Expert Q&A

Had my hashi’s annihilated thyroid removed today: best practices and common mistakes to avoid

Understanding Life After Total Thyroidectomy for Hashimoto's

Having your thyroid removed due to Hashimoto's marks a significant turning point. Without a thyroid gland, your body no longer produces its own thyroid hormones, making daily levothyroxine or similar replacement therapy essential. Most patients need 1.6-1.8 mcg per kg of body weight initially, but absorption varies with age, gut health, and concurrent medications. In my experience guiding thousands through the CFP Weight Loss framework, consistent blood work every 6-8 weeks initially helps dial in your dose to alleviate fatigue and support metabolic recovery.

Nutrition Strategies to Prevent Weight Gain and Manage Symptoms

Post-surgery, many face slowed metabolism, insulin resistance, and inflammation that complicate weight loss—especially with existing diabetes or blood pressure concerns. Focus on an anti-inflammatory plate: 40% non-starchy vegetables, 30% quality proteins like wild-caught fish or pasture-raised poultry, and 30% healthy fats. Avoid common mistakes like skipping breakfast or relying on processed "gluten-free" products that spike blood sugar. My book outlines a simple 3-meal structure with no complex tracking: include 25-30g protein per meal to preserve muscle and stabilize energy. For those overwhelmed by conflicting advice, start with eliminating added sugars and seed oils for 30 days to reduce joint pain and support hormone balance.

Gentle Movement and Joint-Friendly Exercise Plans

Joint pain often makes traditional exercise feel impossible after thyroid removal. The biggest mistake is jumping into high-intensity workouts too soon, which can elevate cortisol and stall progress. Instead, begin with 10-15 minute daily walks and gentle resistance bands 3 times weekly. In the CFP method, we emphasize "movement snacks"—short bursts that fit busy schedules without gym intimidation. Aim to build to 150 minutes of low-impact activity per week while monitoring heart rate below 60% max to avoid burnout. This approach has helped clients with obesity and hormonal changes lose 1-2 pounds weekly without exacerbating inflammation.

Monitoring Progress and Avoiding Long-Term Pitfalls

Regular labs should track not just TSH but free T3, free T4, reverse T3, and antibodies. Many err by accepting suboptimal levels above 2.0 mIU/L TSH, leading to persistent weight struggles. Coordinate with your endocrinologist while addressing insurance barriers through documented metabolic improvements. Track symptoms in a simple journal: energy, sleep, joint comfort, and waist measurements. Stay consistent with sleep (7-9 hours), stress reduction like 5-minute breathing exercises, and staying hydrated at half your body weight in ounces. These practices from my methodology prevent the yo-yo cycles you've experienced before, fostering sustainable health even with diabetes management.

💬 What the Community Says

The community shares a mix of relief and anxiety following total thyroidectomy for Hashimoto's. Many report initial weight spikes of 8-15 pounds in the first month due to medication adjustments and surgical inflammation, with frustration over doctors only checking TSH. A common theme is the struggle to find optimal T3 levels—some praise adding liothyronine for better energy and gradual loss, while others debate natural desiccated thyroid versus synthetic options. Beginners with joint pain and diabetes frequently discuss success with low-impact walks and anti-inflammatory diets but warn against rushing exercise. Insurance hurdles and conflicting online advice leave many feeling overwhelmed, though supportive threads highlight patience with dose titration every 6 weeks leading to improved blood pressure and 20-40 pound losses over a year. A vocal minority stresses the emotional side of "feeling lost" without their thyroid, advocating for compounded medications and community accountability to avoid isolation.
Clark, R. (2026). Had my hashi’s annihilated thyroid removed today: best practices and common mist. *CFP Weight Loss*. https://blog.cfpweightloss.com/ask/had-my-hashi-s-annihilated-thyroid-removed-today-best-practices-and-common-mistakes-to-avoid
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
Why has no doctor explained this to me for long-term maintenance (not just short-term) Hitting protein goals. How do you do it and how it connects to gut health and inflammation Is compounded semaglutide with B12 worth choosing over B6 or plain — what do certified weight loss coaches recommend? What is this new frozen hell on a low-carb or ketogenic diet What I learnt as a physician about having Hashimoto for myself and what helped for those with hypothyroidism or Hashimoto's 📖 Refined Carbohydrates — Processed sugars and flours that strip the body of nutrients while driving the hormonal chaos responsible for the modern… New menopause symptom, deep intense chills anyone — evidence-based answer for CFP patients How do you know you are in meno if you take continuous bc: best practices and common mistakes to avoid Can deep extended autophagy reverse deep cavities, does anyone have any experience regarding this on a low-carb or ketogenic diet 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Vomited at new dose, will it happen again next week — evidence-based answer for CFP patients 📖 Modern Wheat Dangers — The hidden threat in hybridized grains that causes gut inflammation and spikes blood sugar more aggressively than pure t… Safest type of fiber: how to talk to your doctor about this Semaglutide + lifting — how are you fueling workouts on low calories and how it connects to gut health and inflammation A Switch from HRT to Birth Control and how it connects to gut health and inflammation 📖 Satiety Signal — The biological 'off switch' for hunger that our protocol restores by healing the gut and balancing blood sugar levels. What keto plus compounded tirzepatide for the last five months looked like: best practices and common mistakes to avoid Upped dosage + changing patch day — evidence-based answer for CFP patients Should i really be aiming for 45 zone 2 minutes per day for fat loss and the role of cortisol and stress hormones What is the Role of Metabolism in Immune System — what do certified weight loss coaches recommend? 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Has Dr. Gundry spoken about the vaccine — what most people get wrong about this 📖 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… Can we stop posting good glucose levels and pretending they are bad: how to talk to your doctor about this Should i really be aiming for 45 zone 2 minutes per day for fat loss — what does the research actually say? How does smoking affect GERD while taking tirzepatide? PCOS linked to childhood trauma if you're on a GLP-1 like semaglutide or tirzepatide So if you're spacing out your shots - what are y'all doing with extra injectors: what to track and how to measure progress 📖 Hidden Hunger — A state where the body is overfed but undernourished, leading to constant cravings because the brain isn't receiving the… Anyone have experience switching from compound injection to pill for long-term maintenance (not just short-term) When men recognize symptoms for those with hypothyroidism or Hashimoto's 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Sanity Check: Is MyNetDiary accurate? Does anyone else love masks mandated so I can hide my facial hair and how it connects to gut health and inflammation Mounjaro diet plan, supplements and workout for those with hypothyroidism or Hashimoto's What actually helped my Hashimoto's symptoms — food changes that made a difference for me: how to talk to your doctor about this Can we talk about the founder 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 To Speed Up Your Metabolism After 40 during the weight loss plateau phase Has anyone had facial swelling and numbness as a symptom/flare up? Did my hashimoto cause this for those with hypothyroidism or Hashimoto's How I feel every time I go grocery shopping for long-term maintenance (not just short-term) 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → How to lose weight while working fulltime at a warehouse job? Is it just me or is Hashimoto’s greatly underrepresented — what does the research actually say? Estradiol Cypionate- I’ve been underdosing- what dose are you at — what do certified weight loss coaches recommend? 📖 Gut Microbiome Repair — The restoration of healthy intestinal bacteria through the removal of lectins and grains, essential for long-term weight… One avocado a day? What's up with that? Does anyone remember if the good doctor ever gave us an explanation for that: how to talk to your doctor about this How I feel every time I go grocery shopping during the weight loss plateau phase Can we stop posting good glucose levels and pretending they are bad — what does the research actually say? Cheat / treat days or meals: best practices and common mistakes to avoid Anyone worried about the FDA crackdown: how to talk to your doctor about this 📖 High-Dose Dependency — The pharmaceutical trap of staying on maximum medication doses indefinitely, which we avoid through our smart cycling me… How do you stop yourself quitting after lack of progress? 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Sometimes after I take my Mounjaro shot I see this at the spot I gave the shot. Anyone know why during the weight loss plateau phase Can deep extended autophagy reverse deep cavities, does anyone have any experience regarding this for long-term maintenance (not just short-term) Can’t stand avocados or guacamole. Help on a low-carb or ketogenic diet Anyone use an auto injector for the compounded med for those with hypothyroidism or Hashimoto's How long did it take you to lose weight on the Plant Paradox': best practices and common mistakes to avoid So if you're spacing out your shots - what are y'all doing with extra injectors: how to talk to your doctor about this 📖 Insulin Resistance — A condition where your cells stop responding to insulin, locking fat in storage; our protocol is designed to unlock thes… Is estriol as effective as estradiol for clitoral atrophy: best practices and common mistakes to avoid Anyone had improvement in symptoms after already eating a clean plant based diet — evidence-based answer for CFP patients