How to Lose Weight On Levothyroxine

Here’s what we know:

People with a sluggish thyroid, from any cause, have no issue gaining weight but many problems losing it.

There’s no disputing the fact that low thyroid function leads to weight gain.

So it makes sense that once you treat your thyroid, this weight should come off, right?

You would think so and, yet, most thyroid patients who take the very treatment intended to fix their thyroid, realize no weight loss whatsoever when doing so.

And if you were to ask your doctor why this is the case, they will handwave you off by saying something about how much you are eating, or how little you are exercising, or maybe that it’s just your age.

But there’s more to it than that:

Reasons Levothyroxine is Not Helping You Lose Weight

I’ve had the opportunity to treat hundreds of thyroid patients when I was practicing and I can tell you from personal experience that levothyroxine really just doesn’t work that well at helping shed extra body fat. 

It’s not that it can’t work, it’s just that it’s often used incorrectly.

So while levothyroxine certainly isn’t the best thyroid medication around (we will talk about some better alternatives later), it is still definitely an option that can be used to help rev up your metabolism and help your body get into weight loss mode. 

But you should be aware of some of the potential issues that you might run into when using it:

#1. Have You Waited Long Enough? (Are You Just Being Impatient?)

This is something that is really important for thyroid patients to understand. 

Whenever you do anything designed to target the thyroid, you must wait a sufficient amount of time before declaring that that thing either worked or not. 

It takes a long time for therapies to take effect and to impact your thyroid. 

How long?

About 4-6 weeks. 

This means that if you make any change to your thyroid medication dose (OR changes to your thyroid supplements!) you won’t see any changes manifest in your body for around 4 to 6 weeks. 

Imagine that you’ve felt poorly for the last 6 months and you finally get put on thyroid medication. 

And after taking your levothyroxine faithfully for 10-14 days you are wondering why you aren’t losing weight and why you aren’t feeling better yet. 

This is why. 

And to complicate matters further, you have to realize that most people don’t get put on the right dose of thyroid medication the first time. 

When you start on levothyroxine you are just given a basic starting dose. 

This dose may be too high or it may be too low (which is more common) but you won’t know for 4-6 weeks. 

It will then take at least another 3-4 rounds of adjusting your dose before you get on the right dose. 

That means it can take up to 12 weeks (at the soonest) to 24 weeks (usually at the longest) to find your dose. 

You get this value by multiplying 3-4x (the number of rounds of adjustments that will be made to your levothyroxine) by 4-6 weeks (which is the number of weeks it will take for you to notice a difference). 

Before you do anything else make sure you have given your levothyroxine enough time to take effect! 

#2. Is it Getting Into Your System? (Is it Being Absorbed?)

The next question you have to ask yourself is whether or not your levothyroxine is actually getting into your system. 

In other words, is the thyroid medication you are taking by mouth actually getting into your bloodstream through your intestinal tract?

It may sound obvious because we just assume that any medication we put into our mouths must be absorbed, right?

Well, you’d be wrong in the case of levothyroxine and other thyroid medications. 

Levothyroxine, in particular, is quite finicky and will look for virtually any excuse to not be absorbed correctly (1). 

Did you take your levothyroxine with food? It won’t be absorbed well. 

Did you take your levothyroxine with coffee in the morning? It won’t be absorbed very well (2). 

Did you take your levothyroxine at the same time as other supplements or medications? It won’t be absorbed very well if you do. 

And if your levothyroxine isn’t making its way into your bloodstream then how will it work?

It won’t. 

This makes absorption a key issue when considering whether or not your thyroid medication is working. 

Thyroid patients are also notorious for having additional intestinal issues which can further complicate absorption of thyroid medication. 

Conditions such as irritable bowel syndrome, gluten intolerance, SIBO/SIFO (3), and acid reflux can all interfere with the absorption of levothyroxine. 

It could very well be that levothyroxine is the right medication for you and that you are taking the right dose but it can’t get into your body because of your gut. 

It should go without saying but if you don’t get levothyroxine into your bloodstream then it won’t help you lose weight. 

#3. Are You Taking Enough? (Is your Dose Sufficient?)

The next thing you need to think about is your dose. 

And by dose, I am referring to how much you are taking. 

We kind of touched on this in #1 but it’s worth going over here as well. 

The unfortunate truth is that a great many thyroid patients are taking the right type of medication for their body only they are on a dose that is too small. 

In other words, they are being underdosed. 

This is actually quite common. 

And the reason is simple. 

Your doctor would prefer that you be underdosed as opposed to overdosed. 

So doctors frequently err on the side of giving you too little levothyroxine. 

In addition, there’s a good chance that your doctor is not giving you enough thyroid medication if they are using the TSH (thyroid-stimulating hormone) as a guide. 

The TSH is one of the worst ways to measure thyroid function in the body because your free thyroid hormones (free T3 and free T4) are much more important. 

It could very well be that your dose of levothyroxine just isn’t quite high enough. 

If your dose is too low it will be very hard for you to lose weight. 

#4. Is it The Right Medication For Your Body? (Would Another Thyroid Medication Be Better for You?)

Lastly, and if all other options have failed, it may simply be that levothyroxine is just not the right thyroid medication for you. 

There are at least 8+ different types of thyroid medications and yet doctors consistently prescribe only one or two. 

They love levothyroxine and Synthroid but fail to prescribe any of the other versions of thyroid medications even though they are viable and effective options. 

If you’ve never heard of these thyroid medications then I would recommend that you spend some time familiarizing yourself with them!

Here’s a list for your review:

• Tirosint
• Tirosint-Sol
• Armour Thyroid
• NP Thyroid
• SR T3
• Compounded T4/T3
• Cytomel
• Liothyronine

These are just a handful of alternatives available to thyroid patients and they can all be used if you are not doing well on levothyroxine/Synthroid. 

Switching between thyroid medications is not very difficult but it may require some time and energy to figure out what works for you. 

But the result will be worth it if it means more weight loss! 

The Best Thyroid Medication For Weight Loss? (T4 vs T3 vs T2)

Is there a single best thyroid hormone for weight loss?

Sort of, but not in the way you are thinking.

The best thyroid medication is the one that works for you. 

I’ve seen people lose weight on virtually all types of thyroid medications ranging from levothyroxine to Cytomel to Armour thyroid and everything in between. 

But here’s what I can tell you:

The thyroid patients who are most likely to lose weight are those who take a comprehensive thyroid hormone profile.

That means using a combination of T4, T3, and T2.

Why?

Because that’s what the healthy thyroid gland produces. And people with a healthy thyroid gland generally don’t have problems with weight gain.

It’s that simple.

If you can mimic this thyroid hormone production, then you’re going to be better off.

Here’s how to do just that:

• Take 100 mcg of T4 thyroid hormone (from levothyroxine, Synthroid, or Tirosint)
• Add 20 mcg of T3 thyroid hormone (from Cytomel, liothyronine, or SR T3)
• Add 100-200 mcg of T2 thyroid hormone (from Essential T2 or T2 Cream)

This simple routine will provide you with T4, T3, and T2, and will work for about 80% of people reading this right now.

That remaining 20% will need some more tweaking (more T3 and less T4, usually), but it’s the best place to start.

But to answer the more general question of which is best for weight loss, the answer is easy:

All things being equal, T3 and T2 are more powerful than T4 so they are more likely to impact your metabolism and weight.

So in the event that you can’t get T4, at least take a combination of T4 and T2 because T2 is the only thyroid hormone available over the counter and T4 is the easiest of all thyroid medications to get.

But best case scenario, you’d be taking all three.

Who Does Best on T4 Thyroid Medication? 

Does this mean you have to take T3 and T2 if you want to lose weight?

Not necessarily.

There are still plenty of people who do well on levothyroxine and Synthroid.

There are also plenty of people who don’t, but let’s focus on those who do for a moment. 

If you fit into any of these categories than levothyroxine may work for you:

• Treatment naive – If you’ve never used thyroid medication before at all then starting with levothyroxine is a great idea. It is much more gentle and milder compared to other thyroid medications. 
• Sensitive to T3 thyroid medication or NDT thyroid medication – Some people can’t tolerate even a small amount of T3 thyroid hormone. If you are one of those people then T4 thyroid medication like levothyroxine may be your best bet. 
• Sensitive to medications and supplements in general – If you are someone who is sensitive to pretty much all medications and supplements then starting with levothyroxine is usually your best bet. 
• Suffer from minimal chronic illness – In general, the more chronic illnesses that you have the more aggressive you will need to be with your thyroid medication. If you don’t have any other chronic illnesses (such as high blood pressure, high cholesterol, obesity, diabetes, etc.) then levothyroxine is more likely to work. Those who do have these chronic illnesses tend to do better on T3. 
• Seeing improvement on levothyroxine in a short period of time – If you’ve been taking levothyroxine for a short period of time (on the order of 2-4 weeks) and you are seeing improvement already then that is a very good sign that this medication will work for you. 

Wrapping It Up

Is it possible to lose weight on levothyroxine? Absolutely. 

Is it easy to lose weight on levothyroxine? Not exactly. 

Is levothyroxine the best thyroid medication for weight loss? No. 

Will it help YOU lose weight? That remains to be seen!

If you are someone who is struggling to lose weight DESPITE taking levothyroxine faithfully then make sure you check out the first section which describes 4 reasons why it may not be working. 

If you’ve gone through all 4 of those areas and you are still having issues then you may need to consider swapping over to a different thyroid medication. 

Before we close I want you to remember one very important thing:

As a thyroid patient, you do NOT have to suffer from obesity and weight loss resistance. 

There is a way for you to lose weight and keep it off but it may require effort on your part. 

Use the tools on my website to help you get there!

Now I want to hear from you:

Are you currently using levothyroxine?

Are you having issues losing weight?

Do you feel that levothyroxine is helping with your weight loss efforts? Why or why not?

Have you tried any other thyroid medications? Were they more effective than levothyroxine for YOU?

Leave your questions or comments below!