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.
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
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.

Have a follow-up question?
More Questions 200 answered
POLL At what strength did Semaglutide become effective for you and its effect on metabolism and insulin levels 2.5 mg no longer working. Move to 3.5 on a low-carb or ketogenic diet How long did you carry a pad post-menopause: how to talk to your doctor about this When people ask how I can tell my sugar's low: best practices and common mistakes to avoid 📖 Tirzepatide — A dual-acting medication targeting both GLP-1 and GIP receptors, providing a more comprehensive metabolic signal than si… Difference between a 3 day and 5 day water fast for autophagy and how it connects to gut health and inflammation Do you avoid socialising or seeing family because of how tired you are and how much effort it is to be in company: how to talk to your doctor about this Astounded to see that 19 million people in the US are on levothyroxine. Why is hypothyroidism so prevalent? What is causing such crazy high levels of thyroid disease — what most people get wrong about this App that can predict symptoms before they get bad: 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… 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Is Dotti a generic or brand-name patch on a low-carb or ketogenic diet What is this new frozen hell — what does the research actually say? Guys, did you know the POWER of exercise for your body if you're on a GLP-1 like semaglutide or tirzepatide Anyone in Maintenance w/ 15mg on a low-carb or ketogenic diet Are Seed Oils Inflammatory for long-term maintenance (not just short-term) Cheat / treat days or meals and its effect on metabolism and insulin levels Any advice for starting maintenance — evidence-based answer for CFP patients 📖 Ketogenic Foundation — Using low-carbohydrate principles to keep insulin low, allowing the tirzepatide to work more effectively at lower doses. Is this normal? Feels like a waste specifically for women over 40 Is this normal, or do I need a new provider? 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Homemade bacon - are curing salts required — what does the research actually say? Calcium oxalate a problem if microdosing San Pedro powder? 📖 Autophagy — The body's natural 'housecleaning' process that occurs during fasting or low-insulin states, promoted during our mainten… Anyone use an auto injector for the compounded med and how it connects to gut health and inflammation How are we getting enough protein? Tips please — evidence-based answer for CFP patients Mounjaro diet plan, supplements and workout: best practices and common mistakes to avoid Was so tempted to hit the drive thru today. Went to the store instead — evidence-based answer for CFP patients Am I crazy for being frustrated by this? Estradiol Cypionate- I’ve been underdosing- what dose are you at when you have PCOS or hormonal imbalances 📖 The Clark Protocol — Our evidence-based framework that combines clinical nurse practitioner expertise with personal experience to solve the o… Does anyone else love masks mandated so I can hide my facial hair — what do certified weight loss coaches recommend? For those that struggled with side effects, have you been able to space out your doses successfully: what to track and how to measure progress 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → What are the biggest misconceptions you’ve seen about GLP-1s and how it connects to gut health and inflammation 📖 Non-Scale Victories (NSV) — Improvements in energy, sleep, and disease reversal that matter just as much as the numbers on the scale during your tra… Are Seed Oils Inflammatory — how a functional medicine approach differs Anyone worried about the FDA crackdown on a low-carb or ketogenic diet Best recipe book during the weight loss plateau phase Are these test results normal? Does anyone else love masks mandated so I can hide my facial hair — what does the research actually say? 📖 One Box Protocol — A revolutionary approach where we stretch one 60 mg box of tirzepatide across three metabolic phases, prioritizing long-… Should we start a new subreddit, that prioritizes evidence-based treatment approaches and science and how it connects to gut health and inflammation Ischias oder Piriformus Probleme when you have PCOS or hormonal imbalances 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Perimenopause, menopause, and post-menopause -- what's the difference? Should i really be aiming for 45 zone 2 minutes per day for fat loss during the weight loss plateau phase 📖 Nutrient Density — Prioritizing foods that provide maximum vitamins and minerals per calorie to satisfy the brain and end the cycle of hidd… Atypical Reaction - Anyone Else? Same Workout Until it becomes Zone 2 when you have PCOS or hormonal imbalances Cheat / treat days or meals if you're on a GLP-1 like semaglutide or tirzepatide How it looks when you lose 170 lbs. but are still a fat man during the weight loss plateau phase Used old Mounjaro pen by mistake - should I be worried — what most people get wrong about this Is Dotti a generic or brand-name patch and how it connects to gut health and inflammation Was so tempted to hit the drive thru today. Went to the store instead if you're on a GLP-1 like semaglutide or tirzepatide 📖 Inflammatory Markers — Clinical indicators like CRP that we monitor to ensure the body is moving from a state of disease to a state of vibrant … Have to stop for 3 weeks for surgery — what most people get wrong about this 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Two week pause, ok to return to current dose and how it connects to gut health and inflammation When men recognize symptoms for long-term maintenance (not just short-term) Astounded to see that 19 million people in the US are on levothyroxine. Why is hypothyroidism so prevalent? What is causing such crazy high levels of thyroid disease when you have PCOS or hormonal imbalances Should I take another dose today? Only symptom high DHEA?