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The Case of the “Normal” Thyroid Level and the 40 lbs Weight Gain

Updated: Nov 12, 2023


I wanted to take a minute and tell you about a patient I just saw. We’ll call her Maggie (not her real name for HIPAA reasons). Maggie, a 45 year old woman is busy. She, frankly is amazing, a force of nature at work, at her kids schools, and does the gym thing. Right around when she turned 43 she started to gain weight, like 40 lbs. She increased her weekly miles on the treadmill and counted calories…She felt “off” and then she started to have thinning hair. After 2 trips to her primary care provider (pcp) she had a few labs run and then after 3 trips she was told she was just getting older, was depressed and given a prescription for an antidepressant.


Well, yeah that wasn’t the cause of her weight gain and hair loss…She was a bit depressed about the situation, but the depression was not the cause of her weight gain and hair loss. It turned out that her pcp didn’t really understand thyroid health and the connection between suboptimal thyroid function and weight gain, hair health and mood.


After Maggie and I talked about her symptoms, added a few important tests to fill in missing information for her thyroid panel we have a full picture of her thyroid health and confirmed that she was making antibodies to her thyroid gland. I also ordered Free T3 and reverse T3 to fill in missing information about Maggie’s thyroid health picture.


Once we had all the information about Maggie’s thyroid labs it was clear that she was starting to slowly destroy her thyroid gland and making less and less active T3 hormone. Her FreeT3 thyroid reading was 2.0 pg/dL (normal range 2.0 to 4.4 pg/dL), technically “normal” but given her symptoms, and the presence of antibodies she has thyroid disease. Thyroid hormones are important to metabolic health (ie how we burn calories and gain or lose weight). The normal range on the thyroid labs was still a symptomatic range for Maggie and causing her metabolism to slow and weight to creep on.


With a full picture of her thyroid health Maggie and I created a custom plan for her. Her personalized plan involved reducing her thyroid antibodies by taking out common allergens from her diet. We also worked on reducing her bodies inflammation, increasing supportive thyroid nutrients in her food and as supplements. In addition to reducing but not fully stopping her white wine consumption we supported her detoxification pathways. We are still working on getting enough sleep and reducing her stress levels, both of which contribute to thyroid and metabolic health.

I didn’t put Maggie on any thyroid medications…and after 2 weeks Maggie started to lose weight and at 8 weeks had lost 16 pounds. It will take some time to lose all 40 lbs, but Maggie is finally stopping the gain and improving her metabolic health. We just received updated labs and the thyroid antibodies have reduced by half and her Free T3 is now 2.8 pg/dL which is progress. An added benefit of all the work she has done is her triglycerides and total cholesterol have improved over those values from 2 years ago when she last had them checked.


Maggie tells me she is happy with the weight loss but even happier with how much energy she now has. If it’s been a while since you last had your full thyroid checked and you are struggling with unexpected weight gain I encourage you to get in and have your labs run. Ask your provider to run Free T3 in addition to TSH and Free T4. Depending on your individual symptoms you may need thyroid antibodies and reverse T3 labs also checked.

If you have questions about naturopathic medicine and how it can help you thrive, check out the link below or call the office to schedule a Free 15-minute Discovery Session. I look forward to helping you thrive…naturally.


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