Eating less and exercising more is often not enough to achieve weight loss goals in those with a sluggish thyroid – and can actually be counterproductive! There are many reasons why thyroid disease complicates weight loss efforts.
Read on to learn more and to find out five things thyroid patients must address if they want to succeed at achieving a healthy weight and feeling their best.
1. Adequate Thyroid Testing & Treatment
A sluggish thyroid means a slow metabolism. A crucial part of regulating metabolism and in turn shedding those extra pounds is to get the right thyroid testing and treatment. A properly working thyroid is dependent not only on enough thyroid hormones being produced, but also on inactive thyroid hormone (T4) being converted to active thyroid hormone (T3). It is also dependent on these hormones getting from the blood into the cells, where they can be used by the body. Unfortunately, many thyroid doctors recommend T4 replacement only (ie. Synthroid), assuming that 1) the body will effectively convert it to T3 and 2) that blood levels accurately reflect how much of the hormones are being used. This is not always the case.
In fact, sometimes an individual with hypothyroidism converts too much T4 into Reverse T3 instead of T3. Reverse T3 blocks the effects of thyroid hormone on metabolism. When this happens, T4-only treatment could actually make the problem worse! If T4-only treatment hasn’t been as effective as you had hoped, you may need a combination of T4 and T3 or even T3-only treatment instead. Make sure your thyroid doctor knows to asses for these possibilities by putting you through a full thyroid panel. This includes:
- Free T3
- Free T4
- Reverse T3
- Sex Hormone Binding Globulin (SHBG)
- Thyroid antibodies
- Basal Metabolic Rate (BMR) and reflex speed
2. The Right Diet (hint: it’s not calorie restriction!)
Many thyroid patients are chronic dieters because they feel there is no other way to maintain a healthy weight than to keep their caloric intake very low. However, research has shown that chronic dieters have a 20-40% lower BMR than expected (the body thinks it’s starving and holds onto fat). Chronic dieting also negatively affects the conversion of T4 to T3. These effects may be difficult to reverse. Instead of focusing on eating less or restricting calories, adopt these dietary principles which have been shown to be more effective for weight loss among thyroid patients.
- Cut the sugars
- Avoid processed foods
- Consider going Paleo
- Stay hydrated
Sugars, grains, and processed foods all contribute to leptin resistance and insulin resistance. These hormones play an important role in regulating appetite and metabolism. When the body over-produces these hormones due to resistance that has developed over time, it becomes very difficult to lose weight.
These foods also promote inflammation, which contributes to thyroid disorders as well.
And lastly, simply drinking water is an easy strategy that is often overlooked. Drink at least half your body weight in ounces (or more if you drink caffeinated beverages) to support your body’s detoxification pathways and boost metabolism. Dehydration can slow down cellular function.
3. Thyroid-Friendly Exercise
Exercise is an important part of any weight loss regimen, but too much of a good thing can be a bad thing and that is definitely the case when it comes to exercise and thyroid disorders. Exercising at a high intensity for long periods of time is often counterproductive for thyroid patients. It puts additional stress on the body, which can create more inflammation and negatively affect cortisol levels. Cortisol levels have an effect on metabolism, blood sugar regulation, and the thyroid.
Over-training in combination with chronic dieting can significantly reduce T4 to T3 conversion. A good rule of thumb for thyroid patients is to perform a workout manageable enough that it could be repeated immediately after finishing. If you are recovering for days from a workout, it is probably too intense. Focus on mild to moderate exercise, such as walking, biking, pilates, yoga, etc.
4. Sleep & Stress Reduction
In addition to over-exercise, lack of sleep and excess stress can also sabotage weight loss efforts in thyroid patients. Being chronically sleep deprived can decrease thyroid hormone production as well as impair T4 to T3 conversion. Inadequate sleep also affects other hormones, leading to more carbohydrate cravings and more fat storage.
Stress raises cortisol levels, which can direct fat to the abdominal area. Elevated cortisol levels also contribute to insulin resistance over time. Intentionally practicing stress management and aiming for eight hours of sleep per night should be just as much of a priority for achieving weight loss as adequate thyroid treatment, diet changes, and the right kind of exercise.
5. Smart Supplementation
If you are a thyroid patient and have already addressed these four important components and yet still can’t lose weight, you may want to talk to your doctor about dietary supplements. Targeted supplementation may offer that extra boost needed to support weight loss and correct underlying causes of thyroid dysfunction, such as nutrient deficiencies. There are tests that can help identify nutrient deficiencies.
A few supplements and nutrients to consider for thyroid patients include:
- Vitamin D
- Conjugated linoleic acid (CLA)
- Omega-3 fatty acids
- B2 and B12
*don’t start iodine supplementation without consulting your thyroid doctor, as it needs to be regulated with current levels and medications in mind
Improving Your Thyroid and Overall Health
Maintaining a healthy weight can be a difficult and discouraging feat for many thyroid patients. Many of the things that work for others are not effective or even detrimental for those with a thyroid condition. If this is true for you personally, we hope that these tools can equip you to partner with your thyroid doctor (or find a new one!) in order to succeed at losing weight and improving your overall health.
At Holtorf Medical Group, our physicians are trained to provide you with cutting-edge testing and innovative treatments to find the answers you deserve and a treatment plan that is personalized to your specific condition. If you’ve been diagnosed with thyroid disease, but aren’t receiving the care and treatment you need, give us a call at 877-508-1177 to see how we can help you!
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3. Moyer AE et al. “Stress-induced cortisol response and fat distribution in women.” Obes Res. 1994 May;2(3):255-62.
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6. Kent Holtorf. “Diagnosis of Hypothyroidism: Are we getting what we want from TSH testing?” National Academy of Hypothyroidism.
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