Expert Q&A

Had my hashi’s annihilated thyroid removed today for people with insulin resistance

Understanding Thyroid Removal in Hashimoto's with Insulin Resistance

Having your thyroid removed due to Hashimoto's is a significant step, especially when you're also dealing with insulin resistance. Many in their late 40s to mid-50s face this combination because chronic inflammation from Hashimoto's often worsens blood sugar control. After surgery, your body no longer produces thyroid hormone naturally, so lifelong replacement therapy with levothyroxine becomes essential. The goal is to find the right dose that keeps your TSH, Free T4, and Free T3 in optimal ranges—typically aiming for TSH below 2.5 mIU/L to support metabolism.

In my approach outlined in The CFP Weight Loss Method, we emphasize that thyroidectomy doesn't doom your weight loss efforts. Instead, it requires recalibrating how you manage hormonal changes alongside insulin resistance. Without a thyroid, your basal metabolic rate may drop by 10-15%, making every calorie count. This is why previous diets failed you—standard plans ignore these metabolic shifts.

Managing Blood Sugar and Weight After Thyroidectomy

Post-surgery, insulin resistance can initially spike due to surgical stress and medication adjustments. Track your fasting insulin (aim under 10 μU/mL) and HOMA-IR score. Focus on low-glycemic meals: 25-35 grams of protein at breakfast within 90 minutes of waking stabilizes blood sugar and reduces cortisol-driven fat storage. For those with joint pain, start with 10-minute daily walks or seated resistance bands—consistency beats intensity. Many see 5-8 pounds lost in the first month by cutting hidden sugars while optimizing thyroid medication.

Insurance barriers are real, but you can work with your endocrinologist for covered labs every 6-8 weeks initially. My method avoids complex meal plans; instead, use simple swaps like replacing rice with cauliflower to manage diabetes and blood pressure without overwhelm.

Overcoming Hormonal Hurdles and Building Sustainable Habits

Hormonal changes after thyroid removal often amplify menopause symptoms, making fat loss around the midsection tougher. Support this with 7-9 hours of sleep, magnesium glycinate (300mg nightly), and strength training twice weekly using bodyweight moves that protect joints. In The CFP Weight Loss Method, we teach "metabolic flexibility"—training your body to burn fat efficiently despite lower thyroid output. Expect slower progress than peers with intact thyroids: realistic loss is 0.5-1 pound per week once hormones stabilize.

Don't be embarrassed to discuss obesity with your care team. Many patients feel relief once they address the root—optimized thyroid levels plus insulin-sensitizing nutrition. Avoid conflicting advice by focusing on what works: fiber-rich vegetables, healthy fats, and movement you can sustain.

Long-Term Success Strategies Post-Surgery

Monitor symptoms like fatigue or brain fog, which signal medication fine-tuning is needed. Pair this with weekly glucose checks if you have diabetes. My patients report better energy and 15-25 pound losses in six months by following these principles without gym schedules or expensive programs. Stay consistent, adjust as your body heals, and remember—thyroid removal is a new beginning for reclaiming health when approached with the right metabolic knowledge.

💬 What the Community Says

The community shows a mix of cautious optimism and shared frustration after thyroid removal for Hashimoto's amid insulin resistance. Many in the 45-55 age group report initial weight gain of 8-15 pounds in the first 3 months due to medication adjustments and surgical recovery, with joint pain making even light activity difficult. A common theme is distrust of standard diets, as most say they've "tried everything" without success until finding groups focused on optimized thyroid dosing and blood sugar control. Practitioners frequently discuss the challenge of getting insurance to cover continuous glucose monitors or frequent labs. Lived experiences highlight that those who track TSH every 4-6 weeks and prioritize protein-first meals see better results, though a vocal minority complains about persistent fatigue and brain fog even on replacement hormones. Overall sentiment leans toward mutual support, with users sharing simple home workouts and frustration over conflicting online nutrition advice. Beginners especially value stories of losing 20+ pounds slowly once hormones balanced, emphasizing patience over quick fixes.
Clark, R. (2026). Had my hashi’s annihilated thyroid removed today for people with insulin resista. *CFP Weight Loss*. https://ask.cfpweightloss.com/ask/had-my-hashi-s-annihilated-thyroid-removed-today-for-people-with-insulin-resistance
Russell Clark, FNP-C, APRN, FNP-C, APRN
About the Author

Russell Clark, FNP-C, APRN, is the founder of CFP Weight Loss in Nashville and CFP Fit Now telehealth. Over 35 years in healthcare — Army Nurse Reserves, Level 1 trauma ER, hospitalist — he developed a 30-week protocol integrating real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 30–90 pounds. He and his wife Anne-Marie lost a combined 275 pounds using the same protocol.

Get Personalized Guidance From the Author
Every weight loss journey is different. Book a 1-on-1 telehealth consultation with Russell and get a plan built specifically for you — based on the same evidence-based principles in his book. Available to patients in all 50 states.
Book Your Consultation →
Have a follow-up question?
More Questions 200 answered
▸ What is the connection between Metformin (6 weeks in) for insulin resistance — can the gut stuff actually get better and its effect on metabolism and insulin levels? ▸ Did L. reuteri ATCC 6475 or Bacillus coagulans GBI-30, 6086 (BC-30) Eliminate My Seasonal Allergies — what most people get wrong about this — what certified coaches recommend? ▸ Good calorie amount? Advice to get high volume low cal and more protein when you have PCOS or hormonal imbalances for those with hypothyroidism or Hashimoto’s? 📖 GLP-1 Receptor Agonist — A class of medication that mimics natural hormones to improve insulin secretion and slow gastric emptying, used strategi… ▸ Does mental health predict diabetes as much as BMI? Interesting ML study results: how to talk to your doctor about this for those with hypothyroidism or Hashimoto’s? ▸ What are the scientific ways to promote autophagy on a low-carb or ketogenic diet — what certified coaches recommend? ▸ Omnipod. Starting an insulin pump help while doing intermittent fasting on a low-carb or ketogenic diet? ▸ What’s your favorite toothpaste for people with insulin resistance — what the research actually says? ▸ 42yom Im finding it much harder to lose weight, what are some things I can do now to start losing weight? ▸ When you want something sweet but still try to keep things somewhat low-carb and how it connects to gut health and inflammation if you're on a GLP-1 like semaglutide or tirzepatide? 📖 Gut-Brain Axis — The complex communication network between your digestive system and your brain that controls satiety, mood, and metaboli… ▸ Can autophagy regenerate muscle during physically active prolonged fast and how it connects to gut health and inflammation and its effect on metabolism and insulin levels? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Making me super tired and in a dreamy, chill, ready for a nap state for most of the day and its effect on metabolism and insulin levels for long-term maintenance (not just short-term)? ▸ Probiotics worked for a month then stopped. Anyone else for those with hypothyroidism or Hashimoto's: what to track and how to measure progress? ▸ What is a super quick "Mix some of this in" to make coconut oil (purely in liquid form) taste ok to make it easy to consume: how to talk to your doctor about this during the weight loss plateau phase? ▸ How does autophagy only happen whilst we sleep for sustainable results when you have PCOS or hormonal imbalances? ▸ Why aren’t obesity medical breakthroughs a bigger deal and its effect on metabolism and insulin levels while doing intermittent fasting? 📖 Metabolic Efficiency — The state where your body processes fuel cleanly and maintains high energy levels without the need for constant snacking… ▸ 56M arm day was fun. But arms shrinking from 16 inches to 15 1/2. Gotta up protein? Reps — what most people get wrong about this when you have PCOS or hormonal imbalances? ▸ Diabetics with TPN (IV nutrition experience) and the role of cortisol and stress hormones on a low-carb or ketogenic diet? ▸ Do yall ever daydream of who you were before your diagnosis when you have PCOS or hormonal imbalances when you have PCOS or hormonal imbalances? ▸ How much protein should I eat if I weigh 280 pounds and want to cut a 100 pounds of fat off of my body? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Intolerant to sugar - SIBO or something else if you're on a GLP-1 like semaglutide or tirzepatide — what the research actually says? ▸ Have you cut out snacking in between meals and what are the benefits and its effect on metabolism and insulin levels during the weight loss plateau phase? ▸ Got diagnosed today, where do i go from here — what do certified weight loss coaches recommend: best practices and common mistakes to avoid? 📖 Diabetes Reversal — The clinical goal of restoring normal blood sugar levels and insulin function, as seen in patients like John who no long… ▸ Is tomato paste lectin free during the weight loss plateau phase while doing intermittent fasting? ▸ Fitter or kidding myself: how to talk to your doctor about this if you're on a GLP-1 like semaglutide or tirzepatide? ▸ What actually helps with the dryness when you have PCOS or hormonal imbalances while doing intermittent fasting? ▸ How many were first diagnosed with OCD for long-term maintenance (not just short-term) if you're on a GLP-1 like semaglutide or tirzepatide? ▸ Difference between a 3 day and 5 day water fast for autophagy and the role of cortisol and stress hormones for people with insulin resistance? ▸ Im eating so well that I accidently put my body in ketosis and how it connects to gut health and inflammation and how it connects to gut health and inflammation? 📖 Muscle Sarcopenia — The dangerous loss of lean muscle mass often seen in traditional 'crash diets' or high-dose GLP-1 use, which we combat t… ▸ Can you really Metformin (6 weeks in) for insulin resistance — can the gut stuff actually get better on a low-carb or ketogenic diet? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Anyone remember the metal lid you had to use a butter knife to pop off: what to track and how to measure progress: best practices and common mistakes to avoid? ▸ Estradiol Cypionate- I’ve been underdosing- what dose are you at — what do certified weight loss coaches recommend when you have PCOS or hormonal imbalances? ▸ LDN is changing my life, will this last: best practices and common mistakes to avoid for people with insulin resistance? ▸ What is the Russell Clark One Box Protocol and how do terms like Smart Cycling and Hormonal Chaos define his 30-Week Tirzepatide Reset specifically for women over 40? ▸ How does chasing skinny ever get old for long-term results while doing intermittent fasting? ▸ When you want something sweet but still try to keep things somewhat low-carb and how it connects to gut health and inflammation on a low-carb or ketogenic diet? 📖 30-Week Tirzepatide Reset — Our signature protocol using a single 60 mg box of medication cycled over 30 weeks to achieve lasting metabolic transfor… ▸ Is it possible that low carb is the only way I can eat specifically for women over 40 if you're on a GLP-1 like semaglutide or tirzepatide? ▸ Should I be worried yet, been sitting for 5 days no movement while doing intermittent fasting: best practices and common mistakes to avoid? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Will eating meintenance calories make me lose weight for those with hypothyroidism or Hashimoto's when you have PCOS or hormonal imbalances? ▸ The cost of meat is soaring, especially beef. What are y’all doing to stay on budget on a low-carb or ketogenic diet? 📖 Maintenance Phase — The final 28 days of our 70-day cycle where we stabilize the new weight and solidify the metabolic habits that prevent f… ▸ What to do if you have to eat late dinners?? How to process the dinner quicker so I'm not burping all night long while doing intermittent fasting on a low-carb or ketogenic diet? ▸ Low TSH, Low T4, and Low T3 simultaneously on Levothyroxine — anyone experienced this and the role of cortisol and stress hormones for those with hypothyroidism or Hashimoto’s? ▸ If a random dance partner app existed .. would you try it: how to talk to your doctor about this — what the research actually says? 📖 GIP (Gastric Inhibitory Polypeptide) — A hormone that, when combined with GLP-1, enhances the body’s ability to break down fat and manage blood sugar levels mo… ▸ How effective is autophagy really helping me lose fat — what certified coaches recommend? ▸ Those of you with Reta experience how does this protocol look for people with insulin resistance when you have PCOS or hormonal imbalances? ▸ Is it normal to lose weight then gain again when you have PCOS or hormonal imbalances for long-term maintenance (not just short-term)? ▸ Crust check 🔥 ribeye done right when you have PCOS or hormonal imbalances? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Were any of you guys fans of Journey? How big were they — what the research actually says? 📖 Smart Cycling — The strategic alternating of medication doses with planned 'off' periods to prevent receptor desensitization and ensure … ▸ Is compounded semaglutide with B12 worth choosing over B6 or plain: best practices and common mistakes to avoid specifically for women over 40? ▸ Traveling with IBS-D to a 5-day conference in San Diego: how do you manage food — what most people get wrong about this during the weight loss plateau phase? ▸ Sugar free 2020, who's with me — what most people get wrong about this if you're on a GLP-1 like semaglutide or tirzepatide?