Expert Advice

Hypothyroid Weight Gain: A Frustrating Problem with Real Solutions

Acella Pharmaceuticals, LLC., is partnering with Lindy Ford, RD, LDN, to bring greater awareness to the importance of thyroid care and education. This post is sponsored by Acella Pharmaceuticals and should not be construed as medical advice. Please talk to your doctor about your individual medical situation.

Disclaimer: The information provided is for educational purposes only and does not substitute professional medical advice. Consult a medical professional or healthcare provider before beginning any exercise, fitness, diet, or nutrition routine.

It’s so frustrating. You eat what you did in times gone by but still gain weight. Your exercise level has stayed the same. What’s going wrong? Is eating less and exercising more the answer?

Understanding Weight Gain from Hypothyroidism

When diet and exercise remain constant, unexplained weight gain of more than a few pounds should be addressed with your healthcare practitioner. It’s possible that the weight gain is from other underlying or undiagnosed issues. So I recommend my patients have the full spectrum of thyroid labs run (not just TSH).

The thyroid is a master gland of the body that regulates metabolism, or how efficiently your body burns fuel for energy. Hypothyroidism occurs when the thyroid hormones are low, and this most definitely makes your metabolism slow down. However, thyroid hormones are not the only hormones at play in hypothyroid weight gain.

The hormone leptin, which is made in fat cells, primarily targets the hypothalamus in your brain. This "satiety" hormone tells you when you are full. When leptin and the thyroid are functioning normally, your metabolism efficiently regulates food intake and energy expenditure.1

Leptin resistance occurs when too many fat cells release leptin or with thyroid dysregulation from autoimmunity.2 There may be more than enough leptin circulating in the blood, but the leptin receptors shut down and don’t signal the brain you are full.

I know this paints a bleak picture, but there is hope for a healthy weight in your future with a few lifestyle choices.

Tips for Hypothyroid Weight Gain

1. Talk to your healthcare provider about treatments to enhance thyroid hormones.

I recommend thyroid hormone replacement with naturally-derived* porcine hormones to my patients. I personally use NP Thyroid®. It contains both T3 and T4. Synthetic hormones often contain one type. Thyroid replacement gives a boost to your metabolism, but you have to go further.

2. Consume a lower carb, nutrient-dense, real food diet.

Your body needs a plethora of vitamins, nutrients, minerals, healthy fats, and protein for optimal thyroid functioning. Concentrate on getting an overabundance of low-sugar vegetables, lots of healthy fats, including omega 3s in fatty fish and nuts, and clean protein.

Some fruit is fine but should be limited because of fructose, the sugar in fruit. Leptin resistance, hypothyroidism, and insulin resistance are often interconnected.3 Concentrate on the lower glycemic fruits such as organic berries, apples, pears, and grapefruit.

Lower your intake of carbohydrates, especially refined carbohydrates. Yes, the kind that we all love but don't love us back.

Completely eliminate or greatly reduce polyunsaturated vegetable oils such as soybean, vegetable, canola, sunflower, and peanut oils. They create an inflammatory response in your body that complicates hormone functioning.

Learn more about nutrients that are especially helpful in boosting thyroid hormones in one of my recent articles, “Nutrients for Better Thyroid Function.” Optimizing these nutrients will give you a better chance to boost your metabolism.

3. Avoid consuming low-calorie and low-fat diets.

When you possess healthy levels of leptin, and your receptors are functioning properly, your appetite is decreased. When the receptors are malfunctioning and leptin doesn't reach your brain, your appetite becomes voracious.

When you eat a low-calorie diet, the body will increase the secretion of ghrelin, the hunger hormone, as well as leptin. This leptin isn't sent to the brain, so both of these hormones trigger appetite.4

An article published by the Harvard School of Public Health offered this comment from Dr. David Ludwig about the research: “This study raises the possibility that a focus on restricting carbohydrates, rather than calories, may work better for long-term weight control.” Ludwig is a professor in the Department of Nutrition at Harvard University’s T.H. Chan School of Public Health and led the study with Dr. Cara Ebbeling from Boston Children’s Hospital.5

So yes, calories do count to some extent, but not exactly in the way we once thought. They are not created equal, and the body has vastly different physiological responses to the calories in food.

Healthy fat creates fullness, so while you are healing your leptin sensitivity, fat will provide satiety. The low-fat diets of the past have been the greatest contributor to yo-yo dieting. Dieters end up ravenous and unable to stick to any program. They often gain back all of the weight and more for good measure. Fats also help you absorb more of the all-important nutrients that boost your thyroid and heal your leptin resistance.

4. Get consistent exercise, but don’t over exercise.

You may hear your practitioner tell you, “Eat less and exercise more.” I’ve seen countless patients try this only to end up frustrated and overweight. Overexercise can increase cortisol to unhealthy levels and wreak havoc on thyroid hormones.6

Consistency is what rewards your body. Aim for “metabolism confusion," 20 minutes daily, six days a week. This means mixing things up to maximize the benefits and keep your metabolism humming.

I do interval workouts five days a week, where I incorporate weights and cardio. I also do deep stretching or gentle flexibility workouts once or twice a week. I never overexercise.

These strategies will not only help you avoid thyroid-related weight gain but also will help you increase your energy and maximize your long-term health.

*Naturally derived refers to the biological nature of the porcine-derived desiccated thyroid ingredient found in the product.

REFERENCES: 1. Perello, M., Çakir, I., Cyr, N. E., Romero, A., Stuart et al (2010). Maintenance of the thyroid axis during diet-induced obesity in rodents is controlled at the central level. American Journal of Physiology-Endocrinology and Metabolism, 299(6), E976-E989. 2. Duntas, Leonidas, Biondi, Bernadette. The interconnections between obesity, thyroid function, and autoimmunity: the multifold role of leptin. Thyroid. 2013 Jun;23(6):646-53. doi: 10.1089/thy.2011.0499. Epub 2013 Apr 4. 3. Gierach, Marcin, Gierach, Joanna,  Junik, Roman. Insulin resistance and thyroid disorders. Endokrynol. 2014;65(1):70-6. doi: 10.5603/EP.2014.0010. 4. Ebbeling, Cara, Ludwig, David et al. Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial, BMJ 2020; 371 doi: 5. Effects of varying amounts of carbohydrates on metabolism after weight loss. TH Chan Harvard School of Public Health. 2018 6. Roach, Steve. Hypothyroidism and overtraining: Too much of a good thing. The Carolinas Thyroid Institute. Jan 20, 2012.


Note that DTE products, including NP Thyroid®, have not been reviewed by the FDA for safety or efficacy.

Important Risk Information

Drugs with thyroid hormone activity, alone or together with other therapeutic agents, have been used for the treatment of obesity. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects.
  • NP Thyroid® is contraindicated in patients with uncorrected adrenal insufficiency, untreated thyrotoxicosis, and hypersensitivity to any component of the product.
  • In the elderly and in patients with cardiovascular disease, NP Thyroid® should be used with greater caution than younger patients or those without cardiovascular disease.
  • Use of NP Thyroid® in patients with diabetes mellitus or adrenal cortical insufficiency may worsen the intensity of their symptoms.
  • The therapy of myxedema coma requires simultaneous administration of glucocorticoids.
  • Concomitant use of NP Thyroid® with oral anticoagulants alters the sensitivity of oral anticoagulants. Prothrombin time should be closely monitored in thyroid-treated patients on oral anticoagulants.
  • In infants, excessive doses of NP Thyroid® may produce craniosynostosis.
  • Partial loss of hair may be experienced by children in the first few months of therapy but is usually transient.
  • Adverse reactions associated with NP Thyroid® therapy are primarily those of hyperthyroidism due to therapeutic overdosage.
  • Many drugs and some laboratory tests may alter the therapeutic response to NP Thyroid®. In addition, thyroid hormones and thyroid status have varied effects on the pharmacokinetics and actions of other drugs. Administer at least 4 hours before or after drugs that are known to interfere with absorption. Evaluate the need for dose adjustments when regularly administering within one hour of certain foods that may affect absorption.
  • NP Thyroid® should not be discontinued during pregnancy, and hypothyroidism diagnosed during pregnancy should be promptly treated.


NP Thyroid® (thyroid tablets, USP) is a prescription medicine that is used to treat a condition called hypothyroidism from any cause, except for cases of temporary hypothyroidism, which is usually associated with an inflammation of the thyroid (thyroiditis). It is meant to replace or supplement a hormone that is usually made by your thyroid gland.

NP Thyroid® is also used in the treatment and prevention of normal functioning thyroid goiters, such as thyroid nodules, Hashimoto’s thyroiditis, multinodular goiter, and in the management of thyroid cancer.
Revised 10/2023