Why is Weight Loss so Difficult After Thyroid Removal?

Gain 20 Pounds After Thyroid Removal? 

I mean it, it’s a serious question. 

Have you gained 20 pounds or more after your thyroid has been removed? 

If so, you are not alone. 

In fact, women, on average, gain around 20 pounds after they get their thyroid removed according to several studies (1) which looked into the matter. 

The question is…

Why does this happen and is there anything that you can do about it?

You already know that your endocrinologist or thyroid doctor is probably not even concerned about your weight gain. 

They probably already attributed your weight gain to your age or some other issue even though the weight gain started RIGHT after your thyroid was removed. 

And this is pretty standard, unfortunately. 

The good news is that there is a REASON for this weight gain and that something CAN be done about it. 

The bad news is that it’s often very difficult to lose weight once your thyroid has been removed and that’s exactly what we are going to discuss now. 

4 Reasons Patients without a Thyroid Struggle with Weight Gain

You should be aware that each patient is a little bit different. 

I’ve seen stories of people who gain weight immediately after their thyroid has been removed and I’ve seen people who were fine for a few years and then suddenly experienced rapid weight gain. 

Others still experience a slow weight gain over many years. 

Whatever flavor of weight gain you are struggling with, once your thyroid has been removed will most likely stem down to these 4 reasons. 

You should be aware of these reasons because the chances are high that your doctor will most likely ignore them. 

It will be up to you to advocate for yourself! 

#1. Your Thyroid Regulates your Metabolism (about 60%)

The PRIMARY reason that women gain weight once their thyroid has been removed is actually quite simple. 

Your thyroid gland controls and regulates the majority of your metabolism. 

You know, your metabolism, the same thing that controls how many calories you burn on a day-to-day basis which in turn regulates your appetite. 

The thyroid gland is responsible for controlling about 60% of your entire metabolism (2), give or take a few percentage points based on the person. 

We know this because of clinical studies which have attempted to estimate exactly how much your thyroid contributes to body weight. 

And this shouldn’t come as a surprise. 

Why?

Because one of the biggest complaints of people with low thyroid is weight gain. In fact, it’s the #1 most endorsed symptom by women with low thyroid function. 

Isn’t it ironic that women tend to gain weight immediately after their thyroid has been removed knowing that their thyroid controls a huge percentage of their weight? 

I say ironic because your doctor will try to play it off like your weight gain is due to some other cause when the most obvious cause seems to be overlooked. 

The changes that occur to thyroid hormone regulation in your body once your thyroid has been removed are also responsible for why it is so difficult to obtain a regular weight after. 

It’s going to be very difficult to manage your weight if the very thing which regulates it is compromised and not back at 100%. 

If you’ve gained weight AFTER your thyroid has been removed the first place you should look at is your thyroid medication dose. 

This brings me to the next topic…

#2. Most thyroid patients are UNDERtreated with thyroid medication

The majority of patients who have had their thyroid removed struggle because they are being undertreated. 

What do I mean?

I’m talking specifically about your thyroid medication dose. 

The prescription medication that you were given once your thyroid was removed. 

EVERYONE who has their thyroid removed will need to be on thyroid medication for the rest of their life. 

It’s not an option because thyroid hormone is required to sustain critical functions in the body. 

This is not up for debate. 

But what is up for debate is how MUCH of that prescription thyroid medication you are taking (and what type of medication you are taking). 

This is referred to as your dose. 

And most thyroid patients, including those without a thyroid, are taking a dose that is too small for their bodies. 

This occurs frequently because most doctors dose based on a test known as the TSH. 

In addition, they almost always use the weakest form of thyroid medication levothyroxine and Synthroid. 

These two reasons account for why most patients without a thyroid are not receiving the right dose. 

And, obviously, if your dose is inadequate then you will have trouble with your weight. 

Remember when I said that your thyroid controls and regulates your metabolism?

Once your thyroid has been removed you are now counting on your prescription medication to take its place. 

And if you are not replacing it adequately you will continually gain weight and/or have difficulty losing weight (usually both). 

#3. Most thyroidectomy patients are not on T3 thyroid hormone

Are you currently taking levothyroxine or Synthroid?

If so, you are like most other thyroid patients. 

These medications are the go-to medications for most endocrinologists and other thyroid doctors. 

But there’s one big problem:

Your thyroid gland, when it’s functioning in your body, produces TWO types of hormones. 

T4 and T3. 

But when your thyroid gets removed your doctor almost always will put you on only ONE type of thyroid hormone. 

T4. 

The medications I mentioned above, levothyroxine and Synthroid, contain only T4 thyroid hormone. 

We know that this is a problem because studies have shown that patients who use only T4 medications like levothyroxine never obtain normal healthy free T3 levels after thyroid surgery. 

How can you consider someone to be adequately treated if you do not at least try to mimic the same hormone production that a healthy thyroid gland produces?

And yet this is exactly what most endocrinologists do. 

The healthy thyroid gland produces roughly 80% T4 and 20% T3 thyroid hormone (3). 

But when your thyroid gets removed your doctor puts you on 100% T4 thyroid hormone and neglects to add in the T3. 

This is a big problem because T3 thyroid hormone is 3-4 times more powerful than T4 thyroid hormone. 

Once your thyroid has been removed you are losing the benefit of 20% of the strongest thyroid hormone in your body and replacing it with an extra 20% of a weaker version. 

With this change in thyroid hormone metabolism, it’s no wonder that thyroidectomy patients struggle with weight gain. 

#4. An undertreated thyroid leads to other hormone imbalances

And lastly, another reason that women without a thyroid suffer from weight loss resistance is caused by other hormone imbalances. 

While your thyroid definitely contributes to your overall metabolism, there are other hormones that are regulated by your thyroid that contribute to your weight in other ways. 

For instance, the fat hormone leptin is involved in regulating appetite and metabolism and it is intertwined with thyroid function. 

If you have your thyroid removed and you do not replace your thyroid levels adequately, it sets the stage for the development of a condition known as leptin resistance. 

This condition is created by the environment of low thyroid hormone but it is not FIXED by simply taking thyroid medication. 

And leptin isn’t the only hormone that is, in part, regulated by your thyroid. 

Another fat-storing hormone that is, in part, regulated by thyroid hormone is insulin. 

Women without a thyroid tend to develop insulin resistance and leptin resistance over time if their thyroid is not treated adequately. 

These hormone imbalances make weight loss even more difficult and MUST be addressed if you want to lose weight long-term. 

Is Weight Loss Impossible After Thyroidectomy?

What does all of this information mean for you if you don’t have a thyroid?

Will it ever be possible to lose weight and get back to a normal healthy weight?

The answer is yes. 

But you should be aware that your weight loss journey will be much slower than people who have a thyroid. 

That’s just the unfortunate situation that you are now in once your thyroid is gone. 

I usually tell people without a thyroid to expect weight loss at about a rate of 50% compared to people with a thyroid. 

They will also have to try about twice as hard as the average person. 

Yes, it’s slow, and yes it’s hard, but it’s not impossible. 

Another thing that you should know is that your thyroid medication is going to be a very important part of your weight loss journey. 

Because your thyroid can no longer produce thyroid hormone on its own, you will need to pay close attention to what type of thyroid medication you are using and how much you are using. 

Your goal here should be to try and mimic whatever production of thyroid hormone your thyroid was producing BEFORE it was taken out. 

This will almost always include a combination of T4 and T3. 

If you aren’t familiar with T3 thyroid medications then I would recommend you look at both Cytomel and liothyronine. 

These are prescription medications that contain the T3 thyroid hormone and can be added to your existing dose of levothyroxine or Synthroid. 

You can also get T3 thyroid hormone from other thyroid medications such as Armour thyroid or other formulations of NDT. 

Either source will work but make sure you do NOT neglect this step!

Do Supplements, Diet, and other therapies Work? 

Assuming your thyroid medication has been optimized your next step will be to get aggressive with additional therapies. 

This means you will absolutely need to look directly at the types of foods that you are eating, the types of supplements you are taking, and how much you are exercising. 

Remember: 

You will need to work twice as hard to lose weight compared to someone who has a thyroid. 

This usually means that having cheat days from your healthy diet, at least in the beginning, is not really an option for you. 

It certainly isn’t fair but it’s better to know that this is the case than to not. 

When I talk about diet, I’m really talking about healthy eating. 

You want to avoid any type of diet which is considered a “calorie-restricted diet” as these types of diets will make thyroid function worse. 

Instead, focus on diets that include healthy whole foods such as the paleo diet, whole30, or any other version such as that. 

I would also recommend that you look into supplements designed to help thyroid hormone do its job, supplements that can help with weight loss directly, and supplements which help manage food cravings. 

These should ALL be done in conjunction with adjusting your diet (as mentioned above). 

Do not make the mistake of thinking that taking a couple of supplements will help you lose weight because that is not the case. 

Your Turn

While weight loss can be very difficult and frustrating once your thyroid has been removed it is definitely not impossible. 

I have personally helped many patients without a thyroid lose weight and, at the very least, start to feel like themselves again. 

But I am speaking from experience when I say that the weight loss they experience is much slower when compared to people with a thyroid. 

Understanding this phenomenon will help you manage your expectations and prevent you from getting discouraged when you start your weight loss journey. 

Now I want to hear from you:

Did you gain weight once your thyroid was removed?

If so, how much did you gain?

Are you trying to lose weight right now?

What types of therapies have you tried? What has worked? What hasn’t?

Leave your questions and comments below!