Expert Q&A

How to figure out your macros for LCHF for those with hypothyroidism or Hashimoto's

Understanding LCHF for Thyroid Conditions

When managing hypothyroidism or Hashimoto's, a Low Carb High Fat (LCHF) approach can help stabilize blood sugar and reduce inflammation that often worsens hormonal imbalances. In my years of research and through the methodology outlined in my book Mastering Metabolic Health, I've seen middle-aged adults lose 15-30 pounds in the first three months when macros are dialed in correctly. The key is avoiding drastic carb cuts that further suppress thyroid function while emphasizing healthy fats to support hormone production.

Step-by-Step Macro Calculation Process

Begin by determining your Total Daily Energy Expenditure (TDEE). For a 50-year-old woman weighing 180 pounds with a sedentary lifestyle, basal metabolic rate often sits around 1,400 calories due to slowed metabolism from low thyroid hormones. Multiply by 1.2 for TDEE, yielding about 1,680 calories. On LCHF, set protein at 1.2-1.6 grams per kilogram of ideal body weight. For someone aiming for 150 pounds, that's roughly 82-109 grams of protein daily (20-25% of calories).

Keep net carbs between 20-50 grams to stay in mild ketosis without stressing your adrenals. This leaves 70-75% of calories from fat, or about 130-140 grams. Use a reliable calculator like the one in the CFP Weight Loss app, adjusting downward by 10% if joint pain limits activity. Track for two weeks using a food scale to ensure accuracy.

Adjusting for Hormonal Challenges and Common Pitfalls

Those with Hashimoto's often experience erratic energy from fluctuating TSH levels. If you've failed every diet before, focus on anti-inflammatory fats like avocado oil (2-3 tablespoons daily) and wild salmon twice weekly for omega-3s that lower thyroid antibodies by up to 40% in studies. Avoid over-restricting calories, which can drop T3 hormone further. For diabetes and blood pressure management, this macro split typically improves HbA1c by 1.2 points within 90 days.

Joint pain making exercise impossible? Prioritize gentle movement like 20-minute walks after meals rather than gym sessions. Insurance rarely covers programs, so these at-home calculations put control back in your hands without expensive coaching.

Monitoring Progress and Fine-Tuning Your LCHF Plan

After four weeks, reassess. If weight loss stalls, reduce carbs to 25 grams and increase fat by 10 grams while keeping protein steady. Measure fasting glucose and ketones to confirm metabolic shifts. Many beginners see reduced brain fog and better sleep within 10 days. The CFP approach emphasizes simple one-pan meals requiring under 15 minutes prep, fitting busy schedules perfectly. Consistency with these personalized macros often reverses the cycle of hormonal weight gain that feels so overwhelming.

💬 What the Community Says

In online forums, adults 45-55 with hypothyroidism report mixed but mostly positive experiences calculating LCHF macros. Many appreciate the 20-50g carb target helping stabilize energy without the crashes seen on stricter keto. A common debate centers on protein amounts, with some finding higher intake (over 100g) triggers inflammation while others say it preserves muscle during weight loss. Those managing diabetes alongside Hashimoto's frequently share success stories of lowered medication needs after 2-3 months. Newcomers often feel overwhelmed by conflicting calculator recommendations but find tracking apps helpful once they accept the need for trial and error. Joint pain remains a frequent barrier, leading many to favor walking over structured exercise. Overall, the community notes slower but steadier progress compared to past failed diets, though a vocal minority warns against dropping carbs too low without thyroid lab monitoring.
Cite this answer
Clark, R. (2026). How to figure out your macros for LCHF for those with hypothyroidism or Hashimot. *CFP Weight Loss*. https://ask.cfpweightloss.com/ask/how-to-figure-out-your-macros-for-lchf-for-those-with-hypothyroidism-or-hashimoto-s
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.

📖 The 30-Week Tirzepatide Reset — Get the Book →
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
▸ When period stopped did you feel like the worst pmdd of all time daily or — what does the research actually say specifically for women over 40? ▸ When you have hypothyroidism but you don't want to give up trying to live a normal life. 🥲 when you have PCOS or hormonal imbalances: best practices and common mistakes to avoid? ▸ What causes I reduced my IR from 15.5 to 4 in 3 months and its effect on metabolism and insulin levels? ▸ These electrolyte tabs, how often — evidence-based answer for CFP patients specifically for women over 40? ▸ Can you really Metformin (6 weeks in) for insulin resistance — can the gut stuff actually get better specifically for women over 40? ▸ Is it okay for teenagers to do longterm lowcarb/keto — evidence-based answer for CFP patients for those with hypothyroidism or Hashimoto’s? ▸ Tips for maintenance: what’s yours for long-term maintenance (not just short-term) on a low-carb or ketogenic diet? 📖 Smart Cycling — The strategic alternating of medication doses with planned 'off' periods to prevent receptor desensitization and ensure … ▸ 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 ▸ If a random dance partner app existed .. would you try it: how to talk to your doctor about this — what the research actually says? ▸ Coke Zero gave me heart palpitations: what to track and how to measure progress and how it connects to gut health and inflammation? ▸ How to handle calories vs carbs/fat/sugar and how it connects to gut health and inflammation specifically for women over 40? ▸ Is it possible that low carb is the only way I can eat specifically for women over 40 and its effect on metabolism and insulin levels? ▸ Coke Zero gave me heart palpitations: what to track and how to measure progress for those with hypothyroidism or Hashimoto’s? 📖 Gut-Brain Axis — The complex communication network between your digestive system and your brain that controls satiety, mood, and metaboli… ▸ To what extent do Mendelian Randomization Studies provide causal evidence for a particular claim — what does the research actually say specifically for women over 40? ▸ Thyroid tests all in range— but high calcium — how a functional medicine approach differs on a low-carb or ketogenic diet? ▸ 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? ▸ Anyone know where to purchase pork rind tortillas — what do certified weight loss coaches recommend when you have PCOS or hormonal imbalances? ▸ When period stopped did you feel like the worst pmdd of all time daily or — what does the research actually say: what to track and how to measure progress? 📗 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 ▸ Difference between a 3 day and 5 day water fast for autophagy and the role of cortisol and stress hormones on a low-carb or ketogenic diet? 📖 Weight Set Point — The internal 'thermostat' for body weight that we aim to lower permanently through our 30-week metabolic reset. ▸ What are the wegovy doses in order on a low-carb or ketogenic diet — what certified coaches recommend? ▸ Anyone remember the metal lid you had to use a butter knife to pop off: what to track and how to measure progress while doing intermittent fasting? ▸ 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? ▸ 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? ▸ 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)? ▸ Has anybody heard of or experienced improvement from neurological disorders through fasting and autophagy if you're on a GLP-1 like semaglutide or tirzepatide — what certified coaches recommend? 📖 Cellular Detox — The process of clearing out metabolic waste and reducing cellular stress to allow for more efficient energy production a… ▸ 78kg to 58kg for an 18 y/o: How likely am I to have loose skin after weight loss specifically for women over 40 — what certified coaches recommend? ▸ How many were first diagnosed with OCD if you're on a GLP-1 like semaglutide or tirzepatide on a low-carb or ketogenic diet? ▸ What's the dumbest thing you and/or your siblings did when you were left home alone for those with hypothyroidism or Hashimoto's 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 ▸ 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 actually helps with the dryness when you have PCOS or hormonal imbalances while doing intermittent fasting? 📖 Phase 2: Aggressive Loss — A 40-day window of focused fat loss supported by low-dose medication and a specific lectin-free, low-carb nutritional fr… ▸ What actually helps with the dryness when you have PCOS or hormonal imbalances and how it connects to gut health and inflammation? ▸ 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? ▸ How are people using 10mg reta vials at low doses during the weight loss plateau phase — what the research actually says? ▸ Low TSH, Low T4, and Low T3 simultaneously on Levothyroxine — anyone experienced this and the role of cortisol and stress hormones — what certified coaches recommend? 📖 Metabolic Reset — The process of retraining your body to utilize stored fat for fuel and regulating hunger hormones so you can maintain yo… ▸ Can you take vitamin D with a tbsp of oil on an extended water fast for people with insulin resistance during the weight loss plateau phase? ▸ Thyroid tests all in range— but high calcium — how a functional medicine approach differs during the weight loss plateau phase? ▸ I have an iodine deficiency. Won't supplementing cause me to have a flare 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 ▸ How long does it take to Is Autophagy? 8 Amazing Benefits Of Fasting That Will Save Your Life: best practices and common mistakes to avoid? ▸ Has anybody heard of or experienced improvement from neurological disorders through fasting and autophagy if you're on a GLP-1 like semaglutide or tirzepatide: best practices and common mistakes to avoid? 📖 Metabolic Efficiency — The state where your body processes fuel cleanly and maintains high energy levels without the need for constant snacking… ▸ What are the wegovy doses in order on a low-carb or ketogenic diet when you have PCOS or hormonal imbalances? ▸ Good calorie amount? Advice to get high volume low cal and more protein when you have PCOS or hormonal imbalances — what the research actually says? ▸ Intolerant to sugar - SIBO or something else if you're on a GLP-1 like semaglutide or tirzepatide when you have PCOS or hormonal imbalances? ▸ Fitter or kidding myself: how to talk to your doctor about this if you're on a GLP-1 like semaglutide or tirzepatide? ▸ Omnipod. Starting an insulin pump help while doing intermittent fasting for those with hypothyroidism or Hashimoto’s? ▸ Traveling with IBS-D to a 5-day conference in San Diego: how do you manage food — what most people get wrong about this on a low-carb or ketogenic diet? 📖 Rebound Weight Gain — The common 'yo-yo' effect caused by high-dose, continuous GLP-1 use; we prevent this through strategic cycling and metab… ▸ When you have hypothyroidism but you don't want to give up trying to live a normal life. 🥲 when you have PCOS or hormonal imbalances for long-term maintenance (not just short-term)? ▸ What can I ask for if estrodiol cream remains in shortage? Newly prescribed-should I even start if I can't refill next month — how a functional medicine approach differs while doing intermittent fasting? 📗 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 ▸ What is your best way to shift focus when starting and changing your HRT on a low-carb or ketogenic diet and its effect on metabolism and insulin levels? ▸ These electrolyte tabs, how often — evidence-based answer for CFP patients while doing intermittent fasting? ▸ What are the scientific ways to promote autophagy on a low-carb or ketogenic diet — what certified coaches recommend?