Hysterectomy weight gain that shows up years after surgery — alongside anxiety, fatigue and fluid retention — is something we see often. This is Amanda’s patient story, and how decoding her blood work revealed what was really driving her hysterectomy weight gain.
We see a number of women who have had a hysterectomy, laparoscopy, cyst removal, or fibroid removal. Amanda came to us just over a year ago. She had kept incredible track of her blood work, her symptoms, and her journey — from just before her hysterectomy and well past menopause. Her story is a powerful reminder of how much a careful look at your pathology history can reveal.
Amanda had a hysterectomy at 45, after a large fibroid was causing significant period problems. It was the right decision at the time, and it gave her the relief she needed. She was left with one ovary.
For a while, life went on. Then, slowly, things started to shift.
More bloating. More reactions to food she’d always eaten without issue. A rising sense of anxiety that didn’t feel like her. A diagnosis of sleep apnea. Fatigue that she was pushing through to make it through the work week.
Then the weight began to change. Amanda went from a size 8 to a size 14 within two years, a few years after her hysterectomy — despite being naturally petite and despite nothing changing in her diet or her exercise.
Her body was telling her something. She just didn’t yet know what.
What Her Bloodwork Was Quietly Signalling
Women who retain only one ovary after surgery tend to move into menopausal hormone levels considerably faster than women with both ovaries intact. For Amanda, this meant her body was managing a much bigger hormonal shift than most, and doing it earlier than expected.
Over those years, her bloodwork told a clear story, even if no one had connected the dots yet.
First Big Change: A Drop in Vitamin D
In 2018, she had her hysterectomy. For the next three years, her Vitamin D was fine. But from 2020 to 2022 — when she really noticed the mental and weight changes — her Vitamin D went from consistently around 100, to 60 when she had it tested in 2022. When she decided to come and see us, it was 44 (50 is medically “normal”). She walked every day in the sun and nothing had changed about her Vitamin D intake.
The Change That Led Her to Us: A Fatty Liver Disease Warning
(after trying other things that didn’t work)
GGT, AST and ALT within fatty liver disease range, despite only drinking occasionally.
She had been diagnosed with Hashimoto’s in her twenties, but was told there was nothing she could do about it. When she was warned about her liver, she looked back at her years of testing, noting that her TSH had been climbing all that time. She became concerned that she was moving toward a hypothyroid diagnosis. Her TSH levels were within the subclinical hypothyroid range, but still “normal.”
- In 2022, when her Vitamin D was 60, her TSH was 2.86.
- In 2020, six months into the start of her weight gain, her TSH was 3.42.
- When she came to us in early 2025, her TSH was 2.54.
Both earlier levels are within what we consider to be subclinical hypothyroid — all within “normal” Medicare reference ranges.
The historically low vitamin D, rising liver enzymes, and subclinical TSH levels all pointed to the fact that her detoxification and methylation pathways were really struggling.
Clinically, her history told us that her liver was struggling long before this rise in her liver enzymes. Vitamin D goes through a conversion process in the liver too — the liver helps convert the D we get from the sun and D3 into active D, the D that goes to the cells. The liver also clears sex hormones from the blood. When hormone levels shift, as they do through perimenopause and menopause, the liver has to adjust its output almost instantly. If the liver is already under strain, that adjustment doesn’t happen cleanly. So when she was struggling with her periods years ago, her liver would have been working overtime to deal with the excess oestrogen.
Re-Visiting Amanda’s Thyroid Antibodies
When Amanda came to us, we asked her to re-test her thyroid antibodies because her white blood cell (WCC) count had been sitting between 3.5 and 3.8 since 2020 — a sign her immune system was struggling to keep up.
Her TPO was over 700, telling us her Hashimoto’s was a big part of her health picture. Amanda was most concerned about her brain, weight gain and anxiety, but over the last five years her immune system had also become more sensitive. Colds would linger for weeks after she was better, but she just accepted it because after CV-19 it seemed like this was normal for everyone around her.
With her Hashimoto’s antibodies high, this most certainly would be impacting her gut, liver and immune system. And with poor liver function, this caused several issues, including:
- Higher histamine levels, keeping her immune system battling histamine.
- Poor T3 conversion, impacting her energy, brain fog, fluid retention, and weight gain.
- Depleted essential micronutrient levels, keeping her immune system down.
So when we saw that her Hashimoto’s was elevated, it prompted us to really focus not only on her liver, but on topping up her essential micronutrients — especially since her liver had been impacted for so many years.
Thyropause-Level Insulin Resistance, Combined with Thyroid Dysfunction
When she started treatment, both Amanda’s fasting glucose and HbA1c were in pre-diabetes territory. This can be common when we see elevated liver enzymes creeping up for years.
One year after her hysterectomy, Amanda’s fasting glucose was 5.9. It stayed in the high fives, reaching 6.1 in 2020 when she started gaining weight. When she came to us, her fasting glucose was 6.7.
Looking at Amanda at the time, you wouldn’t have ever thought she had pre-diabetes or fatty liver. She was 69kg and just looked a little overweight. But she had always been around 52kg to 54kg and was really uncomfortable.
Between 2022 and 2024, she was really committed to losing weight and improving her energy. She did acupuncture. She took the herbs. She followed her dietician’s recommendations. It didn’t work that well, so she went to see a naturopath/nutritionist. She felt a little better, but the anxiety was so bad she decided to go on anti-anxiety medication. So when she came to us in early 2025, she was really at her wit’s end — and amazing at doing all the tests and being diligent with food and her health.
The First Shift in Reversing Amanda’s Hysterectomy Weight Gain
The first thing we addressed was how and when Amanda ate, to bring her blood glucose and inflammation into a healthy range and take the strain off her system. She had been eating well, but didn’t realise there were certain healthy foods that really impacted her inflammation levels, and that how and when she ate impacted her weight.
Within a month, the change was noticeable. Her fluid retention and bloating had nearly disappeared, and the scale had begun to move.
Amanda also did a genetic test, which showed us exactly how sensitive her liver pathways, immune system, and metabolic hormones were, and how her body needed to be supported around them. This let us match her supplementation — and the timing of it — precisely to what her body was actually short of, rather than guessing.
Six Months In
By six months, Amanda had lost 8kg. Her energy was back to 100%. She was sleeping through the night. Her mental clarity had returned. Digestion was back to normal. And her immune system was strong enough that she went an entire winter without getting sick.
Twelve Month Results
At twelve months, Amanda had lost 14kg and got back to her ideal weight. She felt fully in control of her body again, and it showed — both at work and in how she moved through her days. Her liver enzymes, elevated for nine years, had normalised.
At her most recent appointment (a 16-month check-in), every marker we’d been watching — blood glucose, liver function, vitamin D, thyroid hormones — sat within healthy ranges. It was the first time in nearly ten years that her liver enzymes had been in healthy ranges. She has kept the weight off, without feeling hungry, and doesn’t feel like she is missing out.
What This Means for You
Amanda’s case is a reminder that when the usual advice — eat well, move more, take your supplements — isn’t working, the answer often isn’t more willpower. It’s understanding what’s actually happening underneath, particularly in markers that you may not think much of. Things like Vitamin D, TSH, liver enzymes, and white blood cell count can all be early signs that something isn’t right.
We always encourage our patients to look at the history on their blood work, as it can tell you a much bigger story about what has changed as you feel more symptoms. Learning how to ask more questions and look deeper at your blood work is really important.
If you want to get deeper answers from what those results mean, we encourage you to watch our Genetics & Peri/Post Menopause webcast. We go much deeper on what to look at in different age brackets and phases of hormone changes. It’s a great first step to comparing your pathology history and learning what could be happening for you.
If you relate with Amanda’s story and are ready to get support, please connect with us directly on an introductory consultation here.
Look forward to connecting again.
Warmly,
Tiaan & Carrie
