How to beat stubborn hypothyroid weight gain

How to beat stubborn hypothyroid weight gain

Hypothyroidism and weight gain are two peas in a pod. Dealing with added pounds is one of the most common (and first) symptoms people report. To make matters worse, those extra pounds often hang on for dear life—even after starting thyroid meds.

So what’s going on (besides a lot of frustration)? If you can’t lose the pounds hypothyroidism gifted you, take a look at both typical and unsuspecting reasons behind hypothyroid weight gain—and how to beat it.

Common reasons for hypothyroid weight gain

Slowed metabolism

All the cells in your body need thyroid hormone. When your levels are low, your metabolism slows down, bringing symptoms of fatigue, weakness, drier skin, loss of strength, and weight gain. Because your body processes have downgraded to a lower speed, you won’t need as many calories as before you were hypothyroid. Yet, many of us continue to eat like we always have. Add in that we’re too tired to keep up with our usual activity, and it’s a recipe for packing on pounds.

Fluid retention

Look almost anywhere, and here’s what you’ll read: thyroid weight gain is modest. That means five to ten pounds. But many people report gaining much more than that. One reason might be water retention. It’s common to feel puffy and bloated with hypothyroidism (especially if untreated), and there’s a good reason for it, too. Hypothyroidism may raise vasopressin, which is your antidiuretic hormone (ADH). Vasopressin determines how much water you hold on to—and how much makes it to your bladder.

Another factor is reduced glomerular filtration rate (GFR). Your kidneys need thyroid hormones to work well. When they don’t have enough, they’ll slow down the rate at which your body can clear fluid.

Unsuspecting contributors to thyroid weight gain


When cortisol is too high, your body can’t efficiently convert inactive thyroid hormone (T4) into a form active and usable by your cells (T3). This can make hypothyroidism worse and slow your metabolism even more. But that’s not the only reason to test your cortisol. Elevated levels, especially when combined with a standard diet, can lead to imbalances of insulin and hunger hormones—which also contribute to weight gain.

High estrogen and low progesterone (estrogen dominance)

Women with high cortisol tend to also have high estrogen. Over time, your body uses your progesterone to meet the demand for cortisol. Without enough progesterone to balance estrogen’s effects, estrogen dominance occurs. High estrogen promotes fat storage, especially around the hips and thighs.

High estrogen is capable of contributing to hypothyroidism or making it worse. It lowers thyroid hormones and raises levels of thyroid stimulating hormone (or TSH). Some studies show that it may also play a role in triggering Hashimoto’s, an autoimmune thyroid condition that’s the most common cause of hypothyroidism.

What to do if you’re not losing weight

Re-evaluate your dosage or type of medication

If you’re not getting relief from your hypothyroidism symptoms or seeing gradual improvement, talk to your doctor about whether or not you should try a different thyroid medication. There are options that offer T4 hormone only, T4 and T3 hormones, and T3-only medications, too.

Actively practice stress-relief tactics

Get to the root of your high cortisol by working on reducing stress. (We know: easier said than done.) Even deep breaths throughout your day, a few yoga poses, and warm baths go a long way toward calming your nervous system (and your cortisol).

Consider progesterone

Labs came back and show your progesterone is low? Talk with your physician about whether bioidentical progesterone replacement would benefit you. Progesterone comes with a long list of positives for hypothyroidism: it stimulates and supports thyroid hormones, counters the effects of estrogen, promotes sleep, and is a natural diuretic. Which means it could help you shed some water weight.

Give it more time

If only life came a magic wand, right? As in all things, we rarely get medicine dosing perfectly on the first go. Some people begin noticing positive changes from thyroid medicine within a few days, but, for others, it can take several weeks. Even then, your body’s still acclimating to the increased hormones. Your levels may not stabilize until a few months in, but your doctor will probably want to redo your labs at about six (6) weeks.

Eat real food and drink water

Be sure to get enough H20 daily—that’s 8 full cups. Why would you want to drink more water if you’re retaining water? A steady intake of water lets your body know that it doesn’t need to try to hang onto extra hydration.

Rather than over-restrict calories and risk slowing your metabolism more, switch your focus to real foods. Skipping the additives and preservatives can help reduce inflammation and complex carbs, fruits, vegetables, nuts, and lean meats offer a wide variety of nutrients, plenty of fiber, and promote satiety.