How to Lose Weight With Hypothyroid Disease—and Keep It Off—When Nothing Else Seems to Work

Nestled at the base of your neck, the thyroid gland serves as a master regulator of your metabolism. So slowdowns that occur due to hypothyroidism can make it easier to gain weight—and harder to lose it. Even if you’re following a healthy diet and exercising, weight loss with hypothyroidism can seem elusive. So we asked top experts how to lose weight with hypothyroid disease and keep it off. Here, their proven strategies. 

Why thyroid issues make weight loss so hard

“The thyroid is an important organ in overall metabolic health,” explains Taz Bhatia, MD, (aka Dr. Taz), author of Super Woman Rx. The two main hormones of the thyroid, T3 and T4, are involved in contributing to the body’s basal metabolic rate, or rate at which it burns energy.”

But when you have an underactive thyroid, the gland doesn’t produce proper amounts of these hormones. This means your body burns fewer calories and stores more as fat, particularly in the abdomen or belly region. And when thyroid function slows, it’s harder for the body to lose weight by using that fat for fuel, adds McCall McPherson, PA-C, founder of Modern Thyroid Clinic and Modern Weight Loss.

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The thyroid–insulin resistance link explained

Adding to the problem: The thyroid also plays a crucial role in glucose metabolism, so thyroid slowdowns can cause resistance to the blood-sugar balancing hormone insulin. “As we become more resistant to insulin, we store more fat as opposed to burning it—so the effort women are putting into losing weight doesn’t yield the appropriate outcome,” McPherson notes. 

What’s more, hypothyroidism triggers fatigue that makes losing weight via exercise more of a challenge. “When people are hypothyroid, they’re so tired they barely have the energy to get through the day, let alone try to increase their physical activity,” she states.

“Many women with hypothyroidism have the dual battle of fatigue and weight gain.” —Dr. Taz

Doctor-recommended ways to lose weight with hypothyroid disease

The metabolic mechanisms above can make women with hypothyroidism feel as if it’s almost impossible to slim down. But fortunately, the following slimming strategies can re-energize the thyroid gland to fight fat and boost weight loss.

Re-run your blood tests

Thyroid experts typically diagnose hypothyroidism with a comprehensive thyroid panel, which measures blood levels of hormones and antibodies, including thyroid-stimulating hormone (TSH), free T4, free T3 and reverse T3. These tests are usually repeated every three months until thyroid function is optimized, then redone at least annually thereafter. 

But if you experience stubborn weight gain and other symptoms of hypothyroidism in the meantime, McPherson advises asking your doctor to re-run the panel and check your thyroid hormone levels as soon as possible. 

If results reveal a slowdown that isn’t responding to your current treatment, a medication change can help you lose weight. Your doctor can adjust your dosage of levothyroxine, a hormone replacement drug that contains a synthetic form of T4. 

But T4 has to be converted into “active” T3 by the body, and many women have trouble making the conversion. For them, she finds it’s often effective to add medications such as natural dessicated thyroid hormone (which contains both T4 and T3) or liothyronine sodium (a synthetic form of T3).

Sip green juice

Cutting back on refined and processed foods is crucial for losing weight with hypothyroid disease. “They’re highly, highly inflammatory foods that predispose women to Hashimoto’s disease, the autoimmune disease that’s associated with most thyroid disorders,” McPherson notes. 

In addition to scaling back on processed fare, McPherson advises drinking a glass of green juice daily. “One glass contains the micronutrients found in five to six pounds of veggies,” she says. 

That’s key, since authors of a study in the journal Nutrients found that vegetable micronutrients such as magnesium, iron, vitamin A, copper and zinc help optimize thyroid hormone output. Plus, green juice contains antioxidants and polyphenols that fight thyroid-sabotaging inflammation. 

Focus on food order

Another of McPherson’s favorite ways to spur weight loss despite hypothyroidism: “Ordering your food—and I don’t mean takeout.” Simply enjoy the protein on your plate first, followed by veggies. Then save starchier carbs and sweet treats until last. 

This fights fat storage by blunting post-meal spikes in blood sugar and insulin. And in a study conducted at Weill Cornell Medical College, participants who used the strategy lost nearly five times more weight than those who stuck with their usual ways.

Consider a fluoride filter

The fluoride that’s added to public drinking water can safeguard against cavities. But fluoride is similar in chemical composition to iodine, a nutrient that’s crucial for healthy thyroid function. 

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And a report in the Indian Journal of Dental Research suggests that fluoride can interfere with the thyroid’s absorption of iodine, which can hamper its function. To reduce the risk, invest in a water pitcher like the EpicWaterPure1. It features a filter that’s been independently tested to remove more than 97 percent of fluoride.

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Go for a walk

“Many women with hypothyroidism have the dual battle of fatigue and weight gain,” Dr. Taz notes. “But fatigue limits how intense exercise can be and can often burn them out further.” That’s why she recommends opting for short bursts of movement (think walking, dancing and cycling) throughout the day, then stepping slowly into slightly longer and more intense workouts over time.

Also smart, according to McPherson: Adding resistance training to your weekly regimen. She suggests aiming for 45 minutes of resistance exercises such as squats, lunges and bicep curls on three days of the week, since the weight-bearing activities build muscle to increase metabolic rate. But again, she advises going slowly and working up over time. “I always say listen to your body, and pull back if you’re feeling worn out post-exercise.”