- 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
Hey Dr. Childs!
Writing again as my comment seems to have never been recorded…first want to thank you for all the good information!! I have taken thyroid meds for decades, sometimes just T4, & when able to handle it, T3 with. Last several years kept gaining weight & having other low thyroid symptoms, so doc tried different T4s until Tirosint–then–aak!–gained enormous amount quickly! (a common issue I now see with Tirosint, from online searches). Now have kept gaining even on a different T4 (unithroid). And to add to the problem, I found that now I can’t take T3 any longer as it gives me utterly debilitating hypoglycemia! How to get out of this mess, any thoughts? Thank you so much!
I have been losing weight. My doctor said I have an underactive thyroid, hypothyroidism. Gave me levothyroxine 25 mcg tablet. I’m confused with hypo and hyper. Also, I have all those symptoms of the low cortisol levels. But all this is new to me. Please help me understand better. Thank you so much.
Hi Cindy,
This article should help you understand the difference between the two conditions: https://www.restartmed.com/hypothyroidism-vs-hyperthyroidism/
Thank you, doctor, for your post. I have been on Levothyroxine for a while now. My doctor increased the dose to 100mcg and finally I got him to add25mcg of levothyroxine, which I split and take 12.5mcg twice a day. Before Levothyroxine was added to my antibodies were very high. My last blood test showed a decrease in both antibodies since levothyroxine was added.
I have been having this gut feeling for a while now that Levothyroxine is preventing me from weight loss. It also causes symptoms. I know having Hashimotos makes it difficult to lose weight but something tells me that the Levothyroxine isn’t helping either. I would like to try levothyroxine only medication for a while and see how it’ll affect me.
Hi Elizabeth,
Do you mean liothyronine only medication? If so then this article should help: https://www.restartmed.com/liothyronine/
I am on Levo and have gained about 15 lbs in 6 months. Previously I was on WP Thyroid and enjoying a steady weight and mental comfort. Not so much any more. My doctor is doing an organic acid test and gave me the information about reverse T3. She is really working hard at trying to correct this, but I am curious if you would have any suggestions. My pharmacy was unable to obtain WP, so they switched me.
Hi Robbie,
There are other options available such as NP thyroid, Armour thyroid, and Nature-throid which are comparable to WP thyroid.
Hi! TSH reflex free T4 is .08. T3 Free is 4.1. T4 Free is 1.0. A1C Hemoglobin is 5.8. Sex Hormone 97. All done last week. Weight gain on levo-+25lbs. Switched to Armour on 5/1. Titrated to 60 mg a day now (3 tabs a day). Still not feeling as energetic as I used to and no weight loss. I also have psoriasis and psoriatic arthritis so taking methotrexate and Humira, so I have inflammation. What can I do/take? Add T3 to my regimen? Thanks a million! Been using your info to work with my PA.
Hi Barb,
I would take a look at this post which explains why it may not be helping you with weight loss: https://www.restartmed.com/armour-thyroid-weight-loss/
My Dr. who had treated me ten years retired. Never had a problem with my thyroid until the last six months. I went to another Dr. and he changed my medications without doing any test. He changed my Synthroid from 125 mcg to 88 mcg and took me off Cytomel altogether. I was taking 15 mcg daily. He did do blood work about 2 months ago and has continued to keep me on 88 mcg. I have gained about 25 lbs. want to sleep more, no energy. I feel so bad. Please help! What should I do? I never had any problems with my previous Dr. I’m not sure if he is qualified to know exactly what he needs to do. I do have an appointment with an endocrinologist in October.
Hi Jane,
The best thing you can do is find another doctor who is willing to keep you on what was previously working. If you weren’t having any issues on your old dose then there really isn’t a reason to change. An endocrinologist may be a better option for you given your history.
I’ve been on 50MCG of Levothyroxine since April and have still been gaining weight despite my grain free, dairy free, vegan diet. I had poisonous mycotoxin exposure for the past 2 years that led to a whole host of issues (fungal infections, hair loss, memory loss, confusion, brain fog, irritability, weight gain plus heavy metal toxicity), however I moved and treated, and all other symptoms have subsided besides the weight issue. I’ve been seeing an FMD but still can’t get to the bottom of it. WOuld love your help and advice. Thank you!
My doctor prescribed me with Levothyroxine but I’m not sure if I should take it. Doc says my TSH is on the high range however T3 and T4 are still normal. She said I can try Levothyroxine and see if it makes me feel good or I can do nothing and just monitor my TSH level because my symptoms are mild and may not relate to thyroid at all..Now after reading your article I’m hesitated to take the medicine because I dont want to gain weight!On the other hand I do want to be more energetic…Im not sure what to do now..
Hi Hera,
You can also try natural therapies before you start on the medication. These supplements may help with your energy and improve your thyroid: https://www.restartmed.com/natural-thyroid-remedies/
Hi, I had a full hysterectomy a few months ago. I have only one good ovary left. I am on Synthroid .137mg, that was recently increased from .125mg. My estrogen is high, my dr put me on a supplement to decrease, i3c is the supplement. My progesterone is low, so he is putting me on that to increase. I have gained about 30lb since surgery. I have always had a hard time losing weight. I exercise 4-5 times a week and my diet right now is ok. not great though. Do you think I could benefit from changing my Synthroid?
Hi Phyllis,
It’s possible that changing your medication would help but you would want to make that decision based on your lab tests. That would be the first place to start.
Hello,
I was diagnosed with hypothyroidism 3 years ago. I was started off on levothyroxine, don’t remember the exact dose as it has changed over the years. I have since been on 100mcg for the last several months. My weight has been on a steady rise with the inability to lose weight. I stumbled across this post and brought it to my doctor who agreed to switch me to Naturethroid, I have been on it for a month now taking 60mg, but I was wondering if there was a way to know if this conversion between two medicines is equal to the same dose? I have not noticed a real change, except almost daily headaches. I was able to lose about 4 pounds but i think that is due to a very strict no carb diet due to being diagnosed with PCOS recently as well. I guess I am just wanting to know how I can know for sure the right dose of medication for me as my doctor is not familiar with it. I am only 22 and I am over being overweight and feeling bad. Since reading some of your posts I am starting to wonder if the PCOS was a misdiagnosis due to improperly treated thyroid.. Anything you suggest would be helpful! Thanks for your help!
Hi Shari,
There really isn’t a great way to convert between the two medications because they aren’t 100% the same. You can use some basic guidelines to help but these guidelines don’t take into account how different people react to T3 contained within NDT.
Hi I was diagnosed with underactive thyroid approx aged 12…I’m now 40. Ive been on varying doses of Levothyroxine since with my current dose being 175mcg. My dose gets changed every so often, sometimes I’m told it’s too low, sometimes too high. Over the years I’ve also developed fibromyalgia and rheumatoid arthritis. As you can imagine, the weight and fatigue is pure struggle! I have great difficulty trying to lose weight and I can sense when my thyroid level starts playing up as I start putting on more weight quite rapidly and feel extremely tired all the time. I was using orlistat to help with weight loss and it worked for a while but even that’s not working now. I get mixed messages from the drs as well which doesn’t help either. One tells me having too much of a high dose can cause weight gain and another tells me high dose will cause weight loss and they both work in the same surgery! Life is frustrating and my confidence is at rock bottom! Reading this article has made me want to try the supplements and discuss the additional mendication but I to an extent I already know my dr will dismiss the idea…just the way they are! Where should I go, what should I do? Please help
Hi Nadrah,
Your best bet is to find a physician who is more willing to work with you. You can find out how to do that here: https://www.restartmed.com/thyroid-doctor/
Does this information/advice hold true for those without a thyroid? And, can having a thyroidectomy throw you into menopause?
Hi Gwen,
There’s a lot of information in the article but, in general, yes, the information still applies to those who don’t have a thyroid because your body must still convert the medication that you take in order to activate it.
I started with Graves disease and after an extremely difficult few years trying to avoid radioactive iodine (I suffered from extreme anxiety and panic, along with severe bouts with hives and scary allergic reactions to tapazole) I gave in to two doses of radioactive iodine. I now have Hashimoto’s and am being treated with 100mcgs of Levothyroxine. My blood test results vary and she adjusts them accordingly. This has gone on for 20 years. I feel somewhat fortunate that my symptoms are fairly under control but I cannot, could not ever lose weight. I am 61 and am approximately 35 lbs overweight.
Hi Patricia,
I would take a look at this article for more information about how to lose weight: https://www.restartmed.com/lose-weight-hypothyroidism/
I just started Tirosint 7 days ago. I feel worse and have gained 8lbs in 7 days. I am stopping after today and throwing medicine in the trash.
I have no thyroid due to thyroid cancer, will the above info work for me.?.. Been on Levothyroxine for 9 yrs… Dr kept my TSH suppressed so long, that now I have osteoporosis.. ( I refuse to take osteo drugs) High blood pressure, borderline high cholesterol Now Dr is trying to get my TSH back to the normal range because of the osteo. I’m about 25lbs overweight and exercise 5 days a week doing weight training and cardio in mornings and walk in the evening… Can’t lose an ounce … My dr is an endocrinologist and won’t give me anything but T4 only meds because of my cancer, I’m 64 yrs old …
Hi Dee,
Yes, the information still applies to you if you don’t have a thyroid.
My mom has gained a substantial amount of weight on Levothyroxine. Going to take her to her doc to do the complete testing. Thanks for this valuable information.
Hi Evelyn,
No problem and I hope it helps!
My name is Penny.I have Multiple Sclerosis and Fibromyalgia as well now sub-clinical hypothyroidism.
I have been put on levrothyrexine 100mg weekly then 50 mg weekends.It has now crashed again so 1oomg per week and 150mg on weekends and to be retested in eight weeks.
I have had no change still fatigued sore muscles ,constipated and have cold extremities and yep weight is coming back after shifting 30 kg over time.
I
I eat sustainably with lil to n processed foods boring as that maybe am not perfect still enjoy stepping out of the safety zone.
I have just stumbled upon this article and have no faith in my Dr as all she does is look at the TSH levels thats it heard nothing as to my body choosing to convert to t3 or reverse t3 !!
I have made a refferal to my Edoronologist to sort this out and am taking your information with me as TRYING is better than nothing and I want to be better than what I am.
I will also be ordering that supplement recomended.
Any other recomendations?
Hi Penny,
Start with the supplement mentioned and also these lab tests: https://www.restartmed.com/lab-tests-every-thyroid-patient-needs/
It will help give your treatment more direction.
Hello,
I had stage 4 thyroid cancer with node involvement, and my doc will not prescribe much synthroid or Levothyroxine as she feels it will cause cancer to return. It is impossible to get Naturethyroid here…even the functional docs will not prescribe due to cancer surgery. I was diagnosed with fibromyalgia 20 years ago. What do you think?
Hello,
I have been taking 75g of Levothyroxine for 11 years now. I feel like the dose is not correct for me. I work full time and have 3 kids my youngest is 2. I have been trying to lose weight for years. My doctor has me on phentermine to help me lose the weight, it has helped me in the past but I am wondering if both medication work against each other. My doctor say I can take both pills in the morning but, I am wondering if I should move taking levothyroxine at night. After reading some of your blog post I am thinking my body is making to much rT3. I am not sure what i need to do, I just want to feel better.
Hi Tecia,
I would check out this article on phentermine BEFORE you use it: https://www.restartmed.com/phentermine/
If you use it incorrectly it can damage both your thyroid and your metabolism.
I was diagnosed with hypothyroidism a few months ago after drs found a nodule on my thyroid. My T3/T4 levels were normal but TSH was off significantly. I was prescribed 50 mcg of Synthroid. One month later dr said levels were normalizing but suggested we increase the dosage to 75 mcg due to lack of appetite and weight gain. I haven’t seen much of a change with the exception that my weight continues to increase.
I’m 5’2 and typically weigh 105-108. I work out 4-5 days a week for 60-75 minutes. My diet is primarily pescatarian and mostly gluten and dairy free. I keep my sugar intake very low and carbs at a minimum. Since taking the meds I’ve cut almost all carbs and have had no alcohol, yet I’ve gained 13 lbs. Might not sound like a ton, but 13 lbs in less than two months is very concerning to me. I feel bloated and heavy, and despite my efforts nothing changes.
After two months of gaining weight I’m at a loss. My colleagues comment on how little I eat, yet I’m never hungry and when I do eat, I’m full after a few bites. I recently had a colonoscopy and endoscopy done to confirm there are no digestive issues, and all other bloodwork has come back normal.
If my TSH levels are nearing a good point, should I stop taking the Synthroid? I fear if I stay on it I’ll only continue to gain weight.
Hi Kimberly,
Your TSH has improved because of the medication so if you stop it, it will go back to where it was previously. You didn’t leave much info here but it may have been possible that your original TSH was a mistake. If it wasn’t then you may just need a different type of thyroid medication.
Hi Doctor,
I am currently a 40 year female which I was diagnosed with hypothyroidism on October 2018. It all began in my 30’s in which losing weight became a huge issue for me. I basically completed every diet in the sun and nothing (low carbs, paleo, visited diet doctors, diet supplements etc. ) Since October 2018 I have been taking levothyroxine 75mcg daily, and have gained over 30 pounds !!!!!!! HOW IS THIS POSSIBLE. Besides of my nodules( which was the reason why I went to the specialist), I find it hard to believe that a medication that is supposed to help me lose weight, has given me the adverse effect in gaining weight. This is a complete nightmare. I consistently feel bloated, and I’m pretty much holding the weight in my stomach and arms. This is EXTREMELY unlike me. I have always been active in my life and now I do feel I am not that person any more. I am now tremendously ashamed of who I have become. I have been working out at Orange Theory for about 3 months, prior to this I was running 2-3 miles about 3 times a week. I switched to Orange Theory thinking that I needed a better exercise program, but since I started I have pilled on another 15 pounds. Yes muscle weighs more than fat, but I do not think that is my case any more. My endocrinologists consistently wants to be in a study for a diet pill, but my case is NOT over eating. He consistently says its my diet; however, I do not eat a lot. I eat my 3 meals a day and that’s it. I have small portions and I get full very fast. I feel like he is not listening to what I have to say. As a nurse, it is very frustrating that I sense he is not providing the proper care nor seems to be aware of my concerns and insecurities. For the last week or two, I have had edema of my ankles due to the increase of water retention. I drink a sufficient amount of water daily, and I have no other underlying issues to cause such edema. I actually have made the decision of getting a second opinion because I am so frustrated and discouraged at this point . I was doing my own research and came across your website. After reading it, I am convinced that the levothyroxine is definitely not helping at all. I am desperate at this point and willing to do anything. As far as my labs, everything is within normal limits, especially my TSH. All other thyroid panel labs are within normal limits as well. I am a lost of words and this point. Do you thing the NDT medications would work better? Even though my current labs are within normal limits? I was considering your T4/T3 conversion pills just for the extra help. What are your recommendation.
Hello, I found out in the fall of 2007 I had thyroid cancer. I went in for surgery in December 2007 they did a complete thyroid removal. Following surgery I when they radiation iodine. Prior to my learning of the cancer I had slowly been gaining weight and not understanding why. After surgery I was placed on levothyroxine. I now take Tirosint 175mcg daily. At one point my doctor lowered my dose and I explained after being on the lower dose I felt terrible. Low energy etc. also I have complained many times how much hair I keep losing and I keep gaining weight. He agreed to put me on tirosint instead of levothyroxine. But I am still losing my hair gaining weight and my energy is a little better but not great.
I go they periods of having strong cravings for sugary things or salty things. I also experience where I am wired at night and won’t go to bed until midnight or later but have to be up to put kids on the bus and work.
Not sure what to do when I bring it up my doctor kind of gives me the brush off. Any suggestions
I am a 48 year old woman that had my thyroid taken out 2 years ago the Dr. put me on levothyroxin 88mg and I have gained 20 lbs. And the Dr. said it was my age. Before the removal of my thyroid i was the same weight for 16 years so what can be done. I don’t think my Dr. is going to work with me because he thinks it’s my age.
Hi Tamara,
Are you currently menopausal or peri menopausal? If so, that could contribute to your sudden weight gain.
I think so i only have one or two periods a year if that is the case how do i know the difference if it is that or my thyroid pill and what can i do if i am menopause and gaining weight.
Hi Tamara,
It sounds like you are probably perimenopausal. Before you do anything you need to figure out what is wrong and to do that you will need to check all of your sex hormones + thyroid + leptin + insulin.
I have gained weight with levothyroxin. I started taking it a year ago and have gained around 20 pounds. I also take lexapro, does that combination cause weight gain? I am very frustrated! I eat healthy and exercise around 4 days a week. What would be your recommendation? I was going to see a different doctor before the covid-19 outbreak. My current doctor just tells me my levels are normal, but doesn’t listen to the fact that I don’t feel any better. I need your help since I can’t leave my house. Thank you very much!
Hiya,
I don’t actually have an under active thyroid but am boarderline low but my doctor said my blood work shows my body is working hard to keep it at that level.
I have been prescribed 50mg levo however I have gained 11lbs in 8 weeks – I believe mostly due to levo. I am quite active and was even marathon training but couldn’t drop even 1lb. It’s soul destroying.
I currently also take 3 drops of iodine, vitamin D, vitamin B and iron to try and help but nothing is working. I’d be interested to see what other natural remedies you recommend. I am in the U.K. so it’s different here, my next set of bloods are due in July and they do all thyroid function tests.
Hi Madeline,
I just want to clarify here, but if you are taking thyroid medication (levothyroxine) then your doctor does believe you have an under active thyroid because that is the treatment for it.
In terms of natural therapies, you would want to check out these posts:
https://www.restartmed.com/natural-thyroid-remedies/
https://www.restartmed.com/thyroid-supplements/
In 2014, I was diagnosed with auto-immune hypothyroidism. My TSH was 155 mcIU/mL. My doctor was surprised I wasn’t in a coma! I was started on a very high dose of levothyroxine., maybe 300 mcg. My metabolism shot through the roof. I lost about 20 pounds in just a few weeks. I was very jittery. I was very focused and had tons of energy. As my TSH came back to normal range, my dosage came down and my weight came back and then some. I still take 150 mcg daily. My doctor test only my TSH and T4 about every 6 months. Is there something more she should test for?
Hi Ezra,
Yes, you should check the entire thyroid panel: https://www.restartmed.com/normal-thyroid-levels/
Thank you so much for all this free information!!! Im so glad I found this. I take synthroids… had a carcinome palpillaire at 26 yrs old… they removed my thyroid… and now I’m 38 and I feel like it has ruined my life…. I’m so discouraged… I used to be an athlete and now I cant even run 2 mins…. It’s like it ate all my muscles…. anyways I plan on trying some of your steps… I don’t usually listen to these kind of things but you seem legit. Thanks so much.
Yes I have gained. I only eat 1 x a day. Restricted calories
If I take levothyroxine and liothyroxine could the levothyroxine still cause reverse t3?
thinking about dropping that!
thanks
I have been on Levothyroxine for almost 2 years now. I have lost some weight initially when following a specific diet plan, but since I am unable to lose weight and have gained more. I am now at my heaviest weight despite walking 1h a day, working out twice a week, eating less, avoiding gluten, dairy, soy and alcohol. Not sure what to do anymore and what approach to take… Apart from weight loss, my symptoms aren’t really getting better, I am noticing other symptoms I never experienced before and I’ve had 2 GPs tell me ‘it happens to some people’
That’s finally a great article.. I’m on levothyroxine.. so I gained weight when the doctor put me on 50mcg than they put me on 88 I feel better just to.hear that they wanna put me on 50 mcg back for no resson.. and my lab is only telling me those numbers Thyrotropin Sensitive 3.38 mcIU/mL (0.49-4.67) and no doctor explane if the 88mcg fit me.. I like to take natural medicine but I’m vegan and in those armor is pig .. any other suggestions?
Dr. Child’s – I was on 75 mcg Levothyroxin ,my doctor upped it to 100mcg. Yes can’t lose my stomach fat ,have sleepless nights etc. I don’t think my doctor would go for natural supplements. Any advice? Can I just switch on my own ?
Hello,
Very interesting info. Thank you. I’m 43 and borderline Hypo but with mild symptoms such as hair loss, depression, lethargy, mood swings and horrible pms, plantar facitis and tendonitis etc. my endo put me on 25mg of Levothyroxine and just that made a world of difference to my hair, circulation, moods and muscles problems….but I put on weight in one year, 18lbs to be exact. How do I know it was the levo? Because from 18-42 years I weighed exactly 60kg and am a person who could eat anything. I had a flat stomach 4 days after both of my children. I had a freak body and was always thin. Now I have put on weight and though I don’t mind, I exercise and eat well and I notice the weight steadily increases despite my careful self care. I also have a belly paunch which seems to be thyroid related in many people. I’m loathe to stop the meds bc I like my more even and relaxed personality, the thicker hair and muscle repair but if I keep gaining weight, I’ll stop the meds. Thanks to your video, I’ll check my RT3 levels and explore the T3 options. Thanks for educating us.
I am at my wits end with the thyroid problems. My hot flushes got to the point I was even tested for lupus, I have “flashes” that I look like an overdone lobster bright red from chest underarms neck face even my eyes burn, temperature is usually about 97.5, blood pressure is fine, house is at 62 degrees. I am 15+ years past menopause, estrogen level 78 at last testing. I had partial thyroid removal many years ago (benign), my Father and several in his family had thyroid problems. All was OK until about 10 years ago it all went haywire. I take synthroid 88 mg and TSH went from 0.01 to 7.5 in 30 days, Dr refuses to try any other medications says it is “normal range”. I have gained over 30 pounds, been very very diligent no sugar minimal carbs small portions no alcohol, lost nothing. I hide under a hat as my hair has gotten so thin, eyebrows and eyelashes long gone, cannot tolerate sun !! Tired, weary sleep 10 hours at a stretch but still feel all wound up, crabby miserable. Also taking Crestor, zetia, premarin. There is no endocrinology within 4 hours of us. Now what? Thanks.
I used to be a exercise nut…6’2″ 190lbs. Having gone through a divorce 20 years ago, and a full ACL graft…I loss interest in taking care of my physical needs. A couple years later I was dx w/ high prolactin and a benign pituitary tumor tx w/ bromocriptine switched to cabergoline. Add another 12 years, 70 lbs I was dx hyperthyroid…ablated with 20 microci of I131…now on Levo for 3 yrs and another 30+ lbs. This is aggravating…no energy, little hope!!
I had both my tyroid removed in 2015 I am currently on 2.0 levothyroxine daily.. I have went from 190- 260 do my blood work every 3 months eat some what healthy I exceise at least 4 times a week I also work full time job.. I am far from lazy but by the looks of my weight looks different…. The weight just keeps pilling on ..I so tired of it my body hurts more I’m tired of feeling like this … I just want to stop gaining weight what can I do please help
Hi I am drinking Levothyroxine and i am also experiencing weight gain, and not being able to lose it. I talked to my doctor about my weight gain but she is not willing to do anything about it, so out of desperation i drank my medication wrong and I have seen a little improvement. I had to do blood test and it was all wrong, so my doctor increased my medication, I noticed again just drinking the increased mediation that my weight has gone up a little again. I also don`t know what to do? if i drink little medication i see i am losing a little bit of weight. Any advice, i`m in south africa.
I also forgot to mention they had to remove half of my thyroid gland because they found lumps near my thyroid but they weren`t cancerous
Im on Levothyroxine for 40 years and my weight ha gone up and down like a yoyo over the years My perfect weight was 185 where I felt the healthiest ( south beach diet ) Not on that anymore but I am on a 1400+ cal diet and have gained weight .
Doctors say my tsh is normal. I loved ur video explaining the t4 to t3 and the t4 to R-t3 . So I will ask for the two tests that you recommended and hope they will oblige me ( they meaning my dr. ) Ty so much for the valuable info Doctor Ron V
Hi Ron,
Glad you found them helpful!
Omg thankyou I am just an ordinary jo but an avid reader so i (begged my gp) 3x tertroxin and felt amazing lost the 25kg running and loving life until i was sent to an endo who cut me to half t3 and 75mg eutroxsig gained 30kg and feel like crap i kept telling him I cant be converting but he wont have it and told me cause I was on t3 that it has caused my osteoporosis we need you in Australia
Hi Tammy,
Thank you for being an avid reader! And I hope you find the info helpful 🙂
Hypothyroid since birth here, had an active childhood and teenage years growing up on a farm. Went to uni at 18, less activity, too desk job since my mid 20s and I put on over two stone. Now managing to shift it with increased exercise and a keto based diet. It’s working, I am approx 1 and 3/4 stone down with very low TSH and slightly over range T4. Ive only ever been tested for TSH/T4 to my knowledge and my UK GP is supportive. Thanks for explaining some more of the science behind it all, very useful.
Hi Ian,
Happy to help!
Hello dr Childs,
I’m an admirer of your work, to enlighten the people about how the thyroid works. In the Netherlands the doctors often treat Graves’ disease with a “block and replace”therapy, high dose of methimazole and levothyroxine. Now I know someone who does this therapy and she complained she was gaining weight and she has GO too. The doctors in the Netherlands never want to check Reverse T3 and you have to talk till you’re blue in the face to get Ft3 checked. My guess is that my friend has to ask for the Ft3 to get checked, but what can she do about that weight gain? She is 60 years old, so anything she gains, is very hard to get rid of. What kind of diet should she try? She is already on a low gluten diet, as far as I know. Hope you have some answers for me. Warm regards, Riet
Hi Riet,
I would recommend checking out these resources/articles:
https://www.restartmed.com/weight-loss-hypothyroidism-success/
https://www.restartmed.com/lose-weight-hypothyroidism/
https://www.restartmed.com/thyroid-weight-loss/
My TSH went from 3.90 to 8.81 in a year. I was on 75Mcg of L-Thyroxine. Put on 88Mcg, retested in 5 weeks and it went down to 2.71. Is that strange to drop that fast???
Hi Margaret,
Not really, some people are very sensitive to even small doses of thyroid medication.
Hi my name is Kim & I am congenital/central hypothyroid. My last test results are: TSH 0.050 uIU/mL T3,Free 3.15 pg/mL Free T-4 1.88 ng/dL. I have been taking Levothyroxine at .112 mcg.. But still feeling hypothyroid, my endocrinologist put me on Cytomel 5mcg starting tomorrow, as I just picked it up today. I am 60 years old, I also take anastrozole for breast cancer to keep it from recurring. I have been putting on weight around the middle. When I started seeing my first endo, he started lowering my levo dose, I started at .150 mcg I kept telling him something wasn’t right, but he kept lowering me to my current dose of the .112 mcg, which I’ve been on approximately 18 months. I now have a new endo, and she, after explaining my symptoms put me on this new drug. I am a little concerned with a new to me drug. With the levo dose at the lowest it’s been in my lifetime, plus the Anastrozole, besides the weight gain, I also have almost zero libido and painful intercourse, I had originally blamed the Anastrozole totally, but now having read a bit on other sites plus your post, I’m starting to think that both drugs may be causing the libido issue.. I also take Fish Oil, I take Calcium, B-12 & D3. Getting regulated on the right meds has always been a challenge. It’s just frustrating.
Hi Kim,
It’s almost certain that your libido issues are from anastrozole. Anastrozole essentially induces a medical menopause so you end up with the symptoms of menopause (including painful intercourse) when you take it.
Yes I gained weight on levothyroxine! I became hypo or hashi after I had covid in 2020…i had thyroglobulin levels near 800…and low t3, t4…after starting armour i began to perk up a but but am going through menopause at same time using compounded hormone replacement cream, so it can be hard to decipher which symptoms are caused by which issue. Later levothyroxine was added to the mix and all heck broke loose. My TSH was negligible and t4,t3 borderline normal. My md dropped the armour and i was now inly taking the levo. The weight came on, 15 pounds on my small frame, the fatigue increased, then mild depression… food allergies, and aching, swelling joints. My np increased my levo a bit, but accidentally called in wrong dose higher than she meant.. i took it fir 6 weeks and ended up with hot flashes, night sweats, aching joints, muscle pain, heart palpitations, nausea, sleeplessness, anxiety, moodiness… was then changed to just armour 30 with little improvement. 8 dats sho I stopped taking it all together and my symptoms have improved tremendously. I recently moved to another state and have not found a functional md or DO yet. I need to have bloodwork done asap ! What is your take on everlywell or pomona blood tests in thd meantime until i find an md? And you are so right about doctors just prescribing levo and thinking its a fix and then dismissing our symptoms … i thought i was dying and noone would listen to me. Thank you! Nicole
Hi Nicole,
I’m not too familiar with those lab testing companies other than I know that they exist. Having said that, lab testing is usually fairly standardized so I have a feeling the results are probably accurate.
Hello! I am a 60-year-old female diabetic who was diagnosed with hypothyroidism about 8 years ago when my TSH was just a little over 4. I was never told WHY I had hypothyroidism or the cause. I saw an endocrinologist but I don’t believe they asked for a complete thyroid panel at the time, although they did ask for a vitamin D level, which was found to be low. I have been taking levothyroxine since then at 75 mcg a day. I had been given a diet called the Dysglycemic Diet by a doctor in 2001 which is a whole foods based, healthy fats and healthy carbohydrates diet and had lost about 110 pounds in 2011-2012. I was not diagnosed with hypothyroidism until about 2014 but I don’t know how long I had had thyroid problems at that point. Using this diet, I have always been able to lose weight quickly, about 1/2 lb. a day! I have intermittently done this over the years since and always been able to lose weight at this rate. I have supplemented with vitamin D3 since my diagnosis in 2012. A few months ago I started supplementing with zinc and selenium and vitamin A. My recent TSH was down to 0.66. I am only on levothyroxine. It seems I am on the right track if the TSH is going down and I’m able to lose weight, right? As I said, I am also diabetic and after losing about 30 pounds in the last 4 months I have been able to reduce my medication from glyburide/metformin 5/500 four times a day to now only metformin 500 twice a day. My goal is to get my weight down and be off all medication. So far so good as it seems to still work for me, but it’s curious that I don’t seem to fit the profile of most people with thyroid problems since I don’t seem to have problems losing weight – at least on this diet and now supplementing with vit A, vit D3, zinc and selenium. I’ve just added in an hour of exercise 3-4 times a week the last couple of weeks. Do you think I will be able to improve to a point I can get off the levothyroxine at some point and is there anything else you think I should be doing in addition to these measures?
Hi Nina,
Unfortunately, it’s very hard to predict. The best approach is always to be as aggressive as possible and then see how your body responds. Even if you aren’t able to completely get off of your medication there’s a good chance you can reduce your dependence on it.
Hi Dr. Childs,
I was diagnosed with hypothyroidism March 2021 and put on levothyroxine. At the time I weighed 137lbs and I now 1 year later weigh 156lbs and climbing. My doctor my thyroid levels are now normal said I must be part of the 35% of patients who experience this side effect and was not offering any other solutions or testing. For years I have exercised 5x a week and have a clean diet. I took myself off of levothyroxine two weeks ago and have started taking A, E, Zinc, Quercetin, Selenium, Cortisolv, Seaweed, and MACA. Do you feel taking this approach could reverse this rapid weight gain caused by this medication?
Hi Regina,
It’s always a possibility but I will say that most people gain more weight when they go off of their thyroid medication. There are some people who were erroneously put on thyroid medication that shouldn’t be on it, though, so if you are one of those then it may get better.
Hello Dr. Childs:
I really like your Youtube lecture. It is clear, easy to follow and logical. Thank you.
I started levothyroxine 25 mg after my THS level was borderline high about 2 months ago. I have gained at least 5-6 lbs already and keeps going, which did not make sense to me at all. After viewing your video, I understand it now. Thank you. I will ask my doctor to check reverse T3.
Wendy
Hi Wendy,
Glad you found the information helpful!
Hello. I was diagnosed with under active thyroid 30 years ago. My medication has been increased and decreased many many times. I am 56 years old now and keep gaining weight. I go to the gym everyday and eat very healthy. I cannot lose weight no matter what I do. Please help
Hi Tammy,
Please see this article for more information on how to lose weight with hypothyroidism: https://www.restartmed.com/lose-weight-hypothyroidism/
It has been 5 years now that I am taking levothyroxine 50mg and I have gained weight, I feel tired, have cramps in my legs, joint pain, dry skin, and hair loss. Every time and get the blood test done I’ve been told it’s normal, but this time I said enough. I’ve asked my GP to refer me to an endocrinologist as I firmly believe that levothyroxine is not fixing the problem and is just making me heavy.
Thank you doctor for sharing this, I feel happy that I wasn’t wrong and that are other people like me who are struggling with the same issue.
Hi Isma,
Happy to help! You are definitely not alone. In fact, the majority of people feel just like you based on patient surveys: https://www.restartmed.com/doctors-fail-thyroid-patients/
Unfortunately, you will probably not find much help from an endocrinologist, though, for the reasons listed here: https://www.restartmed.com/endocrinologist-for-thyroid/
This resource can help you find a better thyroid doctor: https://www.restartmed.com/how-to-find-a-doctor-to-treat-your-thyroid/