Do you know if you’re taking the right amount of thyroid medicine, or if you have the idea TSH level for weight loss? When it comes to Hashimoto thyroiditis weight loss, just because you’re taking more does not mean you’re getting better.
Let’s dive into how we can get the right thyroxine dosage for weight loss for you and your body. We’ll explore optimal thyroid levels for weight loss and how you can gain your energy back.
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Before we can begin talking about dosage, we need an overview of the different labs that you need to know.
Each is important, so it’s crucial that you have a good understanding of each. Thankfully I have talked about each of these tests before and you can find out more by spending a little bit of time on my site (Read: How to test your thyroid, the definiteve guide ).
Good thyroid testing means getting a full panel done. This is going to include a TSH, fT3, fT4 and thyroid antibodies.
You are also going to want to make sure that you are preparing the body. This means preparing it in the best way to get tests done.
Did you know that when you take a test, your results can be completely changed?
You want to have thyroid lab tests drawn:
Key Insight: If you are going to have a full panel of tests done, it should be done in the morning and before you take your day’s thyroid tablet. This way, you are able to get the best and most meaningful results possible.
Let’s get a quick refresher on what your scores mean when you have a full panel of tests done.
T4 and T3 are similar but need more nuance. When you have way too much thyroid hormone, T4 and t3 are high. When you have no thyroid hormone, they are low.
But if you are too high or too low by a mild or moderate degree, T4 and T3 usually don’t reflect it. It often just shows up in the TSH at first.
In fact, TSH is 50-fold more sensitive to mild and early changes.
You may have heard that the normal ranges for thyroid tests do not always reflect optimal function. This point applies mostly to the TSH for people who are taking thyroid medications.
Many who are in the “normal” range, but on the high side, can have hypothyroid symptoms. It actually confuses a lot of what we think of as “normal,” because it is actually not healthy.
People who are rightfully on thyroid medication sometimes only feel normal when their TSH levels are on the low side of normal. This might require a higher dose of medication or a different type of medication.
This does not mean that everyone whose TSH is high-normal needs thyroid medication. Nor does it mean that everyone on thyroid medication MUST have their TSH on the low side.
T4 and T4
T4 and T3 levels can fluctuate greatly, often for reasons besides the wrong amount of thyroid hormone.
Things that can change them include:
Too often doctors assume that a low level of T3 means that more T3 is needed. In many cases, it means the body prefers less T3.
The argument that everyone must have T3 or T4 on the high side of normal does not hold water. People with high T3 have higher rates of bone loss, breast cancer, and diabetes. It does not help someone’s health to artificially create high T3 levels.
Taking those points in mind, the following chart summarizes ideal levels for all commonly available thyroid blood tests.
There are so many people, those who fall in the “normal” TSH range, who are subsequently underdosed2. When I think of the optimal place to fall on the range, it has to be low. But it is still within the range.
When your TSH scores are between 1.5 – 4.5, and your free hormones are low to low-normal, you might still fall within the “normal” range. But, you do risk being underdosed when you really need it.
The first real paradox I want to talk about, though, is that a higher dosage is not often doing more (or better) work. In fact, if you take too much your body actually becomes thyroid resistant.
Thyroid hormones are so powerful. Your body has so many different ways of controlling them. This is so they can perform tasks and keep your body humming.
When a thyroid dose is higher than it should be, it takes two to three weeks for these mechanisms to start running faster. During this time, people often feel better or more energetic.
They have received their higher dose, and they start saying to themselves “hey, I feel much better and I have more energy. That extra boost must have done something right.”
It might feel good at the moment. But it is definitely not good for your health in the long-term. Do not confuse immediate success with long-term success. They can be quite different concepts.
Key Insight: The problem with a boost in dosage is that it often does not last, and patients end up going back to feeling to normal. This is where “normal” involves fatigue, weight gain and other unpleasant symptoms. These are not optimal thyroid levels for weight loss.
The patient and the doctor often assume that raising the dose again will help, and it does for another brief period of time4. It is a vicious cycle which finds a way of repeating itself again and again. Because there are no short-term side effects it means that everything’s a-okay.
Unfortunately, what this approach does is leads to unsafe high thyroid blood levels.
Higher doses of thyroid medication are not the answer, as this can lead to:
It is so important that we keep a close eye on the dose of our thyroid medication.
What we do not want is to jump the gun and continuously boost our medication, forever seeking temporary relief from our symptoms.
This simply is not a strategy for success and can lead to really dangerous side effects long-term.
Bottom Line: A higher and higher dose is not the way to go. In fact, while some doctors might argue for this strategy. All it can do is lead to high thyroid blood levels and dangerous side effects like strokes and dementia.
If the first paradox was all about making your body thyroid resistant, the second paradox is all about understanding the different ways that your blood levels might move when a dose is changed. That they can be quite unexpected.
This point is so incredibly important. Understanding this will immediately give you an advantage over probably 99% of the physicians who prescribe thyroid medication.
When a TSH score first starts to get low, you might assume that the free T3 and free T4 will get high, but they often do not. The reason for this is that the body is trying to compensate.
It lowers the TSH to prevent your thyroid from making any more hormone. At the same time, it is speeding the elimination of T3 and T4. This can cause their blood levels to go below-normal, low, or mid-range (rather than high).
If the TSH score is all the way to 0.01, and the dose keeps getting higher, eventually the free hormones do elevate. Although this will not happen at first. It takes time.
Many thyroid experts encourage people to have their free hormones at the higher end of the range4. Unfortunately this doesn’t happen without the TSH being too low, and that in itself does pose dangers to patients.
Studies done on people with healthy thyroid function find that their TSH runs in the low end of normal, but that their free hormones do not end up on the high side of normal.
This works on the other end of the spectrum, too. When the TSH starts to elevate, the free hormones are not necessarily low.
If the TSH gets high enough, eventually the free hormones drop off when someone is extremely hypothyroid.
What do you do if your labs are good, but you are still left feeling fatigued or dealing with unnecessary weight gain?
Here are just a few of the things I think we might need to start considering:
Also want to consider if your:
Start with the TSH!
I know that this can be a controversial opinion, as many have said that we should simply ignore the TSH. I think this might be ignoring something very important.
Your TSH scores can provide a really important launchpad for learning so much about the health of your thyroid.
It does not have to end there, but it is a pretty good start (from there, you can find the right T4 dosage for weight loss for you, too).
The TSH is the first thing to adjust, because it represents the important work that our brain does when it comes to regulating the thyroid hormone.
Your free hormone levels speak to greater problems down the road, not in emergency situations. So they are less important when it comes to starting an investigation into your health.
Once your TSH is optimal, the rest of your “local actors” find a way to sort themselves out. If there are still lingering issues, that is when we need to continue diving deeper and finding out more and more about root causes. (Read: Testing your thyroid, the definitive guide to optimal ranges)
Key Insight: Address your symptoms, but know that they are often not the strongest indicators of what is actually going on in your body.
Your thyroid is so important. It controls powerful hormones which dictate so much of what goes on in your body.
Do you know everything that there is to know about the thyroid?
If you are concerned that you don’t, you need to take my thyroid quiz today.
It will give you the information you need to benefit your body, and to live your best life. It’s always a good idea to keep your health in mind.
1 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3857600/
2 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3267517/
3 – https://www.nps.org.au/australian-prescriber/articles/modern-management-of-thyroid-replacement-therapy
4 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2928892/
P.S. Whenever you are ready, here is how I can help you now:
1. Schedule a Thyroid Second Opinion with me, Dr. C, Click Here for Details
2. Need a Personalized Supplement? Check out My Thyroid Specific Formulations
3. Download and use my Favorite Recipes Cookbook Here
4. Check out my podcast Medical Myths, Legends, and Fairytales Here
Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Adrenal Reset Diet, The Metabolism Reset Diet and The Thyroid Reset Diet.
Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, diabetes, and regain energy. Learn more about the surprising story that started his quest.
Dr. Alan Christianson
Alan Christianson is a Naturopathic Medical Doctor (NMD) who is a board-certified Naturopathic Endocrinologist with a focus on thyroid disorders. He is the author of The Metabolism Reset Diet and the New York Times bestselling book The Adrenal Reset Diet.
He founded Integrative Health, a physician group dedicated to helping people with thyroid disease and weight-loss resistance regain their health.
He has been named a Top Doctor in Phoenix magazine and has appeared on national TV shows and in numerous print media.
Dr. Christianson resides in the woods by a lake in Northern Minnesota with his wife Kirin.
