- 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 was diagnosed as being hypothyroid 5 months ago. It sends as though my levels have slowly moved back to where they should be, however I’m feeling even more tired more irritable am struggling to sleep and have put on 4kg in the last 4 months. I eat 1200 calories a day..and I monitor this. I asked the GP to refer me to a specialist as it is obviously now working for me and i was refused. Do you have any suggestions for what kind of specialist i need to see? Thanks
Hey Sharee,
I would recommend you find someone who specializes in thyroid, insulin and leptin levels.
I am an ER RN, for the last 30 years. I still look like I’m in my 30s although I’ve been blessed with 54 years of living. I was dx with Hashimoto’s at 40 years old. I went through the crazy system we call “health care” and luckily ended up with enough persistence, personal knowledge and progressive allopathic doctors to initially be placed on NDT and did not have 80% of the symptoms I recognize in other patients. I was also fortunate to find online support with some of the progressive doctors and advocates that are not part of the “all in your head” or “that this and call me in the morning” practice. Since 2002, when I was dx, my eyes have opened and then my jaw has dropped on how many patients out there are given “blow off care” and consideration with their symptoms. It’s doctors like you that truly have honored the title of “doctor” “via Old French from Latin doctor ‘teacher’ (from docere ‘teach’)”. I have become my own researcher and student seeking “masters” as if I was a perpetual apprentice of this art of healing. I appreciate all this information and wish there were more out there like you. You are correct it isn’t so much about getting them to do the right tests but receiving the correct treatment. I am now in menopause and have gained 40 pounds in the last 4 years. With your assistance it has dumbified some of the vague knowledge out there enough to go back to basics. The temperature, the diet and the leptin levels and insulin resistance. As an ER nurse, I realized that 12 hr night shifts were a detriment to my functional health and life. This is when I started the weight gain. I couldn’t support my adrenals on the crazy schedule my own kind “nurses” would create of one 12 hr shift on and off one 12 hr shift off etc. I’ve seen “medical” personnel forget or ignore the basics to how our body maintain’s it’s health. Over the years, I have passed on the information to my patients like a covert health ops agent. lol. I have also taught that everyone’s combination is different to unlock their best health. Never let anyone doctor, nurse, lawyer or indian chief convince you it’s about “a pill” or a “surgery”. So after this long comment, I am appreciative of your methods of communicating, educating and sharing all your info for the wealth of health it brings others. I have one question. When in menopause what changes do we look out for with hasimoto’s in order to weather these changes in better balance and health. Are there any articles that may help me understand how to readjust with or after the “change” to further promote optimal health and balance? Any direction would help. Thanks!
Hey Cindi,
Thanks for the comment!
The biggest changes that occur in menopause is obviously the huge and almost complete decline of progesterone and the relative decline in estrogen (usually less than estrogen). In addition to these 2 hormones, women also have a decline in androgens including DHEA and testosterone. In my opinion the replacement of these hormones is what leads to optimal and lasting health – if you are looking to take a natural approach, then you would need to boost adrenal function (reduce fat content) and try to balance estrogen metabolism.
If you prefer to take bioidenticals (or both) then you can simply take these 3 hormones in safe and small doses.
Dr. Child’s
Will this work if my throid was removed? It was removed because it was pressing and closing my wind pipe.
Thank you.
I had thyroid cancer and a complete tyhroidectomy in 2007. I am on a daily dose of Synthroid. Does any of the above written material effect me?
Hi Jill,
Yes, this information is still relevant whether you have a thyroid or not.
Two years ago I had a complete thyroidectomy due to repeat thyroid nodules. I’m currently taking 153 mcg of levothyroxin. I also take selenium and calmag zinc. I was losing weight extremely slowly. All of a sudden I gained it all back, plus some. Help!
Hi Tara,
I would check out this article for more help on weight loss: https://www.restartmed.com/lose-weight-hypothyroidism/
Thank you for a very informative article. I had thyroidectomy three weeks ago. I was on 50mcg of levothyroxin for a week, now 100mcg. If I choose to help myself convert T4 to T3 by supplementing with Selenium, should I take it at the same time as levothyroxin? Also, is it better to take the hormone in the morning, or at night? I read somewhere that it might be a good idea to take it at night for better absorption and no other drug interface. Thank you.
Hi Monika,
Yes you can take it at night for better absorption, I’ve written about other tips and tricks to taking thyroid medication here: https://www.restartmed.com/take-levothyroxine/
I was in car accident tore thyroid had half removed.Surgeon said no problem other half would do all work. Gained 25 lbs went to general MD put on levolthyroxine 0.05mg. Felt brain fog slept a lot no energy. Cut dose in half feel better but soon will stop this all together. See no change. Started a job where going for 8 hours straight walk 7 to 10 miles a night have not lost one pound. Just wrong. Feel better taking half medicine but think should just stop. Metabolism not working when you change life that much and exercise and no results. Help
Hi Connie,
I find that most people who undergo a partial thyroidectomy still benefit or need at least some thyroid hormone. This may be the issue you are experiencing as it relates to weight loss resistance.
I have had awful hypo symptoms for years, but bloodwork always looked good. After I had my daughter, in 2011, symptoms increased, and I started losing my hair. My doctor said my TSH was elevated, so he put me on Synthroid. I had an awful time with that — felt very depressed, crying all day, and felt “weird” – can’t really explain it. I stopped taking it, and within a week, those symptoms disappeared. I was diagnosed with Hashimoto’s 1 1/2 years ago with all blood work looking well, except antibodies were 538. PCP refused to treat, said antibodies shouldn’t cause any symptoms. I attempted to try different diets to help decrease antibodies and symptoms. I was able to lose some weight, but my calorie intake was super low, and the weight always came back on. I did an elimination diet too, but when I added gluten and dairy back in, I saw no change. I found another doctor who tried me on NP Thyroid. My hair lose stopped and new hair was growing in, and I had a few break through periods of energy, but again, I had awful additional side effects show up. I was having trouble getting into a deep sleep, I would completely forget my thought/words, and I began having bad knee pain. The doctor told me to stop the medication, and about a week later, the symptoms stopped, but I gained 2 pounds since stopping, and my hair has been coming out in handfuls. The doctor agreed to test my RT3, which was 16, and my ratio was 1.8. He put me on Cytomel. I have gained 3 pounds in two weeks, and my hair loss has not stopped or gotten any better. It might be good to add that my cortisol is through the roof — my saliva test showed that it was high for each of the four samples I gave throughout the day. I am about to give up and just live with this .. I don’t know what else to try, but the Cytomel is doing nothing but making me fatter!!! The NDT and Synthroid produced so many negative side effects, that I don’t think I can ever take them. I am probably Leptin resistance, but my doctor didn’t seem interested in testing for that. I just don’t know what to do anymore. Any suggestions would be appreciated!!!
Hey CS,
The best thing you can do is find a Doctor who is willing to work with you and who focuses on hormone imbalances.
I was on Westhyroid for many years. When they quit making Westhyroid my Dr put me on Synthyroid. I immediately started to gain weight. Still on Synthyroid and does not seem to be working.
Hi Jodi,
You might find better luck with either tirosint (T4 only) or WP Thyroid (another NDT medication).
You can read more here: https://www.restartmed.com/tirosint/
I’ve had a low body temperature, low blood pressure, high resting pulse rate, and cold limbs my entire life. TSH has always been slightly elevated, usually in the mild subclinal range, but never enough for a doctor to put me on medicine. I do have several large nodules (2cm+) that nobody seemed concerned about either, so I found a new endocrinologist who is monitoring them every three months and has started me on Levothyroxine. My TSH has been sitting right around 2.8 for the last few months. However, I still have the same symptoms listed above, and I’ve gone from 150, which was already rather high for me, to 180 pounds, or an size eight to a fourteen. I am a health conscious vegan and have been for the last fifteen years, so I know it isn’t my diet that is making me fat. I know I may need more levothyroxine to get my TSH down further, but before it dips too low, I would like to see if T3 would help, but my endocrinologist says it is in range and would be concerned with what might happen if we start down that path. What would happen if we were to put some T3 into my regime before recalibrating my Levo dosage?
Hey Miranda,
I wouldn’t recommend self dosing or adding medication without guidance of a physician.
Hi dr. Childs, I was recently diagnosed with hashimotos and was put on levothyroxine by my endocrinologist. Before seeing him I was struggling with weight gain (about thirty lbs) heartburn, hair loss, fatigue, and emotional imbalance. No doctor seemed to be able to figure out what was wrong with me until I went to this doctor. He diagnosed me and then promptly put me on levothyroxine. Well not only have my symptoms stayed the same but I’ve actually gained MORE weight!! Yet I just saw my endocrinologist a few days ago and he said that my levels were definitely almost in the normal range and just put me on a higher dose of the thyroid meds. He seemed confused as to why I hadn’t lost weight like ‘most’ of his patients had. I asked him to check my estrogen and cortisol levels because I’ve been on birth control for about ten years now ( the same one) and I’ve heard/ read that estrogen dominance can cause hashimotos or trigger it. I have no idea if this is true since you never know when reading things on the Internet. He reluctantly gave me the lab work and I’m going to get it done soon. I have thought long and hard about going to see a naturapath doctor to see if they can help me more than this doctor obviously seems to be able to. Can you give me any suggestions? Thanks, Olivia
Hey Olivia,
The best thing you can do is find someone knowledgable about hormones. You are right to be apprehensive about testing for other hormones to see if they are contributing. I can almost guarantee you have both estrogen issues and cortisol issues without even checking your labs, but I can also tell you that those problems are most likely secondary to other issues. Which means treating them most likely will not result in significant improvement – and that’s why it’s best to find someone to help guide you. Good luck!
Thank you! Is there a difference between a naturapath doctor and a functional doctor as I see you have suggested to many people? Not sure of what kind of doctor to choose. Also, I live in Athens, GA. Do you know of anyone in this area that would be good to go to? You seem extremely knowledgeable about this and I would almost pay to fly from here to Arizona just to see you!
Sorry I don’t know anyone in that area. You can find more info about working with me on my 1-on-1 page.
Well thanks for the info! Do you think this doctor might have the right approach for me?
Hi Dr. Westin Childs,
I live in Ottawa, Canada and like many, I have struggled with Hypothyroid Symptoms, probably now for about 18years.(I just recently, found out that I have hashimoto after I demanded the doctor to run the various tests on the thyroid panels). I am working with a naturopath, put I feel like I am not getting the proper solutions to my problems. I am finally on ERFA NDT for the past 6 weeks and haven’t noticed much difference. You have mentioned a functional doctor – do you know of any functional doctors in Ottawa or close to Ottawa. Thanks.
Hey Vinee,
Sorry I don’t know anyone in that area.
Before all this started, I had lost down with weight watchers and walking 2 miles 5 days a week to 160. Then all of a sudden my nodules on my thyroid started growing and I gained 30 lbs back. My dr recommended surgery and my thyroid was removed. I’ve been on Synthroid since June, 2016. No luck losing the weight. I’ve been doing paleo/gluten free and tai chi, also resumed walking. Still no luck. After a lot of research on my part, I’m being switched to a natural thyroid hormone. So I’m hopeful. Thank you for putting out this information!
Hey Terry,
You are welcome!
For most people switching medications is an important step but usually not the only thing necessary to help with weight loss.
I’ve taken this medication for years now and I am 26yrs old. I still suffer from fatigue, brain fog and painful/dull aching joints. I eat very healthy due to a pancreatic attack a few years ago. I will try this and see if there is any improvement. Do u recommend to stop taking the medication if I plan on trying this new method?
Hey Ash,
No I would not recommend that you stop taking the medication without the guidance of a physician.
Hi, My daughter is 17. She was diagnosed with Hoshimotos at age 14. Since she was diagnosed and put on Synthroid 88mg now 100mg, she has gone from 109 to 149 in a little over 2 years. She exercises approximately 45 during the week a day. She drinks nothing but water, She does not like greasy foods or cheese. We are at a loss when the doctors tell us her levels are normal. We feel like as soon as she started the Synthroid she grew and gained weight. On her growth chart she was around the 25% then she started her meds and now she is 89%. Being a teenager that is trying everything she can think of, including cutting out gluten it is so frustrating. Thank you for your articles. I want to take her off of Synthroid waiting to hear back from her doctor.
No problem, Jen. Good luck!
Hi Dr. Childs,
I’m 52 and have been on 75 mcg ofLevothyroxine and 5 mcg Liothyronine for several years. My most recent thyroid labs are all in the “normal range” (Total T3 114; TSH 1; Free T3 3.1; Free T4 1.7 Thyroglobulin Antibodies <20). I understand from your web site, these aren't all the labs needed, but its what I have for now. Just over a year ago I was put on 25 mcg Atenolol for high blood pressure and also at that time I began having severe anxiety and panic attacks. I was on effexor but have recently weaned myself off of it. I have gained about 10 to 15 pounds over the past few years and cannot lose it counting calories. For the most part I eat healthy and avoid known sensitivities like dairy and gluten. I probably consume 1500-1800 calories per day, I am active and work out regularly. I have numerous traditional hypo. symptoms recurring and know that something is off. I have begun your 10 day reset program and will likely start the 60 day program as well. I was being treated by my general practitioner for thyroid issues and cannot get an appointment with an endocrinologist until December. Do you think I am taking too much Levothyroxine and way too little Liothyronine? Do you think 1500 calories per day is restrictive at my age? Thank you for all your information, I'm hopeful this is the beginning of the end!
Best,
Shawna Reynolds
Hey Shawna,
The 10 day and 60 day programs are completely different, but the 10 day is a great starting place. There’s no way to tell if you are on enough medication, the factors involved are more complex than just looking at lab work and why most providers miss the mark when it comes to medication and dosing.
I started out on the levothyroxine and I felt absolutely horrible for 2 years.finally my endocrinologist put me on Cytomel and it made a world of difference in my energy level so he decided to go ahead and put me on Armour Thyroid. once I got on the Armour Thyroid I felt fantastic, but still had a lot of problems losing weight 2 months ago I started a diet through a clinic. i dropped 20 pounds in a matter of 3 weeks I feel fantastic I continue to drop weight.
Hey Sharon,
Awesome! Thanks for sharing your story.
Hi, I’m a 34 yr old female. I was diagnosed with hypothyroid Oct 2015. I was prescribed .50mcg of Levothyroxine and experienced rapid weight lose within 2 months and then it all came back. I asked my doctor to adjust the dosage and add Cytomel.
I’ve been taking .25mcg of Levothyroxine and 10mcg of Cytomel. I’ve been putting on one pound per month and from the date I was diagnosed I’ve now put on 22lbs. I’ve dieted, worked out vigorously and nothing works.
Do I need to stop taking Levothyroxine? Increase my Cytomel? Increase both I’m at the point that I want to stop taking all these meds and just try supplements.
My latest labs:
Tsh: 1.24
T3: 143
Free t4: 0.77
T3 Free: 3.10
Reverse t3: doc won’t order this lab test
Weight 139
I’m desperate to lost this weight. Any advice would be very appreciated.
Hey Sabeen,
I can’t provide specific medical advice to you unless you are a patient of mine. Unfortunately you will have to take these questions to your current doctor. You can also find some info here: https://www.youtube.com/watch?v=6x9hhnBr0mc
Hi
My latest blood tests show I’m optimal , I’m on levothyroxine 75mg and 50mg alternate days. I have 40lbs to lose. Being overweight is ruining my Life!
Shall I increase my dose o for levo to 100mg per day?
Thanks
Hey Susan,
I wouldn’t recommend increasing your dose without physician supervision, in addition increasing your dose by 25mcg is not likely to help with weight loss at all.
Can my family doctor do this for me? I have been to 2 different endocrinologist and neither will run a full thyroid panel for me? My family doctor listens to me much more than my endocrinologist. But, I’m not sure how familiar my family doctor is with hypothyroidism after RAI.
Hey Susan,
Any Doctor can do this for you, but as I’ve mentioned previously ordering the tests doesn’t mean anything if your Doctor doesn’t know how to interpret them correctly.
Hi,
I am a 36 year old female. I just started taking Levothyroxine 25mg 3 days ago for an under active thyroid. I also have anemia. I was extremely exhausted and was eating a lot before meds but the strange thing was is that my weight didn’t go up. Since I started the Levothyroxine and iron 3 days ago, I have gained 1.5 pounds. The 1st day on Levothyroxine, I felt ridiculous energy, I couldn’t sit still but I liked this since I was feeling so tired and unmotivated before. I also wasn’t as hungry! The 2nd day, pretty much back to normal but with a little bit more energy than before meds. I was hoping to feel the same as the 1st day which I don’t think is a typical reaction? My stomach is now so bloated and crampy. I’m not sure if the weight gain is caused by the thyroid meds or the iron or both! I am stopping the iron to see if that helps but I am very concerned with gaining weight on this medicine. My thyroid was only slightly off the past 2 times they have tested me. I am wondering if I should be taking medicine for thyroid? Maybe my symptoms of exhaustion are from the anemia? Do you have any recommendations on taming both thyroid and anemia problems without weight gain? I am going to speak to my doctor tomorrow. Thank you!
Hey Gina,
Unfortunately I can’t provide you with medical advice unless you are a patient of mine.
My doctor started me out on Levothyroxine recently. I gained even more weight, so he switched me to Synthroid (saying that some people do not have good results with the generic form). I have continued to gain weight.
Before starting the medications, I had a sudden weight gain of 15 pounds in 2 days time. Both my cardiologist and internist detect no evidence of edema.
I have tried to find a functional medicine doctor but cannot find any in our state.
How do I find a doctor in my area, Omaha, that will be able to help?
Hey Joyce,
It’s hit or miss in terms of finding one that is local.
My doctor also started me on Levothyroxine and has switched to me to Synthroid 125 mg. Both medications caused weight gain. I can’t lose weight no matter what I do. I have always been a thin, athletic person but, since thyroid cancer (complete thyroid removal in October 2015) I have gained 45 pounds. After being switched to Synthroid, my energy level increased but, I am still gaining weight. I play volleyball, so I am still active.
I had my parotid gland and three lymphnodes removed soon after, in January 2016, because of a tumour. I have heard of another person who also had their parotid gland removed soon after thyroid cancer. Have you ever heard of a connection between the thyroid and parotid?
Since the surgeries I noticed that I am very sensitive to milk products and some grains.
I am going to try your suggestions to see if this makes a difference and will update my findings.
Hey Sonya,
I would look at this post here for more information regarding weight loss after thyroidectomy: https://www.restartmed.com/weight-loss-thyroidectomy/
Unless you get proper treatment your weight isn’t likely to budge much.
I stopped taking levothyroxin a month ago after taking it for at least seven years. During that time I did a hormone test and was diagnosed with adrenal fatigue. Over fifteen years ago I was diagnosed with an autoimmune disease.
I didn’t feel like levo was helping. I still felt tired a lot while taking it. But I was also using caffeinnated pop daily for energy which was a viscious cycle.
I stopped drinking pop almost four months and and started drinking a green smoothie every morning consisting of kale, spinach, blueberries, protein powder, beet powder, flax seeds, chia seeds, almond butter, almond milk and coconut water.
I was feeling more energy after stopping pop and starting smoothies, but since I’ve stopped the levo, I’m feeling more sleepy and sluggish throughout the day.
I wondered if having taken the levo all these years made my thyroid lazy and now it just needs time to get used to working right again.
My doctor is a traditional one and has only tested my T4 levels. He said he would test again two months after my stopping the levo to see where my levels are.
After reading this article, I learned more about my thyroid than I’ve ever known and will be requesting more extensive testing but most of all I’m going to listen to my body and make sure I do the basics first, good nutrition, enough sleep, some exercise. All of my other blood work is normal except for the autoimmune numbers that show sjogrens but that’s better than lupus like in the past. As for weight gain, the smoothies and eating better and smaller portions and taking care of grandkids two days a week have helped with that. I’ve lost seven pounds in about two months going from 172 and staying at about 164-165. I am 52 years old.
Hey Lisa,
I’m glad you found it helpful and thanks for sharing your journey!
Hi I have been on levethyroxine for 20yrs now. I did try armour thyroid at one point but couldn’t afford it and Dr didn’t run all my labs and switched me back. I am on 190mcg and my weight keeps on increasing. This is very informative and I will look into it as I’m at about 260lbs when I am 100lbs overweight and keep telling my Dr things are not right. Time to look for a new dr. Thank you for this info.
Hey Nicole,
No problem! I hope you find it helpful.
Hi Dr. Westin,
I am looking for some advice. Firstly, apologies for the long story, I am not good with writing short emails.
I was diagnosed at 20 with hypothyroidism. To quote the doctor, it was difficult for them to pick it up in the blood test because the values were so close to the “recommended range” (I can’t remember what they tested for exactly). My symptoms were hair loss and the fact that I was overweight. Note that at this point in my life, I was a severely stressed person who did little to no physical activity and ate poorly. Since then, I have been taking 0.05 mg Eltroxin (believe it is similar to Levothyroxine) per day. I did not notice a significant decrease in weight after using it, but the abnormal hair loss stopped.
In the last 2 years (4 years after the initial diagnosis), I have lost about 20 kgs by changing my lifestyle, i.e. eating habits (I follow a diet very close to the typical banting diet) and exercise (combination of strength, cardio and yoga). I have also learned how to deal with stress in a better way. This weight loss was not triggered by the thyroid medication, although I was still on the medication. I am weighing about 62 kg (136 lbs) and feel as healthy as I think a person could. There has also not been a need yet to increase the Eltroxin daily dosage over the course of 6 years.
Today, I am 26 and worried that the initial diagnosis was too extreme/perhaps not even necessary. I am worried that I will become totally dependent on the medication and that at some point, it could completely inhibit natural thyroid functionality. My mother had thyroid problems as well and I remember reading that it can be passed on.
I asked my doctor how we could do a proper thyroid test and he recommended that I stop taking Eltroxin for 3 weeks before doing a full blood test (incl. antibodies to detect whether it is auto-immune or not). Obviously, this scares me. I would like to hear your take on this. Is this something you would recommend? What can I expect? As I mentioned, my symptoms were minimal. I understand that the half life is typically around 10 days, so would I even notice any recurring symptoms in just 3 weeks?
I am an idealist, and hoping just by following a proper diet/exercise regime and supplementing my thyroid naturally, I will be able to continue without taking the medication again. Unless it is auto-immune, of course.
Thank you for taking the time to read this and respond. Generally I avoid forums like the plague because it is dangerous to compare your story to the others here, but I would really like to hear your opinion.
Hey Violet,
I’ve seen very few cases of patients who were able to control and manage their thyroid without the addition of medication or other factors that they are usually unaware of. You are certainly welcome to try but I wouldn’t continue the lifestyle therapies without further assistance from a physician for very long especially if you continue to feel poorly.
Hi Dr Westin,
Its a nightmare… I have always been healthy, in shape, exercise regularly, teach zumba, eat right, taught others how to lose weight, and generally been within 10 lbs of my goal weight at all times. I was diagnosed with Hashimotos about 1 1/2 years ago after experiencing awful but classic symptoms. I am 45 years old but feel 80. I have joint pain, weight gain, brain fog, and depression. So I was first subscribed Levothyroxine. That did not work… but my TSH numbers got within range. I still felt all the symptoms. So I was switched to Synthroid. It works marginally better… but I still feel joint pain, weight gain, brain fog, and depression. I have been steadily gaining weight despite working out regularly and my nutrition on point. WHAT THE!!!!! I just went over 200lbs! I am almost the same size I was when I had my son 12 year ago! OMG! Seriously!
My doctor says… my Synthroid is right cause my TSH is within range… so he won’t HEAR me! I am not crazy! I am over 200lbs! and my joints hurt! and I am tired!
Anyway, (I am breathing now, lol) I just ordered your recommended supplements. I need to find another doctor asap!
Hopefully, this works. Thanks for the info!
Hey Tam,
No problem and I hope it helps, keep us updated!
I take synthroid and cytomel. I have been tracking my thyroid levels from each test over several years and found that the number didn’t matter so much to why I would gain or lose weight. What really made a difference was exercising and switching to gluten free, dairy free, organic diet. This may not work for everyone but Everyone can adjust their diet and exercise first to see if that helps before just assuming it’s not enough/too little thyroid medication and relying on that to resolve all problems. I did for so many years and kept thinking a perfect tsh level or number would be my answer. My realization was how much nutrition and the right diet for my body played a part in healing my body.
Hey Kristina,
You are absolutely correct that thyroid medication is just a small part of the overall picture, but in many patients it does take more than simply changing up the diet. It’s also very important to get on the right combination of thyroid medication(s) which usually means some form of T3.
Hello Dr Childs.
I have a unique situation. I was diagnosed with thyroid cancer in 2012. I’ve had a total thyroidectomy and went thru radioactive iodine treatment. I am currently cancer free. However last year I was diagnosed with Cushings Disease and had a tumor removed from my pituitary gland in April 2015. After the surgery I was put on 60mg of hydrocortisone and have been working on tapering off. This week is the first week I am not taking it and have bloodwok next week to see where I’m at. I am on 112mg levo because I was having tacacardia issues most likely due to the Cushings and/or the steroids. I can’t get a clear answer from any of my Drs if the steroid has been effecting my levo and thus making hard to lose any weight. I have thought about supplementing with selenium to see if that would help but I’m worried about the warnings about taking it. Is there a safe dosage to take long term and do I also need to take zinc as well?
Hey Krista,
You have a complex case but your hydrocortisone is absolutely contributing to your weight gain/weight loss resistance. You will need to find a physician knowledgeable in hormones to help you further.
I am on the Levothyroxine and everything you are saying is exactly what I’m experiencing:(. Can I stop taking it all together without bad side effects for starters? I know you practice in AZ and we recently moved here…I’m hoping to get connected with you in order to stop this crazy cycle. I’m also wondering if leaky gut is associated with all of this, is there a connection between the 2?
Hey Stephanie,
I wouldn’t recommend that you stop taking thyroid medication without physician supervision as that can be dangerous. Your gastrointestinal tract is involved in thyroid conversion and may play a role, but not usually a very large role as most patients believe.
Hi. I was diagnosed a few years back w/ hypothyroidism. I was on Levothyroxine and then switched to Synthroid. However, I still have had the same symptoms as many here who are struggling w/ the tiredness and brain fog and achy joints and depression and weight gain (even though I have been working out like crazy and limiting my calories). I am also on Welbutrin for depression, which I am not sure how that affects weight. To add to that, I am in full blown menopause and was MISERABLE w/ the hot flashes so my ob/gyn put me on Prempro/hormone replacement therapy. It really has helped me w/ the hot flashes but the symptoms of hypothyroidism are even worse. Like I said, I have been VERY disciplined w/ my diet and exercise and still have gained 17 pounds over the last year and a half. My dr. referred me to an endocrinologist and just today I had my first appt. w/ her. She is switching me to Naturethroid. I really really really hope it helps. I am so discouraged. 🙁 Anyway, just stumbled across this blog on Pinterest and thought I would check it out. Wish me luck. Thanks.
Hey Amy,
Thanks for sharing your story and good luck on naturethroid! As long as your dose is high enough you should be fine.
Yes I am on Leventhroxydyne and haven’t lost weight in 6 years since I’ve been on it. Thank you I’m going to talk to my Dr.
Hey Steph,
No problem and good luck!
Hi, I have recently been gaining weight that I can not loose at all. I have not had a thyroid for 20 years, and have been on synthetic. I have in the past gone thru Thyroid Storms, and wish to never experience that again. I use a Endro for my testing and meds, but all he will ever prescribe is the synthroid or levothroxin. I have asked him many times about trying something else such as the armour, he refuses. However, I am very scared to do anything on my own because I do not wish to go thru the storms again. The panic attacks are unreal. I just need something to give me some energy, I am sluggish all the time always having trouble with bloating and fatigue. Do you recommend adding anything to the levothroxion that I currently take that may help. I take 112mg daily, at this time my family is on the Obama care so going to another dr is out of the question. It is very hard to get referred.
Regards
Nancy
Hey Nancy,
It will probably be very difficult to find a Doctor who takes your insurance who will actually be able to help you, but that is the first step to take.
Thanks for the reply. Can you recommend anything that will help with weight loss? I seem to be starving within 30 min after eating a meal..
Regards,
Nancy
Hey Nancy,
You can check out this post for more info: https://www.restartmed.com/leptin-resistance-thyroid-resistance/
Hi, I have hashimoto. I am currently taking 125mcg Levothyroxin and Tsh levels are good. My T3 free is 2.7 and my T4 free is 1.3. For the life of me I can’t lose a single ounce. I work out at the gym 5 days a week, I eat a hard boiled egg for breakfast, eat spinach and carrots for lunch and fish for dinner. Only drink water and nothing in between. What do I do? I’m 20 and so discouraged.
Hi Tailor,
Your issue may be related to low T3, you can read more about it here: https://www.restartmed.com/low-t3/
Does all this apply if I have no thyroid? I took a radioactive pill 14 yrs ago to disolve it. Depending on how I eat I can lose 9 lbs in 3 days & then gain 7 lbs in the next 3 days.
Yes, the physiology still applies to those without a functioning thyroid.
Dr. Child’s,
Thank you for your article. I have learned a great deal of information. I am 24 years old and have struggled with my weight most of my life. I have hypothyroidism and I currently take 150 mcg of levothyroxin. I have seen an endocrinologist who specializes in the thyroid department. He had me on 35 mcg of levothyroxin and then put me on qsymia (weight loss medication). He told me I would need to take qsymia like it was heart medication because I would be over weight my entire life if I dont. I switched doctors to an family doctor who specializes in endocrinology and as a tested my thyroid every 2 months and did a huge panel she eventually put me on 150 mcg of levothyroxin. I don’t currently see a doctor right now because of an insurance change. I think I remember her talking about my thyroid not making t3, although I don’t remember her saying what we could do about that. I although curious about supplements I could take to help t4 convert the the good t3 and any other advice you could give me. Thank you so much again for your article and your time!
Brandi
No problem, Brandi – I hope it helps.
Dr. Childs,
I have been on synthroid for about ten years and although I have gained some weight, I am not that concerned about that issue. I am more concerned about feeling sluggish and tired. I have also lost almost all of my eyebrows. I have read that this has something to do with thyroid. My doctor has said that my numbers are within the normal range. Should I be asking for other thyroid tests?
Hey Melonie,
It could be due to a number of issues but starting with advanced thyroid lab tests would be a good idea
Hi Dr. Childs,
I have hypothyroidism and take 50mcg levothyroxine,
My bloods are stable and I have been able to lose weight. So I want to ask what are the best diet changes to make for losing even more weight!
Thanks
Hey Atiebah,
That’s great! There are lots of resources on this site regarding diet and such – I would start with those.
Hi Dr Childs, my name is Hele. I’ve been on levothyroxin for over 15 yr. I currently take 2 pills a day of 112 mcg a day. I’ve gained alot of weight over the years. Ue to a large appetite. I’ve switched Dr and I was on 200mcg for yrs. The increased dosage haven’t seemed to help my energy level. Even though I m 64 yrs old I have to push to do everything I want to do. I try exercise which help make me feel some better. I’ve been told my levels are fine up until recently wen the dosage was increased. I’ve only seen enough endocrinologist once.This was when I was first diagnosed. I have mood swings,depression and the rest that goes with it. Now I feel like I am coming unglued at times. I have an 11 yr old granddaughter I’m trying to help raise,which doesn’t help my body seemed to have really gotten bad with fat in so many ways. I have low self esteem which didn’t just start. I have been forgetting alot and really have to style focused in order to get through things. What is your advice?
Hi Helen,
The best and first place to start is with a complete thyroid and hormone profile, from there you can determine what your main issues are and then treat them!
I have no thyroid (it was removed) and I take 600 mcg a day and can’t lose weight, have problems sleeping, very dry skin and drs that just check levels and increase medicine.
Hi Deanna,
It would probably be a good idea to test for reverse T3, you can learn more about this test and why it’s important here: https://www.restartmed.com/reverse-t3/
Hello,
Really enjoying the information in you article. I too have been on levothyroxine for over 20 years. I am constantly battling my weight. I have often complained that even thou I am on the medication I still have the symptoms of hypothyroidism. My doctor insists there is only 1 test and that my levels are normal. I am definitely going to start with my morning temperature.
Hey Beth,
Sounds like a good idea! Keep us updated.
Hi I was put on Thyroxine by my GP despite my blood work been within in the normal range, this was becasue I complained of tirdness and not been able to loose weight despite eating 1000-1400Kcal per day and excerising daily. I took the tablets for 8 months and my dose varied 25-75mg. I became concerned that the tablets were causing damage and stopped taking them over 5 years ago…I am now eating 1000Kcal per day and excerising daily and my wieght has not changed my concern is that these tablets wrecked my metabolism and if they have can i fix it?
More likely the caloric restriction has caused the metabolic damage, but it is definitely present and be very difficult to reverse.
Hello wonderful article. I have recently had my thyroid removed due to a very large goiter on the isthmus. I’m 3 month post op an I do realize it takes time to feel better however how can I convince my doc to add in a t3….currently I’m on 175 levo and he seems content to keep upping it. I feel like a train hit me most days but the weight gain is out of control. I’m frustrated. Any ideas on how to sway him to athe least try would be great thanks.
Hey Samantha,
I hope you found it helpful. It’s often very difficult (almost impossible) to convince a Doctor to treat you a certain way so I usually recommend against that. Unfortunately there isn’t a way to “convince” them to change how they treat because chances are they have been treating this way for years.
I’ve been on 137 mcg of Levothyroxine for 20 yrs. and have done nothing but gain 80 lbs and lost hair and energy
Hi Joyce,
Your issues may be related to a number of issues but I would first look into your dosage: https://www.restartmed.com/levothyroxine-dosage/
Thank you for your very informative and interesting article.
After finally being diagnosed with overt autoimmune thyroiditis I was put on levothyroxine. It took 9 months to get my levels in range but after two years on it I still felt dreadful and had put on 3.5 stone in weight which nothing would shift. I took the law into my own hands and started a gluten free diet and slowly swapped from levothyroxine to ThyroidS (NDT) results were almost immediate and I slowly improved in all areas – better energy, depression banished, psyche integrated again so I felt like the person I had been, heart pains reduced and I lost 3 stone. However several problems remain intractable. My sex drive seems to have gone for good. It remained albeit a bit unreliable for the first year on levothyroxine then it went completely. NDT has not restored it. I also get anxiety and feel completely wiped out in the evening. I do an outdoor physical job full time but it still feels wrong. I also crave sweet things like pineapple juice and sugary coffee. My toe nails and finger nails are horrible the toenails are deformed and very to hard to cut and my fingernails are fragile and the quick lifts up I have to keep them very short indeed. I take vit D3 3000iu daily and a good quality multivitamin (vitabiotics immunace). I have also developed a bakers cyst in my right knee which started on levothyroxine. Any idea why I have these problems and what I could do to alleviate them? I am in UK otherwise I’d be looking to get on your books.
Hey Frances,
NDT can help many patients but it certainly isn’t perfect for everyone. Many patients need more T3 than what is provided by NDT and that may be part of the issue. Another big part may be that your symptoms are caused by some other problem unrelated to your thyroid. You need full testing to determine where they are coming from.
Thanks for getting back to me so rapidly with some food for thought as to my ongoing problems and how their origin might be further investigated. It had not occurred to me that they might be unrelated to the thyroid condition given the huge significance it has had on my life and health over the many decades it went undetected and the massive struggle it has been to get to where I am now. Your suggestions give me something to work with to try and move forward, which I very much appreciate.
Hi Frances,
Glad you found it helpful and I hope it works out for you! Keep us updated 🙂
I was diagnosed with Hypothyroidism 5 years ago and Hashimotos 2 years ago. I started seeing an Endocrinologist last fall after not being able to lose weight when I used to have trouble gaining weight. I have gained 30 pounds since my diagnosis. I am taking Synthroid 75mcg, Liothyronine 5mcg and Low Dose Naltrexone 1.5mg. I am having no luck in losing any weight and am getting really frustrated.
Hey Aimee,
Most likely you will not be able to lose weight with “traditional” weight loss methods, you can poke around my site to look at case studies and examples to see how/why hypothyroid patients can lose weight. The worse thing you can do is try low calorie diets, the HCG diet, Jenny craig, etc. as these will only make your condition worse.
I have no thyroid due to two cancer surgeries. I weighed 150 in 1989 and now 230. I have been on levothyroxine and keep gaining. Please email me some info to take to my endocrinologist. Sometimes I feel like they don’t listen.
Hey Beatrice,
Unfortunately they probably won’t listen, so you may have to look to other specialists to get better care. The current paradigm of treatment includes T4 only medication based only on the TSH despite evidence to show that this approach does not work for every patient (this alone is a huge reason I have so much success in treating patients).
Hello Dr. Westin, I have always suspected that my Levothyroxine is in no way really regulating my thyroid function enough to help me from “not gaining extra weight”. I have been on Levothyroxine – 175 mcg for almost 20 years. For the past 5 years my levels have been consistently going down – after Hysterectomy. Right now I am at 137 mcg.
I am fairly active. Active than most of my family and friends and very careful with my diet. But, no matter what I do or do not do, my weight has been an issue. I am atleast 10-15 lbs overweight. I keep fluctuating between 138 and 146 lbs. My Ideal weight would be 125 – 128 lbs. I am 5’2″ and 45 yrs.
I have tried various training techniques.. but something really needs to change and I believe it is the T3 supplement that might be the key.
My Sugar levels seem to be good. But, I never tested A1C so I do not know. So far I have been high 80s and 90s with glucose during well exam.
Having said that, id there is anyway I can try T3 over the counter. Just in a small dosage to see if that makes a difference before I approach my doc for a regular dosage or combo dosage.
If so which one would you recommend ? Thanks for your time. I would love to get a one-on-one but at this time it is pretty expensive. I would like to start off something on my own, before I think about the consultation.
Thanks
Preethi
Hey Preethi,
Unfortunately there isn’t a way to get T3 over the counter because it is a prescription medication. I would also advise against using it without physician supervision due to the number of side effects that may occur as a result.
I am 66 years old and a thyroidectomy on 11/2013. I still have my parathyroids though. I take 100mcg of Synthroid 6 days/per week as ordered by my endocrinologist. I gain weight very easily and have a hard time losing weight now. In listening to your discussion, I wondered if the information you discuss is the same for having a thyroid and taking meds vs. thyroid removal and taking meds? I also take Losartan for blood pressure and Simvastatin for high cholesterol. My doctor does testing for TSH, Free T3 and Free T4 but not the others you have suggested. My last results: TSH 0.502, Free T4 l.660, Free T3 2.880. I will talk with him about Reverse T3, thyroid antibodies.
Hey Debbie,
Yes the same information applies to those with or without a thyroid.
Dr. Childs, what is your advice if any about switching to T3 only for someone who does not have a thyroid?
Hey Melissa,
It can be done, but I wouldn’t recommend it without physician supervision due to a theoretical lack of thyroid receptors in brain tissue. In general it’s safer to keep some T4 and increase T3 as you titrate down T4 dosage over time.
Thank you so much. It’s so difficult to find any doctor who can comment on treating people with no thyroid. Really appreciate your willingness to interact so freely with those on your site
You are welcome!