Does it feel like you can rapidly gain or lose 5 pounds day to day?
I’m not talking about changes to your weight that happen throughout the course of the day, this is normal.
If you weigh yourself in the morning and then again in the evening, there will be a several-pound difference.
But what isn’t normal is to see a 5 pounds change on the scale from one morning to the next.
This indicates there’s a big problem.
And it’s a big problem that just so happens to affect many patients with hypothyroidism.
When this sort of rapid weight happens, it’s easy to just automatically assume that it’s fat.
But that’s rarely the case.
Rapid weight gain is almost always a problem related to fluid, water shifts, or changes in water weight in some form or fashion.
This is because it’s hard to truly pack on 5 pounds of fat in a single day.
In order to do this, you’d need to have a serious problem with your hormones.
The kind of problem that only occurs in rare medical conditions.
But that doesn’t mean that the type of rapid weight gain you’re experiencing isn’t a problem and shouldn’t be dealt with.
In order to figure out how to fix the problem, though, you need to understand what causes it.
And you also need to understand the difference between normal weight gain in hypothyroidism and the rapid types of weight gain we are about to discuss.
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Normal Weight Gain vs Abnormal Weight Gain in Hypothyroidism
Does hypothyroidism normally cause weight gain?
Absolutely.
It doesn’t have to, but it definitely does in many people (for reasons explained here).
Many (most) patients who are diagnosed with a sluggish thyroid can expect to gain anywhere between 10-15 pounds directly from their thyroid condition.
This occurs because thyroid hormones control and regulate metabolism.
As thyroid hormone levels fall so will your metabolism and you will gain some weight.
This weight gain will be a true increase in fat mass and tends to occur slowly and evenly across the entire body.
What can be confusing is the fact that some thyroid patients gain a lot more than 10-15 pounds.
And while this extra weight gain is related to their thyroid problem, it’s not directly responsible for it.
This extra weight tends to come from the issues we are about to discuss.
And it is these issues that can cause your weight to fluctuate rapidly from day to day.
Rapid Weight Gain Causes:
#1. Swelling, Edema, and Water Weight
As I mentioned earlier, if you are rapidly gaining weight you should always look at your fluid levels first.
Fluid levels refer to the amount of water that is being stored in your body at any given time.
And, believe it or not, this can fluctuate significantly from day to day based on variables like your salt intake, your hormone levels, and even your carbohydrate intake.
Here’s how your body handles fluid if you don’t have a thyroid problem:
The fluid that you get from foods and beverages makes it into your intestinal tract where they are either absorbed or kept to soften the stool.
From your intestines, this fluid makes it into your bloodstream where it heads to all of the cells and tissues that need it before making it to your kidneys where any extra is eliminated as urine.
There are many places where things can go wrong resulting in fluid accumulation and extra weight gain.
And for thyroid patients, they are extremely susceptible to edema because of a condition known as myxedema (1).
Myxedema is a condition in which glycosaminoglycans and hyaluronic acid accumulate in the skin and tissues.
These compounds can hold many multiples of their weight in water so wherever they go, water and fluid will follow.
True and full-blown myxedema is rare and is thought to only occur in severe cases of hypothyroidism, but it’s very likely that a less severe and more subtle form of myxedema occurs in many thyroid patients.
And because water is so heavy, even mild cases of edema can result in big changes on the scale.
Edema can occur all over the body and in just about any tissue, but when your thyroid is responsible it tends to accumulate in specific areas.
One of those is in the face, especially around the eyes.
This is known as periorbital edema (2) and it’s a problem that roughly 22% (or about 1 in 5) of patients with hypothyroidism will experience.
You’ve probably experienced this issue yourself if you’ve ever woken up with swelling around the eyes and face.
Fortunately, this swelling tends to subside as you wake up and as gravity pulls the extra fluid from your face back into circulation where your body can eliminate it.
On top of periorbital edema, approximately 55% of patients with hypothyroidism will experience another type of edema known as peripheral edema (3).
In peripheral edema, the swelling is localized to the legs.
But this type of edema is a little more problematic than swelling in the face for a few reasons:
The first is that there’s a lot more tissue down there which means a lot more fluid can be held in your legs.
And the second is that it’s a lot easier to miss subtle swelling in the legs than in the face.
You’re always looking at your face but how often are you examining your legs?
Probably not as much.
For this reason, peripheral edema accounts for more weight gain than that of periorbital edema and it’s the condition you should look for first if you see big changes in the scale.
How can you get rid of this extra water?
By optimizing your thyroid.
The single best way to help your body mobilize this extra fluid and to pee it out is by increasing how well your thyroid functions.
But other things like exercise, massage, compression stockings, being active, taking certain supplements, and adjusting your electrolyte intake can all help.
Not all cases of edema are from the thyroid, though, so if you have edema you always want to get checked out to make sure you aren’t missing a more serious issue.
Edema isn’t the only condition that can cause rapid weight gain which is why we need to talk about gut health next…
#2. Constipation
If you start to see the scale going up by several pounds each day, the first thing you should do after checking for swelling is ask yourself when you last had a bowel movement.
It’s not pretty, but your bowels can hold not only a lot of food but also a lot of water in the form of stool.
And stool volume can play a big role in how much you weigh day to day, especially if you are not eliminating it on a regular basis.
This is a big problem for thyroid patients because one of the most common symptoms of hypothyroidism is constipation (4).
When thyroid hormone is low, your gut will slow down which means you will have fewer bowel movements.
This problem can get so severe that some thyroid patients only experience a bowel movement once every 4 to 7 days.
Obviously, if you have 4 days worth of food in your gut, you’re not only going to see changes on the scale, but you will also feel incredibly bloated.
The actual weight of stool varies based on consistency and food intake, but one bowel movement can weigh anywhere from ¼ of a pound to 1 pound.
It seems that weighing stool isn’t an exact science, though, because many people who suffer from chronic constipation will say that they can easily gain 5-10 pounds in a week if they don’t have a bowel movement.
The volume of food that you are eating and the type of food that you are eating will also play a role here, so keep that in mind as well.
While being constipated is never fun, it’s not something you have to deal with forever.
Chronic constipation in hypothyroidism can be treated by optimizing thyroid function and by improving gut health.
Adjusting your thyroid medication, eating more fiber from fruits and vegetables, and drinking plenty of water can help you have more regular bowel movements.
Your goal should be to have at least 1 bowel movement per day, and anything less than this represents a problem and should be evaluated.
#3. Menstrual Irregularities (Hormone-Related Weight Gain)
This one only applies to women but because women get thyroid disease at a rate of about 6-8x more than men, it’s very important!
It’s fairly normal for women to gain weight during their menstrual cycle with the average being around 3 to 5 pounds.
But this number can go much higher, especially if there are imbalances in progesterone and estrogen.
In fact, some women report that they gain anywhere from 5 to 15 pounds the week of their period.
The weight gain that women experience during their menstrual cycle is, once again, related to fluid shifts.
The hormones progesterone and estrogen play an important and opposing role in managing fluid levels (5).
Estrogen causes women to retain fluid and progesterone causes women to shed extra fluid.
When balanced, this system works well and no extra fluid is retained.
But when there is a relative imbalance in estrogen and progesterone, you can see big changes in weight gain that persist after the cycle is completed.
And hypothyroidism is known to interfere with not only the menstrual cycle but also the hormones that govern this cycle.
It’s estimated that about 20% of women with hypothyroidism experience irregular menstrual cycles (either heavy cycles or infrequent cycles).
This is because of the impact that thyroid hormone has on progesterone levels (6).
In the hypothyroid state, progesterone levels are lower than normal which means estrogen can act uninhibited.
The result? More weight gain from fluid throughout the menstrual cycle.
You can easily differentiate menstrual-related fluid retention from standard edema because of how and when it occurs.
If your weight gain is cyclical and if it occurs during your period then it’s very likely related to the impact that thyroid hormone has on your sex hormones.
Once again, this problem can be fixed by optimizing your thyroid hormone levels which will then act to balance your progesterone-to-estrogen ratio.
If you think your weight gain from your thyroid is more related to an increase in fat mass as opposed to fluid, then you’ll want to check out this article next.
It walks you through some of the most common mistakes that thyroid patients make when trying to lose weight.
Now I want to hear from you:
Are you someone who rapidly gains or loses up to 5 pounds in a single day?
Do you attribute these shifts in your weight to your thyroid? Or do you think it’s related to something else?
Do you suffer from swelling or constipation related to your thyroid?
Are these two things contributing to your current weight?
Leave your questions or comments below!
Scientific References
#1. ncbi.nlm.nih.gov/books/NBK545193/
#2. ncbi.nlm.nih.gov/pmc/articles/PMC9354917/
#3. ncbi.nlm.nih.gov/books/NBK554452/
#4. pubmed.ncbi.nlm.nih.gov/6706068/
#5. ncbi.nlm.nih.gov/pmc/articles/PMC8551666/
#6. ncbi.nlm.nih.gov/pmc/articles/PMC5980701/
Hello Dr. Childs,
I just read the article pertaining to re-creating one’s own NT formula.
I am currently not on any thyroid medications and am waiting to have my doctor order a reverse T3 test and two other tests you recommended after seeing that THS is normal, Free T4 is in range and T3 is flagged low. I am currently using your thyroid supplements: Essential T2,T3 Conversion Booster, Thyroid Adrenal Rest Complex, Thyroid Biotic & Thyroid Hair Regrowth Booster. Can I use the re-created NT formula without a doc’s prescription? I only saw using it alongside of a prescription?
Thanks for your reply in advance!
Hi Angelika,
Yes, it’s perfectly fine to use those supplements without thyroid medication. You may need thyroid medication for other reasons, but the supplements are still effective with or without it.
I went to the drs initially with all the hypo symptoms ie. constipation, weight gain, fatigue but was diagnosed with Graves. Since going gluten free I am no longer producing Graves antibodies.
I got my RT3 tested privately and it was at the very end of the scale on the high end- way over the normal levels. The endocrinologist was not interested in those results neither was my doctor. The endo says he doesn’t need to see me anymore. Currently I’m putting on weight even though I eat carefully, low carb, no treats. I’ve got chronic fatigue. Do you have any recommendations on at least what I can try. Thanks
Hi Kathy,
Yes, you can find helpful information to assist on your weight loss journey here: https://www.restartmed.com/weight-loss-with-hypothyroidism/
How can I lose weight and activate metabolism
Hi Nita,
You can learn more about losing weight with hypothyroidism here: https://www.restartmed.com/weight-loss-with-hypothyroidism/
I live with hypothyroidism since I’m 12 years old. Now I’m in menopause at 52. I have lost 30 pounds 2 years ago and gained 10 pounds, although I follow a Plant based, oil free diet. I exercise almost everyday for 30 to 45 minutes.I don’t understand what’s going on. I noticed facial edema possibly around my eyes and it drives me crazy as well. I’m taking levothyroxin and your supplements as the hair growth and the thyroid essentials. What can I do to loose the 10 to 15 pounds, and the edema? Thank you
Hi Stefanie,
Aside from a whole food diet, intermittent fasting, and regular exercise, you can also look into these supplements: https://www.restartmed.com/product/weight-loss-bundle/
If you need help with diet and exercise, you can use these resources:
https://www.restartmed.com/perfect-thyroid-diet/
https://www.restartmed.com/best-exercises-for-your-thyroid/
This has happened to me a few times, where I gain around 20lbs in a week. I can tell when I’m drinking plenty of water but not much is coming out. Tweaks to thyroid meds (NDT plus SR T3) don’t assist, need to take really extreme measures to get the water weight down. Very very low cal diet works to eliminate water but not sustainable otherwise have tried a potassium sparing diuretic which worked amazingly (other diuretics do nothing). Diuretic however causes other problems, so can’t continue with it. Do you have any other suggestions on how to combat #1 in your article? I’ve got hashimotos hypothyroidism, partial thyroidectomy 11 years ago. Gluten free. Thank you.
i am in my mid-40s and starting last august, gained weight every menstrual cycle until december when i had put on a total of 8 pounds. it was the most i have ever weighed (i eat well and exercise and am very lean). anyway i also started having dehydration symptoms (headache, dry mouth) but when i would drink water i would feel worse. my rings wouldn’t fit, i always felt i had incomplete urination and i almost couldn’t button my jeans anymore. anyway in late december i read about wilson’s syndrome (it has been discredited in most medical circles, i believe) but it just gave me the idea to try t3. i added 5mcg of cytomel to my 75mcg of tirosint and the headaches stopped. two weeks later i added another 5mcg of cytomel and within a week, all the weight came off. i feel way better now than i have my entire hypothyroid journey (about 4 years) and have returned to the same weight i have been for 20 years! i just want to throw this out there in case anyone is dealing with the same thing! NDT never worked for me, so i never messed with t3.
Hi R Echols,
It would definitely be a mistake to assume that because NDT didn’t work for you that T3 wouldn’t either. It’s very frequently the case that simply switching from one type of thyroid medication, even within the same class or group, can have a profound impact on thyroid management. For instance, even if liothyronine didn’t work for you, it’s still possible that Cytomel might. There are a ton of medication combinations that can be tried and used when it comes to thyroid medications and there is some combination that works perfectly for each individual. It just requires some trial and error to find it.
Dear Dr.Childs,
I live in the UK, I was misdiagnosed with complex thyroiditis which led to atrophied thyroid gland with hypothyroidism, damaged pituitary gland due to a headinjury and undermedicated by my GP for 2 years ( GP then decided as my TSH was too low that I was now hyperthyroid and stopped my levothyroxine meds.). I have since been diagnosed properly by an endocrinologist and I am treated with levothyroxine and liothyronine. But I still have all these symptoms you have described although I am now post menopausal and have been since I was 45 years old. No amount of dieting or exercise appears to make any difference and I can put on weight by 5 to 10lbs in as little as 24 hours ! 🙁 My cortisol level has been high , 2 years ago, but the blevins have come down and I still haven’t been able to lose weight even though I’ve been careful with what I eat and how I eat. On occasions I have managed to lose 10lbs only to wake up one morning to find I’ve put on over 5lbs ! I have no idea what’s going on now ! 🙁
Thank you for all your research Dr Childs, you are a beacon of light. I have hypothyroidism and have both chronic severe constipation for years, and chronic severe swelling in my feet, lower legs and ankles. Side note, interestingly, when I had a CAT scan a few years ago the iodinized contrast they used sent me into Graves’ disease, hyperthyroidism state, really high ( 400% ) anti-tsh antibodies. I had to go on methimazole for 2 years, now I am back to treating hypo.
The swelling is ruining my legs, skin is showing vascular insufficiency in lower left leg, peripheral neuropathy set in. I have also been continuously putting on more and more weight despite healthy eating and activity levels, have always thought it was water weight but didn’t know why until your article touching on myxedema. I am certain you are on the right track with not all myxedema being severe, that is me, I am very interested in finding out if there is a way to get rid of the water attracting substances my hypo body that were created as your article discussed. I feel all my water is being pulled into these tissues, not leaving enough for my intestines -severe chronic constipation.. I am around 3.0 TSH on 75 mcg Tirosint. Like your mom Dr . Childs, Tirosint has seemed to help me although my edema still persists. I could not tolerate other thyroid meds, just made me feel worse. I was prescribed 5mcg Liothyronine to take with Tirosint but that didn’t seem to make any difference with weight gain or edema likeI thought it would. I really need help getting my swelling down, it is critical, and after seeing several doctors no one knows where the swelling is coming from. You know, I am grateful you wrote about this. If I could end my swelling I know my weight would drop al lot, I feel like a stranger in my own body. I appreciate any insights, thank you kindly.
I can easily be up four pounds from one day to the next. Definitely retaining fluid in legs, can feel tightness in the evenings. Also, my reverse T 3 is almost at 20. What needs to be done to correct this problem?
Hi Diane,
You can learn more about reducing reverse T3 levels here: https://www.restartmed.com/reverse-t3/
I’m at such a loss with my endocrine system & function, I could just cry. There seems to be no rhyme nor reason to my levels or symptoms. All I know is that I’ve spent the last 5 plus years in absolute misery.
I have very low T4 levels, and my TSH is usually very low, if not nonexistent. I am currently about 50+ pounds overweight, and I feel like much of it is due to swelling & hormonal issues. In the last 10 years, I’ve had 3 different huge weight swings- I know this is going to sound unbelievable, but it is true- each time I’ve either gained or lossed 40 pounds in 3-4 weeks time. Along with the weight, my blood pressure also rises to very high levels, my vision worsens, and I develop a severe case of depression, that completely saps all of my motivation. The weight gain completely changes my appearance, altering the shape of my face to the point where I look like a different person. My legs become heavy & swollen but most of the weight goes to my middle, and my waist has gone from my normal 26 inches to 37 inches!
I feel like my body is deformed; I can’t find anything that fits me correctly, from shoes, to rings to jeans. I can’t even wear makeup correctly, it seems, with all of the swelling in my eyes & face. Aside from all of this, my cholesterol levels are off the chart terrible, I just found out I now suddenly have osteoporosis
(I just turned 50) & I have a very large benign thyroid nodule that keeps getting bigger.
I’ve tried all different doses of thyroid medication, but nothing seems to make any difference at all. I’ve seen several endocrinologists, but no one seems interested in helping me feel better. I feel like there must be something else going on- my body seems to be begging me for help & mentally it’s becoming harder & harder not to become completely overwhelmed and discouraged.
Is there any advice you can offer as to a direction I might begin to address my symptoms? Any suggestions you may have would be so appreciated. Thank you in advance!