The Connection Between Hypothyroidism and Insulin Resistance + How to Treat it

Do you feel like it's impossible to lose weight with Hypothyroidism?

​It actually isn't impossible and I will explain how later, but first I need to share a story with you. 

​I had a patient who came to see me in the office recently. 

She was 43, on levothyroxine (for years), about 60 pounds overweight, and wanted my help in balancing her hormones and help her lose some of that weight. ​

Like most other people, she had tried to lose weight following every diet you can think of, but nothing seemed to work for her. 

So I got to testing her labs.

Know what I found? ​

More...

Elevated insulin with hypothyroidism

Insulin resistance. ​

And THAT was her primary problem.

Her thyroid wasn't all that bad, she ultimately did better on Armour thyroid - but her main problem was the insulin.

Once we got her on the right regimen, cleaned up her diet, fixed her adrenals, replaced nutrient deficiencies and put her on a fasting program her weight started to shed off.

And that's what we are going to talk about today.

​Hypothyroidism and Insulin Resistance. And why it's impossible to lose weight unless you address BOTH issues. 

What is Insulin Resistance?

Insulin is the hormone that increases after you consume sugar or carbohydrates from foods (1). 

It puts sugar inside your cells and protects your body from high levels of sugar in the blood.

That's what it's supposed to do - when everything is working correctly.

When insulin levels remain chronically elevated (like when we eat a lot of sugar in our diet), your body becomes resistant to insulin. And that's where all the problems start.

High levels of insulin cause you to store the calories you eat from your diet as fat in your belly.

​So high levels of insulin = you gain weight (even if you eat fewer calories). 

I've put together a list of some symptoms I see in my patients that have insulin resistance: (But don't worry I will tell you how to order and treat your insulin resistance below)​

  • Inability to lose weight
  • Belly fat (or visceral abdominal fat)
  • Cravings for sugary foods
  • Irritability when going long periods of time without food
  • Dizziness and lightheadedness when fasting

Any of these symptoms sound familiar?

Let's talk about why insulin resistance is a big deal...​

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Hypothyroidism is Common but so is Insulin Resistance

If you count all of the people with Hypothyroidism you get pretty close to about 1 in 20 adults in the US (2). It's INCREDIBLY common.

Prevalence of hypothyrodism

And on the other hand, you have insulin resistance (AKA Diabetes) of which about 1 out of every 10 people have (3)... 

Prevalence of diabetes and insulin resistance in the USA

​Not only are they both common, I find that most Hypothyroid patients are ALSO suffering from insulin resistance on top of their Hypothyroidism. 

And this can lead to weight loss resistance, inflammation and worsening hypothyroid symptoms. ​

Is Insulin Resistance Sabotaging your Weight Loss Efforts?

​Identifying and diagnosing insulin resistance is the first step to treatment. 

To understand why reversing insulin resistance is critical to weight loss we have to talk a little bit about physiology.

​We already mentioned that in the presence of insulin your body will store all calories you eat as fat. 

​But it also does something worse...

When insulin levels are high, your body is unable to burn your fat cells as a fuel source.

This process is mediated through a hormone known as hormone-sensitive lipase (4).

So, in order to burn fat (and actually lose weight), you HAVE to reduce insulin levels.

To depict this I like to use this graph:

Burning fat in the presence of insulin

​(Photo credit: Peter Attia of Eating Academy

​As you can see: 

As insulin levels fall, your body is able to actually unlock your fat cells and start to burn them for energy.

When insulin levels are high, your body can't unlock your fat cells to use as energy.

That means your body uses primarily glucose as an energy source. Which can cause a lot of the symptoms I mentioned above...

As Glucose levels drop in the blood your body tells your brain to increase your cravings for sugary foods, it also makes you irritable, and sluggish.

Are any of these symptoms sounding familiar?

Hypothyroidism Can Worsen Insulin Resistance

Now that you understand how insulin works, you need to understand how your thyroid interacts with insulin. 

Thyroid hormone, specifically T3 thyroid hormone, has an impact on how sensitive your cells are to insulin. 

The lower your T3 is the more likely you are to develop insulin resistance. 

On the flip side, the higher your T3 is the more likely you are to develop insulin resistance as well. 

This means that both states of hypothyroidism AND hyperthyroidism can lead to or exacerbate insulin resistance (5). 

But, in addition to this, insulin resistance also seems to play a role in altering how much thyroid hormone your body is capable of producing. 

Both insulin and thyroid hormone play together in a bi-directional way. One always impacts the other which means that BOTH are important. 

The good news is that most of you reading this probably fall into the category of hypothyroidism (meaning your thyroid hormone or T3 is too low). 

If you fit into this category, you will most likely have trouble losing weight because your low T3 is contributing to the development of insulin resistance. 

You MUST address your thyroid if you have any hope of reversing insulin resistance in your body. 

You can very easily test your T3 levels by looking at 2 tests:

#1. Serum Free T3, and...

#2. Serum Total T3

If either of these values is low (regardless of what your TSH is) then you need to address this problem by either altering your medication or by undergoing natural therapies

So How do you Know if you have Insulin Resistance?

Diagnosing insulin resistance is actually pretty easy once you know what you are looking for.

The problem is that most Doctors will NOT be ordering these tests at baseline.

So, in order to get the proper evaluation, you may have to ask for and interpret your own tests.

Don't worry.

I can walk you through it. 

Ask your doctor for the following lab tests: ​

  • Fasting Insulin levels
  • Hemoglobin A1c (Abbreviate Hgb A1c)
  • Fasting blood sugar
  • You may ultimately need post-meal glucose levels as well

Now that you have your lab tests in front of you, let's go over the "optimal" ranges:

  • Fasting Insulin levels: This should be < 5 (note that < 5 does NOT rule out insulin resistance) 
  • Hemoglobin A1c (Abbreviate Hgb A1c): Should be < 5.3 (note that Hgb A1c is not a perfect test by itself and a number of conditions can falsely elevate or decrease this value) 
  • Fasting blood sugar: Should be < 85
  • Post-meal glucose: 2-hour post-meal glucose should be < 120
Early signs of insulin resistance

Believe it or not, diagnosing insulin resistance can be very difficult when in doubt I would recommend that you consult with your Doctor - just make sure you find one that is knowledgeable. 

*Resources and links for optimal ranges are at the end of this article. ​

Now that we know WHY insulin resistance is a problem, let's talk about how you can reverse it...​

​How to Reverse Insulin Resistance and Heal your Thyroid

Despite what conventional medicine would have you think, insulin resistance IS treatable. 

In the conventional medical world, treatment is targeted at blood sugar. The problem with that method is that you are only going after the symptom of insulin resistance. 

Blood sugar rises as insulin resistance increases, and when it gets too high that's when Doctors diagnose you with Diabetes.

But diabetes is really just advanced insulin resistance.

And, while some medications can be helpful in reversing insulin resistance, the majority of your treatment should focus on the following areas:​

#1. Test and Treat your Thyroid Adequately

I briefly touched on what you need to do earlier in this article but I want to go over it again in a little more detail here. 

Before you move on to any of the next steps you need to make sure that your thyroid is optimized. 

If you are taking medication then this means ensuring that your lab tests are in the "optimal" range. 

If you are not taking medication, or if you are having a hard time getting on thyroid medication, then you can always use natural therapies such as these

But for most of you, you will probably need to look at your medication. 

And when it comes to treating insulin resistance, most people do well on thyroid medications that contain the hormone T3. 

Medications such as Cytomel, liothyronine, and Natural Desiccated Thyroid hormone tend to help the most both in terms of weight loss (6) and in helping normalize insulin levels. 

A word of caution, however. 

Do not take more T3 than necessary because taking too much may actually make your insulin level worse! 

In addition to addressing your thyroid, you MUST also take into account other factors such as your diet (the foods you put into your mouth), WHEN you eat, how much you eat, which supplements you take, and what medications you are on. 

Let's dive into these in detail as well...

#2. Diet to reduce Insulin levels

Diet i​s important in reversing insulin resistance, but alone it is usually not enough - especially for advanced insulin resistance. 

Increased insulin leads to obesity

​Consider the image above. 

What you put into your mouth can certainly cause an increased level of insulin and ultimately lead to insulin resistance.

However, once insulin levels get high enough they can cause insulin resistance by themselves in a vicious cycle.

That's why diet is a good first step but usually not enough.

I recommend focusing on a nutrient-dense, real whole-food diet, low in refined carbohydrates and sugar. You can get an exact idea of what I'm talking about by checking out my thyroid reset diet here.

#2. High-intensity exercise routine

Everyone knows exercise is important, but the type of exercise matters a lot. Especially if you are trying to lose weight and reverse insulin resistance.

Studies show that high-intensity Interval Training is especially helpful in sensitizing your body to insulin (7).

​In addition, you can get more bang for your buck in a smaller amount of time. 

Not sure what high-intensity Interval Training (HIIT) is?

Let me explain:

​HIIT focuses on small bursts of all-out, maximum effort for about 30 seconds followed by 60-90 seconds of moderate activity. 

This process is repeated 5-8x in a single session at least once per week.

​This once per week activity is more beneficial to your body than doing an elliptical for 30 minutes and takes a much smaller amount of time. 

A word of warning for Hypothyroid patients:

Do not attempt high-intensity interval training unless your thyroid hormone is optimized and your adrenals can handle the stress.

Exercise (of any kind) puts a physiologic strain on the body. And this is a normal part of the healing process which causes the release of endorphins and cellular changes which lead to all of the benefits of exercise.

And while exercise is important, it's better to take it easy at first otherwise you risk making your thyroid and adrenal function worse. ​

  • Quick Tip: If after exercising you are fatigued for several days then that is a sign you need to look at your thyroid and/or adrenal function. Exercising should make you tired and sore, but it shouldn't last more than 3 days. 

#3. Intermittent fasting protocol

Fasting is a 4 letter word for a lot of people.

But the truth is that fasting is probably the single most effective way to treat insulin resistance (8). 

​Here's how it works:

The longer you spend without eating the lower your insulin levels fall.

Once your body uses up the majority of stored glucose in the liver, your body MUST use triglycerides from your fat cells to provide your body with energy. 

As insulin levels fall your fat cells become "unlocked" by hormone-sensitive lipase, and you are now burning fat for fuel and sensitizing your body to insulin in the process. 

This is obviously oversimplified, but you get the point!

Fasting = good for reducing insulin resistance

​BUT, and this is a big but...

Like high-intensity exercise, I don't recommend starting intermittent fasting unless your adrenals and thyroid function are optimized.

If you start fasting and you experience any of the following you may need to optimize your thyroid and adrenals first:

  • Dizziness or lightheadedness
  • Headache
  • Extreme cravings
  • Tremors or "shakes"
  • Intense thirst
  • Increased urination

​Do not attempt fasting if you are on insulin and a diabetic. You WILL need medical supervision and if you try to do it by yourself you may put yourself in danger from hypoglycemia. 

This is how I start patients on a gentle intermittent fasting program:

Start with 12-14 hours.

Eat an early dinner at 7pm.

Eat a late breakfast/early lunch at 11:00am the following morning.

Repeat this process twice per week. ​

#4. Supplements to Treat Insulin Resistance

I saved this part for last because it's typically the first thing people want to do!

While supplements can definitely help reverse insulin resistance and help you lose weight, they should NEVER be used in isolation.

If all you do is grab your supplements and go, you will not experience the results you are looking for.

Having said that these are the supplements I recommend to my patients which have scientific studies backing them:

  • Berberine - I recommend using 1,000mg at least daily. Berberine has been shown to be as effective as Metformin in reducing Hgb A1c (9). 
  • Pure Lean PurePack - This has a combination of Cinnamon, Alpha lipoic acid, Chromium and Green tea - all of which have been shown to decrease insulin resistance. I use this because it puts everything in a nice convenient to use package and includes other helpful nutrients that most people are deficient in. 
  • Konjac root - This supplement is a viscous fiber that expands in your stomach helping to keep you full, feed good gut bacteria and reduce insulin resistance. It's also been shown to actually help with weight loss (10). For maximum benefit take 4 capsules 15 minutes before each meal and while intermittent fasting throughout the day. 

We are going to put this all together at the end for maximum effect, so keep reading. 

Do you have debilitating fatigue?

When trying to add these tips to your regimen it's VERY important that you don't do more harm than good. 

Before you start doing high-intensity interval training or intermittent fasting you need to make sure that your thyroid hormone medication is optimized and that your adrenals can handle the stress. 

If you aren't sure whether or not you should start I would recommend you check out this post here.

If you are still having hypothyroid symptoms, or the signs and symptoms of adrenal fatigue I would caution against exercising and fasting.

Also, take note that there is a difference between brain-based fatigue and physical fatigue. 

In brain-based fatigue, you will get fatigued after heavy thinking or mental activity. If you are experiencing this type of fatigue then exercise CAN help. 

In physical-based types of fatigue, you will be wiped out after exerting yourself physically. If you are experiencing this type of fatigue then exercising and fasting may make your condition worse. 

Putting too much strain on your adrenals can lead to excess cortisol and weight gain

You can learn how to test your adrenals and cortisol levels in this article

#5. Medications that help sensitize your body to insulin

In addition to supplements, there are some medications that can actually help sensitize your body to insulin.

Most of the time this won't be an issue if early insulin resistance, but if you have diabetes (and advanced insulin resistance) you may be on 1 or more medications.

If you fall into this category I would recommend you optimize your medications and consider getting on one or more of the following:

  • Metformin - Metformin is cheap and can be effective if used early on. 
  • Acarbose - Acarbose helps reduce the amount of sugar you absorb from your foods and can be helpful for some people who have trouble resisting sweets. 
  • SGLT-2 Inhibitors (11) - SGLT-2 Inhibitors help your body eliminate extra sugar by causing you to urinate or pee it out. 
  • GLP-1 Agonists - GLP-1 Agonists like Victoza are probably the most powerful medications at reducing insulin resistance. They are also very effective in helping people lose weight and keep it off. 

​Other medications may actually cause an increase in insulin (especially if they stimulate the release of insulin). 

See your doctor for further information. ​

Your Next Steps

​You won't start feeling better and losing weight unless you take ACTION. 

With that in mind I've come up with 4 steps that I want you to follow to get the process moving:​

  • Change your diet: You have all of the resources here to make it happen in this insulin resistance diet guide. My guide has all the guidelines including what foods to eat, what foods to avoid and what portion sizes you need. 
  • Balance and check your hormone levels: Insulin resistance is made worse by other hormonal imbalances like increased levels of leptin. You can find out what hormones I'm talking about here and how to go about getting the right tests
  • Get your supplements and start using them: These are the supplements that I recommend and use in my clinic - Berberine, Purelean Pure Pack, Konjac root. Use these in combination with the other therapies listed here for the most benefit. 
  • Consider adding intermittent fasting and HIIT into your regimen (advanced): Use caution when adding these into your routine. I recommend starting with the other options above first. 

Final Thoughts

​Are you suffering from Insulin Resistance as well? How did you manage to lose weight and fix the problem? Hypothyroidism and Diabetes can be a tricky situation so let's share the information to help as many people as possible. 

*Additional resources:

Screening for Diabetes and Pre-Diabetes With Proposed A1C-Based Diagnostic Criteria (12) 

Glycemic Control and Coronary Heart Disease Risk in Persons With and Without Diabetes (13) 

Glycemic control and coronary heart disease risk in persons with and without diabetes: the atherosclerosis risk in communities study (14)

References (Click to Expand)

This post was most recently updated on January 24th, 2019

Dr. Westin Childs

Dr. Westin Childs is a Doctor of Osteopathic Medicine. He provides well-researched actionable information about hormone-related disorders and formulates supplements to treat these disorders.He is trained in Internal Medicine, Functional Medicine, and Integrative Medicine. His focus is on managing thyroid disorders, weight loss resistance, and other sex hormone imbalances.You can read more about his own personal journey here.

48 thoughts on “The Connection Between Hypothyroidism and Insulin Resistance + How to Treat it”

  1. Dr. Westin- I have been monitoring my weight for the last couple of weeks – it jumps 2-6 pounds a day ! I exercise and I am taking thyroid meds and all suggested supplements. Not sure why it jumps like that from day to day . If you have any ideas please let me know .

    • Hey Shellie,

      It’s hard to say for sure, but in general large swings in weight like that are probably related to fluid shifts more than anything else. Your body shouldn’t burn through fat mass that quickly.

      The supplements will help regulate your thyroid and as your thyroid becomes more stable it should improve your metabolism. I don’t recommend using only supplements by themselves for weight loss however, you really need a comprehensive treatment plan.

      I also recommend checking all other hormonal systems in the body.

      Changes in body weight like you describe can be related to estrogen/progesterone balance.

  2. My doctor told me I am insulin resistant. I am on 1000 metformin a day. I have taken fruit out of my diet and am eating clean. I am eating around 1200 calories a day, and I have not lost one pound. Since doing this beginning in January, I am up 7lb. I am at such a loss. My TSH is down to 1.9 starting at 5.8, and I am taking 65 mcg of Naturthyroid. I have requested possibly adding T3 (Cytomel) as I don’t know if I’m getting enough to work. I am normally 135 lbs. and I am stuck at 177 lbs. This is not me. I realize I may not get back to where I was, but would really like to lose 20-25 lbs. I feel like I am doing all my own research as my doctor is open to some treatments such as a natural thyroid medication, but she has admitted she doesn’t look at all the areas a holistic doctor may. I am looking into using HIIT, fasting, and just hoping to find something that works. I also take 8000 Vitamin D a day, Vitamin B, and Magnesium. I try to get Selium naturally. Any suggestions would be greatly appreciated. My A1C was at 5.9 in January, and is now 5.8 after starting metformin 6 weeks ago. Thank you for your time!

    • Hey Jennifer,

      It sounds like you understand all of the things you need to be doing you just need someone to create a treatment protocol to make it happen, and that can be the hard part. Also, it’s important to realize that your thyroid is only one part of the equation – with high levels of insulin you will never be able to lose weight, even with cytomel or NDT.

      • Where do I go next? My endocrinologist, a holistic dr., who is best to find the “formula” I need to see success? I also have estrogen dominence and am on progesterone cream. I feel like I have pieces and yet there’s still a missing link…

        • I wish I had a good answer for you. I had to learn all of this stuff myself, there is no specialty that focuses on it. Most doctors specialize so they understand a part of it, but very few have the understanding to put it all together.

          An endocrinologist is likely the last place I would look and a holistic doctor will be hit or miss depending on the skill.

        • I hear you. sailing in the same boat since 1 yr.. diagnosed with insulin resistance 1 month ago. I have hashimotos too.. it’s like I am looking for the missing piece in the QUEST TO LOSE WEIGHT puzzle

          • I have had a thyroidectomy many years ago and have never been any meds because all the standard thyroid blood tests come back normal. My body has all the typical hypothyroid symptoms, this year been on a ketogenic diet and was able to loose about 10 pounds after a lot of walking, weight lifting and exercising. Was intermittent fasting 3-4 days a week and my blood sugar fasting would be around 120 around early afternoon? Even though I cut out sugar n had only healthy low carbs my blood sugar would spike with 2 healthy meals a day. I noticed that I have adrenaline fatigue for the past few years and insomnia as well and my cortisol would raise my insulin level. How can you loose weight being insulin resistant with adrenaline fatigue and hypothyroidism? Where do you start? How many carbs ratio to fat n proteins? I am 59-year-old female and very frustrated eating healthy, exercising and unable to lose weight. Would appreciate some advice, thank you

        • A good functional medicine practitioner who understands hormones, autoimmune and nutrition would be able to help you. I happen to know one. 🙂

      • Hi Chad,

        I have been practicing natural/herbal medicine for many years. I formulate my own supplements and medicinal mushroom blends.
        I have Hashimoto’s, have been on T3 and T4 for years and bio-identical hormones in cream form for maybe 7 yrs. I watch my carbo intake very strictly.
        Still struggling to lose 25 lbs.
        My compounder who was a doctor in India, told me if you am fast you will lower your healthy hormone levels and cause them to down regulate. I don’t do fasting well, usually my blood sugar just goes up.
        I use herbs and diet to keep my sugar down. And have taken my A1c from 6.1 to 5.6.
        I completely went of T3 and also for a bit off T4 and noticed my blood sugar readings immediately went to normal.
        I am presently off T3 because my doctor doesn’t think I needed it and it maybe causing some insulin resistance. Do you know that is listed as a side effect for both thyroid meds?
        I also have read that ALA can reduce thyroid hormone levels. Saw that in a clinic article.
        Right now I’m wondering if I really need thyroid hormone at all? I was found to have TBG deficiency and low iodine. Been taking iodine.
        I have a compounding lab that is doing much better hormone testing on me along with my new doc. My TPO at one time was 780!
        Gotten it in half so far.
        And no, I really don’t eat much gluten
        I am allergic to cows milk, have been all my life, so I stick to goat and sheep.

        • Hi Lisa,

          Good question! Thyroid medications do not cause insulin resistance, it’s the thyroid status that causes it so it’s related to your dose. If it’s too high then it can cause insulin resistance just as if it’s too low. Hope this helps 🙂

  3. Hi Dr. Childs,
    I enjoyed your article and how you broke it all down to make sense. I have been suffering with hypothyroidism since after the birth of my son 9years ago, although the I suspect it was before that. Anyway to make a long story short I have not been regularly going to my endo because she is cold and purely looking at my TSH as a road map and not my T3 and only tests free T4 sometimes. Others didn’t take my insurance at the time and just had baby #2 4.5 months ago and honestly haven’t been back to have my thyroid checked. I brought myself back down with extra pills of synthroid I’ve had to 75mcg because that’s around where I was at before but know and feel this isn’t right. It took me almost arguing with my endo to even try armour and when I missed one spot when I came back she immediately started me back on synthroid no ifs ands or buts :(…I did well on it but I can’t say that it made a huge difference, but my #s always looked good and I felt good.
    I did lose weight on my own several years ago with lots of cardio/some weights and cutting out as much sugar as I could and eating as clean as I could. I lost 30lbs in two months and kept it off for quite some time. I’m 5’2″ and weighed 170 then after losing 30lbs and now am 227 after having my daughter :(. I now have a different insurance and not sure where to turn honestly. I read an endo might not be the best to go to, should I try a family dr? I was never told I have hashimotos but assume I do since my endo told me there was no cure for my hypo and I have an autoimmune disease with high inflammation in my body. She told me I will have to take thyroid replacement for the rest of my life. My dad, sister, aunt and uncle all have hypo and my uncle had to have his thyroid removed. I’m 28 and there isn’t a place on my body near my joints that isn’t sore. I’m not a lazy person at all but I’m not running or making an effort to walk daily like I use to though. I’m just at a loss and feel lost where to turn where they won’t just look at #s and assume things are A-OK when they’re not. I need someone to actually listen to me and. It assume I’m just trying to play dr and know it all, I’m not and would truly love someone to guide me.

    I felt my absolute best and as shedding lbs and inches when my TSH was 0.28 but not sure what the my free t4 or t3 was. I do assume and feel I have insulin resistance if I try to cut out sugary foods now and the sugar cravings are SO intense I just want to have a huge sugar binge and have to find things to occupy me and I try drinking a lot of water to try and help curb it. Ita awful and I’m just having a hard time all around. I have the typical moon face, dry skin, cracked heels, major hair loss, moody, brain fog, memory loss, half my eyebrows are gone, over weight of course, joint and all over pain, easily fatigued mentally and just over all feel BAD. Some days I’m literally fighting to get through and now that we have our 4.5month old that has slept awful since birth I feel like a walking zombie.

    If you can offer any guidance, of any kind I would appreciate it.

    Thank you!

    • Hey Kelly,

      Thanks for the comment! Unfortunately, when it comes to patients like yourself you really need a complete workup. There isn’t a lot of information I can provide that will be actionable to you because I really have no idea what is happening inside your body without looking at labs, etc.

      It sounds as if you are likely being under treated with your thyroid hormone, but I’m sure you also have other issues going on as well.

    • After reading your story, it feels like i read mine except i have 2yrs old boy and gall bladder wes removed last year.
      I don’t have word to explain my helplessness due to all this issues.it feels like nobody can help.

  4. You need to distinguish between type 1 and type 2 diabetes. Not all diabetes is the same. Type 2 has many factors including genetics, lifestyle, and diet. Type 1 is an autoimmune disease, is not preventable and has no cure. Insulin resistance can happen in both diseases, since people with Type 1 must administer insulin themselves and can build up a resistance over time due to this. Please clarify your facts, this is damaging and spread wrong information. Insulin Resistance should not be labled as “AKA DIABETES”

    • Naturally I am referring to type II diabetics with insulin resistance if I say it is reversible. Any type I diabetic should understand that their disease isn’t reversible (in most cases). Regardless, the point still stands for type I Diabetics – you can still use these therapies to reduce insulin resistance and increase the effectiveness of insulin in type I diabetics, I have done it many times in both type I diabetics and latent adult onset diabetics (type 1.5). I think you should use the recommendations to help reduce your stress 🙂

  5. What an amazing article with best knowledge I had been detected with insulin resistance and thyroid from 2012 its a tough battle after my doctor removes me from medication I tend to put on weight back again. I have from your article gained knowledge on supplements and high intensity work outs shall work on them.

  6. Hello

    I am a hypopituitarism patient taking replacement Cort, T3 & Armour, Testosterone, Fludrocort, and HGH. Dysfunction is likely in the hypothalamus. It came on slowly and was missed for several years.

    I strongly suspect that I’m now suffering thyroid resistance and insulin resistance. It’s been one severe complication after another, and my endo is now stopped at antioxidants. My thyroid was always “normal” but I still had severe hypothyroidism symptoms. Labs can mean squat.

    I’m using supraphysiological Cytomel T3 and Armour but could be a lot better. I was “normal” for almost 90 days once, but it didn’t last. I remain dragging. Sleep is erratic and is now being monitored.

    I’ve exercised cardio almost 400 days consecutively and lost more weight that I care to. I’ve started weight training again. I am serious about recovery.

    Any direction or suggestions would be forever appreciated!

  7. Hi,

    I found the information in this article very helpful! I am a 50 year old female with longstanding Hashimoto’s (diagnosed at age 16). I’ve been on synthroid most of my life with no problems until 2 years ago when I began menopause and began suffering severe fatigue. At the time, my ferritin and vitamin D were very low but with supplementation they are now good. The last 2 years have been very tough as I have not felt well and I put on 20 pounds when I tried switching my thyroid medication. I tried NDT but didn’t do well. I am now on a combination of synthroid and T3 and feeling somewhat better but not 100%. Recently my blood work has revealed pre diabetes. On 10/24/16 my fasting insulin = 6, my fasting glucose = 91 and my HbA1c = 5.8. I made some dietary changes, lost 8 pounds and 3 months later my numbers are fasting insulin = 3, fasting glucose = 86 and HbA1c = 5.7. Better but still at risk I understand. My question is with my insulin being on low end, is this still insulin resistance? Or could I possibly have developed an autoimmune attack on my insulin producing cells? My doctor thought I should take Berberine, but I’m a little nervous that it could make my blood sugar drop too much. If i do get my blood sugar lowered and normalized, would that help with T4 to T3 conversion which seems to be very poor at this time. Also, I am experiencing intermittent blurry vision and tinnitus and don’t know if they are related to thyroid or blood sugar. I would love your input.

    Thank you,
    Cat

    • Hey Cat,

      More important than your fasting insulin is your post prandial insulin level. It’s possible, but highly unlikely that you’ve burned out your pancreas and your insulin levels are low as a result. It would be very easy to check what your 2 hour post prandial insulin is, which would likely prove you have insulin resistance.

  8. Good Evening –

    I had a hysterectomy 7/5/2016 and a thyroidectomy 8/26/2016. We are now 7 months since the thyroidectomy with fatigue and weight gain. My TSH is still being regulated with my next check occurring in 4-days.

    I was heavy before my diagnosis but it seemed like overnight I picked up 40lbs. I thought it was due to me quitting smoking. Fatigue then set in with swelling, etc … I was then diagnosed with Hypothyroidism by my PCP about 2 years ago with TSH at 62.6. Immediately started Levothyroxine and within 9 months, had developed “bug” eyes and was then advised I had hyperthyroidism. I was pushed by family to see an specialist who took me off all meds and re-ran tests after 6 weeks. I was told I have both hypo and hyper (Graves). Eyes continued to get worse and my TSH levels moved into negative numbers which then pushed me into the thyroidectomy.

    6/16/16 I was checked for diabetes because of my glucose levels and I had 5.5 for HgbA1C and 111 for the Est Avg Glucose with my Dr advising I do not have diabetes.

    11/1/2016 Vitamin D came in at 31.

    12/1 TSH was 8.80 and Free T4 was .69

    2/1 TSH was 5.39 and Free T4 was 1.01

    Believe I am in need of some of the meds and/or supplements mentioned in this post and possibly from the main page. I would greatly appreciate any insight, help and/or advise you are willing to impart.

    Sincerely,

    Anna

  9. Hello, I believe I am insulin resistant or at least starting to be as my blood glucose remains high after eating “white” foods (although I’m underweight). I’ve gut out grains such as brown rice and quinoa as well as they make me feel “hungry” and I often wake up at night with low blood sugar symptoms, even though my glucose checker says I’m fine. Now the only carbs I eat is fruit and I have to keep that to a minimum as well otherwise it throws my Thyroid off (I have hashimotos). I feel like I might need more carbs than this but feel stuck with the insulin resistance. What does one do in this scenario?

  10. Is it possible to reduce your TSH naturally without meds? Such as whole food plant based diet…supplements? I have been reading about selenium, zinc,and vit A and D

  11. Hello,

    Thank you SO much for your work; your pages on thyroid, insulin and leptin are really informative and accessible.

    I have some questions for you. I was diagnosed with Hashimoto’s in November 2016. since then I have gained about 4 kgs, up to 62 kg, when the high end of my weight range used to be 52 kg. I am about 60 cm, or 5 ft. 3. I eat between 1000 and 1500 calories per day, but I try not to count, due to a history of under-eating and over-exercising.

    My doctors are trying to optimise my thyroid hormones now; my TSH is very suppressed, but my T4 is around 25% and T3 50%. I have asked for tests for reverse T3, leptin and insulin resistance, which will be conducted in 2 weeks, but my doctor already gave me a prescription for metformin.

    I returned from India about 1.5 months ago. I was there for a month, and ate no meat while I was there, and fruit every morning (the opposite of the AIP diet I usually follow). I lost a very visible amount of weight there, and have gained it all back and more since returning. my doctors thought it was water weight at first because of how fast it came back. But I have a body composition test done, and its mostly fat (my calorie recommendation from the test was about 1450).

    I am really confused at this point about what/how much I should be eating, and what I should be doing for exercise. I had taken about 7-8 months off of intense exercise to give my adrenals a break, now only doing yoga and pilates. But it is hard to justify this after seeing my body composition results. . . should I be doing HIIT and trying to fast? should I be eating so much protein?

    Thank you again

  12. I have really been struggling with the impact that post-cancer Tx Grave’s disease has had on my life. I have had such a hard time finding supportive medical professionals. I can’t seem to acclimate to the whole idea of spending so much time and money getting blood drawn. I despise the constant loss that I am suffering. How do I get the energy, interest, and determination to chase down all of these numbers and keep tweaking away at the dosage and developing my own understanding because most of the healthcare people don’t know or don’t care? When I see my own reflection, I feel like I am looking in a funhouse mirror. I have never been more depressed in my life.

  13. Hi there, I hope you can help me out. I am on a zero carb diet, have hypothyroidism (balanced results!) and have insulin resistance. My glucose levels are in perfect range. This is my status after losing 140lbs within 5 years.
    My issue is that I constantly suffer from hypoglycemia when fasting for too long (22h) and reactive hypoglycemia after meals. My next step, because the weight simply won’t go down no matter what I do, was to ask my doctor if Metformin would be an option for me. My fear is though that this will lower my blood sugar levels even more as a side effect, and not only insulin production. Could this happen? What would you recommend in my case? Looking forward to hearing your thoughts.

  14. Well, I’m going to be starting your program.

    In 2009 my epilepsy finally got controlled after brain surgery and a new medication on the market. I was able to drive again and join a gym. I worked hard for a year and a half going to the gym, changing my lifestyle in how I ate, and help from a trainer. I lost 40 pounds and kept it off for 4 years.

    Suddenly, I noticed weight coming back on. It didn’t make sense to me. I was working out the same, ate healthy protein to maintain the muscle I’d developed, counted calories, everything the trainer asked. The weight kept coming. I was tired all the time no matter how much I slept. My trainer suggested getting my thyroid checked.

    I had an appointment with my neurologist, so I asked her to order bloodwork for my thyroid along with her usual requests. She agreed. A couple weeks later, the nurse called me and said everything came back fine. I passed on the info to my trainer and we were both stumped. More time went by.

    Next, I had an appointment with my general doctor. I told him all that was going on and he ordered is own blood work. I later heard from him that I had hypothyroidism. No one in my family or relatives had this, just like no one else but me had epilepsy. He put me on synthroid.

    A year went by, I still felt tired, not better. My numbers were better, but still low. I asked for a referral to an endocrinologist. He agreed and sent a referral. There aren’t many in my area, so the only office looked at my records and said no, my thyroid was doing well enough.

    I was really disappointed, something just was off still. I was on a commutervan looking out the window one day and saw a new office and it was an endocrinologist. I wrote down the name quickly. I called and inquired if they’d take a patient without a referral and they said yes. I scheduled an appointment.

    I met with that endocrinologist and he took a look and said something was right. He ordered some tests, one to check protein levels. When I met with him a couple weeks later, I did have hypothyroidism and he wasn’t happy with the levels, but I had insulin resistance. I had no idea what that was. He couldn’t explain it very well, but he was going to change my medication.

    I was taken off synthroid, he liked the natural treatments more. He said doctors get a kick back of money from the pharmaceutical company from prescribing that. It wasn’t the right medication for me. I started armour thyroid, 75 mg daily. Also, I started metformin, 500mg twice daily.

    Still from this, eating as I was taught was healthy eating and working out (cardio and resistance) no weight loss from all of this.

    I’ve continued to gain weight. I gained the 40 pounds back, plus another 30.

    My endocrinologist sees me once a year, he thinks everything is fine enough.

    I’m going to try your program, change my lifestyle again and hope for success.

  15. I was shocked at a A1c of 5.7 and glucose running at 99 in 2011. Focused on reducing simple carbs, exercise, nutrient dense food, avoding GMO, soy and eating on a intermittent fasting schedule, all food 11am to 6pm. Now A1c 5.1 glucose in low 80’s. Still struggling with optimal thyroid control after my prior Endo left and finally found a good new Dr.

  16. Hello Dr. Childs,

    I really appreciate the width of information that you have provided in this article.
    My name is Satvik, I am 27 years old.I am obese and have subclinical Hashimoto’s (T3 and T4 are in the normal range, TSH is 5.8). I also have hypertension. Recently I was diagnosed with insulin resistance and metabolic syndrome, my HbA1c is 5.2 and fasting blood glucose is 90. I am about to start the gym exercise and am planning to go on to a low-carb ketogenic diet for weight loss. Could you please advise as to whether going on a keto diet be a good idea?

  17. I have insulin resistance and hypothyroidism. I’m on Metformin and a different thyroid medicine instead of armor which is what I used to be on. I also have a few other medical problems and medications I take. I exercise daily and have been working on a better diet. It’s sometimes hard to eat better because I’m in college and I have a meal plan. How would you recommend shedding the weight? (It’s mostly in my stomach area, hips, and thighs) I’ve been trying for three years now and it feels like I haven’t lost any but I keep gaining. I’m roughly 180 and 5.9 and 21 years old.

  18. Hi Doc.

    My TSH is 9.5. T3 and t4 are normal, reverse are normal. I am 5’11 and 170 pounds and 8 percent body fat. My symptoms are oily skin and cystic acne. No one in my entire extended family has ever had acne before in their lives. We are of middle eastern descent and eat meat, rice, vegetables , fruit and nuts. Unfortunately i always have to watch what I eat in fear of another breakout, which are hard inflamed pimples under the skin that last for months. Also, I have terrible insomnia. I take no supplements. Its strange because I stopped going to the gym for several months, and started consuming tons of healthy calories and my weight stayed the same. It doesn’t seem this symptom aligns with hypo. Anyway, a doc put me on levothyroxine, But I was wondering if you had a more natural approach. I was reading about adaptgens and read ginseng is good for high tsh levels. Any other ideas?

  19. I am very glad I found this site. It has been very helpful. I was recently diagnosed insulin resistant and was put on Metformin. I have Hashimotos and have lived a pretty healthy and active life. It wasn’t until I had my second child that I began to really struggle with my weight. Right before my insulin resistant diagnosis I was a poind away from my predelivery weight and it was extremely difficult to cope with. I have been following a gluten free diet for about 2 years now. I do interval running a3 times a week and HITT training twice a week and my weight has not changed. I did notice with the Metformin that my bloating and inflammation all over my body has decreased. I dont know when or how much longer it will take to start seeing some weight loss. I dont know what else to do. I am on cytomel and levothyroxine aswell. I just dont know what else to do to help me get down in weight.

    • Hi Zarai,

      I would definitely make sure you look at your T3 level as well as your leptin. Both insulin resistance and hypothyroidism can contribute to weight loss resistance.

  20. Hey Dr. Childs,

    Great article! I do have one question: It’s become increasingly common to see insulin resistance being paired with hypothyroidism. The general suggestion seems to be that thyroid hormone levels co-vary with insulin levels (i.e., as thyroid hormones dip low, we become more insensitive to insulin).
    I’m wondering, which is the mechanism of action? Or, better still, what is the causal pathway linking thyroid hypofunction with insulin resistance?

    Cheers,

    Michael

    • Hi Michael,

      It’s my understanding that thyroid hormone itself drives the changes to insulin sensitivity (as you described) and it’s probably mediated through cellular pathways/receptors, but I’m not 100% sure that this is the mechanism. It could also be through alterations in the metabolism of fats/carbohydrates/proteins which thyroid hormone can influence as well.

  21. I have been told I am insulin resistant. I am also hypothyroid. Struggling to find a Dr that treats both together. The two Endocrinologists that I have talked with will only deal with my thyroid and not my Type 2 Diabetes. I live in North Louisiana. Are you familiar with any Doctors I could contact that would work with me.

  22. Hello, I have hypothyroidism and insulin resistance. I am 21 years old and I do CrossFit six days a week and also run some. I eat a very well-balanced healthy diet and continue gaining weight. I started out at 165 last year and am now up to 215 and don’t know what to do. I was wondering what you would recommend? I do take levothroxine and I’m pretty sure this medicine is making me gain weight also. Please let me know what supplement or plan you would recommend for me please and thank you.

  23. Wow! Thank you so much for explaining this. I’ve been diagnosed with Insulin Resistant for 14 years and suffering with it for MUCH longer. No one has ever explained the link with T3 ( my Mum and 2 sisters have an underactive thyroid and take T3) and why I have always struggled to lose weight on standard diets! I’m finally losing weight on a low carb diet and am going to get my thyroid function and in particular, T3 tested. THANK YOU SO MUCH!

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