Why Thyroid Medication Sometimes Does Not Fix Fat Loss or Symptoms
In simple terms, Synthroid (levothyroxine) gives your body T4. T4 is not the really active thyroid hormone. Your body still has to turn T4 into T3 for it to actually raise metabolism, support fat loss, and improve energy. That conversion step matters more than most women are ever told. When your body is calm, nourished, and rested, T4 tends to convert into T3. When your body is - under stress, - inflamed, - under-fed, - over-trained, - or under-slept, it often converts T4 into reverse T3 instead. Reverse T3 is an inactive form of thyroid hormone. It blocks thyroid receptors and slows metabolism inside the cells. So even though your blood work might show normal or even high thyroid hormone levels, your cells can still be functionally hypothyroid. FitnHealthy Forever Tip - This is why we recommend asking for complete Thyroid testing including 1. TSH 2. T4 3. T3 4. Reverse T3 5. Free T4 6. Free T3 7. T3 Uptake/TBG 8. Thyroid Peroxidase (TPO) Antibodies 9. Thyroglobulin (Tg) Antibodies This creates a frustrating pattern. You are “on thyroid medication,” but you still feel tired, foggy, cold, or stuck. Fat loss stalls. Energy does not improve the way you expected. Menopause symptoms like sleep disruption, anxiety, hot flashes, or heart racing can persist or worsen. At the same time, having higher circulating thyroid hormone still increases stress signaling, cortisol, nervous system activation, and bone turnover. So your body gets the stress side of thyroid hormone without getting the metabolic benefit. That is why you can feel wired but tired at the same time. That is also why fat loss can stall even when labs look fine. This is not because your body is broken. It is because your body is trying to protect you. Under stress, the body shifts into a conservation and survival mode. It blocks metabolism to preserve energy, holds onto fat to protect you, and prioritizes immediate survival over long-term goals like fat loss or rebuilding tissue.