How to Lose Weight with Hypothyroidism
Thyroid problems are some of the most common health issues. Women are most often impacted, but thyroid issues can impact everyone. Hypothyroidism is a condition in which your thyroid is underactive and doesn’t produce enough hormones. As a result, you may feel sluggish, cold, and have difficulty losing weight.
This condition is very common, with nearly 5 out of every 100 Americans ages 12 and older having hypothyroid problems.
Here’s how to tell if you have hypothyroidism, and what to do about it.
Symptoms of Thyroid Problems
First, some background about your thyroid. This butterfly-shaped gland sits at the base of your neck. It produces hormones that regulate metabolism and which are also necessary for reproductive health, cardiovascular health, neurological health, and more. 
It’s possible to have an overactive thyroid (hyperthyroidism) or an underactive thyroid (hypothyroidism). Hypothyroidism is more common than an overactive thyroid, and symptoms may include fatigue, weight gain, dry skin, and feeling cold all the time. It can also lead to depression, anxiety, insomnia, digestive problems, low red blood cells, and a lot more. 
Thyroid problems are common, but because normal levels can be highly individualized, diagnoses are frequently missed or not made until the problem is severe. You can have all the symptoms of thyroid dysfunction while still appearing in the “normal” range during lab tests. This is why it’s essential to find a physician who will listen to you if you’re having trouble.
So what do you do if you know you have thyroid problems? For many people, it often involves two things: a prescription for thyroid hormone replacement medication (if your levels are low enough) and a diet to lose the thyroid-induced weight gain.
Most doctors will focus on controlling weight by optimizing your thyroid dose and by telling you to cut calories. If you’re seeing a functional medicine doctor or an integrative practitioner, you might be given iodine supplements and a special diet instead.
Either way, approaching your hypothyroidism with a mentality that you need to take away nutrients or energy is the wrong perspective.
Why Hypothyroidism Causes Weight Gain
Unfortunately, hypothyroidism can slow down your metabolism, which leads to unexpected weight gain. No one likes it when this happens. Healthcare providers often place a heavy emphasis on weight, which is beside the point. Your weight didn’t cause your thyroid problem, and losing weight won’t fix it either. Even if you just want to get back to your “normal” weight, you can’t force a gland to simply start working again. But you can do other things to support balance.
Control is often a major factor when it comes to a hypothyroid diet. You want your body to feel good again, and the number on the scale or the way you look in a mirror feels like the obvious way to measure that. But it’s not as simple as cutting calories. In fact, cutting calories is one of the worst things you can do to lose weight with hypothyroidism. 
Five Ways to Lose Weight with Hypothyroidism
If you’ve gained weight from thyroid problems, there are things you can do that might help.
1. Eat a Nutrient-Dense Diet
If your body is running low on thyroid hormones, the answer is not to cut calories and deprive your body of the tools it needs to fuel the body with energy. But before you start eating more for the sake of it, remember that quality counts. High-carb, processed foods contain fewer nutrients than vegetables or protein.
There isn’t a universal thyroid diet, but if there was, it definitely would not be to put you on a 1,200 calorie food plan to “force” your body to lose weight. Instead, focus on consuming as many vitamins and minerals from high-quality, nutrient-dense macronutrients in your daily diet.
2. Avoid Inflammatory Foods
Inflammatory foods includes items you’re sensitive to as well. Depending on what you read, you may see certain foods identified as foods to avoid for thyroid health. This is highly individualized, though. Don’t go seeking a restrictive food plan that may have worked for someone else. You know the foods that don’t settle well in your gut—start by avoiding or reducing those. Next, consider foods that are generally inflammatory or tend to show up repeatedly in people who have gut or autoimmune issues: dairy, gluten, soy, nightshade vegetables, and eggs. [4, 5, 6] Avoid your suspected triggers, and take note if your health improves.
3. Address Your Stress
Stress doesn’t cause health problems on its own, but it can certainly make it harder for your body to heal or recover its balance. Finding a way to address stress is vital, but what works for others might not be what works for you.
Try meditation, spending time in nature, or participating in art therapy classes. Prioritize your mental health, which not only affects your thyroid but also every other aspect of your well-being!
4. Get the Right Tests
Some doctors will only measure your thyroid health by using TSH, or thyroid-stimulating hormone. But this test is actually a pituitary hormone and isn’t necessarily reflective of how your thyroid is doing.
If you are on thyroid medication, your TSH levels may normalize, but that doesn’t mean your thyroid hormones have. It’s important to have your Free T3 and Free T4 levels checked to determine whether your body has access to enough thyroid hormone. If these are too high or too low, you will feel miserable even if your TSH levels are “normal.” When it comes to thyroid hormones, even tiny changes can produce uncomfortable symptoms, so knowing your levels over time can help you keep tabs on your health.
Some doctors are great at doing this, but no one knows how you feel better than yourself. Keep notes of whether you’re generally feeling good or bad next to your thyroid levels to understand what is a good balance for you.
5. Use Hormone Replacement Therapy
In the natural health community, taking medication is often villainized. But if you have certain thyroid conditions, you may have a medical need for thyroid hormone replacement to feel better. There are several thyroid medication options available and likely one will work far better for you than the others. Don’t be afraid to tell your doctor if you’re not improving over time or if you want to try a different solution.
What Not To Do for Thyroid Weight Loss
There are four main things that you don’t want to do when you’ve gained weight from thyroid problems. These might be your first natural inclination, but remember to focus on the bigger picture instead.
1. Don’t Cut Calories
With hypothyroidism, your body is trying to rebalance itself from a major deficit. Further increasing the strain on your body by cutting calories or forcing it into a ketogenic or fasting state increases your stress load, even if it produces some short-term weight loss.
Focus on supporting and adding nutrients that help, not on what you need to reduce, cut, or take away. Most are already tired from low thyroid hormones—don’t add to the fatigue by introducing low blood sugar into the mix.
2. Don’t Over-Exercise
If you can’t cut calories, can you exercise your way into weight loss? While this might seem logical, and is a common belief in people with hypothyroidism, the problem is that when you’re already fatigued, intense exercise can further deplete your metabolic engine.
Gentle exercise, like walking or yoga, is far better for supporting physical activity requirements and supporting sustainable weight loss, while decreasing the odds of further digging yourself a hole of fatigue.
3. Don’t Supplement with Iodine
While the thyroid requires iodine to make hormones, simply taking a supplement doesn’t fix the problem of not having enough T3 or T4. Why? The mechanism for making thyroid hormones is not a simple one-plus-one-equals-two formula. Iodine from food sources can be put to use as needed, but in supplement form, it’s more concentrated and consumed in higher doses.
When someone has thyroid autoimmunity, even supplementation well below the tolerable upper limit can result in a shift to hyperthyroidism, perpetuating an increasing attack from the immune system on the thyroid. You can be diagnosed with hypothyroidism and not know you have autoimmune thyroid problems, and sending yourself into hyperthyroidism from a supplement is not the way you want to find out.
The other problem is that iodine blood tests are not reliable, and single urine samples don’t necessarily result in an accurate level. Without an easy way to measure your iodine status, standalone iodine supplementation may carry far more risks than benefits. Consuming iodine in a multivitamin is generally not as much of a problem as taking a higher dose iodine supplement. 
The Bottom Line
When you find out about thyroid problems, it can feel defeating to watch your weight increase without changing any of your behaviors. It’s even more challenging when you’re actively working to support your thyroid health and the scale doesn’t budge at all.
Remember that weight is not the single most important marker of health. Inflammation levels, energy levels, and gut health are more reflective of overall health. Once your other symptoms have been addressed, the weight will typically return to a place of balance. But healing can take time.
Thyroid problems typically build silently for some time before they’re recognized. You won’t be able to turn around and lose weight instantly without sacrificing other aspects of your well-being. Focus on ways that you can measure your progress and your health without obsessing over your weight.
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