- 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
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.
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.
I’m on Armour Thyroid 15mg 6xxx
Is there problems with this drug..
Hey Lisa,
It depends on your body and your dose. Generally, no, but some people do better on other medications.
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.
Hey Kari,
Probably progesterone and/or HCG.
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.
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.
Thanks
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.
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.
Hey Yelena,
I’ve never used it so I can’t say.
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.
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.
Dr Childs-is there a doctor in wichita kansas you would recommend?
Hey Tina,
Sorry, I don’t know anyone in that area.
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.
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.
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.
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.
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
Hey Barbara,
Adrenal supplements might help with energy but they will not help with weight loss.
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.
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.
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.
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.
Hey Besty,
It may be unless you find someone who is willing to treat you correctly.
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.
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.
Hey Jayne,
Thanks for the comment and your insight, unfortunately your story is all too common.
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.
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.
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.
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.
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.
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.
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.
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.
Hey Carey,
You can find more info in this article here: https://www.restartmed.com/weight-loss-thyroidectomy/
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!
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.
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.
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.
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.
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
Hey Nicola,
You can find more info on how to lose weight here: https://www.youtube.com/watch?v=vCkaYL-Uvjc
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.
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.
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!
Hey Francisca,
Away from levothyroxine, typically split dose between morning and night.
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!
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
Hey Nancy,
No problem and good luck! Please keep me updated on your progress.
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.
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!!
Hey Channing,
You are welcome. In terms of starting doses you will need to figure out what works for you. In general you will most likely feel better on NDT only versus NDT + T4, but getting him to switch you completely may be difficult. You would probably do better on T4 + T3 instead of NDT + T4, doses will vary based off of your body, etc.
Hi dr Westin Childs I’ve read your article with interest. I’ve been on 175mg levothyroxin for two years now & despite countless trips to the doctors I feel awful, my weight keeps going up & up despite eating less than I ever have, I’m tired all the time & my mood is very low. My skin is very sensitive & dry & I don’t feel like I’m living just exsisting. Living in England it’s a one treatment fits all so it’s very hard to get anywhere any help you could give would be great thanks
Hey Jennifer,
There’s only so much you can do without the addition to thyroid hormone if your body needs it. You can try changing things within your control like diet, exercise, stress reduction, etc.
I’m wondering what you think about only taking T3 (cytomel) and no t4 .
Hey Shannon,
I use it frequently in my office, you can find more info in these articles:
– https://www.restartmed.com/cytomel-weight-loss/
– https://www.restartmed.com/cytomel-side-effects/
Dr. Childs,
I am currently on WP Thyroid 1.75mg. A month ago my Dr. increased from 97.5 to this amount. I have continued to gain weight anywhere from 5 to 10 lbs a month. I have been diagnosed with Hashimoto’s as well. I do not know where to turn. My diet is clean, I work interval training 3 days a week and am taking the supplements you discuss in the podcast. Any advice is appreciated!!
Thank you,
CB
Hey CB,
You need to make sure that you have addressed any underlying hormone imbalances – specifically insulin and leptin levels.
Hi
I am taking 150mcg of thyroxine daily and have put on 6 stone over the last 2 years. I eventually found a doctor willing to test my T3 and even though my results show I should be on T3 or cytomol, he will not prescribe it. What was the point of the test?
My T4 was high, TSH midway but my free T3 was 3 and the norm is 3-6. As it fell “within range” he said he wouldn’t prescribe and told me to go on a diet! I have a bag of crisps and a bar of chocolate once a month.. FFS!!
I eat no processed foods, all fresh and healthy and nothing out of tins or jars, fruit, chia seeds, I take Selenium, Zinc, Copper, Adrenal support and I exercise my dog daily along with renovating my property!
My skin is itchy and my nails are brittle. I also took my basal temperature for 2 weeks along with my resting heart rate but my doctor barely looked at that. All he was interested in was my blood tests… I did manage to get him to refer me to an endocrinologist but he told me he would say the same… We shall see!!!
Hey Debbie,
That is kind of the cruel joke about thyroid lab tests. It doesn’t matter how much YOU know or what tests YOU ask for, all that matters is how your doctor will treat you. That’s why I generally say that getting the right tests is only 5% of the problem, the other 95% is the treatment. Your endocrinologist will say the exact same thing as your PCP, I can almost guarantee it because they are all trained the same way.
The best thing you can do is seek someone out who will really look at your tests and treat you differently.
HI- I JUST FOUND OUT I AM HYPO . i AM TAKING LEVOTHYROXINE AND I FEEL LIKE I’M LOSING WEIGHT,is THIS POSSIBLE ?EVERYTHING THAT I’M READING IS THAT IT MAKES YOU GAIN WEIGHT. IT’S ONLY A WEEK INTO TAKING THE MEDICATION BUT I FEELING GREAT!
Hey Heather,
Yes, some patients do very well on Levothyroxine and in fact can lose weight. If you fall into this category then stay on the medication 🙂 There is no reason to change if it works well for you.
Hi Dr. Childs,
I am a 63year old male living in Canada, who has taken Levothyroxine for the past 15 years. I never really had any symptoms before the Dr. said I needed to start this routine ( based on blood work) and I have never felt any different after taking it, other than my weight stays at least 35 lbs more than it should be, no matter what I do. am a Vegan if that makes any difference, ) I don’t take any other meds, and have no other health issues, and if I could,I would rather not take any meds at all, or if there is a natural herb or other alternative, I would prefer that.
Thank you,
John
Hey John,
Your inability to lose weight is probably not due to the levothyroxine you are taking but some other issue like insulin resistance or low testosterone. I would check your fasting insulin levels and free/total testosterone levels.
Hello Dr Westin Childs.
I am on 125 MCG levothyroxine and I have no thyroid gland since 2006 my Dr refuses to give me T3 because if this and saids I don’t need but only T4. Every year I gain a little weight from 2006 at 170 lbs and tall, to now 2016 at 291 lbs. I’m fatigue 24/7 no energy, want to do a lot but my body won’t bulg with my brain. And its extremely depressing. My home looks like a tornato hit it. And I used to keep a very clean home. And now I have growths or cyst on my adrenal glands. No money to take care of it. Any suggestions with my extremely fatuge thank you so much for helping people like me . Rebecca
Hey Rebecca,
There are some things you can try but ultimately it sounds like the best thing for you is to find a doctor willing to work with you. Generally speaking supplements and other changes have a small impact on symptoms like fatigue.
Hello Dr. Childs. Thank You for publishing this article. I found it very helpful and informative. I now understand what could be the cause of my unexpected weight gain. I have been on Levothyroxine 75mcg for over a year, and while lab results look within range, I am unable to lose any weight. My Dr cannot figure it out either so he suggested I see a nutritionist. Out of frustration, I decided to STOP taking Levo and decided to try Thyrostim, from Biotics Research. I actually started today, so I am curious about the reaction. let’s see. Also, FYI, I am diagnosed with sub-clinical Hypothyroidism. I do not have any of the common effects, except weight gain. Next.. I am going to try the basal temperature. I will let you know. Thanks Dr. God Bless You!!
Hey Carlos,
No problem and I hope it helps! Keep us updated on your body temp.
Dr, Childs.
I recorded my basal temperature for 7 days: 96.9, 96.8, 97.1, 97.5, 97.3, 97.1, 96.6. all fall below 97.8!
I began to take a Thyroid Supplement-Thyrostim, from Biotics Research. I am also taking Selenium and Zinc as you suggested, including the adrenal support supplement; and continued to take Levo!! I really want to stop taking it but am afraid 🙁
I also began a temporary elimination diet…I stopped eating dairy, eggs, butter and meat, grains and gluten. I added juicing (green) to my diet. So far..I dropped 3 pounds! this is progress…
as always, I appreciate your feedback and suggestions.. God Bless!!
Hey Carlos,
Great job! Keep us updated on your progress.
Hi Dr. Westin.
I am a 55-year-old woman. And my big problem started right after my hysterectomy two years ago. All of a sudden my feet especially my toes are constantly cold and numb. I never had the symptom before the surgery. They put me on a HRT which made me feel very odd, not myself. I went to a naturopath who tested my thyroid hormones. T3 was low and my T4. She started me on NDT and then added 25 mcg of Cyromel. And put me on HRT with progesterone from a compounding pharmacy.
That definitely helped my sense of well-being. But my feet are still constantly cold and numb. I don’t have circulation issues according to the doctors. But it seems like it was cause and effect from the surgery. I’m very frustrated. I’m working with a Doctor Who is somewhat open to trading thyroid issues. I am currently on one grain of NDT and 25 MCG of Cytomel. But my test just came back I’m still low on T3 and T4.
I asked I am getting my progesterone and estrogen levels checked this week. I am wondering if I may be low in progesterone as I am getting thinning hair and cystic acne. I wonder if I should ask to have my reverse T3 checked too? I can put up with being lethargic and needing a nap every day but the cold feet is just so frustrating! Even when it’s 70° out I still have to wear toe warmers in my tennis shoes.Its debilitating. Any help you could offer would be much appreciated. Thank you!
Hey Laurie,
I’ve mentioned this before here but it’s worth mentioning again, it’s less about the tests you order and more about the doctor who is interpreting them and managing treatment. Even if you get your doctor to order the tests you mentioned above most have no idea how to replace hormones so it’s largely irrelevant.
I would check all of the things you mentioned above and seek out treatment for them if they come back abnormal.