Is Your Thyroid Causing Weight Gain in Perimenopause?

When I talk with women who are experiencing unexplained weight gain, one of the first questions that comes up is, “Could it be my thyroid?”

Thyroid hormones play a huge role in regulating metabolism and how the body uses nutrients. And as we age, the thyroid can get sluggish. Hypothyroidism is sneaky and experts say that undiagnosed thyroid disease is an epidemic, especially among women. Add to that the high estrogen and/or cortisol levels that occur in perimenopause and it’s a perfect recipe for extra pounds to pile on.

Research shows that even small changes in thyroid function can cause weight gain. In fact, many women who have been told their thyroid test results are “normal” may still have a reduced thyroid function that’s enough to cause weight gain and other bothersome symptoms. Unexpected weight gain and difficulty losing weight may be one of the first noticeable signals that something’s amiss.

Making good nutrition and supplementation a consistent part of your life is the most effective way to support your thyroid. Many of us spend much of our lives dieting in a yo-yo cycle of feasting or fasting. This is NOT consistency and leads to a confused metabolism and more weight gain.

Here are a few ways to support your thyroid:

  • Make sure your estrogen/progesterone balance is optimal. High estrogen can cause “functional hypothyroidism” because estrogen raises thyroid binding globulin which essentially renders thyroid hormone inactive. This is a situation where lab tests look normal but symptoms of hypothyroidism are present
  • Clean up your diet. Whole foods are best. Take a high quality multivitamin-mineral supplement that includes iodine and selenium. These 2 are powerful thyroid supporters. Also look for zinc, iron, and copper. All of these support the conversion of T4 to T3.
  • Eat your meals and snacks at regular times. Missing meals or snacks can stress your thyroid because of an increase in cortisol. Cortisol decreases TSH, lowering thyroid hormone production. It also inhibits the conversion of T4 to active T3, and increases the conversion of T4 to reverse T3. 
  • Include protein and fiber at every meal to optimize blood sugar balance. Good sources of fiber include fruits and vegetables and whole grains.
  • Completely eliminate gluten, sugar/sweeteners, alcohol, and junk food. These ingredients can interfere with healthy thyroid function, especially if you have Hashimoto’s thyroiditis.
  • Learn which foods contain thyroid-suppressing compounds known as “goitrogens” — including cruciferous vegetables such as cabbage, broccoli, and cauliflower. If you suspect thyroid problems, steam or cook these vegetables to reduce the goitrogens. Bonus: these foods also help lower estrogen levels if that’s an imbalance you struggle with.
  • Manage your stress. When cortisol elevates due to stress, your T4 gets turned into reverse T3… this turns down your body’s metabolism.

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If you haven’t had a recent thyroid evaluation, it may be time to get tested. Blood tests are the best way to do this. A COMPLETE thyroid panel will include a TSH, free T3, free T4, TPO and reverse T3 measurements. Ask your provider about getting all of these. Many lab panels include ONLY a TSH and that’s not enough for a complete evaluation.

Make sure you know your numbers. Don’t settle for “everything’s normal”. In 2002, the American Association for Clinical Chemistry (AACC) lowered the normal range for TSH to 0.3-2.5. Many labs are still using outdated ranges with an upper limit of normal of 5.5. If your TSH is over 2.5 and you are having symptoms such as hair loss, depression, constipation, fatigue, and dry skin (along with weight gain), talk to your health care provider about trying a low dose of thyroid replacement medication.

Dr. Anna Garrett is a menopause expert and Doctor of Pharmacy. She helps women who are struggling with symptoms of perimenopause and menopause find natural hormone balancing solutions so they can rock their mojo through midlife and beyond. Dr. Anna is the author of Perimenopause: The Savvy Sister’s Guide to Hormone Harmony. Order your copy at

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