Weight loss is hard enough—especially if you feel like your body is working against you.
Those with Hashimoto’s face an especially tough obstacle.
The disease is characterized by an underactive thyroid (hypothyroid), which can wreak havoc on your metabolism and lead to weight gain, fatigue and other nagging health problems.
But there are specific steps you can take to overcome this struggle.
Below, we discuss why it’s so hard to lose weight with Hashimoto’s and how exactly you can change your diet to help you start shedding those extra pounds.
What is Hashimoto’s Disease (Hashimoto’s Thyroiditis)?
It’s the most common form of hypothyroidism in the Western world, and is about eight times more common in women than men (1).
Symptoms can often be absent or mild at first, but can become more apparent as hypothyroidism progresses. The most common symptoms of Hashimoto’s include:
- Weight gain
- Excessive fatigue
- Feeling cold
- Brain fog
- Poor memory
- Joint and muscle pain
Why is It So Hard to Lose Weight with Hashimoto’s?
Since the thyroid directly impacts your metabolism, losing weight can be a real struggle with Hashimoto’s.
An underactive thyroid significantly slows down your metabolism, meaning you’ll be burning fewer calories than you typically would. It can also impact your energy levels, leaving you less motivated to exercise or eat well.
Stress may also exacerbate your symptoms and promote weight gain since it also slows down your thyroid function and, inevitably, your metabolism (2).
All of these factors can make weight loss feel practically impossible—but it doesn’t have to be.
Below are 7 ways to help get you on track to boost your metabolism and drop any extra pounds.
Summary: Hashimoto’s thyroiditis is an autoimmune disease that affects the thyroid. Common symptoms include weight gain, fatigue, constipation and joint and muscle pain. Losing weight with Hashimoto’s can be especially difficult given the thyroid’s direct role on metabolism.
1. Check Your Medications
Unfortunately, you can’t cure Hashimoto’s with diet alone, so the type and dosage of thyroid medication you take is especially important.
The most common medication prescribed for Hashimoto’s is levothyroxine (Synthroid, Levoxyl, Unithroid, Tirosint), which is a synthetic form of T4. Levothyroxine has been shown to be most effective on average, but Armour (made of dried and powdered thyroid glands) may be better tolerated for some.
Others may be unable to convert T4 to T3, so doctors may prescribe a combination of the two. There also may be something to taking levothyroxine along with liothyronine (a form of T3), which one study found led to weight loss in some people (3).
Visit your doctor to discuss the appropriate medication and optimal dose for you.
Make sure that you are taking your thyroid meds at the same time each day on a fasting stomach, and avoid eating any food within one to two hours of taking your meds to make sure they absorb properly.
Summary: Check with your doctor to make sure the type and dosage of your thyroid medication is optimal for you. Take your meds at the same time each day and avoid eating anything for one to two hours after taking them.
2. Reduce Added Sugars and Refined Starches
You don’t need to go to the extreme of going low-carb to lose weight, but you do need to reduce your intake of refined carbs, especially added sugars and sweeteners.
The average American eats over 77 pounds of sugar each year (not including sugar substitutes). This works out to almost 23 teaspoons, or 360 calories, per day in sugar. While this number is actually down from past years, it’s still far too much.
These types of carbs are “empty calories” because they offer no beneficial nutrients. You can find added sugars in most packaged foods, including:
- Flavored waters, sports drinks and fruit juices
- Granola bars
- Flavored yogurt
- Nut butters
- Salad dressings
Also beware of “gluten-free” or “low-fat” products that add unnecessary sugars.
It’s best to avoid no-calorie artificial sweeteners (like sucralose, aka Splenda) as well. In fact, these types of sugar substitutes were even shown to trigger the development of Hashimoto’s in one 52-year-old female (4).
You don’t need to give up sugar all together, but you should start to limit your intake. Start small. Replace dessert with a piece of fruit, pick natural yogurt over the flavored variety, and opt for a handful of nuts instead of a granola or protein bar.
Summary: While following a low-carb diet is not necessary, cutting out added sugars and refined starches is if you’re looking to lose weight. Start by reducing your intake of packaged foods, flavored waters, fruit juices, sodas, cereals and other sugar-sweetened products.
3. Load Up on Protein and Vegetables
Basing each of your meals around protein and vegetables is one of the keys to losing weight with Hashimoto’s.
Protein is an important component to a well-balanced diet. Several studies have found that meals high in protein are more satiating than those high in carbohydrate or fat (5).
This means you’re less likely to overeat when dedicating a portion of your plate to high-protein foods, like:
Research has shown that higher protein diets can promote weight loss. In fact, one study found that eating roughly 25-30% of your total daily calories in protein can boost metabolism by up to 80-100 calories per day (6, 7).
With each meal, your portion of protein should be about the size of your fist.
Alongside satiating protein, vegetables should fill up at least half your plate (or about the size of your whole hand).
Some of the most nutrient-dense varieties include green leafy vegetables, mushrooms, and cruciferous vegetables like cabbage, broccoli, cauliflower and Brussels sprouts.
These types of veggies contain essential vitamins, minerals and phytonutrients.
Vegetables are also some of the best sources of fiber, which is especially important for those looking to lose weight. Dietary fiber not only feeds the healthy bacteria in the gut, but can also promote appetite suppression and weight loss and decrease the risk of metabolic syndrome (8, 9).
Summary: Focus your meals around protein and vegetables to help you stay satiated and provide you with the most amount of essential nutrients, including fiber.
4. Get More Selenium, Zinc and Iodine from Food
Selenium, zinc and iodine are essential minerals that work directly with the thyroid.
These are critically important nutrients for anyone with Hashimoto’s, and you want to make sure your diet contains enough of each.
The highest selenium content in your body can be found in the thyroid.
Selenium helps recycle iodine and is essential to thyroid function. It’s also a potent antioxidant (10).
Therefore, you want to make sure you’re consuming enough selenium-rich foods in your diet, including:
- Brazil nuts
Supplementation is not necessary, unless advised by your doctor. In fact, just one Brazil nut contains roughly 68-91 mcg of selenium, enough to surpass the recommended daily allowance (RDA) of 55 mcg for adults (11).
Zinc is essential to the production of thyroid hormones, and thyroid hormones are essential for the absorption of zinc.
This is why zinc deficiency is often linked to hypothyroidism (12).
Zinc deficiency in the developed world mostly comes down to diet or difficulties with absorbing the micronutrient. For example, if you have Crohn’s disease or follow a strict vegetarian diet, you may be at risk of a deficiency (13).
Either way, a diet rich in zinc is recommended for everyone. The RDA for zinc is 8 mg per day for women and 11 mg per day for men. You could easily reach that with just two raw oysters.
These are some of the top sources of zinc:
- Nuts and seeds
Iodine is also essential to making thyroid hormones, but deficiencies in the U.S. are pretty rare.
That said, people who follow vegetarian or vegan diets are more susceptible to an iodine deficiency.
The best way to make sure you’re getting enough iodine is to first focus on foods that are rich in selenium and zinc—most also contain iodine, especially seafood, seaweed, eggs and yogurt.
The RDA of iodine is 150 mcg for adults. Iodine supplementation is also not recommended, unless advised by your doctor.
Other Possible Nutrient Deficiencies
Other common nutrient deficiencies in Hashimoto’s include:
- Vitamin B12
- Vitamin D
- Ferritin (iron)
These nutrients can also be obtained from eating many of the foods mentioned above, including meat, seafood, eggs and dairy.
Summary: A healthy thyroid depends on a diet naturally rich in selenium and zinc. This includes foods like seafood, beef, chicken, eggs and legumes.
5. Consider Removing Gluten from Your Diet
Gluten sensitivity and celiac disease may play a role in the development of autoimmune conditions like Hashimoto’s.
Some people have reported significant weight loss simply by switching to a gluten-free diet.
The theory is that, in the presence of gluten, your immune system will mistaken your thyroid tissue for gluten and start to attack the thyroid (hence the term “autoimmune”). Roughly 16% of those with celiac disease have antibodies that go after the thyroid (17).
If you’ve been diagnosed with Hashimoto’s, you should first get tested for celiac disease. Even if the results come back negative, you may still want to consider taking gluten out of your diet for a few weeks to see if you feel any better without it.
If you don’t, then gluten is likely not a problem for you.
Summary: Some people have reported significant weight loss simply by switching to a gluten-free diet. If you’ve been diagnosed with Hashimoto’s, you should first get tested for celiac disease.
6. Try Removing Dairy from Your Diet
If you’ve found no improvements after removing gluten from your diet, try eliminating dairy.
One study found that over 75% of patients with Hashimoto’s were lactose intolerant (22).
Another discovered that lactose intolerance significantly increased the need for T4 medication in those with Hashimoto’s (23).
Like gluten, dairy has the potential to increase inflammation and trigger an autoimmune reaction in some people, which could worsen your symptoms.
The Autoimmune Protocol (AIP) is an elimination diet that involves cutting out potential bothersome food groups, including dairy, grains, beans and legumes, nuts and seeds, nightshade vegetables and more.
The goal of AIP is to eliminate any type of food that may be causing inflammation in the gut and exacerbating autoimmune conditions like Hashimoto’s.
It’s recommended to cut out these foods for at least 30 days to see if it helps your symptoms.
Summary: Hashimoto’s can often be linked to lactose intolerance. Removing dairy from your diet could help lower inflammation and improve your symptoms.
7. Commit to Regular Physical Activity
Along with focusing on the dietary changes above, committing to regular exercise is essential for jump-starting your weight loss.
Being active helps you burn more calories. It can also boost your mood, energy and metabolism—and it doesn’t even require high-intensity workouts.
In fact, research has found that longer bouts of low-intensity exercise, like walking, can be just as effective for weight loss (24).
Start by aiming to walk 10,000 steps at least every other day.
Also try adding in a few sessions of weightlifting or body weight exercises per week to build lean muscle, which will not only help you build your strength and mobility, but also increase your metabolism (25).
Summary: Regular physical activity is essential for kick-starting weight loss. It helps you burn calories and boosts your mood, energy and metabolism. Try to commit to a longer duration of low-intensity exercise most days of the week, and also include weightlifting or body weight exercises a few days per week.
Additional Tips to Losing Weight with Hashimoto’s
Here are a few more tips to help you lose weight with Hashimoto’s:
- Get a good night’s sleep: Poor quality sleep is just as bad as a poor diet when it comes to keeping your weight under control. People who get little sleep tend to weigh significantly more than those who get at least 7-8 hours per night (26).
- Stay hydrated: Water can do far more than quench your thirst. It can also help you eat fewer calories, especially if you drink up to 16 oz (475 mls) before meals (27).
- Practice portion control: There are many tricks to cutting back on your portion sizes, like simply using smaller plates and cutlery. The bigger your plate, the more you’ll likely consume (28).
Following each of these steps above can help you successfully lose weight with Hashimoto’s—even if it seems impossible. Just remember to stay patient as your body starts to gradually respond to these dietary and lifestyle changes.