • Maintaining daily physiological cycles

  • Controlling appetite

  • Managing sexual behavior

  • Regulating emotional responses

The hypothalamus makes a hormone called thyroid releasing hormone (TRH). It also tells the nearby pituitary gland to release a hormone called thyroid-stimulating hormone (TSH). Those hormones then go down to the thyroid and tell the thyroid to produce and release thyroxine (T4) and a little bit of triiodothyronine (T3).

T4 is an inactive thyroid hormone, while T3 is the active version. Both are essential for brain development in infants and for metabolic activity in adults.

Specifically, these hormones help the brain, heart, liver, muscles, and other organs of the body function properly throughout adult life.

In order for T4 to work in the body, it has to be converted into T3. This actually works through several organs, including the liver and the kidneys. 80% of T4 is converted through the liver, and 20% is converted through the kidneys to make T3 (this will clearly be important when it comes to fatty liver disease).

Then, T3 goes into all the cells and it affects metabolism and many other things. Once it’s done its job, there’s a signal that’s sent back to the pituitary and the hypothalamus telling the glands to turn these off. It’s a negative feedback loop that regulates a lot of hormonal functions in the body.


When you have hypothyroidism, it essentially means that your thyroid is underperforming or working sluggishly. The most well-known causes of both subclinical and clinical hypothyroidism include:

  • Gender: A study published in the journal Endocrinology and Metabolism showed that women are two to five times more likely to develop subclinical hypothyroidism than men.

  • Age: TSH tends to rise as you age, making subclinical and clinical (overt) hypothyroidism more prevalent in older adults.

  • Iodine intake: Hypothyroidism tends to be more prevalent in populations that consume sufficient or excess iodine, a trace mineral essential for proper thyroid function.

  • Zinc deficiency: When it comes to thyroid function, zinc is not only involved in the conversion from T4 to T3, but also in the synthesis of T4, T3, and the thyroid-stimulating hormone that comes from the pituitary down to the thyroid itself. Without enough zinc, you cannot convert T4 to T3 and you can’t make thyroid hormones.

If you have hypothyroidism, symptoms can include:

  • General loss of energy

  • Slowed metabolism

  • Weight gain

  • Bradycardia

  • Dry skin and hair

  • Constipation

  • Cold intolerance

  • Puffy skin

  • Hair loss

  • Altered cognition

  • Hyporeflexia

  • Menstrual irregularities/infertility in women

  • Stunted growth in children

Fatty Liver Disease

Normal Liver and Fatty Liver

Now, there are two different categories of fatty liver. One - alcoholic fatty liver disease (AFLD) - is caused by drinking too much alcohol, while the other is a non-alcoholic fatty liver disease (NAFLD). You can develop NAFLD from eating very poorly, and it’s more common than you’d think.

In fact, 25% of the population actually has NAFLD. And it’s not just overweight people or people with a gut. Skinny people are actually twice as likely to develop NAFLD-related complications and die from a fatty liver than overweight people. Why? Well, it’s probably because they’re skinny and they think they’re healthy and they can eat whatever they want - so they ultimately neglect their health and develop undiagnosed long-term problems.


When someone develops a fatty liver, there are virtually no symptoms. You start to develop a gut, but it’s very rare to have symptoms until the condition begins to advance. Then, eventually, the person starts experiencing:

  • Fatigue

  • Weakness

  • Nausea

  • Abdominal pain

  • Right shoulder pain

  • Pain in the upper right tract

  • Maybe headaches on the right side

  • Pain in the right rhomboid

Big-Picture Issues

Eventually, after years of inflammation, people with fatty liver develop cirrhosis - the same issue you get from being an alcoholic. In fact, the damage from high Fat Storing Hormone - and from a lot of sugar - is almost identical to the damage from alcohol. When you develop cirrhosis, you lose liver function. You also lose the ability to detoxify - which means you have a buildup of toxic waste.

That’s especially true if you’re consuming the sugar from high fructose corn syrup because fructose will really damage the liver faster than other sugars.


The Connection Between Hypothyroidism and Fatty Liver

So these are conditions that many people deal with at some point in their lives. While it’s certainly important to understand them and be able to identify the signs and symptoms, it can be even more important to understand that they’re often connected.

What is the connection between these two organs?

As we mentioned, 80% of the conversion from T4 (the inactive thyroid hormone) to T3 (the active thyroid hormone) occurs through your liver, so the body needs a healthy liver to properly convert most of that hormone. The other 20% is through the kidney, so if there’s kidney damage that’s also going to inhibit the conversion.

The problem? The higher the liver enzymes are (and high liver enzymes indicate liver inflammation or fatty liver) the worse the thyroid is. That’s because thyroid-stimulating hormone (TSH) levels are going to be lower if you have high liver enzymes.

This, of course, can lead to a massive number of symptoms, because you can start experiencing both symptoms of fatty liver disease and symptoms of hypothyroidism.

No one should live like that.

Luckily, neither of these problems are set in stone. If you can improve the liver, then - even by a little bit - you’re going to get huge improvements in the thyroid.


Hypothyroidism: Hashimoto’s

Most hypothyroidism is Hashimotos’

There’s one more thing to take into consideration here. 90% of the time, when you’re dealing with hypothyroidism it’s a Hashimoto’s type condition.

Hashimoto’s an autoimmune thyroid issue. This is different from standard non-autoimmune hypothyroidism because, with Hashimoto’s, you actually have antibodies working against the thyroid and attacking it. Your own system is attacking your thyroid, and this keeps it inflamed and functioning poorly.

That’s another issue too because, if you have Hashimoto’s hypothyroidism, just the fact that you have hypothyroidism can contribute to fatty liver.

So fatty liver can exacerbate issues with thyroid function, and Hashimoto’s hypothyroidism can contribute to fatty liver. Each condition can inform and contribute to the other.

That said, in the majority of cases, the root cause of a fatty liver is either fructose or a high carb diet. It is not the fat that you’re eating that is causing the fatty liver like a lot of people talk about, it’s the carbohydrates that are converting.


How Do You Remedy the Situation

The good news is that there are many things that you can do to improve these conditions.

Some of these suggestions improve the function of the liver, while others actually work on both hypothyroidism and fatty liver at the same time.

1. Selenium

Selenium, for example, is a very powerful antioxidant. It can also detoxify mercury.

So selenium is not just good for the thyroid - it’s also good for the liver. If you have an autoimmune case of hypothyroidism, you’re going to generate a lot of hydrogen peroxide. This will act as an antioxidant to counter that and the free radical damage that occurs from your own immune system.

2. Healthy Keto and Intermittent Fasting

Healthy keto and intermittent fasting will actually help remove fat from the liver. Why? Because you’re cutting the carbs and sugar that cause fatty liver, and you’re fasting. Remember, though, that I’m talking about healthy keto here, which requires that you incorporate vegetables. You want to do at least 7 cups of vegetables (7-10 cups) each day - and you can really have an unlimited amount. Why? This will:

  • Help make sure that you get enough potassium and other vital nutrients

  • Keep that liver flushed out

This is the number one way to keep yourself from developing a fatty liver on the keto diet.

Keep in mind, though, that if you have a belly and you have fat around the organs, your body is not going to address that first. It’s going to go after the fatty liver first. So you may not see any fat loss on your belly right away because you’re actually going to be losing weight on the inside.

Once the liver fat is gone, then you’ll start seeing a reduction in your belly - or at least you’ll see it a lot faster. This is very important.

3. Milk Thistle

Milk thistle, a flowering herb related to the daisy, is one of the best herbs for the liver. It helps strengthen the function of the liver cells, which is why it’s often used as a natural treatment to address various liver problems, including cirrhosis, jaundice, hepatitis, and gallbladder disorders.

4. Choline

Choline is a type of B vitamin that is essential to proper liver function. In fact, many studies show that a choline-deficient diet will actually lead to fatty liver disease.

Adding sufficient choline to your diet, then, will act directly on the liver and help dissolve some of the fat that accumulates when you have fatty liver disease.

And guess what food is high in choline? Egg yolks. You can also find high concentrations of choline in meat, poultry, fish, dairy products, cruciferous vegetables, and certain beans. Other dietary sources of choline include nuts, seeds, and whole grains.

5. Zinc

Zinc is great for the thyroid and the liver.

As we mentioned, zinc is involved in the conversion from T4 to T3 and in the synthesis of T4, T3, and the thyroid-stimulating hormone that comes from the pituitary down to the thyroid itself. Without enough zinc, you cannot convert T4 to T3 and you can’t make thyroid hormones.

When it comes to the liver, zinc has been shown to naturally inhibit the inflammatory and antiviral effects of interferon lambda 3 (IFN-λ3), a protein strongly associated with tissue damage in chronic liver disease. This data shows that zinc has the potential to be used as a simple and effective treatment against acute and chronic inflammation in the liver

6. Vitamin D

Vitamin D, zinc, and selenium are really good for an autoimmune situation. They’re also good for the liver.

Specifically, a 2007 report in The New England Journal of Medicine noted several health benefits associated with vitamin D. More recently, vitamin D has been shown to play an important role in reducing the risk of many chronic diseases, including type 2 diabetes mellitus, cardiovascular diseases, cancers, and autoimmune and infectious diseases.

Vitamin D is also produced by the liver. The liver produces 25-hydroxy (25-OH) vitamin D, also known as calcidiol, the immediate precursor to the metabolically active 1,25 dihydroxyvitamin D 1-25 vitamin D, also known as calcitriol.

25-OH vitamin D is the most abundant circulating form of vitamin D, and its measurement is used to assess vitamin D deficiency.

If vitamin D is low, then it could be a signifier that there’s something wrong with liver function in the body.


In summary, if you follow this list and improve the liver with these nutrients, you’ll also support the thyroid.

If you want more information on these topics, check out these other very interesting videos on the thyroid:

Disclaimer: Our educational content is not meant or intended for medical advice or treatment.

Editor’s Note: This post has been updated for quality and relevancy.

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