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How To Exercise with Hashimoto's or an Autoimmune Condition

January 19, 2018

Fact: Exercise is good for you. But how do you exercise with Hashimoto's or a thyroid condition? There are lots of additional factors to consider.



Research tells us that exercise is good, but we have to consider additional factors when exercising with autoimmune conditions like Hashimoto's.


Here's what we know:

  1. Physical activity is a critical part of maintaining good health (mind and body).
    Exercise is well-studied in its effects on reducing risk of heart disease, type 2 diabetes, depression, and also improving immune function.

  2. With Hashimoto's, over-exercise can potentially break down the body (and thyroid hormone) faster than it can repair & recover.
    In other words, too much physical activity (high intensity, length, or frequency) could worsen already low thyroid function.

    Why? Exercise reduces the available T3, active thyroid hormone, that your body can use. Proper rest and recovery can increase these levels, so continually over-exercising could actually cause thyroid symptoms to get worse! This is often a conundrum because many of us gain weight as a result of low thyroid function, which slows down the metabolism, and our first reaction is to eat less and exercise more.

  3.  Exercise intolerance and low endurance/strength associated with hypothyroidism could be a result of HPA (hypothalamic-pituitary-adrenal) axis dysfunction.
    HPA dysfunction is often referred to as "adrenal fatigue," although recent findings show that this may be an inaccurate name for this condition.

    Here's what happens: You exercise beyond your threshold - and then your body perceives itself as under stress, creating cortisol as a result. Cortisol is a stress hormone that allows your body to keep meeting the demands you're placing on it, as a survival mechanism. However, a high level of cortisol can not only cause inflammation, but it also dampens your immune system function and signals the pituitary (the gland in your brain that directs thyroid function) to slow down/stop creating thyroid hormone.

    This is how hypothyroidism can be made worse and worse by exercising beyond your body's capability to rest and recover.



So how do you know if your workouts are counteracting your thyroid recovery?


As we mentioned, the answer depends on the state of your adrenals. If you're in a certain state of HPA dysfunction or dysregulation, cardio exercise especially can do more harm than good. Of course, virtually any type of exercise - aerobic or anaerobic - has the potential break down body tissues. 


It seems counterintuitive that resting or cutting back on workouts could improve your health!


Some signs that your workouts may be adding to your overall stress load:

  • A string of bad workouts - you don't feel quite right or like you can train like you were a few weeks ago, with no apparent explanation

  • Unexplainable soreness, aches, and muscle tension

  • Sleep disruption

  • Difficulty/slow recovering from workouts

  • Overall feeling of being worn down

  • Weight gain, despite working out harder or eating less/more regimented diet

I was an ultramarathon runner and ignored nearly all of these warning signs in my workouts prior to my Hashimoto's diagnosis; I had to "retire" to prioritize getting well again. It's very understandable to have anxiety and even denial around no longer doing something you love; if you're like me, it may take some time before you come to a point of acceptance or willingness to go without. Personally, I tried to find every piece of research or evidence that endurance running could still be possible - and it took me another 6 months of stubborn-ness and running (feeling worse and worse each day) before I questioned whether my dedication to my sport was making me more or less healthy. Eventually, I found other forms of exercise that actually made me feel better and added to my health. But it is not an easy decision.



Finding your edge

The guidelines below based on the concept that over-exercise can contribute to inflammation and worsening of thyroid symptoms, as I mentioned above.


reasonable amount of exercise can provide oxygen, improve circulation,
and support proper immune system function - all necessary factors for healing. 


The best thing you can do is start low and work up so slowly. Conservative is better, as overdoing it cou