How Hypothyroidism Could Be Impacting Your Weight, According To Experts
Weight loss takes commitment, patience, and a whole lot of discipline, but it can be especially difficult for those with hypothyroidism. Fortunately, there are expert-approved tips and tricks that can make losing weight with hypothyroidism more doable.
Hypothyroidism is an autoimmune condition where the thyroid gland (located in the neck) does not produce enough thyroid hormones which are responsible for regulating metabolism, energy production, and other vital bodily functions, says Avantika Waring, MD, an endocrinologist and chief medical officer at 9amHealth. Nearly five out of 100 Americans age 12 and older have hypothyroidism, and it is most commonly diagnosed in women and those over age 60, per the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
The causes of hypothyroidism can vary, but it's most commonly due to the immune system making antibodies that attack the thyroid, which ultimately results in thyroid gland dysfunction, says Andres Splenser, MD, an endocrinologist affiliated with Memorial Hermann. Common symptoms associated with low thyroid function can then include fatigue, cold sensitivity, dry skin, hair loss, constipation, mental fog, menstrual irregularities, and weight gain, he says.
But how can you manage losing weight with hypothyroidism? Ahead, experts break down tips to make weight loss less stressful and more manageable.
Meet the experts: Avantika Waring, MD, is an endocrinologist and chief medical officer at 9amHealth. Andres Splenser, MD, is an endocrinologist affiliated with Memorial Hermann and clinical faculty at Baylor College of Medicine. Chelsea Stegman, RD, is a dietitian and founder of Chelsea Stegman Nutrition.
The Thyroid-Weight Gain Connection
“I often describe the thyroid as the key to your energy and metabolism, so when thyroid hormone production is low, it’s almost like you have one foot on the gas and one on the brakes,” says Chelsea Stegman, RD, a dietitian and founder of Chelsea Stegman Nutrition. As a result, your metabolism slows down, leading to fewer calories burned at rest and potentially weight gain, she says.
Your thyroid hormones, triiodothyronine (T3) and thyroxine (T4), are also responsible for digestion and metabolism. The less T3 and T4 your body produces, the less your body burns calories for fuel which can lead to weight gain, per a study in the International journal of general medicine.
That said, significant weight gain is typically more common when thyroid hormone levels are low for a sustained period of time, says Dr. Waring. The degree of weight gain also depends on the severity of hypothyroidism, genetics, and environmental factors, says Dr. Splenser.
How To Lose Weight With Hypothyroidism
Here, experts break down actionable tips for weight loss, starting with lifestyle and diet changes you can implement right away.
Don’t skimp on sleep.
A lack of shuteye can cause your weight to go up because it disrupts your hunger and fullness hormones, says Dr. Splenser. As a result, sleep deprivation can trigger late night snacking and poor dietary choices, ultimately increasing your daily caloric intake. When you’re sleep deprived, the body also usually wants instant energy in the form of carbs, refined sugars, and caffeine, so do your best to get at least seven to eight hours of sleep a night, he says.
Keep stress in check.
It’s easier said than done, but stress can negatively impact your health by affecting sleep and appetite regulation, so practicing daily stress management strategies like yoga, meditation, and deep breathing exercises can help, Stegman says. Less stress also reduces cortisol levels (your stress hormone), and high cortisol can make weight loss more challenging, says Dr. Waring.
Make sure you’re eating enough.
It may sound counterintuitive, but eating enough calories throughout the day is the pathway to supporting thyroid function, preventing long-term under-fueling, and improving metabolic efficiency, says Stegman. Long-term calorie restriction can also slow down your metabolism over time and modify the way your hormones operate, which is why you should never go below 1,200 calories per day in your effort to drop weight. (That said, 1,200 calories a day is a minimum, and your required calorie intake is likely much higher!)
Your exact caloric needs depend on your age, gender, activity level, muscle mass, current weight, and the amount of calories you burn at rest (a.k.a. your basal metabolic rate), so it’s best to work with a doctor or registered dietitian to find a calorie “sweet spot,” says Stegman. From there, a pro will help you determine the proper caloric needs (including adequate protein, fats, and carbohydrates) to support your thyroid, energy, and metabolism.
Eat more antioxidant-rich foods.
Hypothyroidism can be associated with increased oxidative stress (a bodily condition that happens when your antioxidant levels are low), and high oxidative stress is linked to increased body weight, studies suggest. Luckily, adding more antioxidants to your diet can help reduce oxidative stress in the body, so it’s worth snacking on berries, green tea, green leafy vegetables, turmeric, beets, and even a little dark chocolate, Stegman says.
Get intentional about selenium intake.
Not only is selenium a mineral required for thyroid hormone production, but it’s a powerful antioxidant that can help reduce inflammation in the body, says Stegman. A generally balanced diet is usually suitable for your daily selenium intake, but it’s worth adding salmon, chicken, turkey, tuna, and Brazil nuts—which contain high levels of selenium—to your weekly menu. The recommended daily selenium intake is 55 micrograms (mcg) for adults ages 19 to 70 years old, 60 mcg for pregnant women, and 70 mcg for breastfeeding women, per the National Institutes of Health (NIH). (Fun fact: Eating one Brazil nut a day can help you meet your daily requirement since a single nut contains 68 to 91 mcg).
Consider a Mediterranean diet.
The Mediterranean diet includes whole grains, nuts, seeds, fruits, vegetables, legumes, and lean protein like fish, chicken, and seafood, making the diet plan a great potential weight loss tool, says Dr. Splenser. Why? It emphasizes nutrient-dense foods that provide fiber to help you feel satiated, helps regulate blood sugar, and supports gut health, all of which support a healthy metabolism, says Dr. Waring. Plus, loading up on the fruits and veggies and cutting out sugar and processed foods keeps you fuller for longer, which can reduce overeating.
The Mediterranean diet has also been linked to improved markers of glycemic control, including fasting glucose, insulin, and hemoglobin A1C (HbA1c), per a 2021 review published in the Journal of Internal Medicine. And even without intentional calorie restriction, a diet rich in fruits, veggies, and whole foods often results in reduced weight around the belly and weight loss, according to a 2022 study in the journal Nutrients.
Prioritize regular exercise.
Exercise boosts metabolism and promotes weight loss by burning calories, so Dr. Waring suggests working out for at least 30 minutes a day. The type of exercise is up to you, but a mix of aerobic workouts (like walking, swimming, or biking) and strength training might be a good idea, Dr. Waring says. For instance, strength training has a significant impact on your metabolism and fat burning capabilities, studies show—so incorporating resistance training a minimum of three days a week could help you see results.
When To See A Doctor
If you experience symptoms of hypothyroidism such as fatigue, constipation, menstrual changes, cold sensitivity, dry skin, hair loss, and brain fog in addition to weight gain, it’s time to see a doctor, Dr. Splenser says. From there, they will order a simple blood test to check your thyroid hormone levels, perform a physical exam, and ask questions about your symptoms, family history, and health history, he says.
If low thyroid levels are confirmed, hypothyroidism is treated by taking a medication to replace the missing hormone, commonly known as thyroid hormone replacement, says Dr. Waring. The medication (levothyroxine) comes as an oral tablet, capsule, or liquid solution and is taken daily on an empty stomach, she says.
Unfortunately, there is no “cure” for hypothyroidism, however the condition can be well-managed with thyroid hormone replacement, says Dr. Splenser. “Thyroid hormone replacement with medication can bring levels back to the normal range and allow patients to have healthy and happy lives.”
That said, if you start taking thyroid medication, it doesn't necessarily mean you will suddenly lose weight. "Taking thyroid hormone by itself—or being over-treated with thyroid replacement—is not likely to cause weight loss without adequate lifestyle changes," says Dr. Splenser. Too much thyroid hormone may even cause dire health consequences like palpitations, anxiety, higher risk of an irregular heart beat (arrhythmia), weakening of the bones (osteopenia or worsening osteoporosis), and even in some individuals increased appetite, he says.
The bottom line? Consult your doc before making any major decisions, and know that the solution may not be one-size-fits-all.
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