Decreased thyroid function, or hypothyroidism, is commonly associated with weight gain. But contrary to popular belief, effective treatment with Hypothyroidism medications that are trying to restore normal thyroid hormone levels is not associated with clinically significant weight loss in most people.
Thyroid and Your Weight
Your thyroid gland is in charge of sending hormones into the bloodstream that help keep your metabolism in check. When your body doesn’t make enough of these hormones, that process will slow down.
This also puts the brakes on other body functions. You might feel cold, tired, or sluggish.
The truth is only about 10% of your total weight gain is likely due retaining water because of hypothyroidism.
“People with hypothyroidism often have gained quite a bit of weight before their diagnosis,” says nutrition coach Cheryl Harris, RD. “They may experience fatigue, and that makes it harder to have the energy to eat well and exercise regularly.”
But the bigger question is this:
How can I be gaining weight on a medication that is supposed to INCREASE my metabolism?
How can that be?
Well, the truth is that Levothyroxine doesn’t necessarily increase your metabolism… at least not in everyone.
In this post I’m going to show you exactly why Levothyroxine can cause weight gain and what you can do about it:
T4 to T3 Conversion Matters… A lot
Before we talk about how Levothyroxine and Synthroid can cause weight gain we need to talk about some basic thyroid physiology so it all makes sense.
Your thyroid, under the influence of TSH (if working properly), pumps out the hormone T4.
What you need to understand is that T4 is an inactive hormone. By itself it doesn’t do anything for your body except act as a reservoir for T3.
In order for thyroid hormone to be active in your body it MUST be converted to the active hormone T3.
T3 is the hormone that enters into your cells and actually activates biochemical processes.
The problem is that T4 doesn’t always convert to T3.
Your body has the option of converting T4 to reverse T3 as well, and reverse T3 is a thyroid blocking metabolite.
The more reverse T3 in your blood stream the less you can rely on normal thyroid blood tests to give you any actionable information.
So what causes your body to turn T4 into the inactive reverse T3?
Levothyroxine and Synthroid are both T4 only Medications!
So here is the primary problem:
Levothyroxine and Synthroid are both T4 only medications.
Most Doctors will prescribe you T4 medication under the assumption that your body will have no problem converting T4 into T3.
And in a perfect world, a world without stress, inflammation or other hormonal imbalances – it would.
But that’s not the world we live in…
Nowadays it’s VERY uncommon if someone has their stress managed, has no other hormonal imbalances and their adrenals are functioning just fine.
In states such as these your body will turn T4 into reverse T3 as a way to “put on the brakes” and slow down your metabolism and cause symptoms of hypothyroidism.
How Levothyroxine Causes weight gain
So how does this all relate to Levothyroxine and weight gain?
We can look at some studies to help us understand:
It showed that patients who take Levothyroxine still have an abnormally low metabolism even with a “normal” TSH.
Levothyroxine and metabolism
This means that TSH as a marker for managing your thyroid medications (in certain people) is inaccurate!
Patients fall into this trap.
They think that because their labs and TSH have somehow improved they are suddenly “better”.
(Note: You can find out how you should be monitoring your body when you take thyroid medication to make sure it is actually working below.)
A study showed that suppressing the TSH did NOT result in adverse side effects.
T4 suppressive therapy no adverse side effects
One of the main reasons Doctors are afraid to prescribe T3 medications is because they are concerned that the low TSH will result in damage to the body over time.
What it really results in is a poor quality of life, and increased incidence of depression.
Here is another very interesting study that compared people taking Natural Dessicated Thyroid to those taking Levothyroxine:
NDT vs levothyroxine
This study showed that patients taking Natural Dessicated Thyroid (Like armour thyroid, naturethroid and westhroid) experienced more weight loss and HALF of the people in the study said that they preferred taking NDT over levothyroxine.
NDT causes more weight loss than levothyroxine
Moral of the story?
Most patients not only prefer to take Natural dessicated thyroid (medication that includes T3 hormone) but this medication also results in more weight loss and an improved quality of life.
One of the biggest problems with T4 only medication is that your body may NOT be converting it to the T3 hormone.
In many patients your body may actually convert it to reverse T3 thereby slowing your metabolism, and actually making you WORSE.
Slowing your metabolism = weight gain.
But here is another important note:
Natural Dessicated Thyroid still contains T4 (in fact the majority is still T4).
That means that sometimes NDT can actually make hypothyroid symptoms worse as well. People with this problem need pure T3 medications like Liothyronine.
So what can you do to prevent this?
What to do if you think Levothyroxine is Causing Weight Gain
Luckily there are some things you can do to find out if you are being under treated with your medication or to see if levothyroxine is not the right medication for you.
1. Check your Basal Body Temperature Each Morning
Checking your basal body temperature is a quick and easy way to estimate your basal metabolic rate.
Your basal metabolic rate is basically how many calories you are burning on a daily basis.
In under treated thyroid patients this will obviously be lower.
How to check your basal body temperature:
Each morning, as soon as you wake up, write down your morning temperature. I recommend using an axillary thermometer (but you can also use an oral thermometer). The goal here is consistency.
Plot your morning body temperature and watch for patterns. Your body temperature should be > 97.8. Period. Anything less than this indicates that your metabolism may be slowed. *Note that medications may interfere with the reliability with this test (medications like beta blockers and narcotics).
Basal body temperature when hypothyroid
Notice the image above which shows what an untreated hypothyroid patient looks like and notice how the graph becomes much more stable after armour thyroid kicks in.
2. Check your Resting Pulse or Resting Heart Rate
I also suggest that you check your resting pulse rate.
Hypothyroid states are well known to cause a slow heart rate or low pulse.
If you have hypothyroidism I recommend buying a wearable fitness device to monitor your pulse, how well you sleep and how active you are throughout the day.
This data that you collect can help your doctor see & adjust the thyroid dosage.
Combining basal body temperature with resting heart rate is a very powerful combination and can help you determine how well you are being treated.
Your resting pulse should generally be > 50-60 at night while you sleep, unless you are a WELL conditioned athlete. A resting heart rate lower than that indicates an issue (though doesn’t necessarily mean it is thyroid related).
If you are on medications like a beta blocker or narcotics it may interfere with your pulse rate/heart rate.
3. Check a Complete Thyroid Panel
Finally, in addition to the other steps above I always recommend a full and complete thyroid panel.
That means the following tests:
Sex Hormone Binding Globulin
Combine these tests with resting heart rate and basal body temperature and now you are practicing good medicine!
Finally Losing Weight with Hypothyroidism
If after checking your body temperature, pulse and thyroid lab tests you find that your tests fall outside of the normal range then it’s time to make some changes!
The First Step
The first step to fixing your problem with levothyroxine is to try and switch medications.
I recommend that you find a Doctor who is willing to work with you and is willing to prescribe medications that contain T3.
These medications include: Natural Dessicated Thyroid (Armour thyroid, Westhroid, Naturethroid, etc.) and/or Cytomel.
If you are working with an Endocrinologist you may have more luck in asking them to add Liothyronine or Cytomel to your regimen.
Even adding 5-10mcg of Liothyronine can be enough for some people (though not the majority).
Whenever possible I do recommend finding a Doctor that specializes in Functional Medicine.
If changing medication is not an option for you then you can check out this article that has TONS of tips and tricks to help you lose weight with Hashimoto’s and Hypothyroidism.
Alternatives if your Doctor won’t work with you
There are several things YOU can do to optimize your thyroid function even if your Doctor won’t work with you.
Start Supporting my Adrenal Glands
Your adrenals produce over 50 hormones that tell almost every bodily function what they need to be doing. These hormones affect every function, organ and tissue in the body. Eating refined foods and sugars will cause a spike in your blood sugar levels, which in return cause the body to release insulin and as a result the adrenal glands will release more cortisol. When your adrenal glands are compromised this puts your body in a catabolic state. Which means your body is breaking down. Since your thyroid glands controls the metabolic activity of the body, it will attempt to slow down the catabolic state by slowing down your metabolism. Many of the foods that I had been eating blocked nutrients from being absorbed such as whole grain bread, beans and tofu/soy products. These foods also created inflammation in my digestive tract. When there is inflammation in the digestive system undigested proteins leak into the blood stream creating a heightened immune reaction that often exacerbates thyroid issues. I had to focus more on eating the most nutrient dense foods possible and find my trigger food sensitivities. lastly, eliminate all processed food, high carbohydrates, gluten, corn, soy and sugar, plan meals around protein and healthy fats then load up my plate with vegetables.
I had to start eating nutrient-dense foods that were easy to digest and have healing qualities such as
- homemade bone broth
- grass fed meats
- pastured meats
- wild game
- pastured organ meats
- natural fats such as coconut oil
- grass fed butter/ghee
- full fat grass fed dairy
- mineral rich Himalayan sea salt
- wild fish
- Cruciferous vegetables (cauliflower, broccoli, Brussels sprouts, etc.) Cooked…. (Limit 2x week)
- Fatty fish (e.g., wild-caught salmon)
- Organic hormone free Chicken and turkey
- Seeds, such as raw pumpkin, chia seeds and flax seeds
- Kelp and seaweed
- Celtic or Himalayan sea salt
- fermented foods
- leafy greens
- Nitrate free bacon
- Nuts, such as walnuts and almonds
- Coconut Flour, Almond Flour , hemp seeds and Chia seeds
- bone broth
3. Add in moderate Exercise
High intensity exercise is can do more harm than good.
4.Reduce your inflammation
Chronic inflammation can spread and have more harmful effects than just one area in your body. Your body can experience things like higher blood pressure , allergies, create autoimmune issues, experience joint pain, cause heart problems, harmful swelling, bone loss, it can lower your iron levels and it just have a negative impact on your entire well-being. Did you know that chronic inflammation can also raise your reverse T3, which means this might be the reason why your hypothyroidism was created in the 1st place. We must get the inflammation under control. Cut out foods like gluten, sugar, refined carbs, fake foods, soy, and vegetable oils and add in fresh whole fruits, healthy fats and fiber. Start creating your own body lotions and cleaning supplies.
5. Balance Insulin and Leptin levels
Leptin and Insulin resistance will also cause your body to turn T4 into reverse T3.
In addition high levels of Leptin are responsible for reducing metabolism and increasing appetite.
You can read more about reducing leptin levels here.
I want to hear from you
Are you taking Levothyroxine?
Have you found it impossible to lose weight?
How many of you have successfully lost weight by switching medications?
If extra weight is the only symptom left after thyroid medication brings your hormone levels back to normal, hypothyroidism probably isn’t directly to blame for it.
I don’t know where to start.”
Hang in there. This wont happen overnight.
I know, there is so much information overload that most people are confused as to where to start. You can start by taking ownership of your health. I wanted you to understand or get a idea of how everything has a part to play in your body. I am on a path to help you, lead you and inform you through this terrible illness. Being diagnosed with hypothyroidism isn’t just here take this pill and it will fix your issues. Hypothyroidism has a root cause. Once you start addressing the root of your problems then your body can start healing itself. Your body is an awesome design but there is a complex balance between everything. It’s a domino affect. If you have something in your body that is overworked it will cause a major shift in your body. Don’t worry the good news is it can be healed.
Sometimes we have to do a little pruning of the branches, in order for the tree to be healthy again. A number of things can be the reason why you have hormonal imbalances, food intolerances, thyroid issues, adrenal fatigue, weight gain, insomnia, personality changes, leaky gut, depression, an autoimmune disorder, chronic pain, no metabolism and low sex drive, bloating, anxiety, menstrual problems and infertility. It starts with becoming aware and how your health can be influenced by many different circumstances.
How would you define good health? Logically one would define good health as absence of a disease or following some sort of ground rules that avoid developing a disease. This book can help you begin to understand what a Keto Autoimmune protocol is and start guiding you in the redevelopment and healing of your body. You will begin to understand how to fix your gut, strengthen your immunity and fight inflammation with an autoimmune approach. The Keto AIP removes all the common inflammatory food triggers that stimulate a possible autoimmune reaction in the body. Along with helping to reset those adrenals, boosting that energy and doing a little ass kicking to those hormones that have decided to act like a wild college student and pull an all-nighter the day before final exams.
Your health doesn’t have to be a difficult situation but a positive realization that things need to change. This new lifestyle change has many parts to it and I hope you will embrace not only the physical but the spiritual awakening. Common food intolerances that are known to trigger inflammation are eliminated in this Keto AIP protocol are Nightshades, Eggs, Grains (gluten), Dairy, Legumes, Corn, Soy, Dairy and lectins.
A Women’s Holistic Holy Grail Handbook for Hypothyroidism and Hashimoto’s: How I healed my Hypothyroidism and Autoimmune Disorder with Personalized Nutrition
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Health and Happiness,AudreyXoXoAudrey Childers is a published author, blogger, freelance journalist and an entrepreneur with over a decade of experience in research and editorial writing. She is also the creator and founder of the website the hypothyroidismchick.com. Where you can find great tips on everyday living with hypothyroidism. She enjoys raising her children and being a voice for optimal human health and wellness. She is the published author of : A survivors cookbook guide to kicking hypothyroidism booty, Reset your Thyroid, Hypothyroidism Clarity, A survivors cookbook guide to kicking hypothyroidism booty: the slow cooker way and Hypothyroidism: The Beginners Guide: How to stop surviving and start thriving. You can find all these books on Amazon. You can also find her actively involved in her Facebook Group : Healing Hypothyroidism. This blog may be re-posted freely with proper attribution, author bio, and this copyright statement.
The information and recipes contained in blog is based upon the research and the personal experiences of the author. It’s for entertainment purposes only. Every attempt has been made to provide accurate, up to date and reliable information. No warranties of any kind are expressed or implied. Readers acknowledge that the author is not engaging in the rendering of legal, financial, medical or professional advice. By reading this blog, the reader agrees that under no circumstance the author is not responsible for any loss, direct or indirect, which are incurred by using this information contained within this blog. Including but not limited to errors, omissions or inaccuracies. This blog is not intended as replacements from what your health care provider has suggested. The author is not responsible for any adverse effects or consequences resulting from the use of any of the suggestions, preparations or procedures discussed in this blog. All matters pertaining to your health should be supervised by a health care professional. I am not a doctor, or a medical professional. This blog is designed for as an educational and entertainment tool only. Please always check with your health practitioner before taking any vitamins, supplements, or herbs, as they may have side-effects, especially when combined with medications, alcohol, or other vitamins or supplements. Knowledge is power, educate yourself and find the answer to your health care needs. Wisdom is a wonderful thing to seek. I hope this blog will teach and encourage you to take leaps in your life to educate yourself for a happier & healthier life. You have to take ownership of your health.