- Levothyroxine contains only T4, and your body must convert it to the active T3 hormone, but many patients cannot make this conversion efficiently causing weight gain despite medication.
- Adding T3 (liothyronine) as approximately 20% of your total thyroid hormone dose alongside your T4 produces significantly better weight loss than T4-only therapy.
- Check your free T3 and total T3 levels rather than relying on TSH alone to determine if your levothyroxine is actually being converted to the active form your body needs.
- Combining your thyroid medication with proper diet, exercise, and at least 7-8 hours of sleep each night is essential for weight loss since thyroid hormone alone cannot overcome lifestyle factors.
Are you on levothyroxine but still gaining weight?
Believe it or not, this is a big problem for a lot of people.
But how can you be gaining weight on a medication that is supposed to increase your metabolism? Is this even possible?
Absolutely.
The truth is that levothyroxine doesn’t necessarily increase your metabolism and studies show that most people who start it typically don’t lose any weight at all.
Worse than this, some people gain weight when they take it.
Today I’m going to explain why this phenomenon happens and what you can do about it if it has already happened to you.
You Can Take Levothyroxine & Still Not Have Enough T3
The first thing you need to understand about levothyroxine is that it contains a thyroid hormone that is considered inactive.
By itself, it doesn’t do anything except act as a reservoir for T3 and T3 is the most active thyroid hormone in your body.
When doctors prescribe levothyroxine, they are doing so with the intent that your body will be able to activate it so it can be used.
But that doesn’t always happen.
In fact, many thyroid patients are unable to activate T4 into T3 and have what we refer to as a thyroid conversion problem.
And to make matters worse, some people create the anti-thyroid metabolite reverse T3, instead.
Reverse T3 acts to block the binding of T3 at the cellular level.
The more reverse T3 you have, the less functional your thyroid is.
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.
In it, patients were given T4-only medications and treated based on their TSH, very similar to pretty much everyone reading this right now.
The researchers then tested their resting energy expenditure (in other words, their metabolism) both before they added the thyroid hormone and after they suppressed the TSH.
And do you know what they found?
They found that thyroid patients taking thyroid hormone, even with a suppressed TSH, did not see an increase in their metabolism or their body weight.
This would run counter to what you would expect, especially given that thyroid hormone is the major regulator of metabolism in the body.
Either physiologists have been wrong about thyroid hormone for centuries, or, it may have something to do with the type of medication that these patients were given.
In other words, would they have lost weight if they used a thyroid medication that contained T3 instead of T4?
That’s a more interesting question that was answered in this study:
In this study, patients were given either a T4-only medication (like levothyroxine) or a Desiccated Thyroid Extract (like Armour Thyroid) and evaluated over a period of time.
They found that those patients who were taking the desiccated thyroid extract experienced “modest” weight loss to the tune of about 3 pounds compared to the T4-only group.
This may not sound like a lot of weight loss but remember, it happened without any other intervention.
These results support the idea that thyroid hormone regulates metabolism, but that T3 does a much better job than levothyroxine.
But we don’t have to stop here, there’s one more study worth mentioning:
This one compared equivalent doses of both T4 and T3 thyroid medication, based on the TSH, and then evaluated for body weight and cholesterol.
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.
In other words, pound-for-pound, T3 thyroid hormone is far more effective than T4 thyroid medication at managing thyroid function.
And practically speaking, this means that levothyroxine will not have any impact on weight for most people who take it.
This may be news to you, but it isn’t to most doctors. They are just afraid to prescribe T3.
Which is why it’s important to note here that the patients in this study who took T3 did not have any change in their blood pressure, heart rate, or insulin sensitivity which are the common reasons doctors give for not prescribing T3.
These three studies do not prove that levothyroxine will necessarily or automatically cause you to gain weight, but they do shed light on how it’s unlikely to help you lose weight.
When you combine this fact with the real scenario that many thyroid patients are being under-treated and not taking full advantage of lifestyle changes like diet and exercise, it’s easy to see why so many people report weight gain when taking it.
The good news is that you do not have to accept this weight gain because there are things that you can do about it:
Step #1: Check your free T3 and Total T3
The absolute best way to know if levothyroxine is working for you is by evaluating these two lab tests.
The reason it works is simple:
Remember, levothyroxine only contains T4 thyroid hormone, but in order to be used by the body, it must be turned into T3.
So if you are taking levothyroxine and you are not seeing an increase in your free T3 or total T3 afterward, then it is very likely that your body is not activating it.
And we know from the studies that I mentioned before if you are not activating it then it will not have the positive impact that you are looking for on your metabolism.
Unfortunately, many doctors are often unwilling to order these tests, usually because they don’t know how to interpret them, which is where step #2 comes into play:
Step #2: Check your basal body temperature and resting heart rate
You don’t have to do this step if you can get your free T3 and total T3 labs checked, but if you can’t, for whatever reason, or if you just want to get started right away, you can look at these two metrics.
Both your heart rate and body temperature can be used as proxy measurements of global thyroid function.
They aren’t perfect, but they are a down-and-dirty method that can give you an idea as to whether or not your body is activating your levothyroxine.
They work because as T3 increases, so too will your resting heart rate and basal body temperature as these are both correlated with basal metabolic rate.
You will know pretty quickly if levothyroxine is not doing its job because your body temperature will be less than 98.6 degrees and your resetting heart rate will be in the 50s.
Someone who has normal thyroid function and normal T3 levels should see a normal body temperature and a resting heart rate somewhere in the 70s.
Step #3: Create a more comprehensive thyroid hormone routine
As I alluded to previously, it’s actually really to solve this problem and help your levothyroxine do its job.
All you need to do is mimic the thyroid hormone production of the healthy thyroid gland.
This makes a lot of intuitive sense, but, for whatever reason, very few doctors and patients actually do it.
The healthy thyroid gland produces a combination of T4, T3, and T2 thyroid hormones.
But when you take levothyroxine, you are only giving your body one of those three important hormones.
The reality is that you can take all three and doing so helps many thyroid patients get back to feeling 100%.
For most people, it looks like this:
- 80% of your total thyroid dose should be T4 as levothyroxine or some equivalent – Practically speaking, this is usually around 80 to 100 mcg.
- 20 % of your total thyroid hormone dose should be T3 as liothyronine or some equivalent – Practically speaking, this is usually between 5-20 mcg.
- 100 to 200 mcg of T2 thyroid hormone as 3,5 diiodo-l-thyronine – T2 is the only thyroid hormone available over the counter and can be purchased in supplement form.
I’ve already done the research to come up with these ratios and doses and they are based on what the healthy thyroid gland produces and what most thyroid patients feel better on.
Some deviation may be needed, of course, but I would recommend starting here.
Does this mean that levothyroxine never works?
Does Levothyroxine Ever Cause Weight Loss?
Does this mean that levothyroxine never works?
Not at all.
There are definitely some people who get by just fine using only levothyroxine without any other thyroid hormones.
You really won’t find those people around here, though, because as a percentage of the whole, they are relatively small at around 20%.
And they don’t go around looking for advice on how to lose weight on levothyroxine because they don’t have that problem.
But the truth is that levothyroxine is fine for a small minority of people as long as they are able to activate it.
What’s key here is understanding that just because levothyroxine by itself doesn’t work for many thyroid patients, it doesn’t mean that it is a bad medication.
Unfortunately, this is the conclusion that many thyroid patients jump to.
It’s not that levothyroxine is bad; it’s that your body is unable to use it.
But this problem can be solved with the addition of other thyroid hormones.
So don’t make the mistake of thinking that you must use a certain type of thyroid medication to feel better.
After all, levothyroxine is incredibly easy to get and incredibly cheap.
In a perfect world, all thyroid patients would be taking thyroid hormone cream that includes T4, T3, and T2 or Tirosint-Sol with liothyronine and T2, but we don’t live in that world and not everyone has access to these medications.
So in the meantime, don’t be afraid to play around with levothyroxine if that’s what’s available to you.
I have seen many thyroid patients get back to feeling 100% when using it in conjunction with T3 and T2.
By the way, many thyroid patients have never heard about T2.
If that’s you, then I would recommend reading this article next.
It discusses the amazing benefits of this thyroid hormone and how it helps with weight loss.
Scientific References
#1. http://linkis.com/www.ncbi.nlm.nih.gov/0wh6l
#2. http://www.ncbi.nlm.nih.gov/pubmed/23539727
#3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205882/
#4. https://www.ncbi.nlm.nih.gov/pubmed/8903695
#5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292454/
#6. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072785/
#7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3219766/
#8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737508/
#9. https://www.ncbi.nlm.nih.gov/pubmed/8834378
#10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2277319/
#11. https://www.ncbi.nlm.nih.gov/pubmed/20883174
#12. https://www.ncbi.nlm.nih.gov/pubmed/20823774
#13. https://www.ncbi.nlm.nih.gov/pubmed/3630857
#14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520819/
#15. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3978663/
#16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056127/
#17. http://www.ncbi.nlm.nih.gov/pubmed/21077724
#18. http://www.ncbi.nlm.nih.gov/pubmed/25555216
#19. http://www.ncbi.nlm.nih.gov/pubmed/19190113
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.
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
Hey Lisa,
You may want to consider finding a new doctor who is more willing to work with you!
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.
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.
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.
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!
Hey Darren,
I would check out this post here for help on how to lose weight: https://www.restartmed.com/lose-weight-hashimotos/
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).
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!
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.
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.
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.
Hey Theresa,
I would check out this post here for more info: https://www.restartmed.com/hypothyroidism-insulin-resistance/
With insulin resistance (which is type II diabetes) it will be impossible to lose weight. It does sound like your thyroid is also not functioning optimally, but insulin is another huge problem you will need to reverse to start losing weight.
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.
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
Hey Angie,
You are welcome! I hope it helps!
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! 🙂
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.
Hey Laurie,
I would recommend you check out this post here: https://www.restartmed.com/hypothyroidism-insulin-resistance/
You may benefit from changing your medication and you absolutely need to address your insulin resistance.
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 Carol,
You may want to refer to this article: https://www.restartmed.com/biggest-loser-study/
In short you are damaging your metabolism and thyroid function by eating so few calories per day. Once you start eating normal amounts of food, you will start to gain all the weight back that you’ve lost.
A better way to lose weight can be found here: https://www.restartmed.com/lose-weight-hashimotos/
What about a resting heart rate at 72, is that in range? Will start checking the temps too.
Hey Mary,
You need more data than just your resting heart rate, it’s just one piece of the puzzle.
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!
Hey Louise,
You can ask your doctor to check the levels for you but most doctors don’t know how to interpret them so it likely won’t be of much help. You may need to find someone else who is more willing to work with you.
That’s what I thought! Thank you
You’re welcome!
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.
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.
Hey Emily,
I have an article for patients in your exact situation: https://www.restartmed.com/weight-loss-thyroidectomy/
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.
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.
Hey Carol,
I’ve written about the best supplements for hashimoto’s here: https://www.restartmed.com/best-supplements-hashimotos/
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.
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.
I’m also diabetic so how do I check my insulin (I check my blood glucose every am)
It’s a serum test so your doctor will have to order it for you. It’s possible to test it at home but not necessary to do so.
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.
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.
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.
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!”
Thanks for your insight, Rebecca!
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.
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.
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.
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.
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
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.
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.
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!!
Hey Sarah,
You are welcome!
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.
What do u mean by ndt?
Natural dessicated thyroid.
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.
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.
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.
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.
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.
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.
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.
Hey Jennifer,
There is definitely still hope, you just need to find someone to help you through it. The metformin generally doesn’t work that well and it sounds like you need to be on T3 medication.
Does synthroid not contain t3?
Synthroid is a T4 only medication.
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.
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.
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.
How do i get a consultation with you?
Hey Liz,
I’m not seeing patients right now but I will send out an email if that ever changes!
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
Hey Tiffany,
There are still many other thyroid medications that you can try aside from synthroid.
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.
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…..no 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.