Thyroid Weight Loss Case Study: 42 Pounds Lost on Byetta + T3 + NDT

Once Kathy had the right diagnosis and treatment plan in place she was able to lose 42 pounds in a matter of months...

But the real question is:

Why did it take her 5+ Doctors to find and treat her and what does it take to help thyroid patients lose this kind of weight?

​The answer might surprise you. 

Most of the time it isn't thyroid issues holding back thyroid patients from losing weight. 

This is important so I will repeat it.

If you are a hypothyroid patient and you can't lose weight, the reason is most likely related to some other hormone problem - NOT your thyroid. ​

I'm going to explain why throughout this post but for a second let's jump back to Kathy.

By the way, here is a before and after picture of Kathy (42 pounds and 3 months later)...

As you go through this post I want you to ask yourself this question:

Is her story similar to yours? 

Kathy before and after thyroid weight loss

More...

Why Doctors Ignore the Problem and Why you can't Lose Weight

If you want to get similar treatment as this case study you can find more about my hormone and weight loss mastery guide designed to help thyroid patients lose weight and feel better. This program includes meal plans, exercise routines, videos, medication guides and more.  

One of the biggest problems I see facing thyroid patients is weight loss resistance. 

They attempt to tackle this problem with repeated bouts of eating less and exercising more. 

There's just one big problem with this approach:

It doesn't work and it can damage your thyroid in the process

This type of dieting may lead to some weight loss in your 20's and 30's, but will almost always result in significant damage to your metabolism and guarantee a very unpleasant 40's-50s with weight gain and weight loss resistance.

Cutting your calories (and exercising more) leads to metabolic damage and numerous hormonal changes that lead to weight gain (1). 

If you are truly interested in losing weight then balancing your hormones, not your calories, is the answer to your problem.

But what does every Doctor tell you if you tell them you want to lose weight and you have thyroid problems?

First - If you want to lose weight you need to eat less and exercise more

Second - They either think you are lying to them about your diet, or they try to put you on anti-depressants.

​Does this sound familiar?

Instead of focusing on how much you eat or how much you exercise, you should be focusing on the following hormones: Thyroid hormone, Insulin, and Leptin.

These 3 hormones contribute to the majority of weight gain and weight loss resistance in most patients that I see and treat on a daily basis.

Yes, testosterone, estrogen/progesterone, and cortisol play a role - but they are usually secondary to the big three listed above. 

This is why it becomes so important to shift your focus away from diet, calories, and food and toward hormone balance. 

But, when was the last time your Doctor talked about ordering these tests?

When was the last time that your Doctor mentioned that these hormones can lead to weight issues?

My guess is probably never - and that is the problem. At the end of this article, you can find some resources to help you find a doctor willing to work with you. 

But for now, let's use Kathy (and her labs) as an example of how and what you should be focusing on...

Download my Free Resources:

Foods to Avoid if you have Thyroid Problems: 

I've found that these 10 foods cause the most problems for thyroid patients. Learn which foods you should absolutely be avoiding if you have thyroid disease of any type. 

The Complete List of Thyroid Lab Tests:

This list includes optimal ranges, normal ranges, and the complete list of tests you need to diagnose thyroid hypothyroidism correctly!

Download more free resources on this page

​Getting the Diagnosis Right

Now, I should take a minute to break down a few things for you before we get into her labs:

First - ordering the right labs is only just the beginning of your treatment.

If you go to your Doctor with a list of labs that I am recommending you are likely to be met with frustration.

Why?

Because if your Doctor knew about these hormones and tests then they would have ordered them to begin with.

Most of the time asking for a bunch of tests the Doctor isn't comfortable interpreting will be met with a big old "your labs are normal".

That's why I want to break these down for you step by step so you understand the big difference between "optimal" and "normal".

So let's take a look at Kathy's thyroid lab tests:

Abnormal TSH kathy
Hypothyroid lab tests kathy

As you can see they all fall within the "normal range", but are they really optimal?

Her TSH is 3.323 with a reference range of 0.35 to 5.5. If you read the blog post I linked above then you will know that an optimal TSH is usually less than 2.5 uIU/mL.

Her sex hormone binding globulin is 40 with a reference range of 18-144 (Optimal range is 70-80).

Her Free T4 is 0.95 with a reference range of 0.89 to 1.76 (Optimal range is usually top 50% of the reference range). 

Her Free T3 is 3.3 with a reference range of 2.3 to 4.2 (Optimal range is usually top 50% of the reference range). 

Right off the bat, you can see that she is hypothyroid just by looking at her TSH alone. 

Why?

Because the pituitary gland (where TSH comes from) is the most sensitive tissue in the body to thyroid hormone.

If your TSH is elevated, then I can almost guarantee that thyroid hormone isn't getting to other target tissues and that is indeed the case based on her sex hormone binding globulin.

So is it true that her thyroid is "normal"?

Absolutely not, and that would explain why her brain fog, energy levels, and weight all started to improve once she got on the right kind of thyroid medication

The bottom line:

She is Hypothyroid and needs thyroid medication.

But what else?

One of her main issues is weight gain and I told you previously that most weight loss resistance is NOT from the thyroid - so what is causing it in her case?

We only need to look as far as her insulin and Hgb A1c levels: ​

Insulin resistance thyroid labs kathy

Her Hgb A1c is 5.7 (optimal range is < 5). This result by itself flags her as pre-diabetic and means that she has issues with blood sugar (2).

And, in addition to her elevated Hgb A1c, she also has an elevated fasting insulin of 21 (optimal range is less than 5 while fasting). 

The combination of these two tests confirms that she suffers from a condition known as insulin resistance (3). 

Most Doctors won't even mention a Hgb A1c that is in the pre-diabetic range because there really aren't medications designed to treat this issue even though it's a big deal. 

High levels of insulin tell your body to store extra calories as fat and they inhibit a hormone called hormone sensitive lipase (4).

When insulin is high, fat burn will be almost non-existent because of this enzyme.

What does this mean for you?

Attempts to lose weight will NOT work unless you can lower your insulin levels (we will talk about that below). 

And this wasn't even her biggest issue:

Leptin resistance kathy

You can see that her fasting leptin level is 48.2 which is VERY high.

Leptin is a hormone secreted by fat cells designed to communicate with the brain. Excessively high levels of leptin in obesity indicate a condition known as leptin resistance (5).

Normal leptin levels should be < 10.

So this leptin is almost 5 times higher than it should be, and along with insulin resistance will make weight loss very difficult. 

Now we have 3 big hormone problems that Kathy is dealing with: 

But she also presented with several nutrient deficiencies that were also contributing to her low energy levels: ​

Low vitamin D and vitamin B12 kathy

Her serum level of Vitamin B12 was 576 with a reference range of 211-911 (Generally I like to see Vitamin B12 > 1,000). 

Her Vitamin D level was 30.1 with a reference range of 30-100 (optimal range 50-60). 

Ok, so now that we know what the issue is we can work on a treatment plan that addresses ALL of these issues that will allow her body to lose weight. 

This is only a small portion of her tests, by the way, the entire lab report is 8+ pages but I only included some of her results for this discussion. 

Gettin on the Right Type of Thyroid Medication

Patients with hypothyroidism are always trying to optimize their thyroid medications to impact their weight. 

They often ask something like this: 

Will switching to T3 containing medications (Like NDT or Cytomel) help me lose weight?

While it is true that hypothyroidism causes your metabolism to slow down (6), the majority of the problem comes from the effects of thyroid hormone on other hormones in your body.

So yes, hypothyroidism does cause weight gain - but only about 10-15 pounds.

That means switching from Levothyroxine to Naturethroid or WP thyroid will usually cause some weight loss, just not a ton. 

The real benefit of adding the T3 containing medications to your regimen comes from the added increase in energy and metabolism.

Adding thyroid hormone helps your body get into "fat burning mode" and helps with weight loss in general.

In my experience, most patients do feel much better on Natural Desiccated thyroid hormone or T4/T3 combinations like Levothyroxine plus Cytomel.

So I don't want to downplay the importance of getting on the right type and dose of thyroid medication, but I also don't want you to think that this will be the "cure" you are looking for.

In the case of Kathy she wasn't on any thyroid medication (despite obviously suffering from hypothyroidism) so adding on some thyroid medication boosted her energy levels, weight loss efforts and cleared up her brain fog tremendously.

For more information about thyroid medications and how to find the best one for you please see these links:

In this particular case, I used a combination of NDT (Naturethroid) and Liothyronine together. 

I've found this combo to work quite well because many patients need more T3 than what is already found in NDT. 

The Role of Temporary Medications to Balance Hormones and Help with Weight Loss

​I also want to talk about how to use temporary medications that can help boost weight loss results by influencing hormone levels. 

Many patients tend to freak out a little bit when I talk about adding medications because they are afraid of being on extra medications forever.

And I understand the apprehension.

But when it comes to conditions like insulin resistance AND leptin resistance (especially if you have both at once) it can be VERY difficult to treat them "naturally".

The addition of temporary medications can help lower both insulin and leptin levels while simultaneously augmenting weight loss and bringing other hormones back into balance.

Let's talk about insulin resistance as an example:

High insulin can cause high or low testosterone levels, high estrogen levels, low progesterone levels and make thyroid function worse.

In this case, it makes sense to help reverse the insulin resistance faster to promote more weight loss and bring other hormones back into balance.

This can be accomplished through the use of GLP-1 agonist medications. 

Medications in this class include Byetta, Victoza, and Bydureon.

These medications were originally intended to be used in patients with Type II Diabetes (7) but are extremely potent in lowering insulin and leptin levels and promoting weight loss. 

Studies show (8) that using them in non-diabetic, obese women can result in significant weight loss (through the mechanism discussed above).

I've found these medications to be great if used temporarily and if used with other treatments. 

A new drug, known as Saxenda, has recently been FDA approved for weight loss (9) which indicates that people are catching on to how effective this class of medication can be. 

In Kathy's case, we added Byetta after she had lost 20 pounds and had reached a plateau.

The addition of Byetta allowed her to drop another 17 pounds over 4 weeks. ​

I prefer to use these medications only as a last resort to help break through plateaus. 

By using them in this way you can prevent using them long-term and you should be able to maintain your weight after you stop using them

The Treatment Plan that Puts it all Together

So how exactly was Kathy able to lose 42 pounds in 3 months? 

Let me go over her exact treatment.

But first, take a look at her 'after' labs:

Insulin after 42 pounds of weight loss kathy

You can see her most recent fasting insulin levels came back at 8.4 (which is down from 21 when we first started). 

That drop in fasting insulin is a huge drop and probably one of the main reasons she was able to get that amount of weight off so quickly.

So how did we do it? 

Treatment plan: ​

  • Medications: Byetta
  • Hormone therapy: NDT + Cytomel
  • Supplements: Probiotics, Protein Powder, Vitamin B12, Vitamin D3, Fish oil, Berberine, and Adrenal Support
  • Detox: FAR IR Sauna plus Whole body vibration therapy weekly
  • Exercise: 30 minutes of walking daily
  • Stress Reduction: Meditation

Most patients and Doctors may believe that adding NDT or simply changing thyroid medication (or increasing the dose) will lead to the desired results but I'm here to tell you that that rarely works. 

Instead, you need a combination of therapies all designed to treat the major issues present in the body. 

This generally means a combination of hormone balancing treatments, changes in diet, the addition of medications if necessary, and of course lifestyle changes.

Using this approach helped Kathy to lose weight and start feeling better. 

After 3 months she lost 42 pounds (with some tweaking of her regimen), her energy levels increased to 8/10 and her brain fog is 75% improved from baseline.

She has a goal to lose another 20 pounds and she is on track to hit that goal within a couple of months.

If you are interested in getting results like Kathy then you need to make sure that you are also utilizing a comprehensive treatment plan. 

The reason I wanted you to compare your treatment to hers was to give you an idea of what is necessary to get where you want to be.

Bottom line: ​

By focusing on her MAIN problems (insulin, leptin and thyroid hormone) we were able to significantly reduce her symptoms and help her lose 42 pounds in 3 months

Don't Forget Nutrients and Supplements to Boost Results

A quick work about supplements and treatment:

Make sure you don't fall into the trap that supplements will be the quick and easy answer to your problem. 

Supplements and nutrients can definitely help, but I recommend that you target them to YOUR body and YOUR needs. 

I recommend basing supplement choices off of laboratory results whenever possible (sometimes clinical symptoms is appropriate as well). 

In this specific case I wanted to go over why I used each supplement:

  • Adrenal support: To help energy levels and nourish adrenal function (based on subjective symptoms)
  • Probiotics: To help normalize gut bacteria, beat cravings, and help promote metabolism. 
  • Protein Powder: To help provide nutrition, basic vitamins, and promote satiety. 
  • Vitamin B12: She was deficient and replacing B12 helped improve both her memory and her energy levels. I prefer the use of injections but oral B12 supplements can work as well. 
  • Vitamin D3 + Vitamin K2: To replace deficiencies and to promote proper calcium regulation in the body.
  • Berberine + Alpha Lipoic Acid: Both designed to help treat insulin resistance and lower blood sugar levels (to help with weight loss)
  • Krill oil: To help balance omega 3:6 ratio and reduce inflammation

Supplements can help BOOST results but if your leptin levels are as high as what was depicted in this case study it is unlikely that supplements by themselves will be enough to treat the problem. 

That's generally why I consider supplements as only a part of an overall treatment plan.

Do you Have Questions About this Case Study?

If you haven't already I would encourage you to check out my Hormone and weight loss mastery guide.

That program contains many of the meal plans, exercise routines, supplements, and fasting protocols that Kathy used to lose weight. It also includes private videos designed to help you get on the right track with your medications if necessary. 

To recap:

Significant weight loss and symptomatic improvement are possible in hypothyroid patients - it just takes the right approach to treatment and management

If you are seeing a provider that is ignoring your Hormones as a cause of your symptoms (or is unwilling to at least look into them) then you may want to seek out another provider.

I've created a resource which you can use here designed to help you find a doctor to help.  

Now it's your turn:

Do you have any questions about this case study? 

Have you been able to successfully lose weight and keep it off?

Are your hormones optimized?

What is holding you back from getting your desired results? 

Leave your questions or comments below! 

References (Click to Expand)

This post was most recently updated on February 8th, 2019

Dr. Westin Childs

Dr. Westin Childs is a Doctor of Osteopathic Medicine. He provides well-researched actionable information about hormone-related disorders and formulates supplements to treat these disorders.He is trained in Internal Medicine, Functional Medicine, and Integrative Medicine. His focus is on managing thyroid disorders, weight loss resistance, and other sex hormone imbalances.You can read more about his own personal journey here.

99 thoughts on “Thyroid Weight Loss Case Study: 42 Pounds Lost on Byetta + T3 + NDT”

  1. Cannot believe someone just know how guilty I feel to see a doctor. Eat less , work out more – 20 years since I’m diagnosed. Getting worst last two years . Would be great if I can buy a plan for me , will be difficult because in UK GP don’t even show you any results . I’m 48 years old 5’3″ – 11.5 stone . Tired to blame my self to be usles and lost a battle with tiredness and stones. My best regards Mariana

    • Hey Mariana,

      I know there are Doctors in the UK willing to prescribe T3 and NDT because they have left comments on my blog before – I think they are hard to find but they do exist out there.

    • Mariana, in the UK the GP may not show you your results, but you are entitled to ask for them. When you have had a blood test done, wait a few days to allow time for the results to be sent back to your GP. Then call the surgery and ask are the results back and what are they. What usually happens is the receptionist will look at your record and say ‘yes results are back, they are ‘normal’ nothing to be done’

      At that point, just say that you would like a printout of the results. They will probably ask why you want them, just tell them you like to keep a personal record so you can compare results against your next blood test. Usually then the receptionist has to check with the doctor on duty that day and then you should be given a printout. Alternatively make an appointment with your GP to get the results and while you’re with him / her ask them to print off the results for you and it must be with the ranges quoted by the lab which did the test.

      Yes there are doctors in the UK who will prescribe T3 and NDT but T3 is being withdrawn from many people as the NHS only uses one supplier and they have put their prices up hugely. In some cases to £400 per month, so the GPs won’t pay for this from their budgets. Many people are sourcing T3 from abroad as many European countries sell T3 over the counter for a couple of Euros a pack. Some people are taking a holiday in these countries just to go and stock up on T3. Most doctors who prescribe NDT are usually in private practice. But once you’ve had a first private prescription from them, you can then source it privately at a much cheaper price. But first best to make sure these 2 medications are right for you as Westin says below.

      Hope thats of help.
      Georgina (Bedfordshire UK)

  2. Hi there,
    Thankfully I found this article and have a bit of hope for my condition. I’m feeling stressed and depressed and I’m in constant pain everyday. I was my whole life 100 pounds and now I am up to 180. I’m only 5 1. I have no energy at all. I live in Windsor Ontario do you know of any good doctors who are as knowledgeable as you in this area? I’m tired of hearing my TSH levels are normal. Obviously I’m not. When I had Graves disease they gave me a radio active iodine pill to take but now tell me I do not need meds. This is so frustrating!!! Thanks for listening to me rant but your article was Amazing and gave me a bit of hope.

    • Hey Jody,

      Unfortunately I don’t know of any other doctors who practice like I do – I’m sure they are out there, I just don’t know them personally.

    • Hi Jody,
      My situation is similar to yours. I live in Kenya but when I was diagnosed I was in Brampton, ontario.

      Same as yourself, I initially had graves and was given radioactive Iodine pill.

      Currently I am battling several issues and my doctor just changes my dose.

      It’s really frustrating and I don’t know what to do.

      I wish you luck and hope you find a good doctor who can help you.

      I just try to be positive and go on, nothing else can be done unless some help comes along.

  3. Hello Dr. Westin…I’m glad I happened upon your facebook page a few days ago! I’m a real mess right now as I believe that my thyroid, hormones and adrenals are all oit of whack! I’m wondering if it might be possible to email you my recent labs and give more detailed information of what is going on with me? I did call and leave a message to your office to see if you are accepting new patients. I would love to be one of your success stories! I’ve been battling thyroid since 2009. Had RAI in 2011…seen numerous practitioners but get the same song and dance about being in the “normal” range but I’m clearly experiencing a myriad of symptoms that are ignored!! I sure would love to discuss more with you in a more private setting. Thank you for all of the information you provide to people grasping at straws to feel better!!

  4. Hi! My name is Suzette and I’m Hypothyroidism but I had radioactive iodine so now I’m on synthroid. I try and try to lose weight I’ll lose 3 or 4 pounds and then after that with all my efforts the scale will say I gained or sometimes it will say I lost some pounds. I’m frustrated. Can you please help me?

    • Hey Suzette,

      If you follow the recommendations in the article you should find success. Without treating you as a patient there’s not much I can do except recommend the topics I’ve already written about.

  5. I am very interested. I used to take cytomegalovirus and levothyroxin. The doctors where I live don’t want to talk about all my other symptoms I have and just blame my thyroid.

      • Hi dr child’s do u happen to know anyone in Australia that practises as you do , Iam on byetta at the moment and oroxine but weightloss is none existent sadly

        • Hey Jeanette,

          I don’t include all of my therapies in my case studies, but I can say that medication by itself rarely results in significant weight loss – it’s the other therapies that I add in that helps move the needle. It’s also a matter of dosing, picking the right medication for the specific person and boosting the effects with other therapies.

  6. Hi Westin,

    You know my husband, Craig Brown, and he has sent me A LOT of your posts and links because I have hypothyroidism. Recently diagnosed and JUST had my 3 month labs since I first started on Levothyroxine. My levels are still on the lower side of things, or less active I suppose. I am tired 80% of the time, I eat until I am physically ill, I have no motivation to lose the weight or even try to diet… I feel like I’m just on a downward spiral. I’m not sure what you could do to help me since I’m in Missoula Montana, but ANY suggestions besides “diet and exercise will help you feel so much better” would be superb 🙂 hard to do those things without that motivation!!

    • Hey Corby,

      Haha, Craig and I were just reminiscing of the good ol’ days!

      Here’s the deal with hypothyroidism in a nutshell: 99% of Doctors treat based off of the TSH (they treat your labs not you as a person) which results in all of the symptoms you are experiencing (weight gain, fatigue, lack of sleep, menstrual irregularities, etc.). By focusing on the TSH you will probably never really symptomatically improve (though your numbers will) which will make almost all of your weight loss efforts fail. Probably the single most effective thing you can do to improve your energy and well being is switch to medication containing T3 and don’t base your dosing off of the TSH (this means something like naturethroid or levothyroxine + Liothyronine). The sooner you can find someone the better – the longer the ‘chase the TSH’ game goes on the more damage occurs to your body.

      The big problem is finding someone willing to treat you as I described above. Unfortunately I can’t treat you in Montana, but you might be able to find someone like me local to give you the medication. I personally don’t know anyone in that area but I will ask around some of my contacts to see what I can come up with and let Craig know.

  7. Hi Dr Child’s
    I am in the UK and have been on levothyroxine for 25 years and have NEVER felt 100% well.
    I have been taking NDT for about 8 months and am supplementing B12, K2 and D3.
    Although I feel slightly better I still have terrible afternoon tiredness slumps. I am about 4 stones overweight and have tried most diets. I lose a few pounds and then weight loss just stops.
    I want to have a normal life and enjoy my life.

    Do you do Skype consultations or can you recommend a Uk practitioner?

    Thanks for reading this
    Laura Stango

    • Hey Laura,

      I don’t know any practitioners in the UK, but I do know that some exist from comments on this blog. I believe most are cash only.

  8. So glad I found this article, have put on 5 stone since having TT 18 months ago. Really struggling to lose it & keep being told the usual “eat less, exercise more”! A very active job, “lots of walking & 3 exercise classes a week should shift something! Really informative article, how do we get the right bloods done though when doctors won’t listen.
    Kind Regards

    • Hey Debbie,

      The correct blood work honestly doesn’t matter if you don’t have the correct Doctor. The blood work is just the beginning, the treatment plan is the important part and that depends on the Doctor.

  9. I have had a total thyroidectomy In 2012. For hyperthyroidism with 5 nodules ,,,now I. Take Oroxine
    I am Tired mane but wide awake nocte till 0100
    I was treated fir over 40 yrs for thyroid disease. Nobody seems to know how to treat it

    Maybe the Cytomel in addition to Oroxine will help?

    • Hey Susan,

      It may help if your problem with fatigue is due to your thyroid – it could certainly still be due to something else as well in which case the medication will not help.

  10. Hello,
    Thanks tor the sharing, it’s very helpful. Unfortunately there are not many doctors which look at the whole picture..
    I have a question regarding the T3 hormone – how it should be taken and is it a part of a *temporary* treatment?

  11. Thank you for all of your help Dr Childs.
    My recent labs came in with TSH .22,
    Total T4 is 5 and total T3 is .7 . My b12 is 588 (just started weekly injections) and my vitamin d is 27. I am currently on 2 grains of armour thyroid, selenium, zinc, d3 (4000 iu) and prescription assist probiotics. I am feeling better but confused about my numbers.

  12. I am 64 (hysterectomy 15 years ago), confirmed Hashimoto’s diagnosis 2 years ago, on no thyroid medication yet. 20 lbs weight gain over last 2 years while eating paleo. Current endo is “let’s wait until thyroid dies and then we’ll medicate.” Also watching calcium and PTH numbers, as both are high. Do you do initial consults using current lab results I might have on hand?

  13. Are drugs like Byetta the only way to treat insulin resistance? My last insulin level was 37.5 (range ends at 24.9) and leptin was 37.2, my doctor talked about putting me on Metformin or Byetta (or something like it) to lower my insulin levels, but we both have concerns about it. I have chronic pancreatitis and all the drugs for IR seem to say not to take it if you’ve had pancreas problems.

    • Hey Elizabeth,

      No there are other ways to treat insulin resistance, but yeah – I certainly wouldn’t throw you on a GLP-1 agonist with a history like that.

      • Can I ask what those ways are? I’m suffering miserably because nobody knows how to treat my IR without causing problems with my pancreas.

  14. Hello, and thank you for the fantastic information. I am desperate to find a doctor who understands this condition and can follow through in the way you do. Can anyone advise in the uk. I feel absolutely desperate. Please help.

    • Hey Jan,

      You will have to touch base with your current doctor because I don’t know anything about your history and I can’t offer medical advice to you in this setting.

      • Yes she was not real concerned with it . I have read a lot about high RT3 not bring good but nothing about low RT3 being a issue . Was just wanting your thoughts on low RT3

  15. Just wondering what your opinion is on levothyroxin. I take thyroid compound 120 mg along with levo 100 mcg. In your opinion, is eliminating levo and combining into one pill a better option? Started on armour a number of years ago and several years back changed to the compound when the pharmacies were having a hard time keeping in stock. Same as usual, can’t lose a pound to save my neck! My doctor would be open to nearly anything! Thanks

    • Hey Dawn,

      It generally doesn’t make a difference if you are using a combination of pills or putting them in the same medication – what matters is finding the ratio of T4 to T3 that works best for your body. Most likely, though, changing up your medication won’t result in significant weight loss.

  16. I am currently on my 4th doctor in 1 1/2 years since having a TT and pathology coming back pappillary cancer. I had RAI, also. I am so frustrated right now. I have been to 2 endocrinologist and 2 general practice doctors. My 2nd was helping me tremendously, only to have the clinic he worked at close. Sometimes, I just want to give up but I know that is not an option since I have no thyroid. I have follow-up with this Thursday. I am hoping this doctor can help me!! Just wondering where you are located? Thanks!

  17. I was diagnosed with follicular and papillary cancer 4 years ago and ended up having my thyroid taken out also have type 2 diabetes and I have osteoarthritis in both knees and both hips I feel so depressed I’m on tablets I can’t lose weight however much I’ve tried and I just need help, I’m due to have my blood test taken again for my type 2 diabetes review is there anything I should be asking my Doctors to do before I have my blood test I would appreciate some help thank you

  18. I have hashimoto thyroid, have gained weight, doing 1200 cal. no gluten, no dairy, no sugar, along with taking bydureon, 88 synthroid, cytamel 5 two times a day. I was at 149lbs went to 183lbs. I am so frustrated. please can you give me some advice.

    Thank you for your time.

    Sandy Van Nosdall

    • Hey Sandy,

      The best thing you can do is find a Doctor willing to work with you and sort out these problems you are experiencing.

  19. I’ve been seeing an anti-aging doc for several years now. My major complaint the past 2 + years is my weight!!!! He switched me to Natures Thyroid several months back and my weight has not changed one ounce!!! I have not been Dx with any type of abnormal thyroid—hyper or hypo. I’m frustrated and ready for a new doc! HELP!!!!!!!!

  20. I love this article! I’ve been dealing with Hashimoto’s since being diagnosed in January 2015. My current integrative doctor has me on Levo 75 mg. I’ve had a hard time adapting to Cytomel even the lowest dose at 5 mcg. as it seems to stimulate my system too much, so we continue to eliminate it. Since I do have Hashi’s, she does not want to prescribe natural thyroid. I’m not really sure I understand why. I’ve recently switched to a compound pharmacy formula of Levothyroxine and actually feel better.

    I’ve reduced my antibodies from 5100 down to 120 since May of 2015 – so am improving, however, weight loss resistance is still my most frustrating symptom. I’m 52 yo, 5’2″ and am now 168 lbs. and feel miserable. I’ve gained 12 lbs. since I started Levo last may. Not sure how else to explain it, as I follow a fairly solid paleo diet.

    I love the idea of intermittent fasting – but wonder if would still be a good approach with Hashimoto’s. I typically eat dinner at 7 pm, and have my first meal usually a high quality protein shake at 9:30 am. Maybe I already am intermittent fasting to a degree. Thank you again for your awesome articles. If you have any comments to my post I’d be overjoyed!

    • Hey Devonne,

      Intermittent fasting really depends on the person, it works for some and in others it can be more harmful than helpful.

  21. I am a 65-year-old woman. I have a past history with serious hormone overload (having suffered from endometriosis and adenomyosis in my 20’s and 30’s until I had a complete hystrectomy at age 36.) I also have HS (skin issues) probably autoimmune and most recently autoimmune Hashimotos’ and adrenal depleation. I am taking Nature-Throid 1/4 tablet am and pm. and a variety of high grade supplements for my thyroid and adrenals. My new MD (with a speciaity in hormones and chronic issues) is talking to me about bioTE hormone pellets (implanted under the skin). I’ve pretty scared to take hormones after my lifelong history with endometiosis pain/inflammation/bloating etc. and so many things are also counter-indicated with Hashimotos’. I am 11 months into the AIP Autoimmune Protocol which is helping me a lot and I’ve lost 21 pounds in the past 11 months that I have been on this protocol. Do you have any feedback about hormones that might reassure me? Thank you.

  22. I would like to know why you have stated that Armour is not gluten free? The research I have done seems to support that it is. I have celiac, and my functional medicine Dr has put me on Armour.

    • Hey Alisa,

      Armour thyroid is gluten free, however I think there are better choices in terms of NDT formulations out there.

  23. I was diagnosed with Hashimoto disease a good 25 years ago and only recently have been finding out so much information that would have been beneficial to my health had any doctor given me the this vital information. I have been researching on my own because most doctors, in my experience, are only quick to write a prescription and never get to the root causes. I am in levothyroxine 125 mcg and have been for quite some time. My vitamin b and d levels have been very low for which I now take supplements. I am convinced I need a different thyroid medicine. I struggle losing weight and had severe brain fog. I have completely eliminated gluten from my diet which has helped tremendously!! I strongly suggest anyone with an autoimmue disease eliminate gluten from your diet. The difference is night and day. I have found that by eliminating gluten and adding krill oil and tumeric has really helped in reducing inflammation as well. I also take a DSF for adrenal fatigue. I am feeling better but not great so I am hoping eventually I will get all the puzzle pieces I need for optimal health.

    Do you have any other suggestions that would be beneficial for people with autoimmue diseases?

    Thanks for all this great info! It’s sometimes difficult sorting through all the information that you come across online

    Chris

  24. I have been using NDT and T3 combination for some time but have been stuck on weight loss for a long time in spite of eating a very healthy diet…no starches, no sugar, no cow dairy, nothing processed…and also walk/run interval training. I am on most of the supplements you referred to in this article. It’s been awhile but every time I’ve had my insulin levels tested, they are in the low normal range. Is it possible for my leptin to be a problem with normal insulin levels? I’ve never had leptin tested before. Thanks!

  25. I was diagnosed with Hypothyroidism right before I started 8th grade (I will be 55 in March 2017). I was started on armour thyroid 2gr daily. I was eventually dropped down to 1gr. Stayed on that dose for years, my weight and energy were normal. With three pregnancy I did keep some of my baby weight. I was changed to levothyroxine because the doctor said the armour thyroid put me at risk for osteoporosis. Fast forward a bit and I’m diagnosed with hyperlipidemia and aI had put on several pounds. Fast forward again and I went to nursing school, was diagnosed with breast cancer and was still creeping up with the pounds, low energy continued and had brain fog; my levothyrine was decreased from 100mcg to 88mcg during this time and put on statins. Cholesterol still not in normal range. I am now cancer free 9 years and still struggling with high cholesterol, weight loss resistance, low energy and brain fog. Should I request to be put back on armour thyroid?

    • Hey Linda,

      It’s hard to say what you will do the best on without more information and without some trial and error. At a cursory glance it does appear that you may do better on T3 in some form, but there is no universal guideline to follow in situations such as these.

  26. I write from Peru and I can write a book about all the drama that the majority of doctors make you go throught, because they are only guided by the TSH levels, do not recommend the use of t3, just Levo. They only use metformin to treat the problem of insulin resistance, (which I have and I found 2 year latter of being diagnose and treated for Hypo and Not being able to lose any weight) I stopped taking the metformine since my vitamin B12 levels were on the floor, I was not warned by my doctor of this side effect.I’m still with some problems of hair loss, fatigue, weight loss, I need to lose 15 pounds, although I exercise and I do not eat gluten or sugar. My last insulin in fasting was in 12.7 (thanks to this post I realized it is a little bit higger)and what I worry the most is not being able to get pregnant when I want. I take B12 vitamins, take T3 (12.5 mcg)and 100 mcg Levo, even though my doctor told me not to take t3. I dont care .. I just want to start taking the Nature Troid and be able to dosage myself. Any recommendation?? I’m desperate..

    • Hey Jean,

      Honestly, like most people who comment on this blog, you really need guidance from someone who understands your situation and can help you get back to normal. For you (at minimum) that means treating your insulin resistance, probably a change in thyroid medication and helping you with weight loss resistance. All of my recommendations would require physician guidance so they really wouldn’t be helpful in this situation.

  27. I write from Western Colorado. I have hypothyroidism. Diagnosed in 2014 with a tsh of 55.9. 5 doctors later even though my tsh levels are in the ” normal” range, with 100mcg of Synthroid. I am still experiencing all the symptoms of hypothyroidism. I recently, read one of your studies, and got my Dr. to agree to a low dose of liothyronine. I have experienced my hair being slightly better, and once in a while a little bit of energy, but no real changes yet. Most of my proplem is weight gain, I was a thin person my whole life until this and gained to date 70+ pounds!! I have tried severe diet and exercise and several thousands of dollars and it does not fluctuate not even a pound. There are only two endocrinologist here an hour away and they are compleatly booked out for up to six months. How can I possibly come see you? You are very thorough,and I belive you can help me.

  28. Dear Dr. Childs: FINALLLY some hope! I have gradually over the past 8 years (since menopause happened) gained about 50 lbs! I eat fairly healthy, do not eat excessively, was exercising even with back issues. Now more sedentary (61 yrs) but I have been to so many doctors, endos, etc. Told the usual eat less, exercise more! Have tried and tried and tried. Have been trying lately to convince myself to just accept myself and move on. I plan to dig our my latest labs and compare and copy your article and take to my new endo in another month. I hate that I have to even interview the scheduler before booking an appt just to determine if this is an “old school” dr that still believes in the upper thyroids ranges or is it someone who is on the same page as me as far as levels! Even tho I am finally in some “normal” ranges thyroid wise, I still don’t feel very energetic and nothing has happened with the weight. I can really watch it, eat so healthy and lose 2 lbs for the week. One day on the weekend of say having pizza and beer and it is back! And if I were to continue to “not watch it” there will be an additional couple lbs and they have just kept climbing. Thank you for giving me some hope! Now, if I can only find a dr who will listen……………………….

    • Hey Terrie,

      You will likely not have much luck showing this information to an endocrinologist, but you are certainly welcome to do it. All of this information is not well known because the research is new, and some of these treatments are considered off-label.

  29. Hi Dr. Childs,

    I’m a bit confused about the leptin and insulin resistance. I have not take the tests for these, but I asked my functional medicine doctor about these and she said that we don’t need to take them as the treatment would still be the same. My treatment at the moment is dairy-free and gluten-free diet to get a very slightly elevated TPOAg. Would it be a good idea to check my leptin and insulin levels and then talk to her about medication with Victoza or Byetta? She is willing to try things so she’s against my suggestions and she is easy to work with.

    Here are my other levels, which have noticeably improved since Aug 2016:
    TSH 1.75 (range 0.4-4.00)
    Free T4 15.39 (range 10-21)
    Free T3 4.15 (range 3.5-6.5)
    TPOAb 69 (range <60)
    TyglAb <15 (range <60)

    So the Free T3 is not great, but it has improved from 3.6. And others have improved as well. I'm waiting for results for Reverse T3, which I believe is going to be high as I have lots of hypothyroid symptoms and a history of long-term stress and SIBO and dysbiosis.

  30. I’ve been misdiagnosisef more often than I care to remember. Most recently my doctor put me in a “medically supervised program and meal plan” that contained soy and corn syrup! The doctor’s won’t listen to me. How can I find help in Orange County, CA ? I am willing to drive to your office but your site says you are not accepting new patients. In despair.

  31. May I ask if you work with thyroidectomy patients? I had thyroid cancer 14 years ago and have steadily gained weight over the years, I’ve lost weight a few times but have had massive rebound weight gain. My thyroid indicators should be different than individuals with a thyroid, as my TSH should be <1 and thyroglobulin levels should also be <1 to indicate that the thyroid cancer isn't growing back. I am currently on 90 grains of Armour Thyroid. Would love your help if you think you can help me.

  32. I’ve been treated by my functional doctor and functional nutritionist for low cortisol, SIBO, nutritional deficiencies and hypothyroidism and these are all back to normal. No medications. So the blood tests are normal for the thyroid as well. I gave a birth to our daughter 4 years ago and I was first able to lose weight a little bit, but then it stopped and I’m still not able to lose any weight and I gain super easily. I was overly stresses for 3 years for multiple reasons and then had all these health issues as a result. I still have something that’s preventing my weight from going down. All the fat gathers around my waist and above (insulin) and I have no waist at all. I’ve been too scared to take a test for leptin and insulin, but also my doctor said that the treatment for resistances of these two would be the same nutrition I’m on already. I’m starting to be desperate to lose weight as I’ve gathered like 15-20kg during the last 4-5 years and since the birth it’s only got more difficult to lose weight. Yet, I’m hungry during the night for example after eating healthily, but no weight goes down. I have never had this kind of issues with weight loss. It’s always been easy just by dropping sugar off my diet, but now that doesn’t do anything. I’m on a low sugar, dairy-free, gluten-free diet and I don’t eat bread daily at all. What could be the cause of the issue losing weight?

  33. The hormone and weight loss mastery guide link does not work. Can you provide me with that information? My surgeon told me that T3 and the other numbers do not matter (everything I read says they do). I had a TT last October and have gained over 25lbs since then. My tsh was 1.7 two weeks ago and I have now been switched to 200mcg synthroid from 175mcg. A couple years ago I was told that I was insulin resistant and was on metformin. Is that a medication you would recommend also?
    Thank you,
    Jami

  34. Are you able to refer me to a physician with similar practices in Georgia? I’m 35, I have recently gained 30lbs over a 3 month period, while working out with a trainer and eating lean meats, fresh fruits and vegetables. I do have a known thyroid nodule and will be seeing an endocrinologist soon for a mass/goiter. I haven’t viewed my lab work, but the nurse called and told me it was all normal
    I feel like Crap.

  35. Hello, my name is Michelle. I had thyroid cancer, had a thyroidectomy in 2003. I was put on synthoid and cytomel in the beginning and I felt like my old self. It was awesome. Then they took me off the cytomel after 2 mos and said I don’t need it anymore and have felt like crap ever since. Ive asked about it because of the weight gain (which I absolutely hate), puffiness in my face and brain fog, constipation and tiredness/no energy. But the doctors say I’m fine that they have to keep me on low dosage. I’ve been cancer free for almost 10 yrs now. I would to find a doctor like you here in colorado but I haven’t you d one. I am desperate to feel better and lose this weight and get my life back

    • Hi Michelle,

      Thanks for sharing your story. I agree that many people feel better when cytomel is added, it’s just a matter of finding someone willing to work with you and prescribe it. Because being undertreated can cause so many symptoms it’s worth spending a lot of time to find someone to help you.

  36. Hello. Thank You so much for the information in this article. I have Hashimotos and chronic pain from a back injury yet giving up gluten and potatoes, taking Armour Thyroid, and now taking methylfolate and methylcobalamin have made a difference. It is important to note that lab tests may show high levels of folate and B-12 in one’s bloodstream and still be deficient. I was taking folate and B-12 and still having symptoms of a deficiency of these. Finally, I found out that I have the MTHFR gene mutation and was not able to process folic acid. I still struggle with the weight issue in spite of dietary changes and getting exercise whether it hurts or not. I plan to check into taking more T3 replacement since the change to Armour made a difference but not perhaps not as much as the addition of t3 would provide. This article has given me hope that there are more changes I can make to help balance my system. I am eager to see how it works.

  37. Dr child’s. I’m one of your classic cases of Dr only putting me on t4 and telling me that it will convert. Sounds good in theroy but I had my thyroid destroyed by radiation due to graves in 1981 when I was 18. I have developed numerous health issues. Fibromyalgia gastroparesis hialtia hernia gerd the list goes on. In finding your information it all makes sense. Getting to the bottom. Treat my thyroid correctly and maybe these will balance out. Oh yeah 75 lbs overweight and 0 sex drive( not good when you are married to a sexual person and menapausal. Ugh I can’t get a Dr to listen to me. I have never seen my case addressed. What are you supposed to do with no thyroid. They just found growth on it. Do you want a challenging case. Well here I am. Please help

  38. Hello Dr. Childs, I’m a male hypothyroid and have been on Synthroid for the last 20 years. Since I’ve got some experience with hypothyroidism, I can almost predict by looking at people, who might have this issue. I was after my mother for years before she switched doctors and the new one diagnosed her as hypo. I recently started dating a woman who I felt is hypo–after some nagging, she also went to an endocrinologist and, after some lab results, put her on half a grain of Acella NDT daily. I was surprised at the low dose, but I thought maybe he would see her in a few weeks to increase the dose. I have since found out that her next appointment is in four months. How long should she be taking her initial dosage before she starts feeling better? She says she’s sleeping better, but is still quite exhausted. I’d hate to see her wait four months to get the dosage raised–or worse, have her be told that her labs are fine (not sure if she’s seeing someone who’s treating her by lab results only or is listening to her symptoms). Thanks much–your site is great!

  39. Good afternoon,
    I have been researching Hypothyroidism daily. I was diagnosed at 6 with Hypothyroidism and began taking Synthroid. i am 38 years old 3 children and never had trouble with weight, mood ect. At 37 my T3 began to stop converting and I was diagnosed with Hashimotos 6 months ago. Of course all my labs are out of line and the doctor has changed me from Sythyroid with Cytomel to Armour with Cytomel. In the last 2 years I have gone from 129 to 160 and I am becoming very depressed. I am a runner and exercise and eat right daily. Reading this article gives me some hope. Should I have these test ran to see if Leptin could be my problem.
    Tabitha

  40. Hi Dr. Childs!

    First of all I cannot thank you enough for your insight. I have been on your blog countless times when I quite literally felt insane because I went from endocronologist to doctor to OBGYN telling me to work out more and eat less (while I was eating 1000 calories and running 25 miles a week!)

    I’m 22 and I finally got to a functional medicine doctor that diagnosed me with hypothyroidism and low cortisol. I’m on supplements and naturethroid. My energy, sleep is getting better but my weight isn’t budging. It’s only been a short time, about 5 weeks, but my doctor thinks I have insulin resistance and added myo-inositol to my regimen. My first question is, how long does it take for thyroid medication to help with weight loss? My second question is if my weight loss is still not moving do you think my doctor would prescribe Byetta or Victoza? I only have about 30 pounds to lose, I am 150 pounds at 5’3″ but just five months ago I was 125. This is the highest weight I have ever been and it happened quite rapidly despite diet and exercise. Thank you again for EVERYTHING!

    Best,
    Shauna

    • Hi Shauna,

      No problem and glad you found it helpful!

      Thyroid hormone doesn’t really help with weight loss as much as people think it does. If it will help it will help very quickly, if you don’t lose weight upon starting it it isn’t likely that it will lead to weight loss down the road.

  41. Dr. Childs, First of all, thank you for taking the time to post all this information, it’s been very helpful and is very much appreciated! My wife is 45 and her current condition sounds very similar to your case study on Kathy. Hypothyroidism, insulin resistance and leptin resistance. She follows a fairly strict Keto diet and exercises regularly but can’t lose weight. Current test results: TSH 2.97, Free T3 2.7, Reverse T3 25.4, Free T4 1.25. We don’t have a current Insulin and Leptin but the last test showed Insulin 6, Leptin 27. Based upon what we’ve read, our plan is to ask her doctor to prescribe either a straight T3 or a straight T3 along with a T4/T3 combo and add the supplements recommended in your plan.

    A big question we have is concerning allergy shots, my wife receives a 1cc shot of an allergy cocktail in each arm every week…it’s the largest dose the doctor gives to any of his patients. Will the allergy shots reduce or even completely negate all the positives we’re trying to accomplish with the thyroid medication?

  42. Hi, I am in uk, over the last 6 months I have changed from levothyroxine to armour and t3, unfortunately it hasn’t helped. I am waiting for my reverse t3 results, I have been reading about the gallbladder causing problems as well. I am taking 21/2 grains of armour and 1/2 of a 1/4 of t3.
    Insulin 59.5
    Tsh 1.23
    T4 57.2
    Free t4 9.36
    Free t3 4.53
    Anti-thyroidperoxidase abs 9.4
    Anti thyroidgloblin abs <10
    Vitamin d 39
    Vitamin b12 285
    B12 active 128
    Serum folate 4.57
    Hba1c 34
    Hs-crop 5.32
    Ferritin 92.1
    Magnesium 1.00
    I am 57 years old and had my thyroid removed about 30 years ago I have never been the same since, low energy and anxiety. My weight has increased and have tried gluten free, low carbohydrate diets, since trying natural medicines I have found my symptoms have increased as my body isn’t absorbing the medications and have got frozen shoulder. Please can you give some advice, as my doctor is thinking of putting me back on levothyroxine. Thanks

  43. I just got my fasted leptin serum test back and I’m at 91.8!!!!! I feel so overwhelmed that I won’t be able to get them normal again. I did HCG 2 years ago 3 rounds… obviously gained all the weight back. I just got on Victoza after finding your article should I be concerned I am so high???

  44. Hi Dr. Childs,

    I found you online and I have questions regarding my hypothyrodism. I am taking Synthroid 125mg and Liothyronine 5mcg, 3 times per day, however, I have no energy, weigh over 200 lbs (the most I have ever weighed). I workout 3-4 times per week with no success of weight loss. I am being told I am in the “normal” range. I am in the Eastern part of North Carolina. Can you help?

  45. What was Kathy’s post-treatment Leptin Level?
    I have Hashi’s, taking 90mg Armour, 10mcg Liothyronine. According to labs it doesn’t appear that I have insulin resistance (although long ago I had been diagnosed with Hypoglycemia… but I’ve done a lot of nutritional healing since then) but my Leptin levels are far higher that Kathys! I’ve brought them down a bit by intermittent fasting, but still above where Kathy was.
    I’ve begged my doctor to try a GLP1 agonist with me, but he just won’t.
    Would this help me with high Leptin but good insulin?
    I really like my doctor in working with my thyroid, but I may need someone else to help me with weight loss. I’m really struggling.

  46. Dr. Childs,

    Thank you for a very interesting case study! My doctor agreed to prescribe Metformin for insulin resistance, to make weight loss easier since I seem to have reached a weight loss plateau. However, other drugs seem more interesting: Byetta, Saxenda, and Victoza. You have written about all three. Is there anyone in particular you’d recommend to an overweight patient with Hashimoto’s (my doctor has also agreed to prescribe Cytomel to be added to Erfa Thyroid), diagnosed with insulin resistance and displaying all the symptoms of leptin resistance? I’m about 60 pounds overweight and desperate to lose weight.
    Catherine

  47. Dr. Childs,
    This is very interesting info indeed and one that I found at the right moment! I have been on Erfa Thyroid since 2014, am optimally dosed (diagnosed with Hashimoto’s in 2001 and spent ten years on T4 only without much symptom-relief). Although I feel much better on Erfa, it has only resulted in modest weight loss even with free Ts in the upper 50% range you recommend.
    However, after being put on synthetic progesterone (Duphaston) six months ago for ovarian cysts I have gained almost 50lbs and was recently diagnosed with insulin resistance. Whatever I do, I seem unable to lose a single pound. My doctor wants me on Metformin but I have read that Byetta or Saxenda might work better. Is there one you think works better than the other and, if so, why? Thanks in advance,
    Cathy

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