Hello Sir, Avoid Soy and goitrogens (cabbage, broccoli..). Take medication on an empty stomach 1 hour before you eat. Use iodized salt and eat 3 brazil nuts per day (selenium). If you are on Synthroid you can discuss Cytomel with your doctor -each have disadvantages. Synthroid is T4 (inactive) and needs to be converted into T3 (active hormone) in body. If selenium is low the conversion will not take place. Soy interferes with the absorption and metabolism of levothyroxin (elthyroxin). Take iron, calcium or magnesium supplement by 4 hours after your thyroid medication. No grapefruit. Stay away from high glycemic starches. Walk briskly, not leisurely and add another exercise to your routine. Try cutting portion sizes of a balanced diet in half. I highly recommend that you be seen by a Dietitian with experience in these matters since you have tried so long and hard. I know you can do it! Regards, Kathryn Shattler, MS,RDN