How Many Calories Should You Eat with Hypothyroidism?

How Many Calories Should You Eat with Hypothyroidism?

You’ve heard it before:

If you want to lose weight then you need to count your calories. 

I hate to break it to you but counting calories may be one of the worst things you can do if you have a thyroid problem. 

Calories do play a role in weight maintenance but they aren’t nearly as important as you might think if you have a thyroid problem. 

Here’s why:

Patients who have thyroid problems have a problem with their metabolism. 

And if you don’t address the metabolism issue then you won’t lose weight. 

End of story. 

There’s obviously much more to this idea which is why we need to discuss how calories impact your weight if you have a thyroid problem, how they impact your thyroid, and how you can actually lose weight and keep it off. 

Today you will learn:

  • How calorie restriction (or counting calories) can negatively harm your thyroid and ultimately lead to weight gain, even if it helps you lose weight temporarily. 
  • Why weight gain in hypothyroid patients is primarily driven by your hormones and not by calories. 
  • Why you should match your calorie consumption to your metabolic rate and how appetite helps you determine this. 
  • More about certain conditions which confuse your appetite and why these must be addressed if you want long-lasting weight loss. 


Foods to Avoid if you Have Thyroid Problems:

I’ve found that these 10 foods cause the most problems for thyroid patients. Learn which foods you should avoid if you have thyroid disease of any type.


The Complete List of Thyroid Lab tests:

The list includes optimal ranges, normal ranges, and the complete list of tests you need to diagnose and manage thyroid disease correctly!


How Calories Impact Your Thyroid

One question that I get asked frequently on this blog and in the comments section has to do with how many calories should be consumed if you have hypothyroidism. 

The question goes something like this:

“I’ve been told by my doctor to eat only X amount of calories per day to lose weight. Is this enough if I have hypothyroidism?”. 

You can substitute out the X for just about any amount of calories under your daily recommended needs which is usually around 2,000 or so and the answer is the same: 

You never want to reduce your calories as a means to lose weight if you have hypothyroidism. 


Because calorie reduction, especially in hypothyroid patients, will result in the combination of ‘metabolic adaptation’ and ‘thyroid damage’. 

The term ‘metabolic adaptation’ is the actual scientific name for what occurs during calorie restriction (1). 

Under persistent calorie restriction, your body responds in a number of ways:

#1. It reduces your Free T3 dramatically (18 weeks is enough to drop your free T3 by as much as 66% (2)). 

This is obviously incredibly important because T3 is the most active form of thyroid hormone in your body and free T3 is directly correlated with your ability to lose weight and keep it off. 

You can think about your T3 level as the true measure of how well your thyroid is functioning and how strong your metabolism is. 

As T3 levels drop you will see an increase in weight gain and a drop in how many calories you burn each and every day. 

#2. It increases your reverse T3 by as much as 27% – 50% (3). 

Reverse T3 is an anti-thyroid metabolite that your body creates when it is under stress and when it can’t convert T4 into T3. 

It’s a sign that your body is not utilizing thyroid hormone correctly. 

High levels of reverse T3 may lead to thyroid resistance and impair what little amount of free T3 you have left floating around. 

Other states that result in high reverse T3 levels include chronic illness and severe acute illness (neither of which are ideal!). 

#3. Your free T4 levels may stay the same or increase (4), most likely owing to a reduction in T4 to T3 conversion.

This isn’t a problem in itself but is an indication that something is changing in how your body processes thyroid hormones. 

#4. Your overall metabolism will drop from metabolic adaptation.

It’s pretty simple, really. 

Low thyroid function results in decreased metabolism which is not something you want if you are trying to lose weight.  

#5. Your TSH may stay the same or actually get lower (5).

This may sound good at first, but the fact that your TSH does increase is probably due to the fact that your hypothalamus is being suppressed and can no longer produce TRH. 

TRH is supposed to stimulate TSH so low levels of TRH will result in low levels of TSH. 

Normally, we think of a low TSH as a marker that your thyroid is producing too much thyroid hormone but in this case, the exact opposite may be true. 

This is also probably why most doctors fail to recognize the impact that calorie restriction has on the thyroid because they are so focused on the TSH (often to the detriment of the patient!). 

With this as a solid framework, let’s dive into some more information about calorie restriction, weight gain, and how it all fits together. 

What Counts as Calorie Restriction? 

If you are following the advice of your doctor and reducing your calories to try and lose weight maybe you have already experienced many of the consequences that I’ve listed above. 

If not, maybe you are wondering if there is a way to only slightly reduce your calories to the point that you lose weight without negatively impacting your thyroid. 

In other words, is there some point at which calorie restriction becomes problematic and some point at which it is beneficial?

Not exactly. 

Any degree of calorie restriction, if prolonged, has the potential to cause issues. 


Your thyroid controls (at least in large part) how many calories you burn on a day-to-day basis. 

This is often referred to as your metabolic rate which is often encompassed in the term metabolism. 

In reality, there are many other factors that coalesce to form your metabolism but it’s easy to think of it in this way. 

While the thyroid controls your metabolism, it’s important to realize that pretty much every single person with thyroid disease suffers from thyroid issues to varying degrees. 

In other words, no two thyroid patients are exactly alike (shocker!). 

If we took 100 thyroid patients and measured their metabolic rate (how many calories they are burning on a daily basis) what do you think we would find?

We would find that each person is burning a different amount of calories each day. 

If we took that same 100 people and measured all of their thyroid lab tests (TSH, free T3, free T4, and reverse T3) what do you think we would find?

Do you think that we would find that every single person is burning the same amount of calories each day? 

Absolutely not. 

Do you think that we would find that each person has identical lab tests? 

Again, absolutely not. 

We would find a great deal of variance among those individuals and we would find that the needs of EACH of these patients are different!

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The number of calories they consume each day would closely mirror the number of calories they burn each day (which is based on their metabolism) and this would be correlated with their thyroid function which is dependent upon how much thyroid medication they are taking (or how well their thyroid is functioning in general). 

How on earth does it make sense to give the same recommendations (thyroid medication or otherwise) to all 100 patients if they are all so different?

It doesn’t at all and that’s the problem. 

Each person deserves their own individual recommendations and advice. 

Even though it’s obviously ideal to provide personalized advice, it’s also not practical in this blog post as hundreds if not thousands of people will be reading this. 

Instead, I’ll give you some basic information that you can work with to help you determine what your body needs. 

Let’s start with the basics: 

In general, you want to avoid ANY diet which seeks to ‘work’ by requiring calorie restriction in any way, shape, or form. 

But please note that when I use the term calorie restriction I am really talking about sustained daily calorie restriction over a period of 3+ weeks or longer (or 21 days straight). 

This is an important distinction because some forms of calorie restriction can actually be beneficial. 

Prolonged and intermittent fasting fit into this category. 

What is fasting if not a dedicated form of calorie restriction? That’s exactly what it is but there seems to be some benefit to this method of calorie restriction compared to constant and prolonged daily calorie restriction. 

Intermittent and prolonged fasting protocols seem to have a beneficial impact on metabolism, thyroid function, and inflammation and typically do not cause damage to the thyroid (unless they are done in excess). 

With this information in mind, the following diets should be considered off-limits: 

  • Diets that impose restrictions on the number of calories you can consume at each meal. 
  • Diets that impose restrictions on the number of calories you can consume throughout the day.
  • Diets that impose restrictions on your portions at each meal. 
  • Diets that entail extreme workouts as a means to burn more calories than you consume. 
  • Diets that promote a specific amount of calories that should be consumed based on generic information such as your gender, height, weight, etc.

If this information isn’t enough, then you can also see a list of diets that would fit into these examples below:

  • The hCG diet
  • Weight Watchers
  • Virtually any other diet which recommends limiting your food intake or counting your calories

Not included on this list would be diets that cause a natural reduction in calorie consumption through their impact on hormone balance or appetite hormones. 

This could be diets such as the ketogenic diet or carnivore diet which may cause natural calorie restriction due to changes in ketones or other biomarkers which influence metabolism. 

These would be considered natural forms of calorie restriction by taking advantage of pathways in the body sometimes referred to as biohacking. 

While I’m not a huge fan of the ketogenic diet for thyroid patients, which you can read more about here, it would technically be ‘approved’ and can potentially be helpful for some thyroid patients. 

The same is true of the carnivore diet

Why Thyroid Patients Really Gain Weight

To further push the point that home that calories do not always correlate with weight gain (or weight loss), let’s look at some of the reasons why thyroid patients gain weight. 

It may appear simple, but it’s actually a little more complex than you might think. 

It all starts as thyroid function declines or as you become hypothyroid. 

This starts a chain reaction of events and each thing makes losing weight a little more difficult. 

As your thyroid function declines you will first see a drop in your metabolism. 

This makes sense because your thyroid is one of the primary regulators of your metabolism and, as every thyroid patient knows, weight gain is one of the first symptoms of low thyroid. 

With this information, we are faced with a problem: 

If that’s true that hypothyroid patients gain weight when their thyroid is low, which it definitely is, why then do they not lose that weight once they start taking thyroid medication? 

If that thyroid medication is ‘normalizing’ their thyroid function, wouldn’t we expect that extra weight to come off if it’s related to their thyroid? 

We would, and why it doesn’t is a complex and confusing topic and something I refer to as the thyroid weight gain paradox or thyroid obesity myth

Important to this discussion, but something we won’t spend time on, is the fact that most thyroid patients are undertreated due to the current thyroid treatment paradigm (but this still applies to thyroid patients who are adequately treated with thyroid medication as well). 

Back to the thyroid and weight gain for a minute. 

As I mentioned above, a drop in thyroid function causes a chain reaction of problems, and these other problems also lead to weight gain. 

What this means is that there are other factors that cause weight gain in thyroid patients and these factors are independent of their thyroid. 

In other words, your thyroid problem caused other problems that need to be addressed if you want to lose weight. 

The biggest and most pressing problem is the influence that low thyroid function has on other hormones in your body. 

Thyroid dysfunction causes a cascade of hormone imbalances that are not ‘fixed’ with the proper replacement of thyroid medication which results in persistent weight loss resistance even in the face of treatment. 

You’ll know if you fit into this category because you will be told that your thyroid looks ‘fine’ but you still won’t be able to lose weight. 

You can see documented examples of how your hormones obviously impact your weight here: 

Do you think it makes sense that the women in these studies suddenly changed the number of calories that they consume right after their surgeries or procedures?

Or do you think it’s more plausible that these surgeries impacted their hormones which then impacted their weight?

Women who fall into any of these categories will never have success with calorie-restricted diets (the answer from most doctors) because it doesn’t address the primary cause of their weight gain. 

The weight experience in each example above was caused by hormone imbalances, not by calories. 

In fact, if you fall into any of these categories and you were to try to restrict your calories you would drag down your thyroid in the process and only make the problem worse. 

If that’s the case, what is the answer? 

Ensure that you address the main problem (your hormones) and not the number of calories that you consume. 

You can read more about how each of these systems contributes to weight gain and how to treat them below:

How Many Calories Should You Eat?

The next logical question you should be asking yourself is how many calories should I consume?

And the answer is actually relatively easy to answer. 

Simply put:

You should be consuming the same amount of calories that your body burns on a daily basis. 

The good news is that your body has a built-in mechanism to help you do just that. 

It’s called your appetite. 

Your brain will tell you when it’s time to eat (unless you have certain conditions listed below) by inducing hunger!

As long as this system is working correctly, you will only be hungry when your body needs fuel and energy. 

And your hunger will subside once you consume enough food!

It’s quite a simple system. 

If you are consuming fewer calories than your body needs then your body will send signals to increase your hunger. 

But what happens if you ignore those signals? 

That’s when the problems arise. 

If you do not respond to the hunger, for an extended period of time, then your body may start to alter the number of calories that it consumes by reducing your metabolism. 

If you persist with your calorie restriction this lowering of your metabolism will continue as well and eventually you will be in a state where you are burning far fewer calories than you used to each day. 

If you don’t believe me, you can take a look at perhaps the easiest-to-understand study on this very topic. 

Contestants of the Biggest Loser (a television series, if you aren’t familiar with it) were studied both before and after their weight loss journey by evaluating their metabolism. 

Researchers found that after their weight loss and dieting efforts, on average, each contestant was burning up 400-600 calories LESS than they were before they started. 

reduced metabolism in patients after calorie restriction

And the worst news is that this damage persisted for about 6 years afterward (11). 

Let’s put this into context so you get a better idea of how this can impact you. 

Imagine a hypothetical situation in which you are burning 2,000 calories per day. 

In this hypothetical situation, you also have hypothyroidism, however, and it’s not being treated correctly (which is very common, by the way!). 

As a result, instead of those 2,000 calories per day, you are burning somewhere closer to 1,800 calories per day. 

Because of this, you are gaining weight and you want to do something about that. 

So you decide to cut your calories down to 1,400 calories per day and you do this for 30 days. 

Initially, you start to lose weight (maybe 5-10 pounds) and you feel great. 

You keep this weight off even though you increase your calories back up to 1,800 to 2,000 per day. 

Eventually, though, as it happens in about 99% of cases, you regain your weight back after about 6 months. 

You want to fight this weight gain so you think to yourself that you’re going to get aggressive and lose this weight fast by doing what you did previously, only this time you are going to eat 1,200 calories per day. 

What happens this time?

Instead of losing the weight like you think you will or should, you only lose about 2-5 pounds and it takes 60 days instead of 30. 

But this time once you increase your calories you regain all of the weight you lost plus some extra and it occurs much faster.

Now you are an extra 5 pounds heavier over this 6-9 month period and confused. 

So what happened? 

The answer is simple, your body ‘adapted’ to the caloric restriction by reducing your metabolism which resulted in your weight gain. 

You would have been better off testing for and addressing the hormone imbalances that were actually causing your weight gain, to begin with, such as your undertreated thyroid. 

This vicious cycle is why there are so many women (and some men) in the thyroid community who simply can’t lose weight no matter what they do or try. 

These same people are often left frustrated and confused feeling like nothing works for them. 

Conditions Which ‘Confuse’ Your Appetite

Unfortunately, it’s only possible to rely on your appetite if you can trust that your appetite accurately reflects how many calories your body needs. 

Under normal conditions, it does. 

But under other conditions, your appetite may actually fool you. 

It’s possible for your appetite to be greater than it should be due to a variety of factors. 

This can make matching your calorie consumption to your appetite quite difficult (but not impossible)!

The following conditions are known to cause conflict with your appetite which may result in you eating more than you should:

The presence of any of these conditions may cause difficulty if you are trying to match your calorie intake to calorie consumption. 

They can and should be addressed first, which may put your weight loss on hold, but will allow you to not only lose weight in the future but keep it off long-term. 

This is, after all, the best way to approach weight loss in thyroid patients, a layered, comprehensive approach. 


The bottom line?

If you have hypothyroidism then you should absolutely avoid calorie-restricted diets as they not only harm your thyroid but also cause long-term damage which can last for years and years. 

The key to weight loss is to address underlying hormone imbalances that exist in your body first while also addressing and treating your thyroid. 

For most thyroid patients, this means using a combination of T4 and T3 thyroid medications, taking thyroid-boosting supplements, eating a whole-food diet, and exercising regularly

I know it is tempting to try and cut your calories for quick weight loss but you must resist the temptation! 

Consider this a warning to avoid these types of diets as they will not only cause weight gain in the long term but also lead to weight loss resistance. 

As you take the right approach to balancing your hormones, you will find that you are not only able to lose weight but keep it off as well. 

Lastly, if this approach resonates with you, you can always find more information on my approach to weight loss (including a list of advanced therapies) in my weight loss supplement bundle and 60-day weight loss guide.

Now I want to hear from you:

Have you been restricting your calories? 

Do you believe you are suffering from metabolic adaptation or a damaged metabolism? 

Do you feel like you are stuck and that nothing you do is helping you lose weight? 

Has anything helped you lose weight? If so, what?

Leave your questions, comments, or concerns below to keep the conversation going! 


















eat this many calories if you have hypothyroidism

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About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 80,000+ people have used them over the last 7 years. You can read more about my own personal health journey and why I am so passionate about what I do.

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#1. Get my free thyroid downloads, resources, and PDFs here.

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69 thoughts on “How Many Calories Should You Eat with Hypothyroidism?”

  1. What if you don’t have a thyroid and are getting your T3 from NDT. Would prolonged dieting still cause your T3 to be suppressed and thus metabolism slowed?

    • Hi Brooke,

      Yes, it has the same effect by blunting T4 to T3 conversion and disrupting hypothalamic function.

  2. I have been diagnosed with Hashimotos Hypothyroidism and four-six months or more (I have lost count) the thyroid specialist I saw told me I was normal and fat and to put the fork down and gave me diet pills, I was with him 20 minutes and charged $400 to my insurance and left without any results I am 200 pounds, 5’11 and 56 years old and cannot afford to keep going to doctors I am on Levothyroxine 100mg daily and still fat with no hope of help SO I am trying to do it on my own. Your info is so wonderful and I wish I could see you because I know I would get the help I need and lose this extra weight, I am SO afraid of food it is not funny. I went gluten and milk free for over two months it has helped but I also have Chrons disease, IBS and Colitis so I am a MESS. But I watch your videos and I appreciate all your information.

    Sincerely, Ronda Feehan

    • Most doctors do not look at the T3 level. Is he checking the T3 level? This might be your problem. You might not be converting the T4 in levothyroxine to the Active T3 you need. And if your TSH was higher than 2.5, my endocrinologist would say you are hypothyroid and want to run the T4 and T3 to see what’s going on and put you on the right supplement. You should ask to see your lab work so you can make a judgment for yourself. Armour Thyroid is what I am on; it is a combination T4/T3 drug.

  3. Thank you for all of the valuable information and helping to make sense of thyroid issues. While I was living in Colorado and under the care of hormone replacement therapy, I was able to maintain my weight. Since moving to the Las Vegas area, I cannot find anyone who provides this type of treatment and I have gained 30 lbs. I am so frustrated and have tried everything to lose the weight yet nothing works. Can you recommend anyone in my area that can help?

  4. I have been yo-yo dieting since I was 16 years old not realizing soon enough my constant weight gain was thyroid related. Yes, I have damaged my metabolism beyond repair I believe. I have worked out exhaustively trying to lose the weight Sometimes it worked sometimes it didn’t and actually brought my immune system down. I’m 65 and finding that menopause is playing havoc with my weight once again. HELP ME GET OFF THE CARNIVAL RIDE I’VE ENDURED ANY SUGGESTIONS. YOU CAN EMAIL ME AT Thank you in advance for your help.

  5. I feel like you are describing my life. I restricted my calories doing the HCG diet. It lasted a short time. My body weight has increased continuously ever sin. It didn’t matter if I exercised 48 to 58 minutes a day, with one day off. I did for 6 months eating healthy. I didn’t lose an ounce. Very frustrating!! I was on armour Thyroid for some time no change still struggling. My current endocrinologist has me on Tirisant 88mg, just increased from 75. Post hysterectomy. I I am fighting an uphill battle. Started the ketogenic diet in January my body isn’t responding like others my age. I am really upset. I have been reading and watching your videos. Learning A LOT!! Going to talk with my endocrinologist next week to see about more testing. Thank you for all you do!!

  6. I had a hysterectomy 15yrs ago and I’ve been told by Gyno,Functional Medicine doctor and Endocrinologist that I don’t need any female hormones tested because I had hysterectomy. My weight was healthy and I was very active until I lost my thyroid to cancer 2.5 yrs ago and everything just unraveled and I started to gain weight and debilitating joint pains.

    After being on Armour Thyroid since Aug 2018 I finally stopped gaining weight but now I’m never hungry and I have to force myself to eat, I’m told I’m fine ..that I just have to deal with it. My body at times feels like a train wreck.

    Should I have my female hormones tested or are the Doctors correct I don’t need the testing? I currently only get the thyroid panel (Ft3,Ft4,T3,TSH)

    Great article…thanks

    • This article /information rings so true to me, it explains my past dieting history exactly. For years we have been told to reduce calories to lose weight. I initially do lose weight but always end up bigger year after year, so deflating!

  7. Very enlightening article.

    I have always maintained the only way I can loose weight is on the Cambridge diet (not for the faint hearted). I have done this countless times over the years and yes, I did help me get weight off. I even got down to a uk size 12/14 once and I was ecstatic.

    But, I have always put the weight back on – plus – when I returned to a normal everyday diet. I’m not a junk food eater, I prepare food from scratch and try to make sure i have a everything in moderation.

    I could never fathom how a salad could result in weight gain!

    I have now resigned to being fat and very unhappy about my weight but there is no alternative for me in the uk.

    At least now I can explain the science behind it. Thank you.

  8. Dr. Childs,

    I was finally able to lose most of the stubborn weight I gained over the years despite a healthy diet and daily exercise by being on Keto and doing intermittent fasting for 2 months. I stayed on it for 7 months because I felt even worse after eating even healthy carbs, like yams. I was able to add carbs back. After that, I hit a plateau and the weight wouldn’t budge further. I was able to be on t3 only for a couple of weeks and lost 5 pounds in about 2 weeks. I still continue the fasting because it’s convenient. I’ve continued to lose weight despite only eating 2 or 3 times a day but have had a lot of fatigue. My doctor blames it on my busy schedule, but stress and work are inevitable. I used to eat every 3 hours when I was younger and up until I gained a lot of weight. Now I don’t have much of an appetite. Is this appetite loss reversible? Or does it just mean my body is fat adapted and doesn’t need calories frequently?

  9. Hi

    Great article.

    I’ve been struggling with my weight for about 5 years now. It doesn’t matter how little or much I eat, or whatever diet I try, the scales are continuing to go up.
    I had an hysterectomy about 28 years ago and have taken levothyroxine for about 20 years. It’s constantly fluctuating but at the moment I’ve been on 125mg a day for about 2 years.
    I’m very rarely hungry and only eat because it’s meal times.
    So, I’ve put on about 2 stone which I can’t reduce no matter how much exercise I do. I’m basically at my wits end.

    I also have fibromyalgia, so doctors just keep saying there’s nothing they can do. I’m just going to get fatter 🙁 With FM comes brain fog, so I struggle to digest all this information.

    They won’t send me to a consultant as the dietician says my diet and exercise are good and all my thyroid tests are within the limits…

    Not sure where else I can go with this.

  10. Dr. Childs,

    You are describing me weight problem since before I had my TT. I can’t lose weight no matter what I do and it’s so frustrating. My doctor has even put me on Phentermine and I still can’t lose weight. I’m still hungry all the time but at the same time do not have an appetite. My doctor keeps blaming it on my lifestyle and when I try to explain to him it’s not that he brushes it off. It’s so frustrating. I am going to talk to my doctor about getting a full panel of bloodwork to see what hormones might be out of whack. Thank you so much for this article!

  11. Dr. Childs, Thanks! Thanks! Thanks for the informative article. I’ve struggled with weight gain for 20 plus years. Being told it was age-related. Then two years ago I was told I have a thyroid issue, guess the numbers finally fell out of the standard range. I’m on Levothyroxine and when I ask the pharmacist if this contained soy, I got the answer “soy is in everything”. I refuse to take any medication that contains soy since I had a severe reaction to a product that had soy in it. I also refuse to take steroids of any kind. This makes my Med Dr’s not too happy since they seem to write prescripts like candy for everything. This little gland is a very powerful controller in our body, which so many just ignore it when it is not functioning properly. Keep up the great work.

  12. Hi, fantastic article, thanks. I have just found out I have hypothyroidism and I cannot eat just about anything without getting stomach cramps and being very bloated – I am not sure if this is even related to my thyroid but I just want to be able to eat something without the pain. Thus far all I have been able to eat without pain is eggs and blueberries. I cannot eat this for the rest of my life, can you please advise on what is “safe” to eat?
    Thanking you in advance

  13. Your information was very good, But if you have a Dr. that doesn’t listen who only ever checks T4 not T3 so leaving you fighting weight gain, also says you must be eating too much its like banging your head against a wall. I have my Thyroid checked once a year.

  14. Thank you for your quick response
    I think I just might do that as, I am getting very depressed with my weight at the moment,plus feeling tired all the time.
    I have cut loads of calories out of my diet but reading your post I’m sure its not the best thing to do. Many thanks again Ron

  15. Also a very helpful article because I was just looking online for how many calories I should be eating. I’ve had a poor appetite for years. It seemed to happen after I had my partial thyroidectomy. This is when I noticed I suddenly had a poor appetite. I also just discovered my B-12 and iron are borderline low.
    I’ve never restricted calories but have issues with eating enough because of my appetite. I eat breakfast every morning and space out meals. Luckily, since starting NDT I no longer experience hypoglycemia or blood sugar issues. I’m a petite woman and weigh 103. I think eating spaced out meals and around the same time has helped me stay the same weight for years, which is a habit I adopted in my early 20s. Overall, the most I’ve ever gained from my thyroid issue was 5-10 lbs of water weight.

  16. I’ve lately got to know that my thyroid’s low. I’m gaining a lot of weight and inches. I’ve started my diet according to an app which tells me how much to consume and how many calories to burn. But still I need a proper thing to know. As to how to get my weight back to normal and also my thyroid to be better

  17. Hi Dr …
    I have been on a 1000 – 1300 calorie diet . Have hypothyroid for decades and trying 16:8 IF. You think this can damage my thyroid function.

  18. So I’ve been doing 1200 calories as suggested by my doctor. And I’ve found that eating healthy I have to take only half my thyroid medication or my blood pressure gets very high and I start having chest and central back pain. In the past when this happened I was sent to a heart doctor who discovered that my thyroid doctor was overdosing me. Someone at my thyroid doctor forgot to notify be of the decrease. Knocking the rhythm of my heart off. I’m currently on a waiting list to see a new doctor. I’ve gone from 50 units to 200 now but at 200 generic synthriod I get chest pains. I’m in desperate need to lose weight I’m up to 365. Not to be skinny but bec I’m having trouble now keeping up with my kids.

  19. Garbage advice. I have severe hypothyroidism and most of weightloss has to do with calorie reduction. Fact. Proven. Non debateable ask a licensed dietitian. You know what keeps me at about 116lbs at all times? Keeping the amount of calories I consume in check. My dr. requires routine full blood panel tests among others for all patients to check their health. I am 100% healthy nearing my mid 30’s. I get perfect blood work on all occasions save when I get it after recently having had a cold. It’s possible to be at a healthy body weight per your size with hypothyroidism.

    • Hi Alie,

      You are certainly welcome to your opinion and I’m glad you found something that works for you. What I can tell you, though, is that what you are doing to your own body will result in metabolic damage over time and you will ultimately be required to consume fewer and fewer calories to maintain your weight and you will live in a state where you are constantly hungry. But it’s your body, not mine, so you can do whatever you please.

      We do agree on one thing, though, and that is that you can live at a healthy size with hypothyroidism 🙂 The difference is that my route allows you to live at that body weight without calorie restriction. But good luck either way!

  20. Hi, my husband had his thyroid removed 15 years ago due to thyroid cancer. The last 3 years the doctors have messed his meds up so that he has gained 80 plus pounds and lots of other issues now. When you have no thyroid what works best to get the weight off?

    • Hi S Thompson,

      You have to optimize your thyroid medication dose as well as other hormones such as testosterone. Optimizing these two hormone systems in men usually results in significant weight loss.

  21. Dr Child’s, Thank you so very much on all the investigative and valuable helpful information. I want to get my thyroid panel tested. I don’t really have a Dr whom I trust. I have a PPO insurance, can you bill my insurance and write me a blood draw?

  22. I haven’t been able to lose more than 5 lbs since my daughter was born in the summer of 2018. At the time I had her, I had been on levothyroxine 50 mcg for 2 years (hypothyroidism, non-Hasimoto). Between diagnosis and getting pregnant, I was able to steadily lose weight on only a slightly restricted calorie (200 less than BMR suggested) and working out moderately 3-4 days/wk. I, at the time, was found to be gluten sensitive (non-celiac) and lactose sensitive so I avoided this in my diet.
    Since I had my Mirena IUD placed and went on antidepressant for PPD in Fall/Winter 2018, I couldn’t drop weight. I’ve had wide symptomatic swings in my thyroid function since 2018 and have, as of recent, upped dosage to 75mcg. I have also developed non-cancerous nodules and a fairly large right-sided goiter. I have also now become soy sensitive, which I try to avoid as much as possible. I find it even tougher to lose weight and I think, because of the mix of my IUD and my hypothyroidism, that my hormones have got to be out of whack. I am due for my annual check up with my primary MD and thinking of asking for an estrogen, progesterone, and testosterone panel to see what’s up in that area. Any other suggestions? I see a different doctor (endocrinologist) for my thyroid.

  23. The Noom program worked for me long term because it helped me find the exact amount of calories that equal the amount I’m burning. There is no restriction per se. At 67 I burn fewer calories than I did in my youth, and I think I had never admitted that. I got adjusted to listening to my body more accurately, and it teaches you to discern types of hunger that are not real hunger.
    I do have my hormones balanced. Izabella Wentz’s website has a list of doctors who do progressive work with thyroid. Look for integrative medicine or anti-aging medicine doctors. They are progressive.

    • Hi Lola,

      I’m not really familiar with noom but if it’s working then that’s great 🙂 The real measure as to whether or not something is working is if you are able to keep your weight off long-term, so keep that in mind when evaluating when something is actually working.

  24. How do you optimize your other hormones when you are over 65? Is bioidentical hormone replacement therapy safe for women over 65 or not? I’ve read so many conflicting studies and articles! Looking for your opinion on BHRT.

    • Hi Sofia,

      Bioidentical hormone replacement therapy is safe and effective for the vast majority of women, especially those post menopausal.

  25. Thanks for a great explanation! I just wish my husband would believe me when I try to explain his current weight loss is not healthy (he argues he’s doing it under a doctor’s care, so it has to be fine).

    Quick back-story…my husband had thyroid cancer in 2014-15, a full thyroidectomy, and only takes levothyroxine. His endocrinologist put him on phentermine about 2 months ago to help get his BP and weight down. He’s lost about 40 lbs so far by severely cutting back calories and not really increasing exercise (pretty much no exercise prior). He gets angry when he eats a little food and adds a couple pounds. I know this way of eating (or lack thereof) is not sustainable for him, but he doesn’t believe me when I try to tell him any of the things you talk about here, including posts about needing T3 if you don’t have a thyroid.

    Can you link to some studies I can show him about this (he’s a lawyer, so he needs facts and numbers, etc)?

    Thanks so much!

    • Hi Stephanie,

      All of the studies are located at the bottom of each blog post in the reference section 🙂 Men can sometimes get away with calorie restriction, at least more than women can. Time will tell, though, because he may ultimately regain all of the weight once he stops with whatever diet he is currently using.

  26. Hi

    Great article.

    I’ve been struggling with my weight for about 5 years now. It doesn’t matter how little or much I eat, or whatever diet I try, the scales are continuing to go up.
    I had an hysterectomy about 28 years ago and have taken levothyroxine for about 20 years. It’s constantly fluctuating but at the moment I’ve been on 125mg a day for about 2 years.
    I’m very rarely hungry and only eat because it’s meal times.
    So, I’ve put on about 2.5 stone which I can’t reduce no matter how much exercise I do. I’m basically at my wits end.

    I also have fibromyalgia, so doctors just keep saying there’s nothing they can do. I’m just going to get fatter With FM comes brain fog, so I struggle to digest all this information.

    They won’t send me to a consultant as the dietician says my diet and exercise are good and all my thyroid tests are within the limits…

    Not sure where else I can go with this.

  27. Hi

    I’ve looked at the download for working out all the thyroid levels, but in the UK we don’t get given all the lab results. The doc just says it’s in range.
    How much does it cost to get these tests done in the US please.


  28. Hey Dr. Childs,
    what about the low T3 Syndrom and intermittent fasting? I do the 16/8 fasting method since 1 month and need fewer calories naturally without restriction. I feel much better, have more energy and my weight went down 3 kg. Is this safe long term? Or does the weight tend to bounce back with this method? Thanks.

  29. I’ve tried many thyroid medications and each one causes significant hair loss consistently. I tried naturthroid, wp throid, compounded T3 and cytomel. It doesn’t just last for the first 30 days. I take compounded bi-est and progesterone and my hormones are regulated well. Get blood tests monthly and adjust accordingly. I also take iodine, selenium and zinc daily. Are there other alternatives you would recommend to help my T3 free that’s consistently around 2.8?

    • Hi Terri,

      Thyroid medications are dosed dependent. Most people don’t take enough medication to move the needle so you need to make sure you’ve actually used high doses of these medications before you make the assertion that they don’t work.

  30. I was on hormone replacement therapy with estrogen/testosterone/progesterone starting at the age of 45 for severe perimenopause symptoms. I lost my extra 15-20 lbs. I felt and looked great. I was already taking Levothroid which I started at 40 years old when I was diagnosed with Hashimoto’s. I was eating a high protein very low carb diet and weight training 3x a week. In my late 40s I stopped being so strict with eating carbs and gained a few pounds. At 48/49 the Levothroid was not keeping my thyroid numbers in range. My endocrinologist told me there was nothing wrong with my lab numbers even though my TSH was over 2, almost 3. At 51 I became fully menopausal. I researched and finally found a doctor when I was 52 who prescribed me Armour. It was like a miracle. My lab numbers were great and my weight stabilized. I was still weight training and active. When I turned 60 my weight started creeping up even though I was still very active and had not changed anything. At 63 I was diagnosed with an aggressive form of breast cancer and stopped the hormone therapy after 17 years (I did not stop taking Armour). I was in cancer treatment for a whole year! Chemo, radiation, targeted biological therapy, the works! My oncologist told me the reason I got breast cancer was from taking long term hormone therapy. I believe it. My girlfriend who was also on hormone therapy long term got breast cancer too, unlike our other friends who did not. I am 70 now and weigh more than I ever have. Still weight training but not as much as before. I swim and garden a lot in summer, and can walk for 2-3 miles. I have accepted my weight gain of 50 pounds from in my 40s. I am lucky to be alive. I am grateful and focus on my family and happiness now. My advice is DO NOT take hormone therapy! at least not long term like I did. It is just way too risky. My primary doctor said I was very lucky to have been diagnosed at stage 1 and via a chest x-ray!!! The x-ray was done because I had severe seasonal allergies/congestion. I feel I dodged a bullet for sure.

  31. Very interesting article. Personally, I never give calories a thought, and I maintain a normal weight post menopause and with advanced Hashimoto’s, and now having been diagnosed with multiple autoimmune diseases, including RA. Hashimoto’s was my first autoimmune disease diagnosed in 2012. In 2017, I had breast cancer, and soon after that autoimmune blood issues. Trying to get my strength and health back, I went to a functional doctor who changed everything I was doing. I stopped eating gluten, soy, and dairy, and added more vegetables and only a fist-size amount of protein at lunch and supper, with gluten-free oatmeal, quinoa, or a sweet potato, with almonds, shredded unsweetened coconut, and a little coconut oil, (with a little almond milk on the cereals) and a little fruit (cherries, blueberries, raspberries, or an apple) for breakfast. If I weren’t allergic to eggs, I would definitely include them in the rotation. I only eat fruit at breakfast. I eat three meals a day, everyday, with a lot of variety, and I take supplements. And I walk at least 30 minutes, usually more, and go to the gym a few times a week. Having Covid 19 last year was very hard on my health and my routine, and I lost about 10 pounds because of it, putting me over the edge for another autoimmune disease. First thought to be polymyalgia rheumatica, testing ruled that out, and RA was diagnosed. It is now more important than before to keep my weight under control and to exercise. Everyday has it’s challenges, but it’s worth the effort to feel well and be able to do the things I want to do.

  32. Very interesting article, Dr. Childs, you are the best to be found on the Internet, thanks for your divulgation, you are helping a lot of people!

    Here’s my experience, I was diagnosed with Hashimoto when I was 17 and am now 50. I never had extra weight except for now, these last 5 years I am putting on weight no matter what I do. I do one-hour sport every day (tennis, dancing, weight lifting, jogging and HIIT). As I gained 20 kg in the last 5 years and was unable to lose it with sport I tried intermitent fasting (20-4) and I was not really hungry, I managed to do it very well and noticed improved brain function and no loss of energy and no hunger (I drank a lot of water if hungry and waited some minutes and hunger went away) but I fainted twice, so I had to stop intermitent fasting…. I tried calorie reduction but I noticed my metabolism was going soooo low (I noticed it in my sports, I was unable to run, swim or do HIIT as before, in my gym they measured my heart rate and told me it was that of 70 year-old a person…) so since I was a bit desperate about it I tried another diet I discovered on the Internet, it’s called the CRASH DIET, it’s from a doctor, Dr. Rafael Bolio, and it worked very well for me, I was finally able to lose weight without being hungry / fainting or slowing down my metabolism, this diet is very good: you eat a fruit and 2 nuts every 2 hours and also 100-gram good quality protein (fish/chicken or eggs) plus plenty of vegetables every lunch & dinner. You never feel hungry and do lose weight and feel very well (energetic to do sports). I finally found what works for me! I am sharing it in case it helps any other person, it’s freely available on the Internet. I was doing pineaple, watermelon, a pear, a full orange, melon or a tangerine plus 2 almonds or 2 nuts every 2 hours, and then 1 breast chicken with plenty of spinachs and brocoli or mushrooms and fish at night with salad or vegetable soup. NO hunger at all, plenty of vitamines and it’s the only diet that worked for me. I usually never took fruits, I don’t like sweet things except for dark chocolate, I drink my tea and coffee with no sugar or sweetener in it… but this diet made me feel very well and I lost 15 kg so far with no yoyo effect.
    Thanks for your great posts Dr Childs, I cannot thank you enough for your great material, it’s excellent!
    Big hug,

  33. So if one gets to the point that the TSH, T 4 and T 3 are all low or suppressed because of starvation.
    I would like to be optimized. My doctor is treating my t3 and t4 but I’m always worried he won’t because my tsh is suppressed. I think it is because of anorexia. Can my levels ever work well? My body has stopped losing no matter what. Currently eating ok, taking your vitamins.
    Thanks for the information. There is almost no information on starvation and the thyroid

  34. I was diagnosed with. Hasimoto’s with in the past two years, I am 73 and been on thyroid meds at least 20 years, mostly levothyroxin or synthroid, have been on Unithyroid & Euthyrox too over the past few years, I currently take Levothyroxin Sodium 75.. what is the difference between all of these, I am 5 ft 1/2 in tall and weigh 142 and have bloated stomach, digestion issues and can not lose weight …….. my TSH is 0.48 ……free T3 is3.2 and free T4 is .89 I would love to lose 10lbs and would like your opinion on these three thyroid meds.

  35. I believe I am suffering from metabolic adaptation or a damaged metabolism. I did the HCG diet approx. 10 years ago with various other low cal diets prior. I lost 125 lbs & I’ve gained it all back. It was torturous trying to not regain. But I just kept regaining & regaining. And no matter what I do—my weight will not budge—and I even seem to be consistently gaining a little bit more each year. My thyroid levels are “healthy” but I haven’t done any other evaluations regarding my hormones. I’m 43 years old.

    This article was helpful—but I’m wondering if there are any supplements that could help with this metabolic damage? Or could you direct me to further reading or specific testing I should do? Thank you.

  36. I just came across this article and it is mind blowing. I have been on thyroid medication since I was 17 yrs old. About 11 years ago I started working out and following a bodybuilding program for fat loss. I was on a crazy calorie restriction and actually had great results. Fast forward 5 years later and I’m comfortably married and put on more weight then ever. I tired out Keto and lost weight only to gain it back. The last 5 years have been the most difficult because I have been on and off of different programs and it seems like no matter how hard I try I just don’t get the results I’m shooting for. I simply want to see my abs again and no matter the deficit I go into I don’t have the results and end up burning out from either the low calorie restriction or the daily grind in the gym. I’m at the point of throwing in the towel and just accepting the inevitable, the dad bod. My labs have been consistent over all these years which is the part that throws me off the most because it seems like if that’s the case I should be like any other normal person. I would love some advice or help outside of this article!

  37. Back in 2019 my FT4 was 1.7 and FT3 was 2.6. Today my FT4 is 1.4 and my FT3 is 3.0. Although my FT3 is still a little low because I’m slowly increasing my Levo you can see the difference. I’ve been tracking and increasing calories for one week only and the results are dramatic. Suddenly, by the end of the week I started to feel better.
    In 2019 I was so unwell I was forced to take a leave from work and was suffering from so many hypo symptoms. In just one week after increasing my calories I’m exercising, walking my dog for an hour, and gardening. Weight has never been an issue for me as my BMI was always around 19, however over this past 6 months I wasn’t able to be active and put on about 10lbs. I’m not fretting about this because I’m focusing on getting better. As an active person this will correct itself later. Right now I’m focusing on feeding my body good carbs, proteins, and fats.
    I’ve never dieted or intentionally restricted calories but simply didn’t realize I wasn’t eating enough, even though I was eating healthy foods. I was a kid in the 80s/90s and my mom fed me sugary cereals and pop tarts for breakfast and sent me to school with lunchables and koolaid. I wouldn’t be surprised if a poor diet and calorie deficiency contributed to the hypothyroidism that started to develop in my youth.
    My current lab results prove what you’re saying is true. Never in the 12 years I was on Levothyroxine could I be active and functional with a FT4 level as low as 1.4! Even my total T3 levels have come up since increasing calories. If you don’t eat enough calories you’ll find that you need higher FT4 levels to function and even then your FT3 will still be too low and you’ll have lingering symptoms of hypo. It took a lifetime for me to realize this was my problem. Restricting calories or not eating enough good carbs, fats, and proteins will sabotage your success on thyroid hormone. Right now I’m not even taking my Cytomel and improving on Levothyroxine alone! Perhaps, when I get closer to optimal I’ll add it back in, if needed. That was a long ramble but it is indeed true because it happened to me.

  38. YES to everything you describe – except for one thing. Intermittent fasting is a terrible idea for those of us with hypoglycemia, which is often an issue for thyroid patients. Long periods without food can affect blood sugar, cortisol, sleep, mood. Moreover, intermittent fasting has been disproven by scientists. “In a yearlong study, participants who confined meals to certain hours lost no more weight than those who ate at any time.” – NYT, referencing UCSF study.

    • Hi Lisa,

      Usually, thyroid patients suffer from insulin resistance and high blood sugar (not the opposite). Just looking at statistics, roughly 50% of the United States has this issue. Hyperglycemia is much more common than hypoglycemia. As a result, fasting is typically a great weight loss therapy for thyroid patients with weight gain because they often have issues with blood sugar and insulin.

  39. Not the case for me.. If I eat according to my appetite, healthy food that is, I still gain weight, though my mediation dosage is correct

  40. I was diagnosed with hypothyroidism about 2 years ago. My TSH is consistently high despite taking levothyroxine and my doctor increases my dosage every time he tests me. I feel awful and I’ve gained weight incredibly fast since starting treatment. My doctor recently added phentermine, increased my levothyroxine dosage, and told me to reduce my calorie intake. I’ve been tracking my calories and taking in an average of 1000 calories per day. I feel worse than ever and can’t tell I’ve lost any weight. Should I see an endocrinologist, and could they help me lose weight?

  41. Hello,
    I was diagnosed with Hashimoto’s 5 years ago and have been in a hyperthyroid state since giving birth to my daughter 11 months ago. Should I wait to be in a euthyroid state before having my BMR tested? (I don’t trust my appetite since it changes so much and I can go a day or two without eating). I have done low calorie lately since the baby weight won’t come off. I haven’t tried intermittent fasting yet since I’ve been breastfeeding but now that I’m almost finished I’d like to start. That being said, would you recommend starting an adrenal supplement prior to fasting to combat adrenal fatigue? It’s worth adding that I have been super lucky and my doctors have listened to me when I tell them what I feel about my body. I’m currently on a levo and liothyronine combo. I get TSH, free T3 and T4 testing done regularly (q 3-6 months) since my thyroid levels haven’t stabilized yet postpartum.
    Would you recommend coming out of pocket for brand name synthroid?
    Sorry for all the questions. Thanks!

    • Hi Heather,

      I don’t think I’ve met a thyroid patient out there that hasn’t had some benefit from using adrenal support so I would say using one is a good idea whether you decide to fast or not, it’s just beneficial for thyroid patients period.

      In regards to Synthroid, it may be worth it but there’d be no way to know for sure without trial and error. If you were going to try anything, then Tirosint would be a good option to consider as well.


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