The Connection Between Levothyroxine and Weight Gain

The Connection Between Levothyroxine and Weight Gain

Are you on Levothyroxine but still gaining weight?

Believe it or not, this is a big problem for a lot of people.

But the bigger question is this:

How can you be gaining weight on a medication that is supposed to INCREASE your metabolism?

Is it even possible? 

Well, the truth is that Levothyroxine doesn’t necessarily increase your metabolism… at least not in everyone. 

In this post I’m going to show you exactly why Levothyroxine can cause weight gain and what you can do about it:


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The Complete List of Thyroid Lab tests:

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T4 to T3 Conversion Matters… A lot

Before we talk about how Levothyroxine and Synthroid can cause weight gain we need to talk about some basic thyroid physiology. 

Your thyroid, under the influence of TSH (if working properly), pumps out primarily the thyroid hormone T4. 

What you need to understand is that T4 is an inactive hormone. By itself it doesn’t do anything for your body except act as a reservoir for T3 and T3 is the active thyroid hormone in your body

T3 is what enters your cells and turns on the genes that increase your metabolism, help with hair growth, and give you energy.

In order for T4 thyroid hormone to be active in your body, it MUST be converted to the active hormone T3.

The problem is that T4 doesn’t always convert to T3: 

different factors that impact thyroid function and thyroid conversion

(This image shows what is required to convert T4 into the active free T3 hormone, it also outlines what causes your body to turn T4 into the inactive reverse T3)

You see:

Your body has two options:

1. Turn T4 into T3 which enters into your cells and activates genetic transcription (this is what you WANT to have happened and what most doctors assume is happening)


2. Turn into Reverse T3 which blocks thyroid action, lowers metabolism, and makes patients feel like they are hypothyroid (this is what you DON’T want to happen but ends up happening in many patients on T4-only medications)

The more reverse T3 in your bloodstream the less you can rely on normal thyroid blood tests to give you any actionable information. 

So if you understand this concept the next question you should be asking yourself is this: 

What causes your body to turn T4 into the inactive reverse T3?

Levothyroxine and Synthroid are Both T4 only Medications

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So here is the primary problem:

Levothyroxine and Synthroid are both T4-only medications.

Most Doctors will prescribe T4 medication under the assumption that your body will have no problem converting T4 into T3.

And in a perfect world, a world without stress, inflammation, or other hormonal imbalances – it would. 

But that’s not the world we live in…

Nowadays it’s VERY uncommon if someone has their stress managed, has no issues with blood sugar/insulin/leptin, has a normal menstrual cycle, is not overweight, has never done yo-yo diets, or has a normal adrenal function.

Do any of these symptoms or situations sound familiar? 

Chances are high that you are dealing with 1 or more of them. 

And in states such as these, your body will turn T4 into reverse T3 as a way to “put on the brakes” and slow down your metabolism and cause symptoms of hypothyroidism.

How Levothyroxine Causes weight gain

So how does this all relate to Levothyroxine and weight gain?

We can look at some studies to help us understand:

Take for instance this study. (1)

Patients in this study were given T4-only medications and treated based on their TSH. 

The researchers tested their resting energy expenditure (this is a way to test for basal metabolic rate or metabolism) both before they added the thyroid hormone and after they suppressed the TSH. 

Do you know what they found? 

It showed that patients taking thyroid hormone (even doses that lower the TSH to <0.1) did NOT have an increase in metabolism or a change in their body weight.

study showing levothyroxine suppressive doses do not impact metabolism

This is really interesting information and it has profound implications for treatment…

For one it shows that our reliance upon TSH as a marker for managing thyroid medication and function is not very accurate.

Don’t get discouraged because there are other thyroid medications that actually do help with weight loss which we will discuss below.

But, for this reason (and many others) I generally don’t recommend using T4-only medications (like Synthroid and Levothyroxine) to treat hypothyroidism and I recommend against using the TSH to dose your medication. 

What’s more:

This study also showed that suppressing the TSH did NOT result in adverse side effects.

study conclusions showing that high doses of t4 do not impact body composition in women.

One of the main reasons doctors are afraid to increase thyroid medications is because they are concerned that the low TSH will result in damage to the body over time.

It’s not uncommon that patients will start to feel better when their thyroid dose is increased, only to have all those symptoms come back again when they are told their dose is “too high”. 

Don’t let your doctor convince you that you are hyperthyroid when you have crushing fatigue, weight gain, hair loss, and constipation – it just doesn’t work that way and you can’t tell someone they are hyperthyroid based on their TSH alone. 

Here is another very interesting study (2) that compared people taking Natural Desiccated Thyroid to those taking Levothyroxine: 

study comparing levothyroxine to natural desiccated thyroid

This study showed that patients taking Natural Desiccated Thyroid (Like Armour thyroid, Nature-Throid, and WP Thyroid) experienced more weight loss and HALF of the people in the study said that they preferred taking NDT over levothyroxine. 

conclusion of study showing that patients prefer NDT over T4

And here is another very important study (3) comparing equivalent dosing (based on pituitary function and TSH) of T4 medication vs T3-only medication:

T3 thyroid medication results in more weight loss compared to T4

This study showed that patients who were taking T3-only medication had more weight loss and better cholesterol than patients who were taking T4-only medication (like Synthroid and Levothyroxine). 

What’s also important is that the patients who took T3 did not have any change in blood pressure, heart rate, or insulin sensitivity. 

Meaning the T3-only thyroid medication was tolerated very well. 

So now we have several different studies showing that patients not only do VERY well on medications containing T3 thyroid hormone but that these medications are also WELL tolerated. 

You can read more about the use of T3-only medication (Liothyronine and Cytomel) for weight loss here. 

Moral of the story?

Most patients not only prefer to take Natural desiccated thyroid (medication that includes T3 hormone) but this medication also results in more weight loss and improved quality of life.

One of the biggest problems with T4-only medication is that your body may NOT be converting it to the active T3 thyroid hormone. 

In many patients, your body may actually convert it to reverse T3 thereby slowing your metabolism, and actually making your condition and symptoms WORSE.

But here is another important note side note:

Natural Desiccated Thyroid still contains T4 (in fact the majority is still T4).

That means that sometimes NDT can actually make hypothyroid symptoms worse as well by increasing reverse T3.

People with this problem need pure T3 medications like Liothyronine to improve symptoms and lose weight. 

You can read more about case studies using NDT with T3 medications here.

What to do if you think Levothyroxine is Causing Weight Gain

If you have constantly gained weight (or even if you just aren’t losing weight) there are several steps you can take to figure out if the dose of thyroid medication you are taking is working in your body. 

You can find a guide on how to properly dose Levothyroxine here.

These next steps are designed to help you determine if your body is turning T4 into T3 or if your body is turning your levothyroxine right into Reverse T3. 

Some of these can be performed at home and others will require a Doctor. 

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It’s also worth pointing out that at the end of the day, you will need to find a doctor that is willing to work with you because if you are not getting enough thyroid hormone then you will either need MORE medication or a NEW medication to feel better.

Step #1: Check your Basal Body Temperature Each Morning

Checking your basal body temperature is a quick and easy way to estimate your basal metabolic rate.

Your basal metabolic rate is basically how many calories you are burning on a daily basis.

This number is really important when it comes to weight loss because it accounts for more than 90% of your total calories burned each day. 

When you exercise you are only focusing on about 5-10% of your calories burned and it has little to no impact on your weight overall (this is why most of you who exercise aren’t losing weight).

If you are not on a high enough dose of thyroid hormone then your body temperature will be lower (4).

This also means that as you start thyroid hormone medication your body temperature should increase as you increase your dose.

If your body temperature is not increasing then this may be an early sign that you are on the wrong thyroid medication or the wrong dose of thyroid medication.

Many factors can alter your body temperature but it is a relatively easy way to check and when you combine it with the other methods listed below it can be quite effective.

You can read more about using basal body temperature to manage thyroid, adrenal, and fertility here.

How to check your basal body temperature:

  • Each morning, as soon as you wake up and before you get out of bed, check your body temperature and record your results. It is very important that you stay in bed (do not get up to go to the bathroom) before you check your body temperature. Also, try to check the temperature at the same time every day.
  • Plot your morning body temperature and watch for patterns. Your body temperature should be > 97.8. Period. Anything less than this indicates that your metabolism may be slowed. *Note that medications may interfere with the reliability of this test (medications like beta blockers, narcotics, diabetic medications, blood pressure medications, and antidepressants)

Step #2: Check your Resting Pulse or Resting Heart Rate

In addition to checking your basal body temperature, you should also be monitoring your resting heart rate. 


Because hypothyroidism is well known to cause a slow heart rate (5) or low pulse (6).

Your resting heart rate is a reflection of your autonomic nervous system which is mediated by norepinephrine and adrenaline. 

It’s also a reflection of your metabolism and your basal metabolic rate. 

Some patients believe that their heart rate in the 50s is a “good” thing because they have heard that conditioned athletes have a slower pulse. 

And that is true if you exercise daily and are not overweight at all, but if you do not exercise and you are 20+ pounds overweight your slow heart rate is NOT a good thing.

Instead, it is an early indicator that your body is NOT burning an adequate amount of calories per day which may ultimately lead to weight gain. 

Another important point is that your resting heart rate should increase with the addition of thyroid hormone (especially T3), making this another great measurement to track as you start thyroid medication. 

If you have hypothyroidism I recommend buying a wearable fitness device to monitor your pulse, how well you sleep, and how active you are throughout the day.

I will frequently request this data from my patients and use it to help adjust thyroid dosing. 

Combining basal body temperature with resting heart rate is a very powerful combination and can help you determine how well you are being treated.

Your resting pulse should generally be > 50-60 at night while you sleep unless you are a well-conditioned athlete. A resting heart rate lower than that indicates an issue (though doesn’t necessarily mean it is thyroid-related). 

As you increase your thyroid medication your resting pulse should be somewhere in the 70-80 range while you are awake and active.

If you are on medications like a beta blocker or narcotics it may interfere with your pulse rate/heart rate in addition to lowering your body temperature, so you must account for this if you are tracking both your body temperature and resting heart rate. 

Step #3: Check a Complete Thyroid Panel

Finally one of the most important things you can do is to check a full and complete thyroid panel.

This will give you direct insight into how well your body is producing, converting, and utilizing thyroid hormones in the body. 

EVERY patient with hypothyroidism should get this panel and they should understand the difference between “optimal” and “normal” levels. 

Your Doctor is most likely basing his recommendations on the “normal” range, but I will show you what “optimal” range you should be shooting for in each test. 

Please note that these values refer to patients who are NOT already on thyroid medication. If you are on thyroid medication then you need to use different ranges. 

The complete thyroid panel:

  • TSH – Should be < 2.0, anything higher than 2.0 is a problem, and being less than 2.0 does not mean you are normal (see this post on why the TSH is so inaccurate
  • Free T3 – Should be in the top 50% of the reference range, many patients have low T3 syndrome which means T3 is usually in the low-normal range but definitely not optimal
  • Total T3 – Should be in the upper 1/2 of the reference range
  • Free T4 – Should be in the top 50% of the reference range
  • Reverse T3 – Should be less < than 15, anything higher indicates thyroid resistance and/or poor T4 to T3 conversion (patients with low free T3 syndrome often have low-normal free T3 with high reverse T3 levels)
  • Thyroid Antibodies – Should be as close to 0 as possible, higher levels may indicate autoimmune thyroiditis and many patients with Hashimoto’s have symptoms of hypothyroidism with “normal” TSH values but still should be treated with thyroid hormone
  • Sex Hormone Binding Globulin – Should be 70-80 in females and 20-30 in men, the SHBG will estimate the cellular function of thyroid hormone in the body (patients with low SHBG will often need higher doses of T3 containing medications)

It is VERY important that you not only get ALL of these tests but that you also look at the “optimal” numbers instead of the lab value reference ranges. 

You want to compare yourself to healthy adults, not just the “average” adult… Because let’s face it, the “average” American adult is far from healthy. 

By combining test results with basal body temperature and resting heart rate you can get a really good idea of how well your thyroid is functioning and how well your metabolism is working.

You should use these metrics to determine your thyroid dose to find the best thyroid medication and dose for your body

How to Finally Lose Weight with Hypothyroidism

So what are you supposed to do if you still have hypothyroid symptoms with “normal lab tests”? 

What are you supposed to do if you haven’t been able to lose weight despite increasing your dose of Levothyroxine or Synthroid?

You have 2 ways to go about this:

1. Change your thyroid medication to include T3-containing medications (NDT and/or T3-only medications)

2. Boost thyroid conversion by taking certain supplements and treating certain conditions that limit the conversion process (we will talk about this below)

The easiest (and probably most effective) way to increase thyroid function and lose weight is by adding pure T3 to your dose of Levothyroxine or Synthroid. 

This allows you to bypass the T4 to T3 conversion process.

Your body can only make Reverse T3 if T4 is present, so if you only provide T3 to the body then it simply doesn’t have the option to create Reverse T3 and your levels will naturally fall.

This is one of the ways to “flush” out high levels of Reverse T3 in the body

You can accomplish this by either switching from Levothyroxine to NDT or by simply adding liothyronine or Cytomel to your total dose.

This step will require that a Doctor is willing to work with you, however, which is why I always recommend seeking out a provider with advanced knowledge about thyroid function. 

If your plan is to take this information to your current Doctor to get them to understand this information or to order the “right” tests it will most likely backfire.

If you don’t have anyone local to you, then you do have a few options: 

Most conventional or traditional Doctors dislike natural desiccated thyroid medication so they are less likely to prescribe this, but usually, endocrinologists are willing to add small doses of Cytomel to your dose of T4. 

Even adding 5-10mcg of liothyronine can be enough for some people (though not the majority).

If you can get your provider to switch you from Levothyroxine to NDT (Armour Thyroid, WP thyroid, or Nature Throid) then that might improve your symptoms as well. 

As a primer remember this:

  • T4 only medications: Levothyroxine, Synthroid, Levoxyl, Tirosint
  • NDT (T4 + T3 medications): Armour thyroid, Nature-throid, WP thyroid
  • T3-only medications: liothyronine, Cytomel, and SR T3 (compounded)

Most patients do better on medications that have T3 in them, so try and stick to the NDT and/or T3-only portions or simply combine them together. 

Does Levothyroxine Ever Cause Weight Loss? 

The answer is that YES Levothyroxine and Synthroid can cause weight loss but only in certain patients. 

Since you are reading this you are most likely not one of those patients but I have written about it extensively in this post.

In order for Levothyroxine to cause weight loss, you must be able to adequately convert T4 to T3 without issues.

Some patients have single nucleotide polymorphisms (7) (genetic changes) which make T4 to T3 conversion very slow. If you have this polymorphism then Levothyroxine and Synthroid will probably not be the best medication for you. 

On the opposite side of the spectrum, some patients are what I refer to as “super converters”.

You can give them T4 and they will turn it into T3 without any problems at all, and these patients often react to T3-containing medications with palpitations and/or anxiety.

Another subgroup of patients have reactions to the INACTIVE ingredients in Levothyroxine and Synthroid which may lead to intolerance of the medication. 

If you can’t tolerate the proper dose of Levothyroxine or Synthroid then you won’t lose weight with the medication.

And lastly, patients who don’t have any other chronic medical conditions are more likely to do well on T4-only medications. 

What I mean by that is this:

The more inflammation you have, the more chronic pain you have, the more medications you take, the more weight you have to lose, and the less likely you are to do well on levothyroxine.


Because all of these conditions will make thyroid conversion more difficult.

So yes, Levothyroxine can cause weight loss but it needs to be at the right dose and in the right individual.

As a quick aside, if your Doctor isn’t willing to add T3 or NDT to your regimen then you might be able to get him/her to prescribe Tirosint instead.

Tirosint is a T4-only medication but has very few inactive ingredients and many patients tolerate this medication better than Levothyroxine or Synthroid.

Tirosint is also helpful in patients with abdominal issues or with patients who are taking acid-blocking medications and studies show it has increased absorption in these settings (8).

  • Bottom line: Even if your Doctor isn’t willing to change your medication to NDT, they still may be willing to either add Liothyronine (T3-only medication) or switch your Levothyroxine to Tirosint. Both of these options may improve your thyroid conversion and lead to weight loss in certain individuals.

5 Steps YOU can Take Today to Lose Weight and Boost Thyroid Function

There are several things YOU can do to optimize your thyroid function. 

These steps should be taken in addition to the steps outlined above for the best results. 

Whenever I treat patients I often employ multiple therapies at once for the multiplicative effect that it provides on metabolism and thyroid function. 

Follow these steps below to naturally boost your thyroid function and reset the metabolic conditions that favor T4 to reverse T3 conversion:

1. Optimize T4 to T3 Conversion

One of the easiest things you can start with right away is making sure that you have all of the right nutrients for proper thyroid conversion.

You can read more in this post about the 13+ nutrients required for proper thyroid creation, metabolism, and conversion but I will go over the most important below. 

The two primary nutrients involved in the conversion pathway are zinc and selenium.

It also happens that MANY patients are deficient in both of these nutrients due to a variety of reasons, which creates a great opportunity for most patients.

Let me go over the benefits of each of these…

Benefits of Zinc Supplementation on thyroid function:

Benefits of Selenium Supplementation on thyroid function:

How to supplement with Zinc and Selenium:

  • Zinc: Take up to 60mg per day (take away from thyroid medication)
  • Selenium: Take up to 50mcg to 200mcg per day (take away from thyroid medication and do not exceed 400mcg per day)
  • Look for supplements that contain both zinc and selenium such as this one

Make sure to use zinc bound to picolinic acid and selenomethionine because both of these forms have the best absorption for thyroid patients. (13)

2. Optimize your Adrenal Function and Cortisol Levels

Cortisol and thyroid function are linked. 

As TSH rises so too does cortisol. (14)

High cortisol levels lead to weight gain, increased insulin resistance, fatigue, and a host of other problems.

Because of this, it’s critical to get proper thyroid hormone replacement. 

But there’s one problem:

Replacing thyroid hormone doesn’t reverse high cortisol levels by itself.

That means you have to take action to help manage cortisol levels on your own.

In fact, one of the main reasons that patients still have fatigue after getting on the right dose of thyroid hormone is because they neglect cortisol and adrenal function as well. 

How do you know if this is a problem for you?

Symptoms of excess cortisol:

  • Chronic fatigue
  • The sensation of feeling wired but tired
  • Increased energy at night
  • Racing mind or anxiety
  • Palpitations or racing heart late at night (generally 2-3 am)
  • Difficulty with sleep or insomnia
  • Difficulty with concentration and staying on task
  • Cravings for certain foods, especially salty or sugary foods

If you have any of these symptoms in addition to symptoms of hypothyroidism then you are probably also dealing with a cortisol imbalance. 

Treatment depends on which type of cortisol issue you have which will require serum or urinary tests to evaluate both cortisol and cortisone levels. 

If you aren’t sure then you can start with an adrenal adaptogen which can help balance cortisol levels, provide you with more sustained energy, and relieve some of the symptoms listed above.

Beginners can get started with this supplement which works quite well with the majority of patients. 

3. Add in High-Intensity Exercise

Did you know that exercising with more intensity and for less time is better than traditional “cardio” type exercises for weight loss?

Or what about the fact that exercise by itself will rarely lead to significant weight loss by burning “excess” calories? 

Both of these statements are true and I will explain why:

You don’t lose weight from exercising because you are “burning” more calories. Instead, the weight loss comes from the balance of insulin, leptin, and the increase in skeletal muscle that comes with it.

Insulin and leptin both cause weight loss resistance (we will talk more about that below) and can make weight loss impossible unless you treat them both simultaneously. 

Lowering insulin and leptin levels allows your body to burn triglycerides (fat cells) as a fuel source instead of liver glycogen

Increasing your muscle mass will allow for a greater basal metabolic rate which translates to increased metabolism and more calories burned at rest. 

The best way to do BOTH of these things?

High-intensity or burst training.

This highly efficient form of exercising doesn’t need to be long in duration, but it does need to be intense.

You should work your heart rate up, break a sweat, and feel exhausted after your workout.

This type of exercise beats out regular “cardio” exercises like sitting on a treadmill for an hour for hypothyroid patients. 

You can learn more about how to exercise and the science behind why it is so powerful for hypothyroid patients here.

4. Reduce Inflammation

Inflammation (15) in any form causes your body to turn T4 into reverse T3. 

As you know from reading this post this worsens thyroid function. 

That means you want to avoid and treat inflammation at all costs. 

One of the big problems with hypothyroidism is that low thyroid hormone sets up the body to develop multiple conditions that may cause inflammation. 

The big one that you don’t want to miss is inflammation related to GI imbalances, specifically SIBO (small intestinal bacterial overgrowth).

This overgrowth of bacteria can lead to gas, bloating, constipation, and increased levels of inflammation in the body. 

What’s even more concerning is that up to 50% of thyroid patients ALSO have SIBO (16) whether they realize it or not.

How do you check for inflammation?

Use these lab tests:

  • CRP: This non-specific marker of inflammation should be as close to 0 as possible, high levels are associated with inflammation in the body but they don’t necessarily tell you where
  • ESR: Another non-specific marker of inflammation, this number should be < 10. High levels of ESR are commonly seen in patients with high reverse T3 levels. 
  • Ferritin: This marker can be used as a marker of iron stores but it is also a non-specific marker of inflammation because it is also an acute phase reactant. Use this in combination with iron studies to determine if your levels are elevated due to inflammation or iron overload.

If you have high levels of inflammation then the best way to treat them is to focus your efforts on the CAUSE and then reverse that. 

This can be difficult sometimes because these markers don’t tell you where the inflammation is, just that it is present.

If you are having difficulty finding the source of inflammation then you can use some supplements to brute force the levels down:

Because managing inflammation is so important for thyroid patients, I loaded my thyroid-specific protein powder with several anti-inflammatory ingredients (including many not listed above).

If you are looking for a simple way to get several anti-inflammatory ingredients while also providing your body with the building blocks for building more muscle, I would recommend checking it out.

5. Balance Insulin and Leptin levels

I saved probably the most important for last…

Insulin and leptin are probably two of the most overlooked hormone imbalances that lead to and perpetuate weight gain in patients.

Not only that but they are often underappreciated and underdiagnosed by providers and most patients don’t really understand what they are or how they work.

Leptin is often associated with high reverse T3 levels, low free T3 levels, and a LOW TSH. 

This can be particularly confusing to patients and providers because patients with leptin resistance often experience multiple symptoms of hypothyroidism and yet to an untrained eye their labs often look “normal”.

You can learn more about treating, diagnosing, and reversing both of these conditions in this post

But what you need to know is this:

If you have leptin resistance and insulin resistance then it will be nearly impossible to lose weight even if you start on the right type and dose of thyroid medication.

These hormones are just that powerful.

It’s tough to treat leptin resistance with supplements as well due to how it works in the body, but you can treat insulin resistance with supplements effectively.

Real Patients and Real Results

If losing weight seems impossible to you after reading this you aren’t alone. 

Losing weight with hypothyroidism can be difficult but it certainly isn’t impossible, it just takes the right approach.

I’ve included several step-by-step case studies below that walk you through real patients of mine including before/after pictures so you can see just how to do it (all of these are patients with hypothyroidism and weight loss resistance):

before after of thyroid patient
before and after picture of kathy weight loss
side by side before and after picture of thyroid weight loss

Now I want to hear from you…

Are you taking Levothyroxine?

Have you found it impossible to lose weight? Have you been gaining weight instead of losing weight?

How many of you have successfully lost weight by switching medications?

Leave your comments below!

More Resources and Links showing why T4-only medications don’t work for everyone:

The Effects of Levothyroxine substitution on body composition (17).

Differences in hypothalamic type 2 deiodinase ubiquitination explain localized sensitivity to thyroxine (18).

Common variation in the DIO2 gene predicts baseline psychological well-being and response to combination thyroxine plus triiodothyronine therapy in hypothyroid patients (19).

Scientific References




















how to prevent levothyroxine related weight gain

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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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733 thoughts on “The Connection Between Levothyroxine and Weight Gain”

  1. I take Levothyroxine 133 MG and LDN (low dose Naltrexone) 3mg. I cannot lose weight no matter what I do. My husband and I went to a plant-based diet (no dairy, gluten, sugar) in January, he’s lost 26 pounds….me nothing. I feel better just VERY discouraged because weight does not budge.

    • Hey Theresa,

      I would definitely check your resting heart rate and basal body temperature. In my office only about 5% of people actually do well on Levothyroxine, the other 95% need T3 in some form. I would say that a good 20-30% really need T3 only medication.

      Start with your body temp and pulse, and in the mean time check out this article which outlines in detail how to lose weight with hypothyroidism:

      What happened to you and your husband is not uncommon. I find that men lose weight MUCH easier than women, and the reason weight sticks around on women is because of hormone imbalances (usually a combination of estrogen +/- thyroid +/- insulin +/- leptin). It is definitely possible to lose weight (I help patients do it all the time), you just have to get the right treatment.

      • I have been on Levothyroxine for 30 years, I can say I have Never had energy and have Always been tired since I had my son 30 years ago. I am 66 now and I feel my life is over because I’m too tired to do anything, I’m at my highest weight, if I starve I can maybe lose 8 or 9 lbs but no more than that. There is a lot more to my story, too little space but that sums it up, I’ve never had a doctor willing to work with me on testing all the right tests, One doctor did reluctantly put me on Naturethyroid but it did give me palpitations, I asked him to test me on All what you suggest but he wouldn’t!! Is There A Good Life with Hypothyroidism???????

      • Hi, I have been on synthroid 100 mg for 10 years and always struggled to loose weight. TSH has been in a normal range recently. A year ago it was low and I bounced up to 112 mg a day. Yet I feel terrible. The muscle aches exhaustion and weight fluctuations has been depressing. I started spironolactin 2 years ago for acne along with my Synthroid. I have Kyleena IUD that release low dose of progestin. My general physician recommended to switch to tirosint 100mg a day as I was complaining about severe allergies from the synthroid. I feel like it stopped working and triggering my allergies more over the years.
        I get heart palpitations from tirosint. It’s been ok so far. I will know my test results soon. Does adding cytomel helps? I tried cytomel 5 mg along with synthroid but it didn’t do much. Weight is my most frustrating symptom. I am 41 year old 5/7 at 150 lbs

    • I am on plant base diet too. I’m a long distance runner. Since I have hit menopause at 50. The scale has gone up. My weight is now 150. I should be 130. I eat organic fruits and vegetables. I exercise 3-5 times a week. Sometimes more. My husband exercises about the same. But eats anything. I’m so frustrated.

      • Hi Shannon,

        You’ll definitely want to have your hormones assessed. After menopause hormones mean much more for your weight than the number of calories that you consume or how much you exercise.

    • T3 is the inactive hormone. FT3 is what is available. Vit.D during the conversion of FT4 ➡️ FT3 (magnesium is used to convert) attaches to the FT3. From there it is attracted to a receptor on the cell that pulls the Vit.D & FT3 into each and every cell in the body. For the receptor to work it requires Zink! If Zink is not present RT3 increases in the body shutting down the receptors.
      These 3 are vital for the process to work.
      Vitamin D

      Zink is the most critical. But all 3 are vital.

      • Hi KB,

        Some of this info is correct but some is not. For instance, you stated that T3 is the inactive hormone but this is not correct. In addition, high levels of rT3 do not shut down the T3 receptor completely but may slow it down however this isn’t universally true.

          • Since Jan, I’ve gained about 30 lbs. I’ve noticed that ever since I started Levothyroxine I’ve gained weight. Menopause doesn’t help. I also have Lupus with sensitivities to “chemically based medicines.-Sulfas-certain hormones. My fatigue is not Lupus related. It’s either thyroid or Adrenal fatigue. I’m on an iron supplement RX but I am majorly exhausted and overweight. Please help.

  2. Hi, I have had thyroid problems for 23 years my meds have never stayed balanced. I have put nearly 4 stone on in the last 6 years and no matter what I do cant shift the weight off. I am so low at this time and can’t seem to get out of this dilemma what can I ask my doctor to do for me, thank you.

    • Hey Sharon,

      I wish there was an easy answer for you, the truth is that most people will have to find a different Doctor to get on the right treatment. To begin with, as stated above, make sure you check your basal body temperature and resting heart rate. You should also get a complete thyroid panel. These three things will give you TONS of information about what is going on with your thyroid. The biggest issue you will run into is not accurate diagnosis, but getting on the right treatment as most Doctors don’t like prescribing anything other than Levothyroxine.

      You can get some tips on what you can do in this article here:

  3. I’ve been on Synthroid .075micrograms for about 7 years now. I also take Meloxicam .15mg. I’ve lost 15lbs in the last 10 years or so but no matter how much exercise I get or how much diet control I use, I just can’t seem to lose weight. My dr says my numbers are “normal” but I still do not feel right. I have trouble sleeping and am tired all day. I have fuzzy-headed thinking and have major issues remembering things. The Synthroid has improved things quite a bit but I’m still not right. I’m going to start doing the temperature and pulse journal and see what I get. Do I need to find a specialist? It’s definite that my regular dr doesn’t seem to see any problem with my thyroid health and doesn’t seem to want to even do the normal tests regularly.

    • Hey Cindy,

      Yes, I agree that checking your body temperature and resting heart rate is a great way to start. In regards to seeing a specialist you will want to find someone who practices “Functional medicine”. Endocrinologists and general Doctors will both practice the same type of medicine: check the TSH and if it’s normal then move on. Trying to get the care you need in that model can be very frustrating as a patient!

      Something as simple as adding T3 to your regimen can make a huge difference.

    • I feel the exact same way. Menopause hit and it’s worse than ever I’m 5’4 and usually weigh 125 but now I’m 160 and have no energy, major brain fog, Fatigued, muscle pain and aches, can’t sleep, no sex drive, and no matter what I do, cannot lose weight.

  4. Hi, I’ve been taking levothyroxine 200mg for over 3 years. I’m not on a diet but eat healthily and try to keep calorie intake to 1500 per day. I eat quite clean foods always use fresh produce, making my own sauces don’t fry foods etc. I’m fairly active and do body combat minimum twice a week. As soon as I miss a week of exercise I notice weight gain. Weight is slowly in my opinion bloody hard to shift. I’m 36 years old.

    • Hey Nikki,

      Check out this post here for more info on why you may not be able to lose weight. Losing weight isn’t about reducing your calories (this method fails 99% of the time), losing weight is about balancing your hormones.

      I see this in a lot of women that I treat in the office, most eat a very clean diet but no matter what they do they are unable to lose weight.

      Post here:

  5. I am taking 100mg of Levothyroxine and find it impossible to lose weight, despite eating a good diet of mainley fish, eggs, fruit, salad and vegitables. I’ve stopped going to the gym beacuse it doesn’t make any difference and i have an active job walking a lot during a normal day. I am 2stone over weight and have a BMI of 26.5, with a family history of heart and lung complaints. I was recently told by my Dr my cholestral was high, which it has never been before, and i was hypo but because my T4 was ok he was not going to adjust my meds, to my knowledge my GP surgery dont test for T3. I have also been diagnoised with IBS. This thyroid condition has taken over my life and i feel as though my Doctors don’t understand how to treat it.

    • Hey Nicky,

      It sounds like you may be under treated. High cholesterol is a very well known consequence of hypothyroidism and indicates that even though you are getting treatment, that you may not be getting enough. In general it can be very hard to find a Doctor that actually knows how to treat the thyroid. I recommend looking for a doctor that specializes in functional medicine.

    • Hi Dr Childs

      Thank you for reply. I have believed I was being under trested for some tme and have researched my condition a lot more recently. I can now go back to my GP armed with some facts and won’t be fobbed off. I will look for a functional medicine sympathetic GP if I am not satisified.


  6. I wish I would have found this article 2 years ago! I was on 200mcg Levothyroxine for two years and just kept gaining weight and was told it was because I’d gone into early menopause at 35 and to lose weight I should just eat under 1100 calories per day. I stumbled across the rT3 information and started experimenting this past Feb with reducing Levothyroxine and adding Cytomel. I’m now at 150mcg Levothyroxine and 25mcg cytomel. I’ve also cut out dairy, grains, eggs, simple sugars from my diet and am working with a trainer for resistance training. Within 2 weeks, I was no longer in menopause and my energy levels were back. I was able to double my intake of food without gaining weight (from 1100 cal to 2200 Cal per day) which helps with energy as well. Then, when I cut those calories again, I should finally be able to lose this weight I gained in the past two years. It’s been a 10 year struggle, and while I want immediate results, I’m trying to be patient because I feel like I’m on the right track finally.

    • Hey Jennie,

      Good for you! Make sure you also look at insulin levels and leptin levels. I never recommend calorie restricted diets for weight loss because 99% of the time all of the weight comes back as soon as you resume a normal diet. In addition 3 weeks of calorie restriction can reduce free T3 levels by 40% for up to 2 years. It’s a vicious cycle that will NEVER lead to long lasting weight loss. I would also look at your vitamin B12 and iron levels. Good luck!

  7. Hi I’m Gill I’m 45 and take levy thyroxine. I take 100mcg. I have gained a lot of weight I.e 3 and a 1/2 stone. I also take mirtazipine, quitiapine and venlyfaxine. This medication as you probably know is for depression an psychotic depression. Gaining all this weight has made my depression worse I think. I also suffer with fibromyalgia have 2 blown discs an arthritis. Please can you help me ?
    Thank you

  8. Omg Gill on the previous comment is almost bang on with my own situation. I have just had my levothyroxine upped to 75 mg, I’m on quetiapine (175mg) and lamotrogine(200mg) and I have 3 bulging discs and arthritis in my facet joints and my knee. I’m 48 years of age. I lost 5 stone in 2013 by having 600 calories a day through liquids and the Cambridge diet, needless to say I put all the weight on and more. I have bi polar and will never come off of the psychotics!! I am going round in a circle, can’t exercise and can’t lose weight. The docs look at me as though I’m just fat and lazy

    • Hey Dawn,

      You’re in a tough spot. Quetiapine is known to cause weight gain ( and being on a calorie restricted diet also reduces thyroid function and therefore metabolism. For this reason you have a couple things working against you.

      Bipolar disorder and depression can also both be caused by tissue level hypothyroidism in the brain. You can see from this study that patients with treatment resistant bipolar disorder improved on T3 medication (liothyronine) alone, link here:

      You can learn more about weight loss here:

      • Hello! I have been on levothroyxine for 25 years. I was 68 kg and now at 45 yrs old, I am 108kg. Very concerned and cannot loose weight. I am a veggie and regularly exercise! Any advice!!! I cannot get GP in UK to prescribe T3! Thank you so much, Antoinette Keylock

  9. Hi! My name is Therese and live in Sweden. I follow this closely trying to find a way to loose weight. It has always been impossible. However 2 years ago I got Levothroxine. Nothing happened. This January I got Liothyronin. From a stable weight (too much though) I started gaining… Pulse and temp is OK since I started with Lio. Now I excluded Levo hoping for a change. Don’t know yet. I eat clean , no dairy or grains… It feels impossible… I will keep searching for answers though.

    • Hey Therese,

      Liothyronine helps probably 60-70% of people lose weight, but it won’t be enough for everyone. In reality getting on the right kind of thyroid medication is just the start. You will also need to check ALL of your hormone levels. You can learn more about it here:

      From my experience the most common hormone imbalance is insulin + thyroid + low progesterone in women.

  10. I am in Canada so haven’t heard of some of these. I am on Thyroid Hormone & take Iodine as well. Started with 60 mg, down to 30 mg but Dr., wants to increase it to twice a day. Feel I am doing okay, 82 & working at losing a little weight. Tried a cleansing diet, lost 12 lbs., so have continued some of it. Was 175 & Dr., said maybe my body was happy there, not me, was down to 169,off track, back to 173. Thank you for the article, hope I can print it to take to my next visit as it may help to get the Dr., to work with me for better results, which taking the pill twice a day MAY not be the right way to go.

    • Hey Babs,

      If your doctor is open to at least looking at the literature then you stand a good chance! Unfortunately, thyroid lab tests can’t be used in isolation to diagnose or treat thyroid disease – they just aren’t that accurate. Good luck!

  11. I have been on Synthroid 88 MCG for over 37 years. I also have Fibromyalgia and my whole body hurts all the time especially joints. I have lost my eyebrows and eyelashes which have come back somewhat. I am always tired and can’t sleep very well at night. I get depressed very easily because I am so tired of being sick and tired. Every time I get my blood work done, which is every six months it’s always the same. (normal). How can that be since I don’t feel good at all? I also developed a goiter when I was nursing my daughter which was 37 years ago. I did some research and found that a goiter really doesn’t go away, is that true? Can you help me please get back on track I am 68 years old and sometimes feel a lot older.

  12. I was diagnosed with Hashimoto’s in 2008. Since then constant weight gain. This year brought more fatigue then normal and severe muscle and joint pain along with edema. I was given one month to try water pills and didn’t loose any of the weight or edema. I tell my doctor and endocrinologist about the pain and they shrug their shoulders with no comment. Really starting to effect my lifestyle. I live in Phoenix. Are you accepting new patients?


    • Hey Tina,

      I have a limited number of spots but I would be happy to help you.

      You can call the office to get more information here: (480) 964-5107

      If you have any other questions feel free to email me as well.

      • Tina’s story is so very similar to mine. I take .137 levothyroxine. I continue to gain weight no matter how healthy I eat. The edema continues to get worse along with fatigue and worsening joint pain. I have been to so many doctors in a plea for help but I am making no progress. It’s so discouraging. I need help.

        • Hey Vicky,

          One thing is for sure there are a ton of similarities in almost every patient I see and the bottom line is that most are being under treated. The best thing you can do is keep searching for a doctor locally to help you.

  13. How does the iron levels in the body and also the estrogen hormone levels affect to this conversion and thyroid hormone functions?

    • Hey Sini,

      Low iron = low thyroid function = lower progesterone = relatively high estrogen (in a nut shell)

      It’s more complicated than that, but generally speaking that’s what I see most often in patients. But just realize that every patient is unique.

  14. I have been on Synthroid since 1992 when I had my first daughter. In 2000, I had my complete thryroid removed due to thyroid cancer. Since then, I have been on Synthroid 175mcgs. I few years ago, my doctor added Cytomel 25mcg. It helped, but it is still not enough T3. I have a regular body temp of 96.7. I have a very stressful job. Regardless of exercise of eating habits, I have consistently gained weight. I need help!!!

    • Hey Melissa,

      I would look for a Doctor who practices medicine similar to me. The thyroid pumps out T4 and T3 in an 80/20 ratio, so most thyroidectomy patients do better with at least 20% of their T4 dose as T3. In addition there are other aspects that need to be looked at including hormones, adrenals and stress reduction. You will have a very hard time losing weight with a high stress level, I’ve seen it in hundreds of patients.

  15. Hello, i had follicular thyroid cancer 23 years ago, i had been on 200mcg of levothyroxine since my operation to do a left thyroidectomy in 1993. Due do keeping my levels suppressed i had my meds increaaed to 225mcg 3 years ago then 2 weeka ago after seening a consultant he has taken me back down to 200mcg. I am over weight do a manual job and cant lose an ounce!

  16. I’m taking Levothyroxine/Synthroid 50 mcg for over a week now from hyperthyroidism then after treatment of Radioactive Iodine last January 2016 I’m now hypothyroidism–weight gain is my main concern, is there any preventive measures to do new to this medical issues…please help…thanks

    • Hey Cynthia,

      Yes! There are many things you can do to prevent weight gain. First, though, if you are gaining weight on your medication that may be a sign that your medication is under dosed or that you are being under treated. I recommend using the tips above in this article to get an idea of what you should be doing to evaluate if your medication is right for you.

      You may also want to read this article here:

      Let me know if you have any further questions!

  17. Hi thank you for this article. I’m 58 and was first diagnosed with a slightly low thyroid when I was in my early 30s but not treated until 4 years ago when I had a series of vertigo attacks. One was quite serious and had stroke-like symptoms aND took months to recuperate from. Regardless, it was diagnosed as bppv. My tsh still read as the low side of normal. My gp at the time put me on Synthroid. I lost some of the brain fog, but lost no weight nor regained energy. Gp refuses to do tests beyond tsh. An endocrinologist I saw was the same. I decided to take matters in my own hands. First, I went gluten free. I lost 10 lbs and some of my skin problems were abated, but not all. I lost a lot of inflammation, such as moon face. I started selenium supplements and felt more alert but did not experience weight loss. After a year of gluten-free dieting I adopted the aip diet. I lost very little until I started taking ashwaganda. With this supplement I I feel more alert an experience gradual weight loss and some more energy. The problem I am having now is substantial hair loss. I am supplementing with biotin and collagen with no change. I realize at my age expectations for recovery are probably not the same but I am feeling better and having an improved quality of life. I am grateful for all of you professionals that share information that helped me. Thank you.

  18. I had my thyroid removed 13 years ago, due to cancer. I was on Synthroid for the first 10 years, then switched over to the generic form, Levothyroxine, due to cost. I have steadily gained weigh over the years. I have had a few months of weight loss when going on a very restrictive diet and have noticed that carbs are the hardest to eat and lose weight…but are my favorite indulgence. I told my husband the other day that maybe I am just going to be old and fat and leave it alone…but it still bothers me inside. I asked my doctor if any of her female patience that were on these medications were at a ‘normal’ weight and after some thought she said, ‘I guess not, now that you mention it.’ But there are no articles on what to do when you don’t have a thyroid…only when your thyroid isn’t working right.

    • Hey Kim,

      Much of the information still applies to those who don’t have a thyroid. If you are being given T4 only medication your body still must convert it to T3 in order for it to be active. So in that sense you still need to focus on optimizing T4 to T3 conversion. I also have some extensive articles on weight loss that you can read about here:

  19. Hello, I have a 17 year old daughter with Down syndrome. She has been on Levothyroxine since age 11. She was always of an average build until she started taking Levothyroxine. She also takes linsopril and digoxin. Her labs are always good. Her weight gain is out of control. She eats very well. Loves veggies and turns her nose up to sweets. She eats very little processed food and I can’t wrap my head around the weight gain. Any advice would be appreciated.

    • Hey Mie,

      In addition to other hormones I would specifically look at Leptin levels. Children with down syndrome seem to have higher levels of leptin when compared to neurotypical children which drives up appetite and increases weight gain significantly. You can read more here:

      It may be difficult to find someone to work with you but you may have luck with a pediatric endocrinologist.

  20. I’ve been on Levothroxine for 5 years. I’m on 200 mcg daily. I have no energy, I don’t sleep well and I can’t lose weight to save my life. I’m busy all day and I actually probably don’t eat enough, I’m never hungry. I can’t find a Dr that really understands and I can’t get a referral from them. I can’t see an Endo without a referral. Any advice on how to get them to listen. I’ve only ever had my TSH tested, it was 42 the last blood test and that’s on 200 mcg. HELP!

    • Hey Jane,

      Unfortunately I wouldn’t recommend seeing an endocrinologist or your GP for thyroid treatment – it will end in frustration for you. Try to find someone who uses a similar philosophy as me and you should be in good hands. Based on your symptoms you are most likely being under treated.

  21. I have hypothyroid and enlarged thyroid. I’m taking 75 mg levothyoxin. 9 months now.I’m overweight, sluggish and living in slow mode. I also have back problems and have constant pain (disc protusion, facet joint hypertrophy,scoliosis) which makes it difficult to walk. My body is in stress and I told my dr who wants to send me for sleep study, mammograms,anything other than helping me with my health issues. I started taking vitamins for thyroid energy and cancelled my appt with dr. I have 2 more refills for levothyroxin but its not working anyway. I’ve scheduled appt with Mayo Clinic as a last ditch effort of relief, but appt not til June.

    • Hey Veronica,

      I would recommend you find someone that is willing to dig deeper into your problem. You may have to look out of the insurance model to get the care that you need, unfortunately. Generally speaking the doctors that the mayo clinic practice the same way as your GP or endocrinologist will.

  22. Is this article relevant if I take levothyroxine due to a complete thyroidectomy from thyroid cancer? I am under the care of an endocrinologist.

    • Hey Jenn,

      Yes, the information is still relevant if you have had a complete thyroidectomy. T4 hormone must still be converted to T3 in order to be active and this must happen whether your body produces it or you are taking it orally.

  23. I have been hypothyroid for 20 years. mis diagnosed for years, now on 100mg thyroxine, bloods normal, Im 12 stone now and on strict diet, no sugar pasta, bead, work full time with special needs guys, busy all the time, no energy, hair thin, no eyebrows, tired.
    gp will not even check T3. wont help with NDT either. told me if I take anything they will not halp at all no further treatment.

    • Hey Angela,

      It sounds like you may want to look into finding a new doctor who is more willing to work with you! I’m sorry you are being treated this way.

  24. I have been on Synthroid for 10 years. 50 mcg. Last Spring my body started falling apart. May 2015 my labs were within range. By Nov 2015 my numbers tanked. My doctor increased my Synthroid to 75mcg. I am up 8-10 pounds!!!! Can that be from the increase in meds. I exercise regularly and eat healthy. My eating habits have not changed nor my exercise. And to top it off, I don’t feel as good as I did before the the setback. My doctor is very supportive and is willing to change my meds to Armour if I want. I see her in May and think I’m going to change.

    • Hey Andrea,

      It’s hard to say for sure what’s going on in your body without further testing. I’d definitely look at a complete thyroid panel but also other hormones like estrogen, progesterone, leptin and insulin.

      Changing to armour may help if your main problem is related to the thyroid but in either event you need further evaluation.

  25. Dr Childs,
    What about someone who took RAI and their thyroid no longer functions? I was diagnosed hyper and that was the route I took 8-9 years ago. I have been on Levothyroxine this entire time. The first 5 years my TSH stayed steady and so did the amount of Levothyroxine. Then for a couple years the levothyroxine was increased to well over double the amount I was originally on. I eat as healthy as I can, mostly vegetables a few carbs, chicken and turkey, and once in awhile a nice steak. I do not lose weight at all. I understand most of what you are saying, but it sounds like the people your speaking to has a working thyroid even if it is working slow or low. Mine just no longer works. So my question is should someone who has a non working thyroid due to RAI be taking a T4/T3 medication or only a T4 medication. Thank you for your time. Please send me an email if at all possible.

    • Hey Carol,

      In general the suggestions in this post still apply to those without a thyroid. Generally, those without a thyroid still need a combination of T4 and T3 because that’s what the body produces naturally with a functioning thyroid. The reason most post thyroidectomy (or RAI) patients gain 20-30 pounds is because they are under treated (the vast majority of the time).

  26. Hi there. I have hashimotos and have had issues with weight. I did lose some but then gained it all back. My energy levels dived again when they lowered my dose due to my weight loss. I never made it to my goal weight. I then also had a hysterectomy and that helped add weight. I suffer from inflammation in my joints causing joint pain. Please help me.

    • Hey Teresa,

      Check out this post about losing weight with Hashimoto’s:

      Weight loss isn’t about calories, it’s about balancing your hormones. In your case it sounds like a combination of thyroid, estrogen and probably cortisol. I also wouldn’t recommend lowering your dose with weight loss, typically it should be maintained unless you get over stimulated from your dose.

  27. Hi, I appreciate the information, but have some notes…..RLC Labs no longer manufactures Westhroid…. Westhroid and NatureThroid were very similar in makeup, so the makers have discontinued Westhroid. They make NatureThroid and now WP Thyroid. WP Thyroid contains only 2 fillers. I switched from Armour to WP Thyroid in January, and if this blog was written in April, this should have been fact-checked for accuracy. Also, if people are learning about NDT for the first time, they should be aware that it all brands of NDT are the same, so different brands will work differently for different people.
    Lastly, it should be mentioned somewhere that the necessary nutrient Iodine, while helpful for conversion of T4 to T3, really needs to be tested first because for some with Hashimoto’s, Iodine is contraindicated and can make the situation worse…

    • Hey April,

      This post wasn’t about iodine but if you read my other posts you will find the information you are looking for. Also, Iodine is not involved in the T4 to T3 conversion process – it is involved in the creation of T4 however. The deiodinases in the body remove iodine moieties to either activate or inactivate thyroid hormone. As an aside, high doses of iodine actually suppress thyroid function and can be used as a therapy for treating thyroid storm. Source:

      Thanks for the update on Westhroid, though it doesn’t change any of my information presented here. I can tell you’ve been reading stop the thyroid madness based on the way you talk about NDT.

  28. I’ve been on hypothyroid meds now for bout 20yrs now, and still don’t feel up to par. I’ve tried so many diets and lifestyle changes as far as, being vegan, vegetarian, gluten free diet, to low to almost no carb diet, and the Mediterranean diet, And loss nothing, I am so tried of trying to lose weight i finely quit trying, But feeling depressed. And still my doctor tells me to watch what i eat. REALLY.

  29. Found out I had hypothyroid with a 7 size growth. Dr says he won’t take it out unless it reach 10. Got the diagnosis 4 months ago. I was extremely sick, sleeping all day and night and never feeling full and also had severe confusion with Deja vu. I’m on Levothyroxine now as well. I have no idea what my thyroid panel numbers are. Should I know? I trusted my dr he’s doing what’s best. But I must mention that about 7 months ago I got the Epstein Barr virus and became extremely sick. I have since been sick many times with viral and bacterial infections. Lack of energy and I have quick onsets of feeling like I’ve been hit by a truck when I as just feeling fine. I also recently had extensive blood tests that showed my levels really bad! My blood had changed dramatically while before all this I was very healthy. I also was having asthma attacks with chest pains and all my allergies became severely worse. So now I’m on fenofibrate and aspirin a day as well. I also take probiotics, apple cider vinegar, b vitamins, multi vit, fiber gummies, asthma and allergy meds and the dr gave me a appetite suppressant pill so I can eat like a normal person. Although the appetite pills are so expensive I can’t afford to keep buying them. I had gained about 15 pounds in all of this but changing my diet and moving more I have been losing. I weighed about 132 after I got sick and now I’m at 127. I used to weigh about 122. I’m confident if I keep moving and keep eating better food , no fast food, I can get my weight down. The hardest part is that I have no energy to work out often. I truly believe the EBV has caused all of this and I wish there was something I could do about that. Going from a very healthy person to super sick often is a big shock. Dr said wont have another ultrasound on my thyroid for 3 more months. I still have minor swelling in my middle clavicle and I pray I don’t have cancer cause he hasn’t done a biopsy. Guess he thinks I don’t need it. Any help with this situation is welcomed and appreciated! Thanks you!

    • Hey Karen,

      I would make sure your doctor is checking your thyroid antibodies. And I would recommend you check your basal body temp and resting pulse as you go through treatment. Your fatigue could be from your thyroid and/or the EBV and it would be hard to say for sure without blood work.

  30. I’m in the same situation! My doctor will not switch me from levothyroxine! I am gaining weight and he will only test my T4 and TSH, nothing else! I literally cried the entire way through this article!

    • Hey Amy,

      I’m sorry to hear about your situation! You may want to look for another doctor who is more willing to work with your specific needs. It can be tough, but don’t give up!

    • Same thing here. My doctor will only test TSH and t4. I’m on snthorid 100 had my thyroid taken out 1 year ago. Eating less than 1000cal due to a test that I had that my calorie intake should be no more than 1060 . I go to the gym 5 days a week 2 and a half hours gaining weight I can’t find a doctor willing to do the other tests.

      • Hey Louise,

        You are fighting two different beasts: hypothyroidism and a damaged metabolism. In order to lose weight you will need the right thyroid medication but that’s only half of the equation – you will need to heal your metabolism as well. Calorie restriction will only make things worse.

        • I would agree – 1000 calories a day is not enough to sustain an adult, let alone someone working out 2 1/2 hours. You’re not feeding your body correctly and your metabolism will greatly slow down x Good luck with everything – it’s a battle i know x

  31. I’ve been on L-thyroxine since 2004 and I have steadily gained weight. It seems that if I so much as look at something with carbs/sugar I gain another 5 pounds. I just tried lifting weights and exercising, but I lost all of my energy to the point that it felt like I just got over the flu and I was still recovering. I am into week 3 of this and am just starting to recover. I also can only work part time because full time is SO exhausting and most of the time I have to take naps after work or when I get a day off, I sleep a good 10 hours to recover. Every doctor that I have gone to will only prescribe the L-thyroxine and wants to downplay any fatigue or weight gain that I have as me being lazy and not exercising enough. They are also just checking the TSH and nothing else even thought I ask for everything. They also tell me my numbers are within normal range if it’s between 1.5 and 4. It’s ridiculous! It is very frustrating and disheartening when all you want to do is feel normal again, have a life again, enjoy life again.

    • Hey Genia,

      I’m sorry to hear about your symptoms, but it does sound like you are having some improvement. Unfortunately many Doctors stick to the TSH because it is the standard of care. In reality, there is no perfect test – even blood work. In order to get a clear picture of the thyroid you really need to look at resting heart rate, basal body temperature a full thyroid panel! But more important is looking at other hormone levels in the body as well.

  32. Hi, I had a TT in 2013 due to Thyroid cancer. I’ve since gained 30 lbs ( was already 20lb overweight) and have been struggling to try and take weight off. I also had a hysterectomy in 2011 which I think may contribute to my inability to lose weight. I take 100mcg of Levothyroxine which seems to be keeping me hyper thyroid with still NO weight loss. I know my endo doesn’t believe or like to prescribe armour thyroid, what do you recommend?

    • Hey Laura,

      You need to get an entire hormone panel to figure out what is going on. Check the following hormones: insulin, leptin, progesterone, estrogen, complete thyroid panel, testosterone and cortisol.

  33. I wish I still lived in Arizona I would get to you ASAP! (I am from Southeast AZ). I was diagnosed with Hashis 4 years ago was put on levothyroxine just 6months ago. I feel awful all the time. I go from hypo symptoms to hyper. I can’t loose weight no matter how hard I try. My body hurts especially my joints all the time. Headaches are another huge issue. My question is do you have info on doctors in the Ft. Worth area that practice “functional medicine” or know how I find that information? Your help would be a blessing!

  34. I have been taking synthroid for years. As i have gotten older i can’t seem to take the weight off. I want to try diet pills but my doctor says no …because of the thyroid pills. Are there any safe ones i can take? I take 75 mcg’s a day.

  35. Hi! This article is great thank you! I had a total thyroidectomy at 18 (8yrs ago now) I have continuously put on weight sinse then, I eat a strict plant and meat based diet. No refined sugars, very limited processed foods and limited fruit. I excerise at least three times a week and still struggle to move weight. I always feel sluggish and tired as I did pre TT. I had Hashimotos disease and a goiter. T3 medication is not funded and very expensive where I live. An my doc is not keen to try me on it. I am thinking I will start monitoring temp etc as you have mentioned to see what it shows. I am currently on 250levo Monday-Friday and 300sat and Sunday. Thank you for this article! Alisha

    • Hey Alisha,

      It’s definitely worth looking into. The crazy part is your thyroid produces 20% T3 when it’s working and yet Doctors only replace hormone with T4 medications. It just makes sense to provide the body with what it would be producing under “natural” circumstances and I do find that most thyroidectomy patients feel better on T3 in some form.

    • Hey Jen,

      You are certainly welcome to your own opinion on the matter, but I would challenge you and ask how many patients you’ve successfully treated and helped with weight loss using levothyroxine? How many patients have you seen gain weight on 1,000 calorie diets while taking synthroid? How many patients have you monitored reverse T3 levels on closely on T4 medication and then on T3 medication?

      The current paradigm is to treat with T4 medication and hope that it converts to T3 in the body, but how sure are you that it is happening? I can tell you from checking and monitoring hundreds of patients on thyroid medication that it doesn’t happen as often as we believe. I can also tell you that standard lab tests do NOT always reflect what is actually happening in the body and at the cellular level.

      And I can also tell you that no clinician will willingly admit that their thyroid patients are “happy” or “satisfied”, they just don’t want to deviate from the standard of care.

  36. Hi Dr Child’s,

    Thank you so much for this article. I have been suffering with hypothyroidism for almost 15 years. The doctors have steadily increased my levothyroxine dosage over the years in which I’m now taking 200 MCG a day. I now almost weigh 300 lbs, I eat healthy for the most part, and exercise as much as possible when I feel like it. Most of the time I am exhausted, my body hurts, I suffer from headaches, my skin is so dry, etc, etc. I know my medicine is mismanaged at this point, but when I mention that to my doctors or ask if I could suffer from hasimotos disease, they basically act like I do not know what I’m talking about and always say well let’s try this for another 6 weeks. 6 weeks have turned into almost 15 years. I’m 40 years old and feel like I have no quality of life. I barely have enough energy to get through a whole work day most days. My family and kids think I’m just fat and lazy even though they know I suffer. My body is constantly inflamed sometimes carrying as much as 10 lbs of fluid and inflammation. I recently found out my father is hyperthyroid and is skinny as a rail (wish that was my case). I will start with testing my temperature and recording my resting heart rate as you suggested above, but could you recommend exactly what blood tests I should request? I would like to be very prepared when I talk to my physician. I have also read that this is an auto immune disease, is this true? If so, could it cause other diseases ie: asthma to be worse? I’m sorry about so many questions, I’m just really tired of always feeling bad.

    Also, could you recommend someone in Virginia?

    Thank you for your time.

    • Hey Chastity,

      Thanks for reaching out and I’m sorry to hear about your situation. Unfortunately I don’t know anyone in that area. You might have some luck searching for functional medicine doctors though.

      To find out what blood tests to order check out this article here:

      Hashimoto’s is an autoimmune disease, yes. Hypothyroidism can be due to inflammation and autoimmunity, but not necessarily.

  37. I take 2 137 tablets of levothyroxine everyday I lost my thyroid four years ago to mens2.. I have been on every dose from 75 to 300 and still gain weight and always feel so tired ..

  38. My TSH levels are at 119 so i was restarted on 50mcg of levothyroxine, since starting the medicine a little over 2 weeks ago, my depression and anxiety are terrible, im crying all the time, i feel likey thoughts arent my own. My chest and jaw hurt and my endo wont listen. She says its because im on too low of a dose, but these symptoms didnt start until after i started the medicine. Before i started it, the only symptoms i had were slight fatigue and weight gain. Im so confused and dont know what to do.

    • Hey Megan,

      That’s a tough situation. You can go back to your doctor and ask for a different medication – even if your endo won’t give you NDT or T3 they can still consider other T4 medications. Either way you definitely need to be seen again and have your blood work rechecked.

  39. I was diagnosed at the age of 39, now 43. I am normally 135lbs. and now weigh 175lbs. This is SO frustrating as I have done everything to try and get the weight to come down, and have done nothing to put the weight on which is maddening… I would be happy at 150 at this point. I am not depressed, but I am VERY mad that this can not be figured out. I have tried Levo, Synthroid, and finally was allowed by my endo. to try Naturthroid. I feel a lot better on the NDT, but I am still way over weight. I have tried clean eating, exercise, you name it. I’d put on pounds just eating straight lettuce. 🙂 Could it be that I just need more of the T3? I have an appointment coming up with my endo. and I am so frustrated I just don’t know where to look next. I feel like it’s me, just in another body. I don’t even know how to shop for this body as I have never had this struggle up to the point where this kicked in. I have a closet full of beautiful clothes that I would love to wear again… Any suggestions? I am not satisfied, and will not accept this is the way it is going to be. Thank you!

  40. Hi! I have Hashimoto’s. I was first put on Synthroid and immediately gained 25lbs and felt worse than I started out. My PCP was willing to work with me & put me on Naturethroid 32.5mg & Cytomel 15mg about 6 months ago. I’ve been feeling better, more energy & losing some weight. From what I read I think I need to continue to have the Naturethroid raised but my PCP has been reluctant to do that. My labs are better but no where near optimal. TSH .01, T3 2.2. Trying to think of the best ways to educate my dr without actually being a know it all. She’s usually open to patients who research.

    • Hey Kim,

      I’m glad you found a doctor willing to work with you. I don’t recommend that you (or your Doctor) base your treatment and dose off of your blood levels in isolation. You should be monitoring a combination of the following: body temp, resting heart rate, subjective symptoms and blood tests. It is possible that your thyroid is fine right now and other hormonal imbalances are causing your issues more than your thyroid. Make sure to get your other hormone levels checked as well, and remember that your thyroid is just one piece of a much larger puzzle.

  41. I currently take 125 synthroid and 5 Cytomel. I can not lose any weight. I am tired all the time. Please give suggestions . I have asked my doctor to switch me to natural thyroid med and he said levels are too hard to keep adjusted. I’m sick of feeling this way! Please help!

  42. I agree with you that NDT’s work much better for most people, but the real trick is finding a doctor who will prescribe them for you. For the most part you can forget endocrinologists because they all swear by Synthroid even in the face of contrary results. I will say that I was not able to lose an ounce on Synthroid, but had good success while on Armour. Unfortunately, the doctor who prescribed that left his practice and I’m still looking for another doctor.

    • Hey Patricia,

      I’m not of the opinion that NDT is the absolute best thyroid medication that exists out there and everyone needs to be on it. It is a good medication, and many people do well on it, but not everyone. The trick is finding the right combination of medication, dosing and frequency for each individual and that can take time. I’m glad that you had success with armour, though! And I hope you are able to find another doctor willing to prescribe it to you.

  43. I just want to say that I have been on thyroid medicine for over 15 years, I have been talking levothyroxine for several years and I lost 220 pounds in 2 years and 4 months without the gastric bypass. It’s called eating until your satisfied and putting the fork down! I was determined! Just some information!

    • Hey Jane,

      Thanks for sharing your story and congrats on the weight loss. What many people (patients and doctors) fail to realize is that lots of thyroid patients out there are already eating 1,000 calorie diets and NOT losing any weight. It’s not quite as simple as eating less when your metabolism is 40-50% of normal.

  44. i feel like I’m dying I’m so tired and my bones ache I have been on levity toxins for 3 yrs can’t lose any weight switched to Aurmor and I feel worse, still going weight. Help

    • Hey Kris,

      NDT doesn’t work for everyone, you may need pure T3 medications or your primary problem may not even be related to your thyroid. You should get an in depth evaluation by a knowledgable physician for further assistance.

  45. Taking 150 levo. For 2 1/2 years. Just changed to 137 about 6 months ago. In this time have lost 20 to 30 lbs including zumba fitness and eating better. Have been stuck seeing nothing now. Have been thinking about going the natural route with medication but I am concerned on what to use and how much, how often. What if it doesn’t work then I’m back to where I started.

    • Hey Amy,

      Great questions and it’s impossible to tell how someone will do when switching medications. In general most people have a VERY positive experience when switching to NDT or T3 from synthroid, but not everyone.

  46. I have been on thyroid meds for years,but have started gaining weight.My joints are stiff now and I feel like i did when I was first diagnosed with hypothyroidism.I have talked with my Doctor and she told me my numbers are good,yet I continue to gain weight and feel tired. What do you suggest I do along with taking my meds which is Levothyroxine. Thank You

  47. I have been on levothyroxine for about 18 months and despite the dosage being put up, i have gained over three stone in weight. Thoroughly and utterly frustrating

    • Hey Stef,

      Sorry to hear about your situation! It can be very frustrating. I would consider having your other hormone levels checked to make sure they aren’t contributing to your weight gain.

  48. I have been on 100mcg Synthyroid for 5 years and I have steadily gained weight. I was first diagnosed when I was pregnant with my first child although I suspect I’ve had thyroid problems since I was a child(never had energy, slept a lot and never could lose weight). I am currently pregnant with my 3rd child and was wondering if taking Armour would be an option for me. If once the baby is born and I begin to breastfeed would it also be safe? Thank you for this article it was very eye opening.

    • Hey Katie,

      You are welcome! Thyroid hormone is safe to take while pregnant and while breast feeding but it should still be done through a physician.

  49. They say I have hashimoto my white blood count was very high they did ultrasound to check for cancer . But was not that I suffer from muscle aches joint aches fatigue My pituitary glad level are very high when I went to Er . I am on 25 msg of level I can’t handle any more . My blood pressure spike when normal blood is very low like 121 over 74. My heart rate. Is at 100 or up but yet I gain weight even off protein diet I take a very low dose for now but I am a wreak dr say there is no other mess to treat hashimoto if I really have this

  50. Thank you for this article. I was diagnosed at 23 with graves disease. After radioactive iodine I am hypo. I take 125mcg of levothyroxine. I have for many years. I live in Tenn. And would love for a doctor to understand our story. I go in 2in3 months to have my thyroid levels checked. I will do the basial temp and resting pulse rate and take this to my doctor. Any advise would be appreciated. Thank you so much.

    • Hey Robin,

      Checking your pulse and body temp is great, but the chances of your doctor acting on that data is very slim. The reason most doctors won’t order a complete thyroid panel is because they don’t know what to do with the results, the same is true for this data.

  51. Hi I found your article very informative. Was diagnosed with toxic nodules in 2005. Had my thyroid oblated in 2006. Since then I’ve had a complete hysterectomy in 2013. Been on .125 levothyroxine for years off and on. Didn’t seem to make much difference. Pretty much hurt all the time. Swelling and now high bp which I’ve never had before. Can’t sleep but always exhausted. Going to talk to my dr and see what we can do. So tired of being tired. Any other advice would be great. Thank you for the help.

    • Hey Dawn,

      You won’t get far seeing your regular doctor – they just aren’t trained to treat people in your position, but you can at least ask them to order the right tests. Look into your other hormone levels like estrogen, progesterone, testosterone and insulin.

  52. I have been on Synthroid for over 5 years. Have not lost weight, no energy whatsoever, very stiff joints and muscles, although I thought this was from getting older, I am 55. I go to my primary care for followups every three months as he says this is what is required, so I know my temp. sits at 97.2 and my blood pressure is good. Although, I feel not no much.

    • Hey Donna,

      Never buy the whole “it’s because your aging” excuse, the human body should NOT age like that. In fact the aging process is accelerated once hormones levels start to decline.

  53. Hi, I have had an ablation to my thyroid due to an extremely overactive thyroid condition. I was told it was Graves disease. They used radio iodine to kill my gland. I have gained a bunch of weight (75 lbs) since and cannot loose any significant amounts. I take 175 MCG of Levothyroxine daily to keep my labs “normal” they are checked pretty regular and the bigger I get the more the doctor says I must take. Please help, where do I start. I feel awful with all this extra weight. I am 50. I now have to take blood pressure meds 2 kinds….. UGH!

  54. I take 50mg synthroid and I notice when I stop taking I lose weight. I did try Levothyroxine 100mg it is my mom’s and I feel better, have lost weight and my nails improve. Not sure what I can do to switch because my Dr is very set on synthroid being the best medication.

    • Hey Sylvia,

      You may need to seek out a new doctor who is more willing to work with your specific needs. Most doctors should realize that not every patient responds to medications the exact same way (especially hormones).

  55. I’ve been taking levothyroxine since I was born as I have congenital hypothyroidism. My weight fluctuates throughout the year, nothing excessive but notice able. I am on the bigger side and funnily enough j don’t even eat that much. I never questioned my medication as I never had a reason too. I guess now I should talk to my doctor about other options

    • Hey Vick,

      It would be a good idea to check your heart rate and basal body temperature, chances are high that you would do well on T3 medication in some form if it is in high enough doses!

  56. I’ve been told I can not make the natural changes you suggest to increase my matabalism because I had afib. I had an ablation in 2010. I have maybe one epasode a year. I am 56 and obese. Having physical issues I feel are related to Hashimoto. Endocrinologist here do not recognize it has its own issues. Some days I can barely walk. Not sure what to do now.

    • Hey Sandy,

      Unfortunately our Endocrinologists don’t really focus on weight loss, but you need to find someone who can help balance your thyroid and other hormones.

  57. Hi,
    I’ve been on levothyroxine for 15 yrs and my current dosage is 150mcg,I’ve been completely unable to lose weight, and I’ve tried everything! I’ve repeatedly asked my gp to try either NDT or adding t3 and been refused every time. The lab won’t test anything except tsh and t4 despite it being requested by my gp and cardiologist. In the last 6 months my tsh went from 2.9 to 16 and nobody can tell me why, dosage increased brought it back to 0.55. I take beta blockers so my heart rate is always slow, I also have primary biliary cholangitis, b12 deficiency, high bp and high cholesterol. I’m at a loss, I’m just getting bigger and bigger and so depressed about it all. Any help would be appreciated.

    • Hey Carolyn,

      It sounds like you may need to find some new doctors who are more willing to work with you. Without changing anything I fear your condition may continue to get worse.

  58. I have been on levothyroxine 150mcg for 33 years now and no matter what doctor I go to and tell them that I am constantly tired never have any energy. They tell me that it is the nature of the disease that I have oh hypothyroidism and diabetes which I have had for almost 20 years. I cant control my blood sugars unless I eat all plant and protein diet and still will not lose any weight. The only thing the doctor will check and this is all the ones I have been to all these years will only test my TSH and T4 nothing else. I wear a fitbit all the time and my pulse hardly ever gets much over 103 even walking it stays low and my resting heart rate averages about 74 but I have times that it will be as low as 64. My basal body temperature is always below 98 usually runs 97.6. I am also on several drugs for my diabetes and it still is not where the doctor wants to have it in the mornings.

  59. Hello there. I had thyroid cancer almost 10 years ago and I have to have my tsh suppressed. The consultant has said I’m not so good at converting t4 to t3 but she always says it’s not a reason why I can’t loose weight. I exercise and don’t eat badly but still have plateued and can’t shift any weight. I also feel hungry and tired. I would be nervous about changing Meds as I don’t want the cancer to come back.

    • Hey Helen,

      Changing your medication would not cause your cancer to come back. And if your doctor is concerned about you being a poor converter it would be worthwhile to check your reverse T3 levels and see.

      If you don’t convert well your reverse T3 levels will be high, your free T4 levels would be normal to high and free T3 levels would be low.

      As I’ve mentioned before, thyroid is just one piece of the weight loss puzzle.

  60. I have had this issue since 1997. My thyroid had been out of sorts numbers reaching 296… My meds have been increased to where I have been taking 300mg Synthroid for years!! I would love to find something else since obviously this isn’t working for me.. I will try these steps and go from there. Thank you

  61. I take 2 grains of nature thyroid for my hypothyroidism and cannot lose a pound. I’ve been on the supplement for 3 months. A lot of other symptoms have gone away, just not the weight.

    • Hey Victoria,

      Like I tell many patients, NDT/armour thyroid/naturethroid etc. is not a magic weight loss medication. You won’t lose weight until you find the source of your hormonal problems, and frequently your thyroid is just a small part of that. You need some deeper evaluation into other hormone levels.

      • Would you suggest a hormone specialist to see areas that could be affecting the non weight loss?
        I am in the same boat! 🙂

  62. Hi, I had most of my thyroid removed about 8 years ago and have been on Levothyroxine since. My blood work is always normal but I am always sooooo tired and though I have not gained weight, it is very hard to lose it. I have tried the low carb diet and will lose a few pounds the first week then nothing after that. Then I will have a cheat day and lose a few pounds the next week. I don’t get it!!! It is very frustrating!!! I am also diabetic and take meds for that.

  63. I have Hashimoto’s, I love to exercise but the next day I HURT!!! So I don’t exercise much, other than daily stretches. I am on Levothyroxine (2 ) 50mcg daily. I am 5’3″ and weigh 145lbs, 50 year old female. I can only maintain this weight by keeping my calorie intake less than 600 calories per day. Not healthy at all. I drink high protein meal replacement and take vitamins. But I stay exhausted all the time. Help!!!

    • Hey Mary,

      You need more data than just your resting heart rate, it’s just one piece of the puzzle.

  64. Hi, I’ve had an under active thyroid for about 15years. I’m on 125mcg of levothyroxine but my doctor won’t change it! I can’t loose weight despite going to the gym 4 times a week and having a personal trainer and I’m tired and miserable all the time! I’m usually asleep by 8:30 but wake up just as tired in the morning! My doctor says my levels are ‘within the right range’ and says I have to deal with or try to reduce stress!!!! They don’t check for T3 as they think T4 is amazing!!! I’ll do the checks you say but I’m loosing hope!

  65. Good Morning, I am currently taking 100 MCG of Levothyroxine, which it has slowly increased from 20 MCG to 100. I am been on this medication since 2002. Since that time I have gained over 100 lbs. No matter what food I cut out of my diet or exercise I do, I cannot lose the weight. Switching medicines never crossed my mind because I thought this was the only route to take for hypothyroidism. I am open to making changes to get this weight off. Any suggestions on what I should do? Thank you.

    • Hey Catrina,

      It’s hard to say without knowing your other hormone levels, but a good place to start would be with adding T3 to your T4 medication. It’s also worth checking all of your labs at baseline prior to making changes.

  66. What do you reccommend for those struggling with all these symptoms after a Total Thyroidectomy? My endo changes my Synthroid dosage every three months, which has an awful affect on me physically and emotionally, and I have not lost any weight in 3 years, aside from when my dosage was “too high” (and I felt great!). I take both Synthroid and Cytomel daily.

  67. I has total thyroidectomy due to thyroid cancer, been on synthroid since then. Blood work shows meds too high but I am so tired I can barely function. Unable to lose weight even though only eating about 1200 calories a day. Tried armour broke out in rash. I also take 2 cytomel a day. So depressed. Help i dont think my body is absorbing meds

    • Hey Judy,

      More likely you are just being really under dosed with your medication. Some people need more thyroid hormone than others but we treat everyone the same, unfortunately you will probably need to seek help elsewhere to get proper care.

  68. Hello, I live in England and have been on levothyroxine for over twenty years, have back and joint pain, do not eat dairy or wheat eat lots of veg and fruit and mainly chicken, cannot lose weight eat less than 1000cals per day, I am a little overweight but cannot lose any weight by cutting down or exercise, find it hard to swallow and get a swelling in my throat if I eat tomatoes or oranges, my cholesterol was abit high at my last blood test also my potassium levels were high,I have a blood test once a year, my doctor has prescribed the same dose of 100mg for twenty years, and does not test for T3 my blood pressure is sometimes high but the only medication I am on is for my thyroid, I have had a lot of stress in my life recently and find it hard to sleep, my doctor seems to think my health is ok, but I feel that I have no energy and cannot do as much as I used to, twenty minutes gardening tires me out, I used to spend two or three hours in the garden. Do you know of any supplements that I can get to help or should I change my doctor I have been with him for thirty years.

    • Hey Carol,

      Just to be perfectly honest with you, you have a lot of work to do to get your health back in order. It’s definitely possible, but it will take quite some time to heal your metabolism, replete nutrient deficiencies and start you on the right type of supplements. Doing just one of these things is not likely to improve your health drastically, but doing them all together certainly would help. Eating 1000 calories per day may keep your weight down but it is damaging your metabolism and worsening your thyroid function, it’s a vicious cycle you will need to break at some point.

      • Thank you for your reply, can you suggest the best nutrient supplements that I can take to get my metabolism working again, I never had a weight problem until I went to the Doctor with a stomach problem that I found out was caused by eating wheat based products, when the blood results came back the Doctor said I had an under active thyroid and prescribed Levorthyroxine but I feel that since I have been taking Levorthyroxine my health has got worse I don’t feel that I have had any benefit from it, sometime I feel that I would like to stop taking it for awhile to see if I feel any better, but because my Doctor said I need to take it for the rest of my life I am afraid to stop taking it. But I think I felt better and had more energy before I started taking it.

  69. Hi there, I was diagnosed via test results that I have done yearly for Addison’s Disease that I now have Hypothyroidism. My doc perscribed the levothyroxine for this and I have yet to get my labs done again to see if it is working. I am still very tired all the time. I can almost pin point when this started happening to me, a little over a year ago I was feeling more tired than usual and sick a lot. I also take Hydrocortozon daily and I felt like that was not working at all. So, I was not surprised that this was happening. But, I have been on the medication now for about 6 weeks and am still very tired and do not feel really any different. I did not gain weight either when all this started. I was about 125 pounds and in about 2 months found myself down to 84 and got scared. I did not go to the doctor because I had not been eating right because I had been so sick so just started making myself eat more. I have managed to get to 95 pounds or so now. That was gained before the medication for thyroid was started. I do not know at the moment what I am but am not gaining. I was wondering if there are any supplements I can take to help improve energy levels and help my adrenals as well. I feel like all this is depleting my cortisol totally. I work and when I do that is all I can do for a day. I go to work and struggle to get through the day and go home and to bed. I will not see my Endocrinologist until July and do not know what she is going to do or check but, I have not seen her for a year now and she diagnosed me over email and does not even know about the weight loss yet. I am not sure if I will even keep the same doc as they have not really been any help.

    • Hey Lisa,

      “My doc perscribed the levothyroxine for this and I have yet to get my labs done again to see if it is working. I am still very tired all the time”

      This sentence says it all. If you don’t feel any better you don’t need lab tests to tell you that. If it was working you would notice a difference.

      You need better thyroid management and better hydrocortisone management. You should also have pituitary function tested, especially if you are now hypothyroid.

  70. I had my thyroid removed 1 year ago today (left one) and went on Levothyroxine – then six month s later got diagnosed as a diabetic. changed my lifestyle 110% and STILL cannot lose weight no matter the healthy eating and daily exercise… TOTALLY FRUSTRATED!!!

    • Hey Lisa,

      You will need to address your insulin levels before your body will let go of any weight. Check your 12 hour fasting insulin, anything > 5 indicates an issue.

  71. Dr. Childs,

    I have been on the corrected dose of T4 and T3 for 2 weeks – I am starting to feel so much better! I can already tell a big difference in my energy level and my attitude.

    Feeling Hopeful!

    • Hey Kelly,

      That’s great news! 🙂 It can take a good 3-4 weeks to completely kick in and we may need to further adjust it, but it’s a great sign if you are already feeling improvement.

  72. HELP!!! Our daughter has Asperger Syndrome, as well as ADHD & Thyroid problems(Hashimoto) & is a big girl.She takes Levothyroxin & I don’t believe it really helps. She complained ALL the time about her throat hurting, tickling feel or a slight popping. A major problem sounds like.The Dr. sees her once, then wants to see her the following year. Not good!!! What is wrong & what can we do about her problem. Sincerely, A worried parent!!!

    • Hey Dee,

      The best thing you can do is take her into see someone who will look at all of her conditions and give you guys a treatment plan that includes potentially changing her medication and addressing any underlying issues. She may also benefit from something like neurofeedback.

  73. I take Levothyroxin and cannot lose weight. I am so discouraged and feel horrible. I have read some literature on Hashimoto’s and currently eliminate grains out of my diet. My next step is to take dairy out of my diet. I seriously need some help as I look horrible in my clothes and very uncomfortable.

    • Hey Judy,

      Diet will only take you so far if your hormones are out of balance and you are being treated with the wrong type of medication/dose.

  74. I was on 125 mcg synthroid. Felt terrible. Migraines, joint pain, brain fog, anxiety, extremely tired with no hope of getting better. Made an appointment with an endocrinologist. First she added 10mg cytomel. No change. Then she tried armour thyroid. It’s taken 5 months to get to 120mg but am so much better! I think I still need 1 more med increase but am waiting till my appointment to discuss. Don’t be afraid of armour and don’t listen to your doctor when he says “well you should feel better. That’s all I can do!”

  75. I have been on Levo for about 5 years. I have always seemed to gain weight slowly. Two and half years ago, I got breast cancer. While on chemo, I went to an Endo. He diagnosed me with Hashimoto’s and changed my medicine. I am on .88mg of Levo and .15mg of Cytomel. Over the last few years, I have gained 30 lbs. My dr’s tell me that it is a side effect of the chemo. I have been done with chemo for almost 2 years and my weight is still creeping up. Nothing seems to work. While I don’t go to the gym, I have 3 small kids and a very full schedule so I am active. Very rare do I get a chance to sit down and rest.

    • Hey Mary,

      It’s hard to say exactly why you are gaining weight, in reality it’s probably a combination of multiple reasons but it doesn’t sound like anyone is really investigating it.

  76. I had a thyroidectomy in 2005. I began on synthroid and switched to armour in 2011. Last year my numbers went crazy and even with increasing dosage I remained hypothyroid and miserable. Four months ago my new endo recommended tirosint. Initially it went well but 2 months later the sweats and bloating began. Now I have reduced from 137mg to 125 mg and still feel miserable and bloated. I am thinking Armour wasn’t so bad.

    • Hey Deanna,

      Sometimes during stressful circumstances thyroid dosing must be increased, but that doesn’t necessarily mean you should have stopped the armour to begin with.

  77. I took levothyroxine a few months along with B12 when blood tests showed hypothyroid & deficiency. Hair fell out, more headaches, still tired, memory issues,weight gain and didn’t see a benefit so I stopped. I take 8 – 10 ibuprofin every 6hours or so to help with aches.

    • Hey Mb,

      You might have done better on liothyronine. Also, make sure you watch your kidney function taking that amount of ibuprofen.

  78. I have been on 150mcg of Levothyroxine for 15 years and have gained 42lbs in weight. I suffered a heart attack just 3 months prior to the thyroid problem (Or did I? could the thyroid problem have actually caused the heart attack?) I also take simvastatin for cholesterol, Irbesartan for heart protection and Nicorandil for Blood Pressure. Because I take Aspirin to thin my blood, I also have to take Lansoprazole to protect my stomach as I have had stomach ulcers in the past. Such a cocktail of drugs is worrying especially as I am now borderline diabetic too and will soon start on metformin. Could all my health issues stem from an under active thyroid being mistreated? I believe they could and have

    • Hey Janet,

      It’s unlikely that your thyroid caused all of the problems, however it certainly contributed – to what degree, we will likely never know for sure. You’re in a messy situation, but in order to get off of those medications you would need a pretty intensive program and someone to systematically remove medications as your insulin resistance improves, weight drops, blood pressure drops, cholesterol improves, etc. Going off of them all at once would not be advised.

  79. I was diagnosed with hypothyroidism when I was 28… 20 years later, I am 100 lbs heavier and always tired … tried to add exercise for over 3 months and just found myself in more pain resulting in doctors saying I had gout … I am not looking to be the girl I once was I just want to be comfortable … I even got frustrated with weight watchers cause I would lose some gain some … Any advice from an expert …

    • Hey Dawn,

      You need the following:

      1. Proper thyroid medication and dosing – probably with NDT + T3

      2. Full hormone evaluation including insulin and leptin

      3. Whole food based diet that is NOT calorie restricted, and to avoid all calorie restricted diets from here on out – they will only further damage your metabolism

      4. And probably most important – a Doctor to help guide you through it

  80. I lost 40 pounds before I had my thyroid removed 3 years ago (they thought it was cancer, but wasn’t) Almost immediately I started putting the weight back on. I followed the same routine, but added in more exercise. Nothing seems to work. I’ve talked to my doctor several times about switching my meds, but he really doesn’t think there is another medication out there that works. I am on 150 mcg Levothyroxin. I need help just don’t know what to do….

    • Hey Kim,

      If you read through the comments you will see that you are not alone. The vast majority of doctors (99.8% of them) practice the same exact way, if you want to get proper treatment you will have to look for that small portion of doctors that understand thyroid function.

  81. I was diagnosed with an underactive thyroid age 15 so 18 years ago. I’ve always taken between 250mg and 150mg as it’s never been stable. Recently I’ve put on 3 stone in 2 years and I’ve been to Slimming World and I’ve been to a Dr’s referral Slimming Group which both said I don’t eat enough yet I’m now a size 24!!!! I’m not even 40 and I feel so I’ll and tired everyday my GP is useless jve asked repeatedly to be referred to Endocrinology but they think they know better. Hopefully when I move I’ll get a better GP who will listen to me my T3 levels are none existent so why they won’t give me a prescription I can’t understand. I also have EDS which they won’t acknowledge either.

    • Hey Rebecca,

      Your main issue is a slow metabolism which is caused by a lack of thyroid function and probably several other hormonal imbalances. Until these get sorted out you most likely won’t be able to lose weight.

  82. My endocrinologist will not prescribe NDT’s… and I am frustrated that after all these years of toying with the dosages of meds, I am still unable to lose weight. Would love any recommendations of where I can turn from here… definitely interested in as holistic approach as possible… should I find a new doctor who would help me switch to NDT’s? Thank you! This article was very informative!!

      • I am not sure why my comment was edited to describe what I was taking and the questions I asked… was really hoping for some help in directing me to what I could do next.

        Is medication the only way to go and no supplements?

        • For the most part, no, supplements are not sufficient by themselves to boost thyroid function enough to completely eliminate symptoms. And, in answer to your original question, I do think it would be reasonable to try and find a Doctor willing to prescribe NDT.

  83. Hi. I am Hilda. I have had 100 % removed my thyroid gland in 2007. I am also suffering from mrb. crohn (first surgery and diagnosed in 1981). I take 200 mkrgr daily of Levaxin. I do not feel well. I am overweight. I have just been to an endocrinolog and I was not to change any medications. I was also told that my blood works were ok. What am I to do? I am exhausted, not sleeping well, not eating at all compared to my weight.

    • Hey Hilda,

      You can try changing your diet and adding supplements, but if you’ve done that and it hasn’t helped then you will need to find a doctor to help you with changing medications, etc.

  84. I have been taking Levothyroxine for over four years. I take 0.075MG [75MCG] daily; then on Saturday and Wednesday I take an additional 1/2 tablet. This is the only actual prescribed medication I take. I’m very tired, and yes weight gain is an issue. I have small nodules. Lately, my hair is falling out again. I’m due for another lab work up and doctor consult. I don’t particularly find that my doctor is helpful as she dismisses my complaints over being tired, etc. Supposedly, this is not due to my Thyroid issue. I only use a regular doctor as my Medicare doesn’t cover Naturopathic doctors [which I prefer] and my Disability income is only $750 monthly. I am 65 years old and as well have other health issues [Sjogren’s Syndrome, PTSD, Psuedo-seizure Syndrome, imbalnce issues due to a permanently damaged inner ear nerve]. I do experience Acid Reflux, IBS, sensitivity to noise [which I thought was mostly due to my PTSD], chronic anxiety, insomnia, night terrors at times, memory loss. I’m very grateful to have found your website [can’t remember how I found it]. I’ve tried researching and doing the “natural” route but then I “forget” what I’ve learned and forget to go that route and just “settle” for the routine my doctor has me on. My quality of life is not great. I’d love to be able to enjoy my new 5 month old Grandbaby [1st time], but they live in Texas, me in Washington and the travel can be quite stressful, adding to my health concerns. I can’t really work, but as well I’d like to be able to do art work and write my book, but I’m so tired all of the time and discouraged.

    • Hey Anita,

      You’re in a tough spot. Unfortunately it will be VERY difficult to find the care you need in the insurance model, most of the Doctors who would actually be able to help you only take cash. But, that is what you need – a Doctor to guide you through this.

  85. Hi
    I had a total thyroidectomy 3 years ago and have steadily gaine weight . I take 125mg of levothyroxine and havent up until now had any other issues. However i have just recently had high blood pressure resdings and 7.2 cholesterol count.
    This has really surprised me as i haven never had this problem before.

    • Hey Margaret,

      Your new cholesterol problem could be from insulin resistance or simply because you need more thyroid hormone.

  86. I take Synthroid.8 months ago I was on 175 mcg. I am now at 125mcg. Weight gain is through the roof. Tired,exhausted,joint aches etc. Need to lose 60lbsto feel normal again

    • Hey Kris,

      I actually think that changing dosing based on the TSH can lead to desensitization of thyroid hormone receptors in the body – I’ve seen many people get to a dose they do well on and then do poorly if they ever go back to it.

  87. I am on 88mg levo, I am not losing weight, I am fatigued and slightly depressed. My dosage was upped about 3 weeks ago from 50 … I do not feel like anything changed, went gluten and soy free nutrition. I am sick and tired of feeling this way

    • Hey Henriette,

      Increasing T4 usually isn’t enough to make people feel better, most people need some T3 (in various amounts) to feel optimal.

  88. I have been taking medication for 3 years now for my thyroid and I can’t lose weight anymore, it so frustrating!!!!

    • Hey Gail,

      Remember that other hormonal imbalances may be contributing to the weight as well! I’m sure thyroid is part of the problem, but it may not be the only problem.

  89. I have been dealing with hypothyroidism for probably 6 years. I gained 80lbs very quickly with little to no change in my diet. My synthroid medication dosage has NEVER stayed the same in those 6 years, it’s always being tweaked. About 1 year ago my endocrinologist told me I have thyroiditis, and basically my thyroid was “attacking and killing itself” and would eventually stop working and my dose would be consistent then. Almost 1 year later, no weight loss, symptoms improved a little, but I can tell I need dosage change. Also monitoring nodules. I’m also on metformin for PCOS, it’s so frustrating because I feel like I’m fighting a losing battle.

  90. I was treated for Hyperthyroidism with radioactive iodine 32 years ago and have been on Synthroid since then. I have steadily gained weight over the years and am at my highest weight now at age 58. Have been on Weight Watchers many times over the years and just cant get the weight off. I do work out about 3 times a week, mostly Cycle or Yoga. I’m tired and unmotivated to do much of anything these past few years. I go to my Primary Doctor once a year for bloodwork and tests are always normal.

    • Hey Liza,

      Make sure to test for the other hormones mentioned in this post: Insulin, leptin, reverse T3, Estrogen/progesterone, etc.

  91. I am a mom on a mission to help my 14 year old daughter who was diagnosed with Hashimotos at age 8. She has 2 goiters and antibodies >1000. Her Doctor immediately put her on Synthroid, but she has never seemed to quite feel better. The bloodwork says her TSH, T3 and T4 are in normal range but she has begun putting on weight which is hard for a teenager to deal with, especially because she is active and still growing. I have been supplimenting her with selenium, magnesium and a probiotic but any other advice would be greatly apppreciated. No young person should every have to feel so tired and have a hard time functioning because their youth should be the best times in life.

    • Hey Tanya,

      Unfortunately there’s not much you can do unless your doctor is willing to look outside of the box and treat her differently.

  92. before I knew better, I developed hyperthyroidism 4 months after my baby was born. The standard protocol was RI, which I did and they said that I have to be on Synththroid forever. Well my dose had gone from 75 mcg to 100 mcg. I started taking nascent iodine and they dropped my dose to 50 mcg which has been for a few years. Do you think it will be ever possible to regain my thyroid function without ever having to take Synthroid? I take selenium and zinc and nascent iodine everyday and recently started taking Kyogreen powder. I tried to get off for awhile, but I just felt awful, sluggish, sleepy, arms tingly, etc.

    • Hey Shirley,

      Probably not if you underwent RAI. You need thyroid function to not only survive but thrive, no thyroid hormone = myxedema coma and death.

      • Thanks for your quick reply, I’m wondering if I could possibly switch to the thyroid replacements you are recommending in the article. Of course, I would be talking to my doctor about it. But I would like my thyroid replacement to work more effectively and efficiently in my body.

  93. My issue is although that’s fantastic info, I’m on Wellbutrin which DOES speed up your metabolism and raise temperature and resting pulse rate so if I monitor those things I’ll see them high anyway…
    Any suggestions? I’m stopping Synthroid. I’ve been on it for 6 weeks and have had undesirable side effects like tingling in hands and feet and bladder issues

  94. I switched to Armour Thyroid last year and I had some pretty intense heart palpitations at first but got the dose lowered and then I felt amazing for a couple of months. Then, my symptoms started creeping back up… fatigue, weight gain, and lots of hair loss. In the year that I was on Armour, I gained 20 lbs and and the symptoms got so bad that I decided I never want Armour Thyroid again. My doctor put me back on Synthroid and my hair loss has pretty much stopped. I haven’t lost any weight (been back on the Synthroid since February). The doctor also ordered an ultrasound on my thyroid which showed 2 2 cm “cysts.” I had an ultrasound that was normal before starting Armour but it was maybe a year before. I am supposed to have another in September to determine if
    “they are growing.” I am so terrified that I have destroyed my thyroid by taking Armour.

    • Hey Laura,

      Not everyone does well on NDT or armour thyroid. I don’t recommend it for every patient because some people have reactions similar to the one you had.

  95. Hypo for 3 years. After a year of T4/T3 combo I was put back on T4 only 5 months ago because of suppressed TSH and racing heart. I used to be so fit and energetic. I am 3 stone heaver than I have ever been in my life, even when pregnant. I can’t eat gluten as it gives me pain, every food gives me indigestion not matter what I try. Doctors want me to take PPI’s which I am resisting. I do a lot of cardio exercise (tennis) because I love it and its the only thing that keeps me sane. Endo told me to give it up but then he also said he wanted to remove all meds from me, crash my body and start again. I have no stamina like I used to have, no energy. I eat mostly veg smoothies yet I get fatter and fatter. I have a great husband and daughter but I don’t go out anymore apart from going to work as I am so ashamed of what I have become. I bought my own NDT online and it gave me lumps under my arms. Feel like there is no hope… matter what I try. usually I am always positive as I know there people a lot worse off than me….jush wish there was something I could do to help myself.

    • Hey Susan,

      It can be really frustrating and almost impossible to do by yourself, I recommend finding someone local that can help guide you.

  96. Hi my name is melissa i am 38 years of age and was diagnosed with hypothyroidism when i was 9 months pregnant my original endo had me on 112 mcg levothyroxine. I eventually with working out lost alot of the baby weight . But mentally i wasn’t well did some research and his nurse wouldnt run certain test so i decided to switch went to another dr who put me on synthroid 127 maybe felt alittle better but not much so with some diagreement i went to another dr who ran alot of test put me on armour 90 mcg i will say i feel best and am symptom free mostly and mentally i see the difference but since i stopped levothyroxine i have gained 15 lbs in like 5 years doing the same exercises that lost the baby weight before on levothyroxine so im leaning tword its the meds what do i do ?!! Take levothyroxine and mentally not he well but maybe be able to lose weight or contine to gain everyevery day and stay on armour?!! I dont know what to do!!!

    • Hey Melissa,

      In reality there is probably a combination of medication that will help you feel better mentally and help with weight loss.

  97. When people blame every symptom on their thyroid (even many people who do not have any evidence of a thyroid disorder), it keeps them from addressing wellness–stress reduction, proper sleep, exercise, nutrition, mental and spiritual wellness and other issues such as iron deficiency, obesity. This is why I have such a problem with these websites. It is a major barrier to counseling patients because they just think it is a matter of getting the right balance of T3 and T4. It is the quest to find the “magic pill.”

    • Hey Kasper,

      Great thoughts and I agree with you to some degree. I do think there are a number of people out there with undiagnosed thyroid disease that have been kicked around and mostly ignored, and there are a high number of individuals as well who believe that they do – but really don’t. In general thyroid disease does NOT account for more than 20 pounds of weight gain in most individuals, so if you have more to lose than that I can almost guarantee you have multiple issues contributing to your weight gain.

    • Hey Lisa,

      It depends on your body and your dose. Generally, no, but some people do better on other medications.

  98. I live in a small town so it is sometimes vertu hard to get info on thyroid and I feel pushed away from doctors. I’m on 100mg of levothyroxine and 25mg of cytomel. I have two kids and with both I lose a lot of weight during pregnancy and feel great too, when I’m not pregnant I gain a lot of weight and don’t feel great. So I’m wondering if my hormones released dieing pregnancy were helping my thyroid and what can I do now.

  99. Hi,
    I have been to several doctors. My levothyroxin fluctualtes from 112 to 100 mcg. T4 was checked 2x in 5 years! T3 1x !
    I can not seem to get through to any of the doctors. Every time TSH is “normal” I am being dismissed. Hairloss and extreme belly and upper torso fat is attributed to stress. I am fighting a loosing battle. 🙁
    My resting pulse rate is 98 or above. This may have something to do with being diagnosed with Polythytemia. No diet has helped loosing weight. Excercise is almost impossible since my pulse goes up to 123 just walking a few feet.

    • Hey Gabriele,

      That usually means your thyroid dose is too high (especially if you are on T3) and will limit your ability to feel better and lose weight.

  100. Hi

    When I was first diagnosed with underactive thyroid 10 years ago I was prescribed levothyroxine and started feeling very unwell after that. After 2 years i was 25kg heavier and barely able to get out of bed. I was then put on combination of levothyroxine and liothyronine which made a big difference. I am now thinking about having a baby and i have been told i will have to stop taking liothyronine and increase the dosage of levothyroxine before getting pregnant and until after the first trimester of the pregnancy. Is this approach correct? I have tried increasing my levothyroxine from 75 to 125 and stopped taking 2×5 liothyronine as a trial run and only lasted 2 weeks as towards the end i felt extremely unwell.


    • Hey Magda,

      Each situation is unique but the bottom line is that your body needs MORE thyroid hormone when pregnant because thyroid hormone helps regulate embryonic development.

  101. Hello Dr. Childs, what do you think about “Thyroid Assist”? Thyroid Assist is a 100% herbal formula. The active ingredients of the product are Bladderwrack (Fucus vesiculosis), Green Oats (Avena Sativa) and Makandi (Coleus forskohlii). Thank you.

  102. I have been on medication for 28 years and have gained 175 lbs. My medication dosage has gone from .01mdg to .250 mcg. I have been on levothyroxine and then went to synthroid and do to cost have gone back to levothyroxine. How do I stop this vicious cycle. I want to get this weight off but my doctors act like it is because I eat to much that isn’t the case.

    • Hey Patricia,

      You will most likely need to change thyroid medication to something containing T3 and unfortunately most conventional Doctors will not prescribe it.

  103. I am taking 100MCG Levothyroxine and i have been takeing this for the past 6 years. Ever sence thin i have put on 75 lb. No matter what i do i can’t get this weight off. I went from a size 10 to a 3x. in 5&1/2 years. I never knew that it was this med. that was causing it. So what do you recomend me to do?. I’m so frustated..

    • Hey Susan,

      You need to find a new Doctor who can actually help you! No need to stay with the same Doctors if they aren’t doing anything for you.

  104. I take armour thyroid 60mcg I was originally on synthroid it did not work well for me.i thought it would be better on armour but it has not.i keep gaining weight and do not feel good.ive gained alot of weight and I have become insulin resisant.any suggestions for me.often I think about just stopping my meds

    • Hey Jenice,

      Not everyone does well when switching to armour thyroid, but you might still do well on T3/naturethroid/wp-thyroid, etc.

  105. I am currently on 225mg of Levothyroxine and have put on alot of weight and find it almost impossible to shift.i had been on 200mg for around 5years and it was upped to 225mg which is alot. Have you any advice please? Do you think other medicatuons is an option for me? Thanks.

    • Hey Sharon,

      I would definitely look into other medications, especially if the levothyroxine isn’t working well for you.

  106. I have autoimmune thyroiditis. I take levo 100 mcg for around a year and in that time i have put on 14lbs that I cannot shift. I take no other meds. I eat a strict veggie diet (and always have) free of refined carbs and sugars, rarely drink, and don’t smoke. I exercise by walking about 5 miles per day, and also swim 6-10k every week. I still cant lose the weight, it’s driving me nuts!

    My hair has stopped falling out in handfuls, I am definitely less tired, and I am warmer than before but still have raynaud’s. My skin is still dry and my heart rate is still low at 49-55bmp, although that is a big improvement from 39bmp prior to levo.

    My TSH is down to 0.5 and my doctor thinks my issues are fixed and i am a hyperchondriac, but I know that gaining this weight is completely unnatural. I don’t want to be exhausted again so I am afraid to come off, but I hate being fat!

    • Hey Estee,

      Your weight gain is likely due to another hormone imbalance which is worsened by hypothyroidism. I would have your doctor check your insulin and leptin levels.

  107. My question is I have been on levothyroxine for 31 yrs started on very high doses of 500 micrograms now down to 175 micrograms I have had and still have a massive weight problem I have had cancer and a hip replacement I am using the slimming world method for cutting down on fat intake any other ideas to help I am 58 and work as a theatre nurse so on my feet a awful lot..

    • Hey Mary,

      Generally cutting down fat is the wrong approach (as is cutting down calories). In a patient with hypothyroidism the standard rules don’t really apply – you need to look at other hormones like insulin, leptin, and the estrogen/progesterone ratio.

  108. I was on levothyroxine for 4 years I was diagnosed when I gained 100 lbs in 6 months. Last summer I switched to armour 135 MG I feel better but I can’t get my weight to move in will try the temp and resting pulse should I also try adrenal supplements? I was working out and nothing again was happening

  109. HI, I just had my thyroid remove 5-23-16 and yes I am on levotyroxine 100mcg. I am exhausted all the time complete brain fog my hair is coming out my skin is dry and I just went yesterday to the orthopedic because my knee was so swollen I needed it drained. I am 52 considered myself to be healthy and now I feel like I have one foot closer to the grave. I have a appt. this Thursday with the endocrinologist other than sounding like I am whining how do I convey this to make them listen. Unfortunately this guy is old enough to be my great grand father and as per my insurance he is the only one in my network to go to.

    • Hey Tammy,

      You won’t ever be able to make a Doctor “listen” the way you are describing. They will treat you the way they have treated patients for the last 20 + years. I would strongly recommend that you look outside of the insurance model or else you may end up suffering needlessly for months to years.

  110. I’ve been taking Levothroxine for 8 years. I have been aggressively trying to lose weight for 1.5 years and have had no success. I exercise 5 times a week and eat very healthy. I used to eat double what I eat now, and I am the same. I never thought that it could be my medication.

    • Hey Dem,

      It could be, but also more likely is some other hormone imbalance like insulin or leptin resistance.

  111. I’ve been taking synthroid/Levothyroxine for about 8 years. Recently I was travelling and ran out of medication. In five days, I lost about 8 pounds and my waist was definitely thinner. Since coming home three days ago and restarting levothroxine (137mcg daily) my bloating has returned and my weight is up.At last check up, my thyroid was below normal level

    • Hey Chris,

      You might be reacting to a filler in the levothyroxine, not necessarily the medication itself.

  112. I’m miserable on synthroid.i can’t get enough sleep and my appetite is out of control. I am so fatigued and depressed. Is this how my life will be? My endocrinologist won’t listen to me.

  113. Complete thyroidectomy in 2010. Endocrinologist lowered dise of Synthroid to 137mcg. I have gained 25+ pounds, have depression, no energy. He refuses to raise meds back up as labs are “nirmal”. Help

    • Hey Lynnr,

      Best advice I can give is to find someone who is willing to look beyond your lab tests. You won’t be able to change your doctors mind and have him treat you different, so it’s often best to look elsewhere.

  114. This article has given me more information than I have had in 26 years. I have been on levothyroxine or synthroid since I was 32. And I have been on every dose available. For 26 years, I have been going to the Doctor every 6 months, and yes, every 6 months my dose is changed. I’m still as active as I was years ago, in fact, maybe even more active. I had put on 160 pounds. I HAVE to push myself everyday. Some days, I just want to lay in bed and cry. And some days I do. Moody, not hungry, depressed, frequent headaches, and everything else that comes with Hashimoto’s disease. I literally have been miserable for 26 years.

    I had my yearly checkup in November. I had swollen legs, swollen face, and I had cried for about a week. Something had to change. I ask my doctor about Armour Thyroid and he gave me a little shrug and said that is was not standard for them to prescribed. Well, that was it for me. I told him I was just going to have to find a doctor that would “help” me. He finally gave in a wrote the prescription. Since November (8 months), I have lost 50 pounds, skin is scaley, and I feel much better. Granted, after 3 months my dose was changed, but I can almost see a light at the end of the tunnel. I also take a vitamin B regimen everyday along with zinc and magnesium.

    I truly wish we had a doctor in my hometown like Dr. Childs that take a normal persons insurance and explained the up and downs of thyroid disease.

    Thanks Dr. Childs. I am getting your ebook for more reading.

  115. I am 41 y.o. female. My Dr just recently put me on Synthroid and Metformin. Was told I’m hypo and insulin resistant. I am already on Adderall for ADD for the last 10 yrs. I’m a former fitness competitor (’09-’12). After my cancer scare (Dec ’12), I went into a depressed state, ate, and gained weight. I workout 4 plus days a week and struggle dropping weight. I’ve exhausted myself causing a negative impact, physical injury and depression (again). My diet is clean though I enjoy wine at night.
    First, is it safe to mix the 3 together? Second, what recommendations could you provide?

    • Hey Brandi,

      Based on history alone I can tell you that one of your main problems is insulin resistance, if you don’t manage that you most likely will not lose any weight.

  116. My doctor put me on levothyroxine last year because she stated that I had a underactive thyroid. I took it for 2 months and got off of it because I gained 20 lbs within those two months. My question is if I start taking the levothyroxine again, can I take the Selenium and zinc while on the levothyroxine? Also, when taking your temperature and pulse is that when you are on the medication or off the medication?

    • Hey Jessica,

      You can take both supplements with your levothyroxine, I’m guessing you are trying to boost the conversion process? And you want to check your pulse and body temp both on the medication and off to see if you notice an improvement when you start taking it.

  117. I’m a 56 year old female in the UK who had RAI I-131 treatment 3 years ago. I’m on 100mg Levothyroxine, 10mg Escitalopram and struggle to keep my weight down. I also suffer from bouts of low mood and tearfulness. Is it possible to take T3 post RAI treatment and would this enable me to manage my weight and mood more easily? I don’t understand the role of T3 and it’s no longer checked in my regular blood tests which only confirm levels of TSH and T4. Hoping for help from the other side of the pond!

    • Hey Sarah,

      Yes you can take T3 post RAI and I encourage most patients either post TT or post RAI to be on T3 in some form, usually to the tune of ~20% of their total T4 dose.

      T3 generally does help patients with mood and weight loss resistance, but not always.

  118. Hi my name is Patty. I have been on medication for 35 years. I just recently changed doctors because my first doctor would not help me lose weight. All he said was that I would have a hard time because of my thyroid. I knew that. Anyway this new doctor has changed my dose of medication but I am still having a difficult time losing weight. I have changed my eating habits, I have been exercising, but the weight just does not come off.

    • Hey Patty,

      You won’t lose weight until your thyroid medication has been optimized and you address insulin/leptin levels.

  119. Hello, I’ve struggling with hypothyroidism and hashimotos most of my life. I was at s time on the natural hormone armour and did lose 20 lbs but then a new doc had switched me back to the synthetic ones whxih were about 2 kinds and now I’m back in lyvothiroxin and I’m gaining so much weight I’m exhausted and completely lost pls help!

    • Hey Natalie,

      Unfortunately there’s nothing I can do unless you are a patient of mine. You can try to go back to the other doctor who had you on the right medication or try to find a different doctor local to you.

  120. Hi Dr Childs
    Finally I have pushed for a specialist appointment with an endocrinologist. I was diagnosed as having fibromyalgia 2 years ago. Ten years ago I contracted ciguatera a neurotoxin from fish. Since then I have been treated with levothyroxine. Over the past 2 years I note that my symptoms for fibro have increased in intensity. I experience chronic fatigue stinging nerve pain depression and anxiety. I also have an irritable bowel and muscle and point pain that moves. Latest thyroid results were v low tsh mid range t4 but t3 was v low actually off the bottom of the range. After reading your post I am beginning to put it together. The thyroid could well be the key. What should I be asking the specialist? Thanks alot Dee New Zealand.

    • Hey Dee,

      If your specialist understands the what I’m talking about then you shouldn’t have to ask them anything, they will just be able to see your results and change your treatment. If they don’t understand it, then it’s generally not worth trying to convince them otherwise – at that point I would seek someone else out.

  121. i am 55 and have been on Synthroid since i was 17. the doctor kept changing my dose as i still wasn’t right.. i was on .75 3 days a week and .88 the other.. i was so anxious couldn’t sleep and have severe IBS…about a yr ago i added liothyronine and dropped syntroid to .50 i’ve gained 17 pounds and just decided to go off of that .. next blood is sept. I’m so frustrated…

    • Hey Mona,

      There’s definitely an element of trial and error when dosing thyroid medication, it’s hard to say what you need without knowing things like your reverse T3 and sex hormone binding globulin.

  122. Hi. My thyroid was removed 20 years ago due to a cancerous nodule. My original endocrinologist gave my 174 mcg synthroid to suppress any thyroid cells left behind ( I also had a radioactive iodine treatment just after surgery). Since loosing insurance a few yes later I haven’t had a bone scan done in 12 or so yrs. she would give me cytomegalovirus when comming off synthroid for a scan then off all for scan. Then when scan was over it was both meds and weaning off the cytomegalovirus over a couple of weeks. While on both I felt NORMAL. Now regular Drs always wanting to drop my dosage. I am currently on 125 mcg levothyroxine. So my question is. What about us who no longer have a thyroid gland at all??? I would love to feel normal again and loose this weight.

  123. I am taking Synthroid and had to have my thyroid taken out. My gallbladder was taken out 23 years ago and I was diagnosed with IBS. I also have chronic pain/fibromyalgia. When ever I exercise with any weights I literally get sick and it takes me about 2 to 3 months to really get over it. I need help. I have looked for a doctor that could prescribe natural thyroid meds for me but there are none within 150 miles of me. I try to eat healthy. I bought a autoimmune cookbook, and gluten free cook books but that is so expensive. I appreciate your advice greatly. Thank you

    • Hey Judy,

      I think diet is a great place to start but remember that diet is just one small piece to the overall puzzle that is your health. For instance my treamtent recommendations have 8-10 steps involved and diet only accounts for 1 of those. Keep on researching and learning!

  124. I have been on levothyroxin for 4 going on 5 years now, I am now at 175mcg tablets. I can never loose weight no matter what I try, in fact I am gaining again. My doctor is only a family physician my insurance will not cover a visit to a specialist of any sort but for 1 visit total.
    I also have kyphosis in my upper and lower spine and sacroiliac joint dysfunction and arthritis in my spine, so exercises are extremely limited to aid me in weight loss… Feeling hopeless as I can’t afford to pay out of pocket for better health treatment of my thyroid when I have the other problems…
    This is what the poor struggle with daily and we get swept under the rug cause we don’t have cash to throw around…

    • Hey Michelle,

      You’re definitely in a tough spot. It is still possible to find decent thyroid care in the insurance model but it’s like finding a needle in a haystack. If you don’t have any other options then I would just keep looking and asking around locally until you find one! Even if you end up having to drive a few hours, it will be worth it.

  125. I have been on levothyroxine for over 15 yrs now..I’m constantly chasten and have gained a ridiculous amount of weight.. I have a p.a. Who refuses to change my mess . I went to an endocrinologist & he pretty much laughed me out of his office.. I am extremely fatigued 24/7 and no one will help me or take my symptoms seriously. Any advice

    • Hey Jenn,

      Yes, the best advice is to find a thyroid specialist that isn’t an endocrinologist or PCP or PA or NP. All of them will treat you the same way and you will only get more frustrated. This usually means looking for doctors that don’t take insurance.

  126. Hi there,

    Nine years ago I had my entire thyroid remove and had a small cancer. It was on the bubble for radiation and I elected not to do it and just monitor with blood work. Since then I’ve gained 100 pounds. I’ve tried everything and can’t lose weight. I’ve read through your posts about not being able to lose weight and so I asked my doctor about T3. She seemed to feel that adding T3 when you’ve had cancer wouldn’t be a good idea. Can you comment? Do I need to look for another doctor?

    • Hey Karen,

      I’m honestly not sure what her thought process was there? It’s felt to be protective to suppress the TSH post thyroidectomy after thyroid cancer because high levels of TSH promote thyroid tissue growth and T3 is the best thyroid medication to suppress the TSH.

  127. Wow! Now I KNOW I need help. Great info.
    My story: Overweight all my life. Naturally low body temp (97.2). Diagnosed w/Grave’s March 2007. Had RAI May 2007. Gained 60 lbs in 3 months. Got on Levo, lost 30… still holding. I am at 250mcg of Levo.
    I have HBP, and Sleep Apnea. Using an APAP now, and BP seems to be down since then.
    BUT!!! I am STILL so danged tired!
    I’m having Roux-En-Y surgery in a few weeks. I plan to talk to my PCP about all this before that though. Maybe she can get me on some T3. If not, then I will be seeing and Endo.
    Any other advice??

    • Hey Kristal,

      If you are on a position where gastric bypass is an option then I can almost guarantee that you have an issue with insulin, leptin AND thyroid conversion. Treating just one of these things is likely not enough to make meaningful change. You can ask about the T3 with your PCP but most don’t feel comfortable prescribing the medication.

      My best advice is to find someone who is knowledgable about insulin, leptin and thyroid conversion and get treatment with them PRIOR to the surgery.

  128. I have a under active thyroid for the past 11 years and am taking 100mg of eltroxin daily, I exercise and don’t eat junk food but find it impossible to loose weight and so fed up front it. Please help, thanking you in advance, nicola

  129. There are sooo many struggling with thyroid issues now days … I had a total thyroidectomy at the age of 22… I was 5’11” and 140 pounds… I was amazingly sick within about 30 days after that surgery, for 16yrs because if you take synthyroid and say you don’t feel well, it’s all in your head because synthyroid is considered the “Magic Bullet” I finally found a book thru my sister called living well with hypothyroidism … that book saved my life… I found a doctor who would listen and could tell I was suffering from myxedemia, because I’m a non-converter to the point i was close to death from congestive heart failure, he told me he could not fix what happened to me, but he could make it better which he did, I now take straight T3 (Cytomel)but I still eat very little, because I’m still heavy, and nothing seems to change that, and since then, I’ve had a 2nd thyroidectomy and neck dissection, and a whipple, and I lost my endo doctor (retired) as well, so I have yet to find anyone in the twin cities metro area qualified to deal with all of this… and since my whipple most docs won’t even touch me, they are too afraid

    • Hey Shannon,

      Treatment definitely gets more tricky after a whipple due to the loss of glucagon. I would look into leptin levels though if you haven’t already.

  130. Hi! My name is Melody Haynes, due to thyroid cancer at age 13 I no longer have a thyroid gland. For most of my life I was prescribed levothyroxine, 175 much. Four years ago I i saw a doctor who finally did the reverse t3 testing and found that my body was reversing. I was prescribed 10 mcg Cytomel, split into two daily doses added to the levothyroxine. I have since moved states and am seeing a family physician who just prescribed what I was already taking. I have gained about 20lbs over the last 6 months. I spend 1-2 hours in the gym 5-6 days a week and can’t seem to make any headway. I eat a seemingly healthy diet, comprised mostly of lean protein, veggies and fruit. I am not obese, I weigh in at around 155lbs but for most of my life I weighed in at 135lbs. I live in a mountain town and there aren’t a lot of options for specialist here. What would you recommend for me?

    Thank you for your time and research,
    Melody Haynes

    • Hey Melody,

      Unfortunately if you can’t find someone local you will need to search someone out that you can either travel to or that you can do phone consultations with. You need a complete hormonal evaluation to figure out what is going on.

  131. Hi Dr. Childs,

    I have Hashimoto’s and bought the selenium you recommended. Can you please tell me when this (& the Zinc) should be taken? With levothyroxine in the mornings? After a meal?

    Thanks so much!

      • Great, thank you! And 1 capsule only? Also, is it ok to take with Zinc and does it matter if it’s on an empty stomach or not? Apologies for the many questions – want to get it right from the beginning!

  132. I am taking levothyroxine 50mg and feel like it’s impossible to lose weight. I have no energy. At all! To top it all off I have a desk job. I am so excited to try some of your solutions. I will share this with my sister she has a thyroid problem also. Thank you

  133. I was put on levthyroxine. I was also put on gabapentin for an atypical form of SAPHO syndrome. I gained 30 pounds in 3 months, so I quit levothyroxine. Made me feel so hungry. I know that weight gain can be side effect of gabapentin but need that for the nerve pain. My TSH was 4 when dr. put me on the levothyroxine. Any comment from you would be helpful.

    • Hey Pam,

      Tough to say what’s going on with such limited history. I would recommend evaluating your free thyroid levels and going from there.

  134. Hi Dr. Childs, thank you for the videos, they are definitely helping me get more educated on the life of not having a thyroid. I had a total thyroidectomy in May 2016 due to cancer and was placed on 150mg of Synthroid and began gaining weight. I am very active, cycling about 100 miles a week (high intensity) and strength train. No matter how much I ride or eat clean I cannot loose weight. Last time I trained like this, when I had a thyroid, I had to eat not to loose weight too quick. My Dr. did add Nature thyroid 32.5 mg on my last visit to see if that would help, but it has not. Two months later, just received a call and they said my levels were high so he was lowering my Synthriod to 130mg plus the same 32.5 mg of Nature Thyroid. My Dr. is an Endocrinologist and is open to changes in my medication. Based on your video of changing to a NDT what would you recommend I ask him to change my meds to for a starting point to help with my weight loss?

    Thank you again for all you do to help educate people in this area!!