Thyroid medication… let’s talk about it.

Are you taking medication and still gaining weight, feeling sluggish, etc? Has your Dr. tried increasing your thyroid medication again… and still nothing is working? Why does it seem like your medication is NOT improving ANY of your thyroid symptoms?

Let’s talk about why!

The Thyroid Conversion

Testing only TSH to assess thyroid function is not enough. The pituitary gland in your brain releases TSH, which tells your thyroid gland to make the thyroid hormone T4 (it only makes a tiny bit of T3 here).

However, your body must convert T4 into T3 (the active form) in order to use it. When the conversion of T4 to T3 is poor, a lot of thyroid symptoms will begin to occur.

The Issue

There is a conversion issue of T4 to T3.

Most of the T3 conversion happens in the gut and liver. However, the conversion can be impaired due to poor gut health, impaired liver health, stress, under-eating, and nutrient deficiencies. 

When the conversion isn’t working well, one will usually see a high TSH, normal T4, low T3. You can get all the T4 you need (i.e. Levothyroxine and Synthroid), but if you’re not converting it to T3, you will still have all the symptoms. In my clients’ case, these include weight gain, low energy, fatigue, body aches, increased thyroid medicine, etc.

What’s Preventing the Conversion of T4 to T3?

There are various factors that can affect the conversion of T4 to T3.

Poor Liver Function

The majority of the conversion of T4 to T3 occurs in the liver. As a result, impaired liver function may affect the conversion, even if the liver enzymes appear to be at normal levels. 

Poor Gut Health

The gut is the other location where the conversion takes place. Disruptions in gut health may reduce your body’s ability to convert T4 into the active T3 hormone. Common gut health issues are dysbiosis (an imbalance of gut bacteria), inflammatory bowel disease, or leaky gut due to inflammation. When there is a lot of inflammation, the body is unable to properly absorb the nutrients in food, which leads to nutrient deficiencies commonly seen in thyroid conditions.


During times of constant stress, your body releases higher amounts of the stress hormone called cortisol. 

As a result, T4 is converted in higher amounts to Reverse T3, which is the opposite of the active T3. Reverse T3 puts the brakes on things so the body can deal with the stress.

Your body requires a gentle balance of Reverse T3. Too much of this hormone due to constant stress can slow the metabolism resulting in weight gain, no matter how little you eat. 

Low-Calorie Diets

Eating too little can be damaging to thyroid function and may reduce T3 concentrations significantly (by up to 50% according to sources).

When you significantly undereat, your body will redirect your thyroid hormone (T4) into the reverse T3 version, which causes your metabolism to drop. This is a protective mechanism to prolong your survival in times of famine and food restriction. This can also inversely lead to high-stress levels which cause gut inflammation. All of these consequences can result in weight gain and worsening thyroid symptoms.

How The Keto Girl Method Helps Reverse Symptoms Naturally

The goal of the Keto Girl Method is to decrease inflammation and reset gut health while keeping the metabolism optimal (i.e. guessing). This is where the anti-inflammatory approach of my method differs from regular keto. 

In addition, it is a mindful approach, meaning I advocate listening to the body and focusing on the right portions of macronutrients without using a carb tracker, weighing or measuring food. 

Below are my Top 3 Tips to Start Reversing Symptoms 

1. Avoid inflammatory foods 

Gluten, dairy, eggs and added sugar are foods that can increase inflammation.

Gluten impairs absorption of fat soluble vitamins (DAKE) and fatty acids (essential for reproductive and adrenal hormones). It also causes leaky gut which increases cortisol (stress hormones).

Dairy contains IGF-1 (insulin growth factor) which spikes insulin and increases testosterone and estrogen which can lead to weight gain.

Eggs have shown to be inflammatory for autoimmune disorders. Hypothyroid clients have seen the benefit of being egg-free.

Now before you worry about what you’ll eat and never being able to enjoy your favorite meal again… as you start to reverse your condition and your body starts to heal, you’ll be able to re-introduce some of these foods while maintaining results!

2. Start intermittent fasting

Intermittent fasting has many benefits, particularly for those with autoimmune diseases such as Hashimoto’s. By not eating for specific times in the day (or night) you can reset your body, decrease sugar cravings, regulate your insulin and improve weight loss. 

I recommend fasting 1-3 times a week for up to 16 hours at a time, including the hours you sleep. Find out more about keto fasting in my go-to guide.

3. Mindful eating & growth mindset

Mindful eating is a simple way to make food more enjoyable and promote better eating habits. The goal is to slow down, pay attention to your meal and be aware of your body, thoughts, and feelings. 

Here are some tips to practice mindful eating:

  • Switch off distractions and devices
  • Check-in with your body – are you hungry?
  • Take small bites of your meal and eat slowly 
  • Appreciate your food and consider the taste, smell, texture, and temperature of each bite
  • Check-in with your hunger and satisfaction during and after your meal – at what point do you feel full?

In addition, your mindset is everything! Be kind, gentle and forgiving. Eat something inflammatory? Miss out on fasting for the week? It’s okay.. forgive yourself and focus on the present!

So, to sum it all up…

As inflammation decreases (through implementing these 3 tips above), gut health will reset and liver health will improve. It then becomes easier for one to listen to their body and eat the proper foods that are healing to their thyroid. This will allow for consistent weight loss and improved thyroid symptoms.

All during this time T3 is finally converted efficiently due to resetting the gut health, and full absorption of the T4 from Levothyroxine. 

My Keto Girls are closely monitored by their physicians, and many have been able to not just lose the weight, but are able to decrease their dosage of Levothyroxine or even able to get off of it completely. Join Today!