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6 Reasons Why it’s So Hard for Women with Hashimoto’s to Lose Weight

by | Mar 16, 2022 | Weight Loss

Hashimoto’s can make it harder for you to lose weight for many reasons, which is why many diets, exercise programs, and countless hours of cardio are failing you. The good news is that once you understand why women with Hashimoto’s struggle with weight loss and address them correctly, healthy weight loss is possible even with Hashimoto’s.

In this article, we’ll cover 5 reasons why Hashimoto’s can make it harder for you to lose weight.

Reason #1: Your thyroid hormone levels are not under control or in the optimal range

Conventional treatment for Hashimoto’s and hypothyroidism may leave you with low metabolism and extra weight. Here’s why.

Thyroid hormones control your metabolism. They stimulate your cells to produce energy by burning calories. Hashimoto lowers your thyroid hormone levels (thyroxine or T4), thus lowering calorie expenditure, even on life-sustaining functions . Therefore, Hashimoto’s can make you gain weight more easily and struggle to lose weight. 

Also, hypothyroidism can also cause fluid retention, which can add around 5 – 10 pounds to your weight. 

Normal thyroid hormone levels on the lab report may not be optimal or healthy

Once you’re diagnosed with Hashimoto’s, conventional doctors tend to titrate your thyroid hormone medications until your thyroid stimulating hormone (TSH) falls within the normal range of 0.4 – 4.5 mIU/L. They typically test TSH, thyroid antibodies, and T4 (thyroxine) [1]. Rarely do they also test the active thyroid hormone T3, or the free and protein-bound thyroid hormones. 

The standard thyroid medications are thyroid hormone replacements. The most common one is levothyroxine or synthroid, which is the inactive thyroid hormone (T4). However, many women feel better adding cytomel, the active thyroid hormone (T3) or thyroid glandulars such as Armor. 

Researchers have discovered that the optimal range of TSH for well-being, fertility, and longevity corresponds to 0.5 – 2.5 mIU/L [2]. This is especially true if you’re pregnant or planning to be. Miscarriages are higher in women with TSH levels above 2.5 mIU/L, especially among those with thyroid antibodies [3,4].

If your TSH is 2.5-4.5 mIU/L and/or you still feel awful or unable to lose weight, you may need your medication doses adjusted or to try a different medication. Speak with your endocrinologist or find another one who will adjust the medication a little further to better manage your thyroid hormones. You may also benefit from testing the full thyroid panel with a functional medicine doctor so they can help you optimize your thyroid function beyond thyroid hormone replacement.

Reason #2: You are not in a caloric deficit

To lose weight, you’ll need to be in a calorie deficit by making sure you’re eating fewer calories than you burn daily. There is no way around this. 

Since Hashimoto’s lowers your calorie expenditure, you may need to figure out how many calories you’re burning daily (maintenance calories) in order to find a caloric deficit. 

Restrictive diets like AIP or Paleo tend to create caloric deficits because they eliminate so many calorie-dense foods. However, it’s possible to not be in a caloric deficit if you have too much bacon and coconut cream. 

The first step is to precisely track every morsel you eat for a week using tools like myFitnessPal or Cronometer. They help calculate how many calories you’re eating.

If your weight is stable, for example at 2200 calories, then you know this is how many calories you are burning daily. To lose a pound a week, simply ensure that you cut out on average of 500 calories daily while following an AIP diet.

The 3 Biggest Workout Mistakes You May Be Making with Hashimoto's

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Reason #3: Your exercise routine doesn’t include resistance training

Pound for pound, muscles burn more calories than fat both at rest and while you move. Thyroid hormones help maintain your muscle mass, so low thyroid function means it’s harder to build and keep muscles. To make matters worse, doctors often advise Hashimoto’s patients to focus on gentle cardio exercises and yoga. 

Instead, you need to lift weights so that you can lose the fat while keeping the highly beneficial muscle tissues. The stronger muscles will also help to stabilize loose joints and overall reduce the joint and muscle pain that is common in Hashimoto’s. 

Because I’ve seen the results for myself and in thousands of other women when they get on the right exercise program, I developed Thyroid Strong. You can do this from the comfort of your own home with a kettlebell, even if you have joint and muscle pain.

Reason #4: You’re always exhausted

Feeling exhausted all the time from Hashimoto’s can make it much harder for you to stay active. You may feel depressed, unmotivated, and exhausted despite getting enough sleep, and promises to kick start exercising feel almost impossible to fulfill [5]

The best way to combat fatigue is by regulating your thyroid hormones and optimizing your sleep routine. Also, since about 30 – 40% of women with Hashimoto’s are anemic, you also want to work with your doctor to diagnose and treat this problem [6].

The 3 Biggest Workout Mistakes You May Be Making with Hashimoto's

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Reason #5: Postpartum and menopausal hormonal changes

Postpartum and menopause are associated with the onset of thyroid problems due to changes in hormones and immune function [7,8]

During early pregnancy, your body stores fat to meet the energy needs of both baby and mama before burning it in the last 13 weeks of pregnancy. Unmanaged hypothyroidism during pregnancy can make it hard for your body to burn off this stored fat during the last 13 weeks. 

Breastfeeding can cause your body to hold onto fat. You have a postpartum progesterone drop, but your prolactin remains high for breastfeeding, leading to a temporary imbalance and low dopamine levels. Scientists are still trying to understand why breastfeeding can make it hard to lose weight, but we know that low dopamine can lead to weight gain [9].

And don’t get me started on the stress, exhaustion, and sleep deprivation that come with being a new mom! Even so, I wouldn’t trade these moments for anything, even though they made it harder for me to lose weight through high cortisol and insulin resistance. 

During menopause, estrogen levels drop, the fat storage relocates from the hip to the midsection because the abdominal fat helps produce the estrogen [10]. Now is also when many women feel their metabolism slowing down because estrogen helps with metabolism [11].

If you’re within a few years postpartum or going through menopause, give yourself some grace. Your body is changing and resisting the fat loss, and it’s not your fault. Fat loss may take longer, but it can happen if you do it right. First, you will benefit a lot from improving your diet, sleep, stress levels, and the right strength training program. Then, consider seeing a functional medicine doctor or naturopathic doctor to balance your hormones. Lastly, many menopausal women also benefit from bioidentical hormone replacement therapy.

Reason #6: Unmanaged inflammation

Aside from lowering your thyroid hormones, Hashimoto’s also comes with inflammation, causing symptoms such as brain fog, joint pain, muscle pain, and anemia. 

Because thyroid replacement medications don’t directly address inflammation, many women continue to be inflamed, which can cause you to hold onto extra weight even though your tests come back normal [12]

Many people find that the AIP diet reduces inflammation markers that exacerbate autoimmune diseases like Hashimoto’s [13]. When the inflammation drops and they’re in caloric deficit, they drop weight. To learn more about an anti-inflammatory diet for Hashimoto’s, check out my Hashimoto’s diet article. 

Environmental factors like mold and inflammatory foods can also drive inflammation. The inflammation can cause your body to hold onto fat [14]. To learn more about this, check out my interview with Dr. Jill Crista.

Here are the six most common reasons it’s so hard to lose weight as a woman living with Hashimoto’s. Do they apply to you?

I understand that trying to lose weight with Hashimoto’s could be very frustrating, especially if numerous diets and exercise programs haven’t worked for you. Women with Hashimoto’s need strength training along with a 360o approach that also addresses all the root causes. I have been there myself and helped thousands of women with Hashimoto’s lose weight, restore their energy, and live pain-free with my Thyroid Strong program.

Affiliate disclaimer: This article contains affiliate links, which means that Thyroid Strong may earn a small percentage of your purchases if you use our links and coupon codes, while the prices will be the same or at a discount to you. This income supports our content production. Thank you so much for your support. 


Article References

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2 Sheehan, M. T. (2016) Biochemical Testing of the Thyroid: TSH is the Best and, Oftentimes, Only Test Needed – A Review for Primary Care. Clin. Med. Res. 14, 83–92.

3 Negro, R., Schwartz, A., Gismondi, R., Tinelli, A., Mangieri, T. and Stagnaro-Green, A. (2010) Increased pregnancy loss rate in thyroid antibody negative women with TSH levels between 2.5 and 5.0 in the first trimester of pregnancy. J. Clin. Endocrinol. Metab. 95, E44–8.

4 Taylor, P. N., Minassian, C., Rehman, A., Iqbal, A., Draman, M. S., Hamilton, W., Dunlop, D., Robinson, A., Vaidya, B., Lazarus, J. H., et al. (2014) TSH levels and risk of miscarriage in women on long-term levothyroxine: a community-based study. J. Clin. Endocrinol. Metab. 99, 3895–3902.

5 Green, M. E., Bernet, V. and Cheung, J. (2021) Thyroid Dysfunction and Sleep Disorders. Front. Endocrinol. 12, 725829.

6 Mincer, D. L. and Jialal, I. (2021) Hashimoto Thyroiditis. In StatPearls, StatPearls Publishing, Treasure Island (FL).

7 Amino, N., Tada, H. and Hidaka, Y. (1999) Postpartum autoimmune thyroid syndrome: a model of aggravation of autoimmune disease. Thyroid 9, 705–713.

8 del Ghianda, S., Tonacchera, M. and Vitti, P. (2014) Thyroid and menopause. Climacteric 17, 225–234.

9 Neville, C. E., McKinley, M. C., Holmes, V. A., Spence, D. and Woodside, J. V. (2014) The relationship between breastfeeding and postpartum weight change–a systematic review and critical evaluation. Int. J. Obes. 38, 577–590.

10 El Khoudary, S. R., Greendale, G., Crawford, S. L., Avis, N. E., Brooks, M. M., Thurston, R. C., Karvonen-Gutierrez, C., Waetjen, L. E. and Matthews, K. (2019) The menopause transition and women’s health at midlife: a progress report from the Study of Women’s Health Across the Nation (SWAN). Menopause 26, 1213–1227.

11 Klinge, C. M. (2020) Estrogenic control of mitochondrial function. Redox Biol 31, 101435.

12 Lutz, J. (2020, June 25) Obesity and Inflammation: A Vicious Cycle. EW.

13 Abbott, R. D., Sadowski, A. and Alt, A. G. (2019) Efficacy of the Autoimmune Protocol Diet as Part of a Multi-disciplinary, Supported Lifestyle Intervention for Hashimoto’s Thyroiditis. Cureus 11, e4556.

14 Holme, J. A., Øya, E., Afanou, A. K. J., Øvrevik, J. and Eduard, W. (2020) Characterization and pro-inflammatory potential of indoor mold particles. Indoor Air 30, 662–681.

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