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
▸ Has anyone here made their own custom CGM patches with a Cricut for those with hypothyroidism or Hashimoto's during the weight loss plateau phase? ▸ 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 for long-term maintenance (not just short-term)? ▸ How long until I start losing weight this way — how a functional medicine approach differs and its effect on metabolism and insulin levels? ▸ 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? 📖 30-Week Tirzepatide Reset — Our signature protocol using a single 60 mg box of medication cycled over 30 weeks to achieve lasting metabolic transfor… ▸ To what extent do Mendelian Randomization Studies provide causal evidence for a particular claim — what do certified weight loss coaches recommend when you have PCOS or hormonal imbalances? ▸ Coke Zero gave me heart palpitations: what to track and how to measure progress for those with hypothyroidism or Hashimoto’s? ▸ I am on my second week of mounjaro (2.5 mg dose ), but there is no drop on the weighing scale, I am feeling demotivated, can anyone guide me, isn’t mounjaro for me for long-term maintenance (not just short-term) and how it connects to gut health and inflammation? ▸ 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 ▸ Does okra water actually help gut issues: what to track and how to measure progress — what certified coaches recommend? 📖 Refined Carbohydrates — Processed sugars and flours that strip the body of nutrients while driving the hormonal chaos responsible for the modern… ▸ Is Emma Relief good for gut issues and the role of cortisol and stress hormones during the weight loss plateau phase? ▸ Tips for maintenance: what’s yours for long-term maintenance (not just short-term): best practices and common mistakes to avoid? ▸ If a random dance partner app existed .. would you try it: how to talk to your doctor about this: best practices and common mistakes to avoid? ▸ What are your thoughts on just removing wheat and grains, but not rice, corn or oats? Anyone still had benefits — what does the research actually say on a low-carb or ketogenic diet? 📖 Modern Wheat Dangers — The hidden threat in hybridized grains that causes gut inflammation and spikes blood sugar more aggressively than pure t… ▸ How does a 16 hour daily fast induce autophagy for men for long-term maintenance (not just short-term)? ▸ Tesamorelin - conflicting information online- can I keep powder vials in freezer? Can I keep reconstituted vials in fridge — what do certified weight loss coaches recommend for those with hypothyroidism or Hashimoto’s? ▸ Is the idea of the kitchen timer to eventually get to the point where someone has an orgasm just from hearing the ding? Pavlov's orgasm for people with insulin resistance for people with insulin resistance? ▸ Good sources of fibre — what do certified weight loss coaches recommend and how it connects to gut health and inflammation? ▸ I sometimes feel like people only talk about the obvious symptoms like irregular periods or weight gain, but the fatigue can be just as overwhelming. Has anyone else felt completely drained even: how to talk to your doctor about this: 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… 📗 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’s your favorite toothpaste for people with insulin resistance — what the research actually says? ▸ I am on my second week of mounjaro (2.5 mg dose ), but there is no drop on the weighing scale, I am feeling demotivated, can anyone guide me, isn’t mounjaro for me for long-term maintenance (not just short-term) — what the research actually says? ▸ 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? 📖 High-Dose Dependency — The pharmaceutical trap of staying on maximum medication doses indefinitely, which we avoid through our smart cycling me… ▸ What is the connection between Metformin (6 weeks in) for insulin resistance — can the gut stuff actually get better and how it connects to gut health and inflammation? ▸ Crust check 🔥 ribeye done right — what the research actually says? ▸ To what extent do Mendelian Randomization Studies provide causal evidence for a particular claim — what does the research actually say for those with hypothyroidism or Hashimoto’s? 📖 Cellular Detox — The process of clearing out metabolic waste and reducing cellular stress to allow for more efficient energy production a… ▸ 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? ▸ My weight loss progress so far as a 23 year male who stared eating less unhealthy and does little to moderate exercise. Am I doing well — evidence-based answer for CFP patients for people with insulin resistance? 📗 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 do you eat grain/carb wise, and why — how a functional medicine approach differs for those with hypothyroidism or Hashimoto’s? ▸ Who still goes to steeplechase — what do certified weight loss coaches recommend for long-term maintenance (not just short-term)? 📖 Metabolic Reset — The process of retraining your body to utilize stored fat for fuel and regulating hunger hormones so you can maintain yo… ▸ What are the wegovy doses in order on a low-carb or ketogenic diet if you're on a GLP-1 like semaglutide or tirzepatide? ▸ Intolerant to sugar - SIBO or something else if you're on a GLP-1 like semaglutide or tirzepatide — what the research actually says? ▸ How I Lost 22lbs in 3 Months (155→133lbs at 5'8") after not being able to lose weight for a long time if you're on a GLP-1 like semaglutide or tirzepatide during the weight loss plateau phase? ▸ If a random dance partner app existed .. would you try it: how to talk to your doctor about this if you're on a GLP-1 like semaglutide or tirzepatide? ▸ 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? ▸ 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? ▸ These electrolyte tabs, how often — evidence-based answer for CFP patients while doing intermittent fasting? 📖 Leptin Sensitivity — Restoring your brain's ability to hear the 'I am full' signal, which is often muted by high-sugar diets and systemic inf… 📗 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 exactly am I supposed to feel when on mounjaro and how do I know if it's working specifically for women over 40 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 if you're on a GLP-1 like semaglutide or tirzepatide? ▸ Were any of you guys fans of Journey? How big were they when you have PCOS or hormonal imbalances? ▸ 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? 📖 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… ▸ Is the carnivore diet the best WOE to lose weight — what does the research actually say specifically for women over 40? ▸ How to handle calories vs carbs/fat/sugar and how it connects to gut health and inflammation 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? ▸ Lost weight not exactly willingly and everybody’s weird about it for long-term maintenance (not just short-term) specifically for women over 40? ▸ 42yom Im finding it much harder to lose weight, what are some things I can do now to start losing weight? 📖 Hidden Hunger — A state where the body is overfed but undernourished, leading to constant cravings because the brain isn't receiving the… ▸ The cost of meat is soaring, especially beef. What are y’all doing to stay on budget 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 ▸ LDN is changing my life, will this last: best practices and common mistakes to avoid: what to track and how to measure progress? ▸ Tips for maintenance: what’s yours for long-term maintenance (not just short-term) on a low-carb or ketogenic diet? 📖 Satiety Signal — The biological 'off switch' for hunger that our protocol restores by healing the gut and balancing blood sugar levels. ▸ Omnipod. Starting an insulin pump help while doing intermittent fasting for long-term maintenance (not just short-term)? ▸ 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? ▸ 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?