108

5 Reasons Armour Thyroid isn’t Helping you with Weight Loss

Are you taking Armour Thyroid and not losing weight

Would it surprise you to know that MANY people are in the same position as you? 

The truth is that Armour Thyroid CAN help with weight loss, but it is definitely NOT a magic weight loss pill.

Having said that...

There are several reasons why Armour Thyroid isn't helping you lose weight and there are several things YOU can do to fix them.​

More...

Does Armour Thyroid Actually Help with Weight Loss?

Armour thyroid picture

The biggest and most important question of all:

Will Armour Thyroid actually help you lose weight?

Most people when they switch to armour thyroid except that their extra weight will magically start shedding off...

And about 90% of people who make the switch don't see those results.

Why does this happen?

​While Armour Thyroid is a great medication (that will probably help reduce your symptoms even if it doesn't help you lose weight) it isn't enough for weight loss by itself.

conversion to armour thyroid from levothyroxine increased patient satisfaction

If weight loss were that simple, then Doctors would be prescribing low doses of Armour to every patient!​

The truth is that your thyroid is probably only contributing to about 10-20 pounds of extra weight you may be carrying right now.

NDT vs levothyroxine
NDT causes more weight loss than levothyroxine

If you have more than that to lose there is a good chance your extra weight is from something else entirely.

Another hormone imbalance...

Poor diet...

Too much stress...

You get the picture. ​

So let's talk about the 5 main reasons that patients who make the switch to Armour Thyroid don't lose weight and what you can do to FINALLY lose those extra pounds: 

1. You Aren't Being Dosed Correctly

One of the biggest issues is that many patients are being under treated or under dosed. 

Armour thyroid contains a combination of T4 (the inactive thyroid hormone) and T3 (the active thyroid hormone). 

One of the main reasons that patients feel BETTER on Armour Thyroid is because of the active T3 portion. 

This portion is actually still quite small: 

1 grain = 38mcg of T4 and 9mcg of T3

Armour thyroid conversion chart

The point is that whenever you give a patient T3 it is approximately 3.3 times more effective at dropping the TSH than T4 medication alone (Synthroid and Levothyroxine). 

​This means that when transitioning from T4 only medication to armour thyroid many patients are usually under treated!

It's also important to note that many providers aren't as comfortable dosing Armour Thyroid as they are levothyroxine and so they will intentionally under dose patients because they are concerned about side effects. 

Transitioning from T4 only Medication to Armour Thyroid​

​If you transitioned from Levothyroxine (T4 only medication) then you should know how to properly convert your medication.

Most conversion charts will show that 100mcg of T4 = 1 grain of Armour thyroid.

In my experience 1 grain of Armour Thyroid is closer to 50mcg of T4.

Using this conversion you can see how most people end up under-treated.

They are previously on 100mcg of T4 medication and are subsequently switched to 1 grain of Armour and they feel no different, when in reality they have most likely just cut their thyroid dosing in half.

More accurate conversion looks like this:

  • 50 mcg of T4 = 1 grain of Armour
  • 100mcg of T4 = 2 grains of Armour
  • 150mcg of T4 = 3 grains of Armour
Thyroid Conversion chart - revised

​But remember:

If you are transitioning from a T4 only medication do NOT start yourself off at the maximum dose of Armour.

If you dose your Armour too quickly you are likely to end up with side effects from the T3: Heart palpitations, Anxiety, Heat intolerance, etc.

Instead start off on a lower dose and titrate up SLOWLY every 10-14 days. ​

2. You Need More T3 Added to your Thyroid Hormone Replacement

​While Armour does contain some T3, your body may actually need more. 

Armour thyroid (and other forms of Natural Desiccated thyroid) contain fixed ratios of T4 to T3.

Meaning the amount of T3 in each grain of Armour is always the same.

Unfortunately some people may require higher amounts of T3 due to tissue level hypothyroidism or the euthyroid sick syndrome

euthyroid sick syndrome

In both of these conditions patients may require higher doses of T3 to saturate cellular receptors and allow thyroid hormone to get into the cells. 

How do you know if you are someone who needs more T3?

Patients ​who need more T3 usually fall into one or more of the following categories:

  • They have high levels of Reverse T3
  • They have Leptin Resistance
  • They have Diabetes, Prediabetes or Insulin Resistance
  • They have extremely low body temperatures
  • They have a personal history of bipolar disorder or a strong family history of mental health disorders
  • They have a personal history of Fibromyalgia or Chronic fatigue syndrome

​If you fall into any of the categories above AND you aren't losing weight on Armour thyroid then you should talk to your Doctor about adding T3 to your regimen. 

Adding T3 to Armour Thyroid

One problem with armour thyroid (and NDT in general) is the static dosing in each individual grain of hormone. 

Each grain gives you 38mcg of T4 and 9mcg of T3.

This is ok for some patients but doesn't allow for altering individual dosing of the T4 and T3 if necessary.

​Patients with high stress, high levels of inflammation, leptin resistance, insulin resistance, etc. will generally require more T3 relative to T4. 

Supraphysiologic dosing of T3 not only helps to overcome these hormone imbalances.

In my experience (and if used safely) ​lowering T4 dosing and increasing T3 dosing provides improved weight loss and improved lipid metabolism. 

This is also confirmed with studies which have shown that transitioning from T4 to T3 dosing (based off of pituitary and TSH testing) improves all of these markers.

T3 medication vs T4 medication

In many patients dropping armour thyroid total dosing and adding T3 can be sufficient to improve symptoms and provide improved weight loss by itself.

​T3 can be added to armour thyroid with the following medications: Liothyronine, Cytomel or SR T3. 

thyroid metabolism reset poster for side bar

3. You are Suffering from Leptin Resistance

​If you aren't familiar with Leptin resistance or the hormone leptin please read this article

​As a quick primer:

Leptin is a hormone that is pumped out by your fat cells (yes they pump out hormones!).

​As fat cells grow, leptin levels increase. As they increase they are supposed to tell your brain to increase metabolism and start burning off that extra fat you just gained. 

When you have leptin resistance ​the exact opposite happens: your body thinks you're starving so it decreases metabolism and increases appetite (even though you have plenty of fat). 

definition of leptin resistance

If you have leptin resistance it doesn't matter how little you eat, how much you exercise or what your dose of thyroid hormone is...

You simply won't lose weight until it is treated.

And, to make matters worse - high levels of leptin actually decrease T4 to T3 conversion in the body.

How do you know if you have Leptin resistance? 

Leptin levels can be tested easily in the serum and fasting leptin levels higher than 10-12 indicate leptin resistance. 

Patients with leptin resistance generally require higher levels of T3 only medications to help reduce the T4 to reverse T3 conversion that occurs with this condition. 

It's important to note that leptin resistance is generally a late finding and indicates that heavy metabolic damage has occurred. 

Leptin resistance is often accompanied by insulin resistance and thyroid resistance (all three conditions are caused by the same thing). ​

Patients with leptin resistance generally require aggressive treatment to reverse leptin​ levels to help with weight loss. 

To see a case study example treatment plan please refer to this post

You can find supplements to treat leptin resistance here. ​

​I've outlined how to treat leptin resistance in this article

4. You are Reacting to Inactive Ingredients in Armour Thyroid

Not all forms of Natural Desiccated thyroid are created equal.

While it's true 1 grain of armour thyroid contains the same amount of active thyroid hormone (AKA active ingredients) as a grain of WP thyroid or Naturethroid - they differ in the inactive ingredients that they contain.

And it is the inactive ingredients that may cause non specific reactions in the body.

In addition these inactive ingredients may alter the breakdown and digestion of which then alters the absorption of thyroid hormone in the body. 

It's also possible that you may simply be reacting to the inactive ingredients and wrongly attributing your "negative" symptoms to thyroid hormone component. 

Using the table below you can see that the NDT form of thyroid hormone with the least amount of ingredients is WP thyroid - though this doesn't necessarily mean that it is the "best". 

Naturethroid comparison table

These changes in inactive ingredients help to explain why some patients react poorly to Armour thyroid with symptoms like headaches, worsening fatigue or rashes - only to find that these symptoms completely resolve upon switching to naturethroid. 

Again it's not the difference in the concentration of thyroid hormone in each individual medication but most likely a reflection of digestion and absorption. ​

The armour thyroid preparation ​

In line with that, Armour thyroid contains methylcellulose and dextrose

These are the inactive ingredients in armour thyroid that may cause some patients to either do better on the medication or worse. 

You can think about methylcellulose as a glue which holds on tight to the thyroid hormone component of the medication, and in order for absorption your body must break the grip. 

Ingredients of armour thyroid

Unfortunately many patients with hypothyroidism also have gastrointestinal issues including low stomach acid. 

This may result in decreased absorption of thyroid hormone or a "delayed" release of the medication into the blood stream.

This exact process is what happens when patients take Sustained release T3.

​The "slow release" comes from the fact that it is harder to digest and absorb in the body, but this also reduces the overall amount of hormone available in each dosage. 

In general patients with GI related issues tend to do better on WP thyroid or tirosint which both have fewer inactive ingredients and absorption tends to be better. ​

  • Bottom line: If armour thyrod isn't helping you (either with weight loss or you still remain symptomatic) you might consider switching to a different from of NDT like Naturethroid or WP thyroid. 

5. Your Reverse T3 is too High 

If you aren't familiar with Reverse T3 please read this article

To recap:

T4 = INACTIVE storage form of thyroid

T3 = ACTIVE thyroid hormone

Reverse T3 = ​INACTIVE thyroid metabolite that competes with T3 for cellular binding

Obviously you don't  want high levels of Reverse T3 because it competes for binding with T3 which creates tissue level hypothyroidism or thyroid resistance

The higher Reverse T3 generally the more hypothyroid you will feel (unless the Reverse T3 is compensatory due to supraphysiologic levels of free T3). 

Because T4 has the ability to turn into T3 or Reverse T3 we need to concern ourselves with what causes the body to preferentially create more reverse T3. 

Reasons your body may produce Reverse T3 from T4: 

  • Thyroid medications containing T4 (Synthroid, Levothyroxine but also NDT like armour thyroid) - This acts as substrate and in the presence of inflammation or other hormone imbalances your body may produce Reverse T3 over T3
  • Inflammation - From conditions like SIBO, Hashimoto's, Food allergies, nutrient deficiencies, medications, etc.
  • Leptin resistance
  • Insulin resistance
  • Obesity
  • LPS - Usually caused by increased intestinal permeability (SIBO, SIFO, SIBO, leaky gut, etc.) 
  • Certain Medications: Anti-depressants, diabetic medications, anti seizure medications, blood pressure medications, Narcotics, etc. (Please don't stop taking these medications if you are on them, but consider discussing options with your Doctor)

Two things should pop out to you after reading that list: 

1) Thyroid medications containing can contribute to elevated reverse T3 levels

2) If you fall into one or more of the categories listed above AND you are taking T4 medication (including Armour thyroid, but especially T4 only medications like Synthroid or Levothyroxine) then your medication may be contributing to your inability to lose weight. 

What happens when Reverse T3 levels are too high?

As Reverse T3 levels climb your cells will have more difficulty taking up active thyroid hormone.

This leads to a situation where you will have the symptoms of hypothyroidism but your lab tests may be "normal".

Your temperature will drop, your metabolism will drop, your appetite will increase in an attempt to compensate for the low metabolism, etc. 

All of these changes ultimately lead to weight gain. ​

The real question is what do you do about it? 

​How do you fix high Reverse T3 levels? 

Because high levels of reverse T3 can be caused by different factors, the best way to treat it is to identify the cause in your body and attack that.

For instance:

If you have high levels of insulin - you need to lower them (use this as a guide

If your leptin is too high - you need to lower it (use this as a guide)

If your ​T4 containing medication is too high you may need to decrease your T4 dose and/or increase your T3 dose. 

Etc. ​

BUT addressing and fixing the cause of the high reverse T3 usually isn't enough by itself. 

For the most benefit this therapy should be coupled with a reduction in the total amount of T4 medication and an increase in the total amount of T3 medication you are taking.  

This will allow your body to "flush" out the Reverse T3 and help improve your symptoms. ​

Wrapping it up

​Armour Thyroid is a great medication and it CAN help you lose weight but it is not a magic weight loss pill. 

At most it will help you lose 10-20 pounds. If you have hypothyroidism and are more than 20 pounds overweight there is a high chance your weight gain is due to some other hormone imbalance.

​If you switched to Armour recently and haven't lost ANY weight then make sure you have addressed these 5 areas: your dose, how much T3 you are taking in addition to Armour, your leptin levels, your allergies and sensitivities to inactive ingredients in medications and finally your reverse T3 level. 

Remember:

You won't be able to lose weight unless all 5 of those areas have been addressed and reversed (if necessary).

​Now I want to hear from you: 

​Are you taking Armour Thyroid? Has it helped you lose weight?

Why or why not?

Leave your comments below! 

Westin Childs
 

I'm Dr. Childs and I write these posts. I'm a physician that specializes helping patients lose weight, have more energy and FEEL better. My practice focuses on hormone imbalances, thyroid issues and weight loss resistance. My goal is to provide the BEST information out there on the internet that is both actionable and trustworthy. Get my free 3 day meal plan here. You can also find more about my personal journey back to health here.

Click Here to Leave a Comment Below 108 comments