The Connection between Low Thyroid & Weight Gain

The Connection between Low Thyroid & Weight gain & What to do About it

Low thyroid function leads to weight gain but not how you think. 

If low thyroid leads to weight gain then why does replacing thyroid hormone in your body not lead to excessive weight loss?

It turns out that this phenomenon can be explained but you have to understand the function of other hormones in your body.

Thyroid hormone is involved in so much more than just monitoring your metabolism and its the effects on other hormones that cause the weight gain you associated with hypothyroidism.

The unfortunate part is that most physicians miss this connection which means you need to understand it for proper treatment...


Hypothyroidism and Weight gain explained

Does hypothyroidism actually lead to weight gain?

The question seems so simple if you have hypothyroidism because no doubt you probably experienced "unexplained" weight gain as one of your main symptoms.

Association between TSH and weight gain

(Studies showing that as TSH increases body weight increases along with it showing the connection between hypothyroidism and weight gain clearly)

But if hypothyroidism leads to weight gain then why don't you lose weight when you start thyroid medication?

Doesn't it make sense that if your weight was due to low thyroid that replacing that thyroid would result in some lost weight?

This happens with pretty much everything else in medicine.

If you have high blood pressure and you take blood pressure medication then your blood pressure will return to normal.

The same is true with cholesterol, blood sugar, etc.

But not the thyroid.

Let's just think about it for a minute...

From a logical standpoint several things may be at play here:

1) You are not getting enough thyroid hormone or you are being undertreated: 

If you follow the logic above that low thyroid leads to weight gain, then maybe you aren't getting enough thyroid hormone in your medication. 

This turns out to be true (but we won't go over that today) especially if your Doctor is treating you by your TSH alone (which is a terrible marker for tissue level thyroid status).

You can read more about why the TSH is not the best marker for assessing thyroid function in this post.

But let's assume that you are getting enough thyroid hormone replacement.

How then can you explain your weight gain and inability to lose weight?

2) Maybe your weight gain wasn't due to your thyroid but a consequence of low thyroid hormone in the body:

Maybe, just maybe, our traditional understanding of hormones and weight gain is not accurate. 

It turns out that this is probably the biggest reason for why thyroid hormone causes weight gain in individuals and helps explain why patients (probably like you) don't lose weight when you replace the thyroid hormone. 

This lack of weight loss after treatment has lead to interesting statements like this one:

Weight gain is not a result of hypothyroidism. 

You may have heard this from your endocrinologist or primary care provider. 

Why do you think they are saying that to you?

Because after treating hundreds (if not thousands of patients) how can you justify the fact that none of your patients are losing weight on thyroid medication? 

In fact, studies have come out to show that using T4 therapy in patients who are overweight actually doesn't lower their weight (1).

The only explanation they can come up with is that thyroid hormone doesn't cause weight gain. 

And this is so far from the truth.

Low thyroid hormone DOES lead to weight gain, just in a way that they don't understand...

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Low thyroid causes other hormones that lead to weight gain

The association between weight gain and hypothyroidism is somewhat complex and includes much more than just your thyroid. 

The easiest way to think about this is to realize that everything in your body is connected.

You can think of this connection like a spider web.

When one string is pulled, it pulls the entire web.

Meaning you can't really change one thing without affecting several others.

This is true of thyroid hormone as well.

As thyroid hormone levels fall it causes a chain reaction which changes multiple other hormonal systems in your body.

And guess what these systems do?

They all contribute to your weight!

Let's walk through what happens:

High insulin levels (+ insulin resistance)

The connection between high insulin (and high blood sugar) and weight gain (2) has been well established. 

What you probably don't realize is that this connection extends to patients without diabetes or pre-diabetes as well.

Patients with highly elevated levels of fasting insulin (and by my personal prediction this is about 50%+ of patients in the US based on serum testing) still have weight gain problems.

So we know that high levels of insulin (and high blood sugar) lead to weight gain, but what you probably don't know is that thyroid hormone influences insulin resistance. 

insulin resistance and hypothyroidism

Low (and high) levels of thyroid hormone lead to the condition known as insulin resistance.

This connection is so strong that low thyroid hormone can actually lead to type II diabetes (3). 

And here's the bigger deal:

Replacing thyroid hormone in your body doesn't take care of this hormone imbalance!

That means you can replace your thyroid hormone, but you will still have insulin resistance.

This is one of the many ways that hypothyroidism leads to weight gain and the treatment of hypothyroidism does NOT lead to weight loss. 

  • Bottom line: Low thyroid hormone leads to high blood sugar a condition known as insulin resistance. High insulin levels lead to weight gain and don't go away with thyroid hormone replacement. 

High leptin levels (+ Leptin resistance)

This might be the strongest connection between weight gain and hypothyroidism and also the most underappreciated. 

Bringing up leptin to your current physician is likely to be met with a puzzling look and a quick change in conversation.


Most physicians simply aren't trained in how to deal with or manage leptin.

Leptin resistance and hypothyroidism

Despite this, the connection is very strong between altered thyroid states and leptin resistance (4).

Hypothyroidism leads to leptin resistance and further weight gain aggravates existing leptin resistance (5).

Leptin is a powerful hormone secreted by your fat cells that act on your hypothalamus (brain) to regulate your metabolism. 

This means your resting heart rate, your energy levels, the number of calories you burn at rest and your body temperature.

Leptin resistance leads to any or all of the following symptoms: 

  • Weight gain and weight loss resistance (even to diets such as the HCG diet, etc.)
  • Cold body temperature (less than 98.0 degrees)
  • Low resting heart rate (usually in the 50-60 range despite being overweight)
  • Ravenous appetite (even after eating large meals)
  • Reliance upon carbohydrates as a constant source of energy (usually sugary forms of foods)
  • Crushing or debilitating fatigue (constantly throughout the day due to low energy production) 

What's worse is that high leptin levels actually make thyroid function worse as well

We will talk more about the treatment of this condition below:

  • Bottom line: Low thyroid hormone leads to leptin resistance and weight gain. Leptin levels decrease thyroid function by reducing T4 to T3 conversion and making hypothyroid symptoms worse. Most physicians miss this condition. 

Low testosterone levels

Again, another missed connection between hypothyroidism and weight gain. 

Testosterone is required (in both men and women) for proper regulation of skeletal muscle mass, energy levels, maintenance of libido and mood

Low testosterone levels lead to weight gain and many other symptoms, especially in women. 

Studies have shown that low thyroid hormone leads to low testosterone (6).

This is particularly important from a weight perspective because of testosterone's influence on skeletal muscle.

The more muscle mass you have in your body the higher your resting metabolic rate will be.

So the drop in testosterone levels results in a drop in skeletal muscle which lowers your metabolism. 

thyroid metabolism reset poster for side bar

Low testosterone levels also lead to low energy which may make exercising and staying active more difficult as well.

And you guessed it:

Replacing thyroid hormone doesn't always correct the low testosterone levels.

Low testosterone may be worsened by insulin resistance (which doesn't go away with thyroid treatment) and with age/menopause.

Making evaluating your testosterone very important from a weight perspective.

  • Bottom line: Low thyroid hormone leads to low testosterone. Replacing thyroid hormone may not result in an increase in testosterone levels meaning you may need additional supplementation of this hormone. 

Low progesterone levels (+ high estrogen) 

This one is different from the rest because many times treating low thyroid can actually improve progesterone levels and reduce symptoms of high estrogen. 

What symptoms am I talking about?

Symptoms of low progesterone (and high estrogen) include:

  • Menstrual irregularities
  • Weight gain in the hip/thighs area
  • Menstrual cramps around your cycle
  • Migraines and/or headaches around the time of your cycle
  • Changes in weight (usually fluid relates) around your cycle
  • Breast tenderness and/or a history of fibrocystic breast disease
  • History of infertility
  • History of endometriosis
  • History of PMS/PMDD

These symptoms all result from the imbalance that occurs from a drop of progesterone

It's helpful to think of estrogen and progesterone as yin and yang.

While estrogen helps build up endometrial and breast tissue, progesterone does the exact opposite.

How to treat endometriosis naturally without drugs

For this reason, it's necessary to have a balanced ratio of progesterone to estrogen (including estradiol, estriol, and estrone).

Even if your estrogen levels remain constant and your progesterone levels fall you will be subject to the symptoms above.

This has to do with the change in the proportion NOT the overall lab value.

And low thyroid helps contribute to low levels of progesterone (7) which can set off the chain reaction of symptoms above.

The good news is that replacing thyroid hormone will often fix the progesterone level, but it may not fix high estrogen levels (this is caused by other factors).

So you may have a combination of low progesterone PLUS high estrogen, and replacing thyroid hormone will only normalize your progesterone levels.

It's this imbalance that leads to weight gain.

  • Bottom line: Low thyroid hormone leads to low progesterone which will shift the balance of estrogen: progesterone in favor of estrogen causing estrogen dominance. This leads to weight gain and many other symptoms. 

Low/high cortisol levels

Next on the list is the hormone cortisol. 

Cortisol is released from your body in response to stress.

This can be stress from exercise, emotional stress, perceived stress and even a lack of sleep.

These are all well-known conditions that cause an increase in cortisol.

Let off of that list is the connection between thyroid hormone and cortisol levels.

It turns out that an elevated TSH (sign of hypothyroidism) is associated with high cortisol levels (8).

This could be from the stress that hypothyroidism places on your body or simply the connection between the two hormones.

In either event, it is clear that there IS a connection and it's not a good one.

High cortisol levels lead to weight gain (usually abdominal), symptoms of fatigue, weight loss resistance, and food cravings. 

High cortisol levels also change other hormones (not a big surprise) and can make insulin resistance worse (9) and elevated blood sugar. 

What's more interesting is that these symptoms also occur with low levels of cortisol. 

And extended periods of hypothyroidism can also cause changes in cortisol leading to low cortisol over time.

low serum cortisol levels

 The tricky part is diagnosing the problem and getting the right lab tests (which we will discuss below). 

  • Bottom line: Low thyroid hormone may cause both low and high cortisol levels which may make insulin resistance worse and lead to abdominal (belly) fat. 

High reverse T3 (+ thyroid resistance)

It is estimated that your thyroid controls about 30% of your metabolism (10).

This is a big deal for many reasons:

1) This helps explain how thyroid hormone DOES influence your weight.

2) It also explains that other factors are most definitely contributing to your weight gain.

Even if you reduced your thyroid function by 50% that means that your metabolism would be roughly 85% of normal.

Put another way:

Instead of burning 2,000 calories at rest each day you would be burning 1,700 calories per day.

Now, in reality, this problem is more complicated and on average I see most hypothyroid patients with at least 30-40% metabolic damage at baseline.

This means that most hypothyroid patients are burning roughly 1,000-1,200 calories per day.

This helps explain why many thyroid patients struggle to even maintain their weight with constant calorie restriction.

Part of this problem stems from a condition known as thyroid resistance

Thyroid resistance occurs when your body produces too much reverse T3 relative to free and total T3. 

This causes competitive binding between the two and results in reduced tissue levels of hypothyroidism AKA tissue level hypothyroidism (11).

Treating this condition requires a knowledgeable physician and one that understands the importance of T3 and reverse T3. 

Weight gain and hormone imbalances on your body

One of the easiest (though not the most accurate ways) to assess for hormone imbalances is by assessing the distribution of fat on your body. 

It turns out that many hormonal conditions result in a change in body fat distribution on the body and may help identify your hormone imbalance.

This should be used in conjunction with lab testing whenever possible, but this does serve to help guide some patients in the event that their doctor isn't willing to order the more advanced tests like leptin, insulin, reverse T3, etc.

With that in mind you can use this list to compare your body fat distribution to various hormone imbalances:

  • Abdominal belly fat - Insulin resistance + Cortisol issues
  • Weight gain in butt/thighs/hips - Low progesterone and/or high estrogen levels
  • Weight all over + ravenous appetite - Thyroid resistance and/or leptin resistance
  • Weight gain in upper arms + reduced muscle mass - Low testosterone

While this list isn't always 100% accurate, it can definitely help guide you. 

I realize that many readers of my blog live in different countries where some of the therapies I recommend aren't even available.

In this case, it may be useful to evaluate your body using the distribution of your body fat and then trialing treatment from there. 

How to proceed if you have these hormonal problems: 

If you are experiencing issues with weight gain or weight loss AND you have hypothyroidism then your next step is to get evaluated for these hormone imbalances. 

I should point out that many general physicians including endocrinologists will not have the knowledge to help you with these hormone imbalances so you may need to seek care from other specialists outside of the insurance model. 

I have detailed case studies and posts walking you through how to diagnose these conditions that you can look at below:

Use these case studies and the other posts on my blog to help guide you. 


It's not impossible to lose weight with hypothyroidism (even if you feel that way right now), it just takes the RIGHT approach from the right physician.

Now it's your turn:

Are you struggling to lose weight with your thyroid?

What has worked for you and what hasn't?

Leave your comment below!

References (Click to Expand)

how low thyroid leads to weight gain

Dr. Westin Childs

About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 45,000+ people have used them over the last 4.5 years. You can read more about my own personal health journey and why I am so passionate about what I do here.

32 thoughts on “The Connection between Low Thyroid & Weight gain & What to do About it”

  1. Dr. Childs,

    Thank you so much for all of the work you’re doing. Words can’t express how badly I’d love to work with you. Especially as a future functional medicine APRN (current RN), I am beyond inspired by your knowledge and expertise. I know you can’t comment on specific cases, but I was just writing to see if you had any quick feedback. 27 year old male here, 10+ year history of raging bulimia, which has really impacted my health negatively (I suppose I’m lucky to be alive). Low free T3, low/normal FT4, super normal TSH, no antibodies or RT3. WBCs have dipped lower and lower over the past 2 years, ferritin has ranged from 7-49, Vit D normal, B12 has ranged from 400 to 1500! Also, testosterone is currently way below range, in the low 200s. Struggling with money so went to a subpar anti-aging endo/internist who was frighteningly ignorant to much of the physiology related to thyroid. He gave me 1/2 grain Naturethroid (I think I need more T3 as I took Thyrogold a few years back with no results) but is really pushing for testosterone injections. I would rather get to the root of the problem. My nutrition is dialed in except that I eat way too many (steamed) goitrogenic vegetables. I take iodine, selenium, zinc, vit d, fish oil, probiotic, and an adaptogen complex.

    If you need a crazy case study, please do let me know. I am barely making it through the day and my symptoms are everything you’ve discussed in your insightful blogposts and videos. So far, my 27 years have been defined by addiction, isolation, alienation, depression, and anxiety despite craving everything I know that life has to offer. It’s all getting very old and I’m ready for life and to feel like a functional human being. I know this is one piece of the puzzle but the literature clearly shows that optimal thyroid function will be quite a help.

    Thank you again for your inspiring work and compassion for those of us who are suffering.

    • Hey Josh,

      No problem and I’m glad you found it helpful so far. I can tell you from experience that patients with bulemia and/or anorexia take a long time to treat (on the order of 8+ months) due to what I assume is from severe metabolic damage. I also believe that doing this early in life seems to set the stage for problems later in life (usually in the 40+ range).

      • Oh goodness, Dr. Childs! So are you saying I’m screwed even if I can fully dig myself out of the hole? Or that I will just require a lot more work to maintain my health despite lifestyle factors being dialed in?

        There’s some research on the metabolic effects of bulimia and anorexia and there seems to be a distinct leptin resistance issue in the case of bulimia, the opposite as in obesity. Would you recommend a leptin diet for someone like me? I’ve seen some and certain things (like finishing eating by 5 or 6 PM) would be very difficult to adhere to. Plus any time of fasting seems to be contraindicated with thyroid/adrenal dysfunction.

        I have to say again: I would do absolutely anything to be a patient of yours. I start UPenn’s accelerated NP program in May and though I am grateful to have gotten in and be one step closer to being able to formally study functional medicine, I’m afraid I will not make it through. I always seem to pull it out and excel despite circumstances but I’m feeling sicker and sicker everyday.

  2. I am happy I have found you.You give us so much TRUE and real info.You know how much it would cost for a minute of these answers.I am suffering with sudden oneset of idopathic Gastroparesis.Mayo gave me my diagnosies.I do have Hoshimotos and am just finnally getting treated for it.My r-t3 is high and they say I don’t convert well.Was on Synthriod 25mg of course and then they put me on 5 mcg of Cymetol.I went way hyper, nervouse irritable, out of control, in just and day and reduced, and reduced and we still have to get it just small enough for me to handel.We all think T3 is going to be awesome and I’m sure it will be once its right.My real question is my throids not that bad, but be have run out of thing to fix other then that and my sex hormone levels, I am 49 have had IP GP for 4 years now.On AIP diet for a while now, my whole kitchen counter is full of the supplements and amino acids and alike that I take.Do you think the sex hormone imbalance could have causes this very painful GP? We do know what else to try/test weve done it all.I refuse to accept this, I will search forever, if not for me all the young women who havent even started their life yet and are all getting this like 80% women? I would think hormones, but ….Please PLease let me know what you think. Your friend, Ava

  3. Hi there! I’m a female in my mid 30”s, I am struggling to feel like myself again. About 14 years ago, diagnosed with Graves, then had both lobes removed (thyroidectomy). I have gained over 60lbs and have all the classic symptoms, high BP, fatigue, insomnia, low estrogen, infertility, endometriosis, brain fog, joint pains, puffy face, major hair loss, dry skin, tightening of hands and feet,lower extremities itch and feel pains as if I’m being electrocuted (weird), zero sex drive, the list goes on and on. Am on Labetalol (100 2x daily), synthroid (150mcg) and was on cytomel, but since trying to become pregnant, after 4 long years of trying with the help from a fertility specialist, I have stopped the cytomel and haven’t been on it even now that my child is 10 months old.
    What should I be asking my endocrinologist to test?
    Leptin, cortisol, insulin??? I need guidance ASAP

  4. This is so helpful! Thank you! Do you offer over the phone “consultations” vs. in office visits for patients that live out of state? I have been BEGGING someone to “help me” for the past two years–five different types of doctors, in fact. All told me, you must be “depressed” or “welcome to being forty and fat!” after gaining 30 lbs RAPIDLY (having been a small build my whole life). All thyroid levels tested “within the normal range” each and every time. A recent visit to an endocrinologist revealed I have several thyroid nodules and blood tests, AGAIN, showed “within normal range” thyroid and cortisol levels. Antiglobulin levels indicate Hashimoto’s. Possibly having thyroid removed in two weeks. Please help me become a “knowledgeable” patient!

    • Hi Cameron,

      Unfortunately I do not offer those types of consultations. The best thing you can do is spend some time on this blog so you have a solid understanding of what makes a good practitioner and then seek out someone like that.

  5. Dr. Childs,

    I feel like I finally have answers to all of my questions! I have been struggling with hypothyroidism and hormonal imbalance for a few years now with no one really listening (at least that is what it feels like). After reading this, I feel it makes sense now. I have also finally found a really good endocrinologist and a fantastic OB/GYN and am now on the right track. THANK YOU AGAIN!

  6. Oh dear !! You would love to work on me…..I have Hashimotos ( 25 years ) and have picked up a whole lot more autoimmune conditions along the way. Including CFS, Fibromyalgia and Gut problems. I have a rT3 of 28. My sex hormones say I’m Estrogen dominant with Low Testosterone. I have high Insulin, and am stage 3 CKD. I have recently started to self medicate with T3 only as I feel so ill on Levothyroxine. I am monitoring my Blood pressure and Temperature along with Pulse and keeping records. I am 4 days into 25mcg of T3. So far no change in Pulse / blood pressure ( which have always been on LOW side ) but I have noticed blood sugar has come down. I plan to add half a tablet of T3 in about a weeks time. Really hope it helps my weight as I’ve gone up and up year on year despite a VERY healthy diet.

  7. Hi Dr. Childs,

    I have seen several doctors in the last 3 years because my weight just started going up. I could literally gain 10lbs in a month and not change anything on the way I eat. I exercise (walk & jog) with my dog. I started with my family physician on thyroid medicine which I did lost about 20lbs within a 3 month period. After having a knee scope because I had a tear, I ended up with something on the toes of my feet(3 doctors couldn’t figure out what it was). Needless to say 4 antibiotics later and then a shot which I believe had steroids in it because as soon as they gave me that shot, the 20lbs pounds I lost came right back on in 1 month. I then went to an endocrinologist (I was thinking maybe it was hormones) he put me on Progesterone, Iodine Complex, Estradiol(cream), DHEA SR. All of this is plant base because I had breast cancer in 2009 – stage 1 – still doing great 🙂 I already went thru menopause back in 2009, 2010, 2011. Cancer doctors wanted to make sure that I was not producing any estrogen. I tried this natural medicine for 1 year watching my weight continuing to go up. I then stopped that medicine last May 2016,dropped 10lbs and stayed that exact same weight until January 2017. During January, for no reason weight up 10lbs. and then in May, I weaned myself off the thyroid medicine because I didn’t feel any benefits from it and haven’t for a long time. I then went up another 10lbs. This weight problem has been going on for almost 4 years and I am now 50lbs weight gain which has totally depressed me. I have gotten rid of all my clothes. My winter clothes from last year no longer fit me because I am 20lbs more and no matter what I do, my weight doesn’t move, it just keeps going up. Its hard to job, my legs feel heavy. I started seeing another doctor who put me on a plant base progesterone (again). No change except weight is climbing. Can you help or at least tell me what I should ask the doctor which tests to do because I do believe my problem stems from my thyroid. By the way, my cortisol is not very high in the morning and drops all day long. My current doctor I am seeing had me do a saliva test (4 of these) because she thinks it is my adrenal glands. Do you know of anyone in Indiana that I could go see that could help me and do the right tests to determine what is going on. I just want to feel good again, have energy and lost all this weight that I have put on. I have always been very active, exercising and I don’t always eat the best because I have to remind myself to eat. I am not an excessive eater and that’s why I get so upset because this weight gain doesn’t make any sense. Thank you so much and I’m sorry that I got so wordy on this comment.

  8. Hello Dr. Child’s,

    I had thyroid removed in 2008 due to goiter Graves’ disease. Was put on levothyroxine 125 mcg. I had ended up gaining 50 lbs. with blotting fluid retention in upper body and face in about 6 mo. Even though my levels were in normal range. They told me it was all in my head the t4 meds were working fine. I had requested to be put armor thyroid as trial, I had lost 20 lbs of fluid within 6- 8 weeks. Then struggled with rest of weight with up and down weight within 170 to 180 weight.

    11-2017 I seen dr and had blood test. My t4 was just over top level of scale. T3 was a lot over and told them I had just taken my armor 1 hr before the test. Everyone says it doesn’t matter when I take my armor for blood work.

    I was on 120 mcg twice aa day. Dr change it without saying anything to me beforehand to 125 levothyroxine once daily. Endo then changed to stop taking any for a week then take 125 mcg levothyroxine 6 days a week. This has caused the return of hypothyroidism with t4 level .59, t3 level .9, tsp 4.59, weight gain of 20 lbs in 30 days, fluid retention in upperbody, body temp went down to 96. I’m to the point it takes me 5-10 minutes to walk 1/2 block. Debilitating pain in back, hips, nerve pain through out body.

    Endo increased levothyroxine to 137 mcg. And see you in 3 mos. he refuses to address any of these other issues and refuses to switch to any other med.

    I am going to see another endo.

  9. So if an endocrinologist can’t help who can?
    I’ve gained 20 pounds in the last couple of months. I’ve been dieting and exercising and nothing helps. I lose a few pounds and gain double or triple.
    I got tested for my thyroid and the TSH levels were at 5.76 the rest was normal. I also had a miscarriage about a month ago.
    I’m not sure which of those 2 is the reason I’m gaining weight. But I was fine before the pregnancy and during. Its now after that I’m gaining weight

  10. Dr Childs:

    My wife was diagnosed with hypothyroid 14 years ago. When we married, she was a petite 5’2″ 118lbs. After our second child, her hormone imbalance went out of control and she ballooned to nearly 160lbs. Since then, and numerous fad diets later, she operates at around 140-145lbs. In order to maintain that weight, however, she exercises like a beast. A mixture of cardio and weight training – and she generally watches what she eats (although we both could do better). She is currently on Synthroid, but nearly all indications you made in the article continue to plague her: cold, fatigued, weight gain in hips, but, thighs; lack of muscle mass despite exercise; resistance to HCG diet; menstrual irregularities; breast tenderness, etc…). I am an active duty Marine who stays fit, but she works twice as hard as I do, and sees very little results. Disclaimer: I’ll love her no matter what, but I’m worried. Somehow I don’t feel like the doctors she sees really know what’s going on with her. Your article makes me even more suspicious. I’ve read about Hashimotos, and other forms of Hypothyroidism, and it seems like every sort of food is “bad” in its own way. What’s left to do? The following portion of your article was of particular interest: “I should point out that many general physicians including endocrinologists will not have the ​knowledge to help you with these hormone imbalances so you may need to seek care from other specialists outside of the insurance model.” Can you provide some specifics? She’s visited a few weight loss clinics and found some results with b12 injections, and a drug called Phentermine (sp?) – though as she became resistant to the dosage, it’s benefits quickly wore off and most of the weight returned. Using alternative methods (diuretics and appetite suppressants) she got down to 129-130 at one point, but lost her menstrual cycle and just “didn’t feel right.” I guess the question is: what now? She is 39 and on the cusp of giving up. I see the depression settling in and am concerned. Thanks for the article. I look forward to any response.

    • Hi Benjamin,

      It sounds like your wife may have some element of metabolic damage and likely some element of thyroid damage from all of the dieting in her life. Your best bet would be to address these two specific issues as that will be the only way to improve her symptoms and help her lose weight.

      • Finally, someone who writes about my exact struggles. Like Benjamin’s wife, I just can’t lose weight or gain more muscle no matter how hard I work out and eat right. I maintained in my 120-130 for years after being fat my entire childhood. I overdid the exercise and always tried to eat 1100-1300 for years. Maybe taking a break for 6 mos here and there but would only gain 8lb and lose it. This past year, I just kept gaining. I tried repairing my metabolism with a reverse diet and got fatter. I only reached 1800 calories before getting depressed so I got off the reverse diet and started a diet. No luck. Now I found a doc outside the normal insurance realm, he specializes in hormones. I’m on Nature-throid, estrogen, prog. and test. I told him I have metabolic damage but he seems to believe these meds will help weight loss?? No results after 40 days. Do I just need more time? You mentioned above sounds Benjamin’s wife has metabolic damage. What your suggestions to fix that? I didn’t see you address how to fix metabolic damage so any tips would be appreciated. Thank you for these wonderful posts and for all of the helpful information!

  11. Hello Dr. Childs,

    I am a 35 year old female 5’5′ in height. I have always been very active, work out, run anywhere from 5-8 miles daily. I have always led a healthy life style. After have 2 boys now ages 13 & 14 my weight has always stayed steady at 140 pounds.

    I had a hysterectomy in May 2017 due to endomitriosis. I only have my left ovary. I am currently taking a testosterone compound cream daily.

    After a long battle (1 year) of finding the right Dr. to treat me, I finally had a total thyroidectomy in February 2018. I had 12 cancerous nodules (papillary carcinoma), 2 very large in size, severe Hashimoto’s and severe hypothyroidism. I had never taken any meds until my surgery. At the time of my surgery I had already put on 20 pounds. I had very little to no energy. I was struggling to go to work every day as a teacher.

    Since my surgery in February 2018 I have continued to gain weight, lots of weight. I am currently to date at 184 pounds. This is more than my pregnancy weight. I am not sitting on the couch eating non-stop.

    I started out taking 137 mg of synthroid. 8 to 10 weeks after surgery I could not get out of bed. I was falling asleep driving home and at my boys baseball games. I finally talked my endo. into adding a new medicine. She added 5 mg 2x daily of cytomel (generic). This has helped to a minimal on my energy. It is like a roller coaster when the medicine is working I feel normal, but it is very short lived.

    Through this process my T4 and T3 levels have been in the normal range. I have talked with my Dr. about my severe weight gain and she blames my sleep patterns, and eating habits. Which could not be further from the truth.

    I recently (May 2018) went to a weight loss clinic in hopes of getting on diet pills (which I have never taken in my life) but I am desperate. They did blood work and noticed that my TSH levels were seriously LOW. My TSH level is 0.06

    I let my endo know about those results and she continues to blame my serious weight gain on other things. I am at a complete LOSS, I am frustrated and can NOT get this weight off.

    What am I missing? What do I need to discuss with my Dr? I need to get my energy level back up so I can run again and get this weight off! I have never been more uncomfortable in my life.

    Thank you for your time and any help you can offer. I have relied on the information you provide and it all seems to make sense to me. I just don’t know how or what to discuss with my Dr.


    • Hi Brittany,

      The best thing you can do is find a knowledgeable physician and work with that person. It is never an effective strategy to try and convince your doctor to look at the “right things” or treat you a certain way. I’ve put together a resource here which should be able to help:

  12. Hi Dr. Childs, What do you mean Low thyroid hormone? Low TSH? or low free T4? What is T4 vs Free T4? I am so confused with these online info, and couldn’t really get help from an endocrinologist. Don’t even ask them for T3. Thanks.

    • Hi Jen,

      Thyroid hormone refers to T3 and T4, TSH is not a thyroid hormone but a hormone which stimulates the release of thyroid hormone from the thyroid gland. If I say low thyroid hormone in a blog post I am usually referring to both low T4 and low T3 or one or the other. Hope this helps!

  13. I’m doing some research to settle an argument.

    I believe that even more than strictly “proper” diet, lack of exercise is not only contributing, but directly responsible for the uptick in sluggish thyroid.

    I’m not waving off the importance of proper, balanced nutrition, understand.

  14. Dr. Childs,

    For a thyroidectomy patient. Do you think T4 or T3 is still important to weight gain? An endocrinologist think if you had been on the levothyroxine long enough,TSH would give accurate results, you don’t need a free T4. If T4 is 1.7 a good number? How it related to weight? Thanks a lot!

    • Hi Jen,

      Yes, both total T3 and free T3 have been correlated with weight loss in several studies. The higher your T3 the more likely you are to both lose weight and keep it off.

  15. Dr. Childs,

    How about T4 to weight gain? Do you know any endocrinologist in Boston area that will review both T4 and T3? I cannot get this doctor to order the test for both T4 and T3, I tried. Thanks. Jen

  16. Hi Dr. Childs:

    I am 51 and have been postmenopausal for almost three years now and have been on hypothyroid meds for about 6 years. Synthroid worked for about three years, then stopped working and I was doing a lot of homeopathy for my postmenopausal symptoms, including hotflashes (those going on 6 years now!), 10+lb weight gain that absolutely won’t budge (I’m athletic), receding gums, some muscle joint pain, low libido. I have been on 48.75mg of Naturethroid since April and saw slight improvements at first but now I feel it’s a waste. (All my T4, T3, and RT3 were normal in bloodwork). A lot of my issues point to estrogen/progesterone imbalance. My ob/gyn recently put me on 200mg progesterone and 1mg Estradiol and my symptoms worsened, so I stopped taking it. I live in the Austin area and I’m sure have good resources. Do you know of any here? I feel like a big, expensive experiment! Thanks!

  17. I have spent a fortune going to functional MDs since 2004 and none of them seem to be able to balance my hormones or understand the principles you outline in your writing. I am very borderline hypo and when going on Armour the lowest dose was too strong – gave me heart flutterings, kept me up at night, etc. I gave that up 4 years ago and am trying to just boost my thyroid and balance progesterone, cortisol, insulin, leptin, etc. I lost 57 lbs in 2013 but staying on the same regimen for years I gradually plateaued and then started gaining again – and I think I wouldn’t lose weight now if I ate nothing ever again! I believe your materials explain why. I am now doing 18/6 Intermittent Fasting, take a ton of expensive supplements, do Bulletproof coffee, cyclical low carbs, extreme efforts for clean natural eating, Power Plate with bands and swimming for exercise, and have started on your Leptin RX, and T3 Conversion products about six weeks ago. I believe they are helping but only time will tell if all this works. I have spent a fortune on a limited budget and that’s very discouraging to work so hard and get so little results from the extreme efforts and expense. I would love to order the Gut Bomb and other products but its not within my reach on my retirement income. Losing weight is like a full time job without pay!! I’m waiting for the magic balance when the fat just starts melting off (like in 2013). I’m hoping your information and a few products will be my breakthrough. Thanks for your excellent service and offerings: I’m counting on this to work!


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