Tidal stream turbines are exploited in regions of high tidal currents. Such energy extraction will alter the hydrodynamics of a tidal region, analogous to increasing the bed friction in the region of extraction. In addition, this study demonstrates that energy extracted with respect to tidal asymmetries due to interactions between quarter (M4) and semi-diurnal (M2) currents will have important implications for large-scale sediment dynamics. Model simulations show that energy extracted from regions of strong tidal asymmetry will have a much more pronounced effect on sediment dynamics than energy extracted from regions of tidal symmetry. The results show that energy extracted from regions of strong tidal asymmetry led to a 20% increase in the magnitude of bed level change averaged over the length of a large estuarine system, compared with energy extracted from regions of tidal symmetry. However, regardless of the location of a tidal stream farm within a tidal system, energy extraction reduces the overall magnitude of bed level change in comparison with non-extraction cases. This has practical application to many areas surrounding the UK, including the Irish Sea and the Bristol Channel, that exhibit strong tidal currents suitable for exploitation of the tidal stream resource, but where large variations in tidal asymmetry occur.