Seven Secrets to Help Thyroid Patients Lose Weight

Hypothyroidism Diagnosis

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The longer it takes you to get diagnosed with hypothyroidism, the more weight you may end up gaining. While you're becoming hypothyroid, even before your TSH is elevated enough to warrant treatment, your metabolism can already be slowing down significantly. This means fewer calories are burned each day, and even those few calories start to add up over time. Since hypothyroidism can also make you tired and achy, you're also less likely to exercise as much or as effectively, which can further reduce metabolism. And, when we're tired, we sometimes eat—especially sugary foods and carbohydrates—for fast energy and to fight fatigue. If you are struggling to get a thyroid diagnosis, it's time to become your own advocate, and work with a practitioner who understands the importance of early thyroid diagnosis.

WHAT TO DO? Read Could You Be Hypothyroid?

I Need How Much Exercise?

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For many thyroid patients, calorie restriction simply isn't enough to trigger weight loss. This is why popular "diet plans" that don't require exercise may not work for us. To keep your metabolism efficient, or make it even more efficient, you absolutely need exercise, because it helps burn calories and fat, it reduces insulin levels, it raises resting metabolism, and helps combat imbalances in leptin, insulin, and growth hormone. But if you want to lose weight, you're going to need to do more than the recommend 20 minutes, 3 times a week. According to experts, healthy people of normal weight need 60 minutes of physical activity a day to maintain weight and avoid excess gain. Meanwhile, half of us do less than 30 minutes of moderate activity a day – and only one in four is actually active for 30 minutes or more. We have work to do.

WHAT TO DO? Get out there, and get moving!

Hyperthyroidism Confusion

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Hyperthyroidism does not equal weight loss. In fact, a percentage of people who are hyperthyroid actually gain weight. Why they do is not clear. It may be hunger is causing excess calorie intake. Or the impaired endocrine system may be triggering poor digestion, insulin resistance, or adrenaline resistance. But hyperthyroidism, including being hyperthyroid due to taking too much thyroid medication, can sometimes result in weight GAIN.

WHAT TO DO? Read Graves' Disease and Hyperthyroidism 101

A Hidden Cause of Weight Gain

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Some of the drugs doctors give you to help your thyroid-related symptoms and problems can actually cause weight GAIN!

For example...

  • Antithyroid drugs such as methimazole and PTU
  • Beta blockers (often given for hyperthyroidism)
  • Steroid anti-inflammatories (i.e., prednisone)
  • Estrogen and progesterone independently, or together as the "pill"
  • Certain antidepressants, especially Prozac, Paxil and Zoloft
  • Mood stabilizing and anticonvulsant drugs such as those given for bipolar disorder, including lithium, valproate (Depakote) and carbamazepine (Tegretol)

WHAT TO DO? If you're on one of these drugs and gaining weight, talk to your doctor about your concerns, and to explore possible alternatives.

The RAI Connection

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Doctors who tell you that they can somehow calculate it and give you just the right amount of RAI to make you neither hypothyroid nor hyperthyroid are not dealing with reality. The truth is, most patients post-RAI become hypothyroid, and many gain weight. Some studies have found that from more than half, to as many as 85% of patients, gained weight after RAI, and there is a dramatic increase in obesity among previously hyperthyroid patients who have had RAI therapy.

WHAT TO DO? Talk to your practitioner about other options, because radioactive iodine is not the only treatment for hyperthyroidism.

If There's Only One Exercise You Do, This Should Be It

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If you have the energy or time to do only one type of exercise – weight-bearing/muscle building, or aerobics, which one should you choose? Well, ideally, you should be doing both, but in my book The Thyroid Diet, I posed this question to exercise expert Paige Waehner, who had this to say:

I would probably choose strength training. When you build lean muscle, you're giving your body the ability to burn more calories even when you're not exercising. A pound of fat only burns around 6-10 calories each day while a pound of muscle can burn up to 60 calories per day. Adding more muscle means burning more calories, period.

WHAT TO DO? Check out our section on Strength Training.

Water and Fiber

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It's very likely that you're not getting enough water. Water helps your metabolism work more efficiently. It can also help reduce appetite, eliminate water retention and bloating, and improve elimination and digestion. We hear about the typical recommendation to drink eight 8-ounce glasses a day, but some experts say drink another 8-ounce glasses for every 25 pounds of weight you need to lose. Philip Goglia, author of Turn Up the Heat: Unlock the Fat-Burning Power of Your Metabolism, recommends you drink one ounce of water per pound of scale weight -- this ends up being a great deal MORE than the standard 64 ounces a day. If you're at a plateau, or weight loss is very slow, it's worth a try.

You're also probably not getting enough fiber. Getting a good amount of fiber is one of the basic tactics things you can do as a thyroid patient if you want to lose weight. Fiber has so many benefits for people with hypothyroidism who are trying to lose weight, and it can come from food, supplements, or both.

WHAT TO DO? Read about some High Fiber Food Options, as well as nutrition expert Shereen Lehman's article Drinking Water to Maintain Good Health.


Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10th Edition. WLL/Wolters Kluwer; 2012.

Garber, J. et. al. "Clinical Practice Guidelines for Hypothyroidism," Endocrine Practice, Nov/Dec 2012. 

Laurberg, P. et al. "Thyroid Function and Obesity." Eur Thyroid J. 2012 Oct; 1(3): 159–167. Published online 2012 Sep 22. doi:  10.1159/000342994

Ross, Burch, et al. "American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and other causes of Thyrotoxicosis." Thyroid. Oct 2016, 26(10): 1343-1421

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