Hypothyroidism and weight lifting

6 Weight Loss Tips for Hypothyroidism

Underactive thyroid can make losing weight even more challenging, but proper treatment, along with diet and lifestyle strategies can help. Thinkstock

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Healthy foods, controlled portion sizes, and regular exercise — these are key components to losing weight. But if you have hypothyroidism, your underactive thyroid gland may also play a role.

If hypothyroidism is inadequately treated it can be harder to lose weight, since the thyroid is a large regulator of metabolic function. (Weight gain is often the first noticeable symptom of low thyroid.) The most important thing you can do — for weight loss and for your overall health — is to get proper treatment for your hypothyroidism. However, making a few dietary changes may help boost weight loss success. Losing weight is never easy, but people who have well-controlled hypothyroidism shouldn’t struggle to lose weight more than anyone else, says Leonor Corsino, MD, an endocrinologist at the Duke Center for Metabolic and Weight Loss Surgery in Durham, North Carolina.

Use these six strategies to jump-start weight loss with hypothyroidism.

1. Cut Out Simple Carbs and Sugars

Kelly Austin, ND, a naturopathic doctor specializing in hormone disorders and the director of the Prime Wellness Clinic in San Diego, recommends a moderate- to low-carbohydrate diet that focuses on complex carbohydrates (think starchy vegetables and legumes) and avoids simple sugars (pass on the candy and soda). According to the Linus Pauling Institute at Oregon State University, foods with a high a glycemic load (like refined grain products and sugary drinks) may increase inflammation in the body. But Dr. Austin stresses the importance of eating enough calories because “low calories can cause a stress response and result in decreased T3 production,” she says.

2. Eat More Anti-Inflammatory Foods

Anti-inflammatory foods can help ease joint aches and pains as well as depression, all of which can result from hypothyroidism, Austin says. And anti-inflammatory foods can help soothe the immune system, which is often in overdrive in people with hypothyroidism, says Tina Beaudoin, ND, the president of the New Hampshire Association of Naturopathic Doctors and medical director of HealthStrong Integrative Medicine in Manchester, New Hampshire. “An anti-inflammatory diet can help calm the immune system and excessive inflammation, and support adequate intake of the essential nutrients needed for healthy thyroid function, including magnesium, B vitamins, zinc, selenium, iron, and vitamin C,” Dr. Beaudoin says. Leafy green vegetables, tomatoes, fatty fish, nuts, fruit, and olive oil are all good foods to battle inflammation. And this diet decreases the burden on the liver to metabolize highly processed foods, she notes. “Healthy liver function is essential because the liver is responsible for converting 60 percent of T4 to T3,” Beaudoin explains.

RELATED: Eat Right to Support Thyroid Function

3. Stick to Small, Frequent Meals

Hypothyroidism slows digestive function, notes Beaudoin. “Eating smaller, more frequent meals with balanced macronutrients — quality proteins, complex carbs, and healthy fats — supports balanced blood sugar and helps avoid the highs and lows of oversized, highly processed meals,” she says.

4. Keep a Food Diary

Your daily caloric intake can quickly skyrocket unless you log everything you eat and drink, Dr. Corsino says. It can also help ensure that you’re eating a balanced diet. “Keeping a food journal is important for someone with hypothyroidism to track their macronutrient intake,” Austin says. “A diet high in healthy fats, moderate proteins, and moderate to low carbohydrates is best for thyroid function.”

5. Move Your Body

Exercise is an important complement to a healthy diet in order to help burn calories, Corsino says. But consider the individual case, Austin says. “If a person is terribly fatigued, exercise can further suppress hypothyroidism,” Austin says. “If a person has properly managed their hypothyroid and has the energy, exercise is encouraged.”

RELATED: 8 Ways to Stay Energized With Hypothyroidism

6. Take Thyroid Medication as Directed

Thyroid hormone should be taken on an empty stomach first thing in the morning with plenty of water, Corsino says. Don’t take it with any other medications and wait at least 30 to 60 minutes before eating breakfast. If your thyroid level still isn’t where it should be when you take your medication properly, it could be affecting your ability to lose weight. Talk with your doctor about treatment adjustments that might be right for you.

Additional reporting by Jennifer Geddes.

How 3 Women with Hypothyroidism Maintain Their Weight

How we see the world shapes who we choose to be — and sharing compelling experiences can frame the way we treat each other, for the better. This is a powerful perspective.

If you have hypothyroidism, you might deal with daily symptoms like nausea, fatigue, weight gain, constipation, feeling cold, and depression.

While the symptoms that accompany hypothyroidism (an underactive thyroid), can disrupt several parts of your life, weight gain seems to be one area that causes significant distress and frustration.

When your thyroid is underactive, your metabolism slows down, which can lead to weight gain.

Hypothyroidism is typically diagnosed in adulthood, but many people will tell you they remember struggling with their weight and other symptoms for years.

Hypothyroidism becomes more pronounced with age and is far more common in women than men. In fact, 20 percent of women in the United States will develop the condition by age 60.

Healthline talked to three women with hypothyroidism about weight gain, how they’ve accepted their bodies, and the lifestyle changes they’ve made to manage their weight.

Ginny on shifting away from calorie-counting

Maintaining a healthy weight with hypothyroidism has been a challenge for Ginny Mahar, co-founder of Thyroid Refresh. Diagnosed in 2011, Mahar says her doctor’s advice regarding her weight gain was “eat less and exercise more.” Sound familiar?

On being diagnosed

For three years, Mahar followed her doctor’s advice. “I used a popular weight loss program and tracked my food consumption and exercise religiously,” she shares with Healthline.

At first, she was able to drop some weight, but after six months, her body refused to budge. And in spite of her calorie-restricted diet, she started gaining weight. As far as thyroid medication, in 2011 her doctor started her out on levothyroxine (she’s now taking the brand Tirosint).

While treatment can lead to losing any weight gained from an underactive thyroid, that’s often not the case.

Mahar says she’s had to come to a deeper acceptance of her body. “With an underactive thyroid, calorie restriction doesn’t work the way it does for people with normal thyroid function,” she explains.

Because of this, she’s had to shift her mindset from an attitude of opposition to her body to an attitude of love and care for her body.

Mahar says she’s been able to maintain what feels like a healthy, acceptable size, and most importantly, a level of strength and energy that enables her to pursue her dreams and be the person she wants to be.

“Sure, I’d love to lose 10 pounds, but with hypothyroidism, sometimes not gaining more weight can be as much of a victory as losing it,” she says.

Mahar feels that message is important for other thyroid patients to hear so that they don’t give up when the scale doesn’t reflect their efforts.

Making changes for the future

Mahar ditched calorie restriction as a form of weight loss, and now aims for high-nutrient, anti-inflammatory meals composed of organic produce, healthy fats, high-quality animal protein, and some gluten-free grains.

“I no longer count calories, but I keep an eye on my weight, and most importantly, I listen to my body,” she says.

By changing her dieting mentality, Mahar says she’s restored her health. “It feels like someone turned the lights back on inside me, after four years of being in the dark,” she says.

In fact, since making this shift in 2015, her Hashimoto’s antibodies have gone down by half and continue to drop. “I feel so much better and rarely get sick — It’s not an overstatement to say that I got my life back.”

Danna on focusing on health choices that are in her control

Danna Bowman, co-founder of Thyroid Refresh, always assumed that the weight fluctuations she experienced as a teen were a normal part of life. In fact, she blamed herself, thinking she wasn’t eating right or exercising enough.

As a teen, she says the amount she wanted to lose was never more than 10 pounds, but it always seemed like a monumental task. Weight was easy to put on and difficult to take off, thanks to her hormones.

“My weight was like a pendulum swinging back and forth for decades, especially after both of my pregnancies — it was a battle I wasn’t winning,” says Bowman.

Finally, after being properly diagnosed in 2012, she had a name and reason for some or most of her lifelong struggle with the scale: Hashimoto’s Disease. Additionally, she started taking thyroid medication. It was at that point that Bowman realized a mindset shift was a necessity.

“Obviously, many factors can contribute to weight issues, but because the metabolism works slower when the thyroid is underactive, what once worked to lose weight, didn’t anymore,” she explains. So, Bowman says, she had to find new ways to create change.

This mindset shift is what helped her finally begin the journey of learning to love and appreciate her body instead of shaming it. “I shifted my focus to things that were in my control,” she says.

Bowman changed her diet to organic, anti-inflammatory foods, added daily movement that included walking and Qigong, and committed to mindfulness practices like meditation and gratitude journaling.

“Diet” isn’t a word Bowman uses anymore. Instead, any discussion related to food and meals is about nutrition and adding real, whole, organic, unprocessed, healthy-fat foods and less about deleting things.

“I feel better and more alive now than I have in years,” Bowman says of the result.

Charlene on focusing on day-to-day decisions, not the scale

Charlene Bazarian was 19 years old when she noticed her weight start to climb. In an effort to drop what she thought was the “Freshman 15,” Bazarian cleaned up her eating and exercised more. Yet her weight continued to climb. “I went to several doctors, who each said I was fine,” says Bazarian.

It wasn’t until her mother, who also has hypothyroidism, suggested that she see her endocrinologist, that things made sense.

“He could tell just by looking at me that my thyroid was likely the culprit,” she explains. After the diagnosis was confirmed, Bazarian was put on a hypothyroid medication.

She says she remembers the doctor telling her not to expect the weight to just fall off since she was on medication. “And boy, he wasn’t lying,” she says.

This began several years of trying every diet to find something that worked. “I frequently explain on my blog that I feel like I tried everything from Atkins to Weight Watchers,” she explains. “I would lose some weight, then gain it back.”

Bazarian says she learned all she could about building muscle and using fitness to increase her energy levels.

She eliminated starchy carbs like bread, rice, and pasta, and replaced them with complex carbs like oatmeal, brown rice, and sweet potato. She also included lean proteins like chicken, fish, bison, and lots of leafy greens.

As far as escaping the toxic diet cycle, Bazarian says that after a spa “aha” moment (being body-shamed by the receptionist because the one-size-fits-all robe was too small), she realized there is no finish line when it comes to maintaining a healthy weight.

“I realized that it’s the day-to-day choices that make the difference and that I have to pay attention to what works for my body,” she says.

Tips for losing weight while dealing with hypothyroidism

Achieving healthy weight loss starts with finding the right doctor that understands your situation and is willing to look beyond calorie restriction. Additionally, there are lifestyle changes you can make. Mahar and Bowman share four tips for losing weight while dealing with hypothyroidism.

  1. Listen to your body. Being mindful of what your body is telling you is one of the most important steps you can take, Bowman says. “What works for one person may or may NOT work for you,” she explains. Learn to pay attention to the signals your body is giving you and adjust based on those signs.
  2. Food is a foundational piece of the puzzle. “Our bodies need the best nutrition we can give them. That’s why making cooking a priority — as well as preparing meals with clean, organic ingredients — is so important,” says Mahar. Educate yourself about what foods support or thwart thyroid function and autoimmune health, and spend time figuring out your unique dietary triggers.
  3. Choose exercises that work for you. When it comes to exercise, Mahar says, sometimes less is more. “Exercise intolerance, hypermobility, or exercise-induced autoimmune flares are risks that hypothyroid patients need to understand,” she explains.
  4. Treat it as a lifestyle, not a diet. Get off that silly hamster wheel, Bowman says. Aim to make healthy food choices, drink plenty of water, commit to daily movement (whatever exercise works for you), and make yourself a priority. “You get one chance and one body. Make it count.”

Sara Lindberg, BS, MEd, is a freelance health and fitness writer. She holds a bachelor’s in exercise science and a master’s degree in counseling. She’s spent her life educating people on the importance of health, wellness, mindset, and mental health. She specializes in the mind-body connection, with a focus on how our mental and emotional well-being impact our physical fitness and health.

Weight loss: Dos and Don’ts when you are suffering from thyroid

Weight gain is the most common symptom of hypothyroidism or underactive thyroid. About 42 million people living in India are suffering from this problem and the difficulty they face to lose weight is unexplained. A person suffering from hypothyroidism is not able to burn calories due to the reduction in the level of thyroid hormones and hence they start gaining weight. This medical condition is known to cause fat build-up in the body.
It is surely difficult to lose weight when suffering from this disease, but it is not impossible. The combination of the right diet and exercise is important to shed kilos, but there are a few other things you need to take care of when you are suffering from an underactive thyroid.

Dos
Balanced diet: It is, of course, important to consume a balanced diet when trying to drop kilos. Same needs to be followed when you have an underactive thyroid. You should be able to overcome nutritional deficiencies like selenium and iodine that disturb the thyroid functioning in the body.
Add iodine and selenium: Iodine and selenium are two important nutrients you need to take when suffering from hypothyroidism. Iodine is important for the synthesis of the thyroid hormone and selenium helps in recycling of iodine in the body. Include seafood, Brazil Nuts, eggs, tuna, salmon, sunflower seeds in your diet, these are some natural sources of iodine and selenium.
Include complex carbs: Complex carbohydrates are rich in fiber. It will help you to keep fuller for a longer period of time and prevent you from overeating. Include whole cereals, vegetables, whole pulse in your diet.
Try metabolism boosting exercise: An underactive thyroid can decrease your metabolism and to lose weight it is necessary to boost the same. If your aim is to lose weight, you need to exercise more than you may have expected.
As per Center for Disease Control and Prevention (CDC), a healthy person of normal weight needs to do at least 150 minutes of moderate physical activity or 75 minutes of vigorous activity per week to maintain weight or to avoid excessive weight gain. In case you have hypothyroidism, you may need to do more than an hour of exercise everyday. Walking, pilates, lifting weights are some form of exercises that you can try. You can also consider strength training and exercise that builds muscle.
Don’ts
Foods with high glycemic index: Restrict food with a high glycemic index such as corn, white bread, refined flour, muffins, cakes. Such food items increase the glucose content in the body which in the end is converted into fat.
Do not cut down goitrogens intake: Goitrogens are substances that interfere with the functioning of the thyroid gland and block enzymes that allow thyroid to use iodine. This forces the thyroid gland to produce more cells to counter the deficit, which leads to the enlargement of the thyroid gland. But do not completely cut down on goitrogens-rich foods as it contains other important nutrients essential for staying healthy.
Bottom line:
-Take an adequate amount of sleep and avoid stress as they lead to overeating and unhealthy food choices.
-Limit your intake of processed food and drink lots of water.
-It is important to consume iodine when trying to lose weight, but restrict processed salt intake and opt for natural sources of iodine.

The Hypothyroidism Workout

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Your thyroid gland may be tiny, but it plays a big role in how well your body functions. That’s because the thyroid produces a hormone that regulates your metabolism, the process that converts what you eat and drink to energy. When you have hypothyroidism, or an underactive thyroid, your metabolism slows, causing you to gain weight more easily and feel sluggish and fatigued.

Too little thyroid hormone also can mean too much bad fat, or LDL cholesterol, in your bloodstream. The thyroid hormone helps the liver break down the cholesterol circulating in your blood and stimulates other enzymes needed to rid your body of triglycerides, another type of blood fat. When you don’t have enough thyroid hormone, your LDL and triglycerides can rise.

What’s more: Hypothyroidism can also negatively affect your mood. The thyroid gland helps regulate the chemical messengers — neurotransmitters — that your brain uses to communicate with your nerves. When your thyroid doesn’t function properly, these messengers can go haywire, leading you to feel anxious and depressed.

“The most important thing you can do for hypothyroidism is to see your doctor and get on the right dose of thyroid hormone,” says R. Mack Harrell, MD, president-elect of the American Association of Clinical Endocrinologists and an endocrinologist at Memorial Regional Hospital in Hollywood, Fla.

Next? Put exercise on your to-do list. Regular exercise is an important part of your overall strategy to manage many hypothyroidism symptoms. Exercise burns calories to prevent weight gain and can counter the effects of your sluggish metabolism. A good workout can also be a mood-booster — while you exercise, your body releases endorphins and other mood-enhancing chemicals.

The Hypothyroidism-Exercise Connection

What’s the best type of exercise for hypothyroidism? A program of low-impact aerobic exercises and strength training, recommends Yaroslav Gofnung, MD, an endocrinologist at Los Robles Hospital in Thousand Oaks, Calif. Low-impact aerobics get your heart rate up and your lungs going without putting too much pressure on your joints, which is important because joint pain is another common hypothyroidism symptom, Dr. Gofnung says.

A stationary reclining or recumbent bicycle and a low-impact elliptical machine are excellent machine choices for cardio exercise. “Walking is a good exercise too, as long as you don’t have swelling in your knees or ankles,” Gofnung adds.

Also, Pilates or gentle yoga can improve core muscles and ease the back and hip pain that can be associated with hypothyroidism.

People with hypothyroidism can also benefit from strength training — exercises such as lunges, leg raises, and push-ups or those involving weight-training machines. Strength training builds muscle mass, and muscle burns more calories than fat, even when you’re at rest. Building muscle can help counter possible weight gain from an underactive thyroid.

The Best Exercises for Hypothyroidism

For people with hypothyroidism, Igor Klibanov, a personal trainer in Toronto, founder of Fitness Solutions Plus, and author of “Unlimited Progress: How You Can Unlock Your Body’s Potential,” recommends cardio and a strength-training routine that incorporates these six exercises:

One-legged dead lift: Stand on one leg while holding onto something for balance (not for support). Keep one hand relaxed in front of your thigh. Push your hips as far back as you can, until your hand touches the ground. Come back up. This should be felt in the glutes (the butt muscles). The back should not curve; it should stay straight, but does not have to be upright.

Squats: Stand up straight and then bend at your hips and knees till you’re in a sitting position. Go down all the way. (Klibanov says it’s a myth that this will damage your knees if you have healthy knees to begin with.).

Overhead press or similar vertical push move. Raise a pair of dumbbells to shoulder height. Turn your arms so they’re facing forward. Lift the dumbbells up until your elbows are straight. Then lower them back down to your shoulders.

Lat pull-down or similar vertical pull move. Grab a pull-down bar with an overhand grip (palms facing away), and pull it down to your collar bone. Keep your back straight, and make sure the bar travels as close to your face as possible.

Push-up or similar horizontal push move. Put both hands on the floor, shoulder width apart. Feet should be stretched out and together. Bend your elbows and shoulders until you’re close to the ground. If a push-up is too difficult, do the same thing either with your hands on a table (while feet stay on the ground) or a wall.

Rowing or similar horizontal pull move. Sit on the bench in a rowing machine with your hands holding the handle that’s attached to the cable. Keep your back straight, and lean back about 10 to15 degrees. Pull the cable back until it touches your mid-stomach. Then release under control.

Start with 15 reps of each exercise and work up to 20. “Most people with joint problems find these to be easy on the joints,” Klibanov says. When you’re starting out, it may take you 15 to 20 minutes to complete your routine. A good, eventual goal: Work up to three sets of 15 to 20 reps, which should take about 40 to 45 minutes, he adds.

Schedule aerobic exercise three to four times a week and strength training with these moves two to three days a week, Klibanov recommends. Doing so can get you on the right track to losing weight and feeling better overall.

Ease Into Exercise

Start slowly and build up. “If you go too quickly, you can injure yourself and set yourself back,” Gofnung warns. Choose exercises that you enjoy and that your body can tolerate to increase the likelihood of your sticking to your routine, he advises.

Adjust the number of reps as you progress. “In just two weeks, you’ll have a different body and you should have a different routine,” Klibanov says. And don’t be shy about progressing, he adds, “The more out of shape you are, the faster progress will come.”

If something hurts, you may need to make a small change such as the angle or position of an exercise or movement. If it still hurts, stop and find another exercise that doesn’t cause discomfort. If you’re having a hard time on your own, invest in time with a personal trainer who can make specific recommendations and show you how to lose weight through the exercises you choose.

Always talk with your doctor before beginning any exercise regimen. And never make exercise a substitute for thyroid medication. With the right medication, you should feel better within three to four weeks and have the motivation to get back to (or get into) a regular exercise routine, Dr. Harrell says.

Combat Hypothyroidism With Strength-Training Exercises

Women with hypothyroidism often struggle with weight loss. That’s because your tiny thyroid gland has a huge responsibility: Thyroid hormones play an important role in regulating basal metabolism, thermogenesis and play an important role in various metabolic processes like lipid and glucose metabolism, food intake and fat oxidation.It regulates your metabolism, which means it converts your food into energy. If you have hypothyroidism, with less energy, you end up feeling sluggish, making you more prone to an inactive lifestyle and further adding to your weight-gain problems.

The resulting obesity can lead to health risks, such as heart disease and diabetes. Hence, trying exercise for hypothyroidism to shed those extra kilos is not only about fitting back into your old denims but also about keeping yourself healthy overall. With a condition like hypothyroidism, however, cutting calories alone may not solve the problem. Here’s where metabolism-boosting exercises come in.

How Muscle Mass Influences Metabolism

A healthy diet and hypothyroid medications prescribed by your doctor definitely help, but they may not be enough to help you shed the extra weight. While unhealthy calorie restriction could help you lose weight, it may also increase your risk of sarcopenia. This implies muscle loss and reduced muscle functioning.

Thus, what’s key is improving your metabolism in a healthy way that doesn’t compromise your physical functioning. A good way to do this is by building more muscle. Muscles burn more calories than fat tissue, even at a resting state. So increasing your muscle mass while losing body fat boosts your body’s metabolism, thus helping you lose weight.

Why Strength Training?

Strength-training exercises are an excellent way to gain muscle mass. Studies have shown that resistance training, along with dietary modification, helps you lose weight. Since strength training increases muscle mass and metabolic rate, you burn more calories. Strength-training exercises also prevent the muscle loss that accompanies calorie cutting, so you stay more fit as you fight the flab. The benefits don’t stop at your thyroid though; resistance training enhances heart health and helps control blood glucose levels.

How to Incorporate Exercise for Hypothyroidism

You don’t need a gym membership or fancy home gym equipment for strength-training exercises. You can always start with basic exercises, such as squats, lunges, leg raises and push-ups. Together, these exercises work all the major muscles in your body. And with just a pair of dumbbells, you can broaden your routine to include basic weight-lifting exercises, such as overhead press, bent-over row, chest press and bicep curls.

For a good metabolism-boosting training programme, alternate between moderate-intensity strength training and aerobic exercise on different days of the week. While doing these exercises though, do keep a few things in mind:

  1. Physical activity should always consider your overall health condition, including your age, heart condition, pregnancy and other factors. Do consult your doctor and a qualified personal trainer before you begin an exercise regimen.
  2. Ease your way into exercise. According to the Cleveland Clinic, an underactive thyroid can cause your heart rate to slow down. So, a sudden return to exercise can stress your heart. Once your medications kick in, start with moderate-intensity exercises rather than jumping in at full force.
  3. There is a fine line between just right and too much. Training too much or at too high an intensity can negate the benefits and do more harm than good. So, it’s better not to overdo it!
  4. Value quality over quantity in your workouts. Multitasking while exercising is a strict no-no. Stay focused, as diversions increase the risk of injury.

With a correct exercise plan, you can boost your metabolism and build strength for a more fulfilling life.

This content is meant for awareness and educational purposes and does not constitute or imply an endorsement, sponsorship or recommendation of any products. Please consult your doctor or healthcare practitioner before starting any diet, medication or exercise.

How To Train If You Have Hypothyroidism or PCOS

Training modifications for Hashimoto’s and Hypothyroid

If you have Hashimoto’s or thyroid trouble, chances are one or more of the following scenarios will sound familiar when it comes to your workouts:

  • You can’t muster the energy to train at all.
  • You can train for a few days, only to hit a wall and need several days to recover.
  • You train regularly, but you’re getting absolutely nowhere with your goals.

Ladies, I feel you here. Of all the women with whom I work, the ones who struggle the most to train consistently are those of you with Hashimoto’s or hypothyroidism.

I assure you: It’s not you, it’s your hormones. A few unique aspects of hypothyroidism make exercise particularly dicey for you.

First, if you have a low-functioning thyroid your metabolism runs slower, plain and simple. You’re fatigued, and you don’t have the stamina to work out regularly. Working with your doctor to improve your energy and stamina is a top priority. Work with your doc to ensure that you’re getting enough T3 (the active form of thyroid hormone, made from T4) and that you’re not losing it to various mechanism such as over-conversion to reverse T3 due to stress, low T3 regeneration in the gut from poor bacterial balance or inadequate free, active T3 levels due to estrogen troubles.

When you’re running low thyroid, not only do you practically have to drag yourself to the gym, you’re also at risk for tendonitis, pain, and nagging, injuries that refuse to heal. Shoulders, knees, ankles, hips, wrists—all of these can be trouble spots if you are low thyroid and put them under stress with repetitive use.

This can, of course, show up as carpal tunnel issues if you use a computer mouse all day, but repetitive motion exercises in your workouts can also be a problem. Exercise choices like spinning or high rep/low weight strength training can be a double whammy for the wiped out, hypothyroid woman due to tons of repetitive movement of the hips, knees, and shoulders, a high cortisol demand, and a concomitant lessening of active thyroid hormone. Ok, that’s actually a triple whammy.

Beyond the physical injuries and tendonitis, women with Hashimoto’s suffer from a deeper, biochemical, injury or sorts: too much oxidative stress. To understand why, we have to talk about glutathione.

Glutathione

Glutathione acts as an immune modulator and antioxidant, and is important in liver detoxification and metabolization of substances like alcohol. This little peptide whose name you may not even know how to pronounce is a big player in how well you feel, how frequently and severely you “crash”, and how much of a struggle it is to lose fat with Hashimoto’s.

Glutathione is considered our master antioxidant. It helps us deal with the ongoing oxidative stress of living, metabolizing, and interacting in our modern world. For those of you with autoimmunity like Hashimoto’s, you have an additional stress: simply having autoimmunity. Part of the fall-out of autoimmunity is oxidative stress, or the generation of free radicals.

What is oxidative stress and why is it so damaging?

Oxidation is the removal of electrons from a molecule which creates a free radical. This free radical is then desperate to steal another electron from a nearby molecule, and without someone stepping in (i.e. our internal antioxidant systems like glutathione) a chain reaction of oxidation and electron stealing quickly gets out of control.

A commonly used example of oxidation is rusting metal—and yes, that’s literally what’s happening in our bodies when oxidation happens.

Oxidation is a normal process and part of how we interact with our world as well as engage in the complex biochemistry going on all the time within our bodies. The problem is that our modern life stressors have us in contact with more oxidation and our antioxidant systems can easily get wiped out. And, if you have autoimmunity like Hashimoto’s, your glutathione defenses are incredibly compromised.

As an unquenched free radical goes on the rampage, our internal antioxidant systems should be donating electrons, cutting off this chain reaction. But when our defenses are overwhelmed, or we have Hashimoto’s and lack robust glutathione systems, the free radicals from oxidative stress rip through our bodies like a tornado. What gets particularly torn to shreds are our mitochondria – the internal cellular powerhouses that convert our nutrients and food to energy.

Know what else generates quite a lot of free radicals and oxidative stress? Exercise.

It’s one of those “good” types of stress, but it’s stressful nonetheless—especially if you have depleted antioxidant systems due to Hahsimoto’s or any other type of autoimmunity (Rheumatoid Arthritis, Lupus, Crohn’s, Celiac, etc.)

This is one of the main reasons why many women with Hashimoto’s feel they can’t recover well from exercise, often despite following a sound nutrition strategy. It’s not just about more getting more rest or eating more carbs, it’s about this overwhelming burden of oxidative stress that the body just can’t handle. (Photo thanks to The Movement Minneapolis)

This can make it extremely challenging to keep up with a regular exercise routine. Often, some women will find that they need several days to recover after a training session, or if they push themselves too hard, they feel like a wreck for days after.

It’s wise to work with someone who can assess this internal system. A few things are known to help, such as whey protein (provided you are not sensitive, which many Hashimoto’s sufferers are), and taking n-acetyl cysteine (NAC, a precursor to glutathione), or more recently, acetylated forms of glutathione which appear to be absorbed better than glutathione supplements of the past.

Once you have more glutathione, you have to be able to recycle, regenerate, and continue to use it lest it can also become an oxidative stressor. Nutrients like alpha lipoic acid, glutamine, cordyceps, and milk thistle are helpful here for recycling the glutathione molecule and keeping this system humming along.

How to “push” when you’re healing adrenal and thyroid issues

There’s a fine line between overdoing it and not doing enough when you’re dealing with hormonal issues. Stress is fickle. It’s necessary to create some stress or the hormonal signals for fat burning and muscle growth won’t be triggered and you won’t make any progress. But if you push too hard, you end up setting yourself back or just continuing to push your system, which is simply unable to recover.

Over-training will always set you back if you have thyroid or cortisol issues. It may go something like this: You have a good day so you go for a walk, then train. You do some sprints or head back to the gym for another class, or decide you don’t need your scheduled rest day. You end up pushing too hard since you were feeling great … and then you feel bad again.

I can’t stress this enough: Avoid the urge to push too hard. Instead, increase your exercise a little bit at a time. Try adding just one more set of a strength training exercise, or just one to five more minutes to your routine instead of another 45 to 60 minutes. Add just one more day of training per week before trying two-a-days.

Test yourself before you wreck yourself! The setbacks are always frustrating, so find ways to do a gentle nudge instead of pushing too hard.

And as I always say: listen to your hormones talking to you via your ACES (appetite, cravings, energy and sleep). While these cues are always helpful, for some women it’s wise to get more concrete data using HRV (heart rate variability) tools such as BioForce or Elite HRV. HRV assess how well your body is coping and adapting to stress each day. It’s an excellent tool to gauge how hard you can train, or if you need another rest day instead.

Training modifications for PCOS

I’ve previously discussed the variance in body types with PCOS and my framework for understanding the differences. One key difference is that the “lean” type tends to be more resistant to storing body fat and better able to shuttle nutrients into the muscle, while the “heavy” type is great at storing fat in fat tissue and less effective at getting nutrients into the muscle tissue. This is all due to each PCOS woman’s degree of insulin resistance and in which tissues are more resistant (muscle or fat).

We are constantly in a state of remodeling, with our hormones using resources and directing an intricate dance throughout the day, building up and breaking down, anabolism and catabolism. This is true of all of us, but the effects are more dramatic in women with PCOS.

Because of this, many women with PCOS feel that they easily get “bulky” from training and struggle to lose fat. While this can be a bit confusing, remember that insulin resistance plays a role in PCOS to varying degrees, but all women with PCOS tend to be more anabolic, therefore their bodies are overall able to put on muscle and fat easier than their hormonally balanced girlfriends.

The woman with PCOS who feels she puts on muscle easy and tends to feel “puffy” or “bulky” when she trains more needs to do a couple things to get better results.

Nutrition is at the top of this list. Dialing in the diet can make a big difference. I know this is a post about exercise but finding your “unique carb tolerance” (UCT), investigating any problematic foods or sensitivities, and balancing your ACES, is job number one if you’re trying to make body composition changes.

Next, consider more exercise. I know we often talk about doing less exercise (which is the best strategy for some women), but the more insulin resistant you are the more your body is in “building” mode, and the more exercise it will tolerate. You don’t have to do crazy-intense exercise, just more activity in general. Lots of walking and even some longer duration cardio is often very helpful for women with insulin resistance and PCOS.

When it comes to strength training, if your adrenals are doing OK, you’ll do well with metabolic conditioning and HIIT. If your adrenals are struggling a bit, as is often the case—women are rarely dealing with just one hormone issue—I often recommend two, more traditional strength training sessions per week with more rest, and one metabolic training session per week. The other days should be a balance of cardio that works for you, between HIIT and longer, steady state cardio—and lots of walking, always.

If your body type is the leaner, more fat-resistant PCOS type, you do have to watch a constant cortisol push from exercise. You will not tolerate the metabolic conditioning and HIIT as well as the heavier body type counterparts. You’ll do well with heavier weights, two to three times per week and a lot of walking.

Now, before you rush off to the gym to manipulate your hormones and PCOS, I want to take a minute to remind you of something I’ve learned the hard way: embrace the body you have.

I have PCOS and, genetically speaking, I inherited bigger thighs—and I have always wanted to make them smaller. Running my way into exhaustion only made my hormone issues (cortisol, insulin and thyroid) worse. Finally embracing these big, strong thighs I started lifting heavier, and yes, I put on muscle and they got a touch bigger. But I have more energy, am sleeping better and while maybe a bit bigger, my legs are actually leaner than ever (even with a less-than-perfect diet and sleep schedule these days). They were smaller when I was a runner, but I was plagued with injuries, I hated doing it, and I was easily wiped out from excessive cardio. Today, I am more at peace with the body I have always fought against.

When in doubt, tune in to yourself

It can take time to understand and heed your hormones’ call, but when you don’t you are your own worst enemy. If you’ve been reading my articles, you know what we need to do is be our own best friend.

Sometimes you have to tune into a hormonal signal, and sometimes you have to turn into your mental chatter. When you aren’t sure if you’re listening to your body or not, start to listen closer to the voice in your head. Is it the voice of your own worst enemy, or your biggest cheerleader? The worst enemy voice is a bit of a slave driver, it uses your insecurities to motivate and berate you. It says things like, “You have to go to the gym because you’re blah blah blah.” Or it may sound like a bit of a whiner, and try to talk you out of what’s best for you by saying things like, “You don’t have to go to the gym. You worked so hard yesterday.” Or, “Go ahead and drink more wine, you trained really hard today…”

The best friend voice, on the other hand makes no excuses, she simply tells you that you need to rest. Not because you did so much yesterday, but because it makes sense for you right now, today.

All women need to stop battling themselves and get on their own side, but in particular, women with hormonal challenges like PCOS and Hashimoto’s will feel the effects even more significantly if they don’t. Both conditions can make weight loss, good energy, and even health seem elusive.

Paying special attention to work with these unique issues instead of against them will not only get you better results, it will stop you from pushing your system into further disarray.

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ORIGINAL ARTICLE

Year : 2015 | Volume : 3 | Issue : 2 | Page : 244-246

The effect of regular physical exercise on the thyroid function of treated hypothyroid patients: An interventional study at a tertiary care center in Bastar region of India
Akash Bansal1, Amit Kaushik2, CM Singh3, Vivek Sharma4, Harminder Singh5
1 Department of Biochemistry, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India
2 Department of Community Medicine, UP Rural Institute of Medical Science and Research, Etawah, Uttar Pradesh, India
3 Department of Community Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
4 Department of Community Medicine, Shyam Shah Medical College, Rewa, Madhya Pradesh, India
5 Department of Pharmacology, Guru Govind Singh Medical College, Faridkot, Punjab, India

Date of Web Publication 16-Dec-2015

Correspondence Address:
Akash Bansal
Department of Biochemistry, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly – 243202, Uttar Pradesh
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/2321-4848.171913

Abstract

Background: Thyroid hormone is a key substance in normal homeostasis, having variable influence on cell metabolism on different organs. Hypothyroidism is common, potentially serious, often clinically overlooked, readily diagnosed by laboratory testing, and eminently treatable. Aim: This study was conducted with the aim of finding the effect of regular physical exercise of medium-intensity on thyroid function in patients already undergoing treatment for hypothyroidism. Materials and Methods: A total of 20 ambulatory treated hypothyroid patients were included in the study. Serum samples were collected and evaluated for triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH) both before and after 3 months of daily 1 h physical exercise, from those patients doing exercise and from those who did not do any physical exercise. T-test was used to find a significant difference between the two groups. Results: Serum TSH was found to be significantly decreased in patients of regular exercise group postinterventionally (P < 0.001) when compared with nonexercise group (P = 0.43). Serum T3 and T4 were also found to be significantly raised in regular exercise group postinterventionally (P = 0.007 and P < 0.001 respectively) but not in nonexercise group (P = 0.92 and P = 0.73 respectively). On inter group comparison significant decrease in TSH was found in regular exercise group (P = 0.002) and significant increase was found in levels of T3 (P = 0.002) and T4 (P = 0.001) in regular exercise group. Mean weight was also found to be decreased in regular exercise group postinterventionally. Conclusion: Every hypothyroid patient should do regular physical exercise along with thyroxine replacement to improve thyroid function.

Keywords: Physical exercise, thyroid hormone levels, treated hypothyroidism

How to cite this article:
Bansal A, Kaushik A, Singh C M, Sharma V, Singh H. The effect of regular physical exercise on the thyroid function of treated hypothyroid patients: An interventional study at a tertiary care center in Bastar region of India . Arch Med Health Sci 2015;3:244-6

How to cite this URL:
Bansal A, Kaushik A, Singh C M, Sharma V, Singh H. The effect of regular physical exercise on the thyroid function of treated hypothyroid patients: An interventional study at a tertiary care center in Bastar region of India . Arch Med Health Sci 2015 ;3:244-6. Available from: http://www.amhsjournal.org/text.asp?2015/3/2/244/171913

Introduction

Thyroid diseases are arguably, among the commonest endocrine disorders worldwide. India too is no exception. According to a projection from various studies on thyroid disease, it has been estimated that about 42 million people in India suffer from thyroid diseases. Thyroid hormones (THs) regulate the renal hemodynamics and basal metabolic rate of most cells. The thyroid gland synthesizes and releases triiodothyronine (T3) and thyroxine (T4), which represent the only iodine containing hormones in the vertebrates. T3 is the biologically active TH. These hormones are required for the normal growth, development and function of nearly all tissues, with major effects on oxygen consumption and metabolic rate. TH synthesis and secretion are regulated by a negative feedback system that involves the hypothalamus, pituitary, and the thyroid gland. Exercise can also improve thyroid function. It can be difficult to find the energy to exercise when feeling fatigued but exercise is particularly important in the treatment of hypothyroidism. Exercise may be one of the most powerful natural therapies to alleviate depression, one common symptom of hypothyroidism. However, clinical studies on hypothyroid subjects are very few, and not much data are available on how physical exercise influences thyroid function in human beings. Hence, we conducted this observational study to see the relation of the physical exercise with thyroid function.

Materials and Methods

The study was conducted in Department of Biochemistry in a tertiary care centre in Bastar area (tribal area) of Chhattisgarh. 20 ambulatory otherwise healthy treated hypothyroidism male patients with comparable level of hypothyroidism were included in study, out of which 10 patients complied to do regular physical exercise for 1 h daily, and rest were not willing to do physical exercise. Serum T3, T4 and thyroid stimulating hormone (TSH) levels were analyzed preinterventionally to avoid any biases in the distribution of subjects into both groups. The regular exercise session in the form of sports or jogging continued for 3 months. All the patients were between age 30 and 40 years. All the subjects were stable on their respective thyroxine replacement doses (eltroxine) since last 6 months. Mean thyroxine dose was 97 mg/day in the exercise group and 100 mg/day in nonexercise group. Brief clinical history and examination along with some epidemiological data were taken. After a written and informed consent samples were collected and processed. Ethical clearance was taken for the study.

Collection and preparation of sample
We collected 5 mL of venous blood with full aseptic precautions without anticoagulant and allowed it to clot. Clotted blood was centrifuged, and clear serum was collected. Fresh serum samples were taken. Serum was checked for hemolysis, and if hemolyzed then that serum was discarded. Serum was analyzed for T3, T4 and TSH for Thyroid profile. This process was repeated again after 3 months of the start of the study to look for changes in thyroid profile if any happened in both the groups.
Analytical methods
Fifty microliter of serum was taken to analyze T3, 25 ml for T4 and 100 ml for TSH hormone level by ELISA method (Omega diagnostics) at 450 nm filter using Microplate Reader model 680 (Biorad). Normal range for T3 was 0.5-1.9 ng/mL, for T4 was 4.8-11.6 pg/dL (females) and 4.4-10.8 pg/dL (males) and for TSH it was 0.5-6.3 mIU/mL. T-test was used to find a significant difference between the two groups.

Results

Totally 20 male treated hypothyroid patients of middle age group ranging 30-40 years were evaluated for thyroid function, out of which 10 patients belonged to regular physical exercise group and 10 nonexercise group. Mean age for all 20 patients was 34.1 + 2.69. Serum TSH, T3 and T4 were analyzed at the end of 3 months in both exercise group and nonexercise group. Serum TSH was found to be significantly decreased in patients of regular exercise group postinterventionally (P < 0.001), but no such significant difference was seen with nonexercise group (P = 0.43). Serum T3 and T4 were also found to be significantly raised in regular exercise group postinterventionally (P = 0.007 and P < 0.001 respectively) but no such significant difference in T3 and T4 was found in nonexercise group (P = 0.92 and P = 0.73 respectively). On inter group comparison significant decrease in TSH was found in regular exercise group (P = 0.002) and significant increase was found in levels of T3 (P = 0.002) and T4 (P = 0.001) in regular exercise group. Mean weight was found to be decreased in regular exercise group postinterventionally.

Table 1: Thyroid profile in exercising and nonexercising group preinterventionally
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Table 2: Thyroid profile in exercise group pre and postintervention
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Table 3: Thyroid profile in nonexercise group pre and postintervention
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Table 4: Thyroid profile comparison in exercise versus nonexercise group postintervention
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Discussion

The present study is the first description of the effect of regular physical exercise on thyroid disorder status in and around this region. Thyroid disorder level is high among native tribal of Bastar region involving more commonly female population. The reason for this is not well known. This may be because Bastar region receives heavy rainfall and it is situated well above plains, so iodine of superficial layer gets washed away with water and here consumption of seafood which is rich in iodine is also less as this area is far from sea. Ground water of some regions in Bastar is rich in fluorine to the level that it may cause fluorosis too. According to present study thyroid functions improve in hypothyroid patients doing regular physical exercise, as TSH levels decreased, and T3 and T4 increased in regular exercise group. Exercising increases metabolic activity, which helps burn more calories and helps keep weight down. Research at the University of Gaziantep in Turkey set out to study the effects of exercise on levels of TSH, to see if it would help those with lower TSH levels. The results showed that medium-intensity aerobic exercise, which the study classified as 70% of a person’s maximum heart rate, produced the best results for improving TSH. Hence some improvement in thyroid function can be attributed to decreasing in weight in regular exercise group. Exercise can by itself also improve thyroid function may be through better perfusion of gland. However this needs to be investigated further. Even gentle exercise such as walking, swimming, or yoga stimulates thyroid gland secretion and increases tissue sensitivity to THs. Peripheral metabolism of THs can be changed significantly by a number of physiological and pathological conditions, which can alter the deiodination pathway and lead to a change in the circulating level of THs. The biological effects of short-term changes in the TH levels are not currently completely understood but are potentially important in the body’s adjustment to stressful or catabolic states. A connection is established between increasing training to 80 km/week and elevated hormone levels. , Examined the TH levels of professional cyclists during a 3 weeks stage competition, they concluded that serum T4, FT4 and FT3 levels showed a significant increase by the last week of competition while concentrations of TSH and T3 remained unchanged.
Findings of the present study were different from previous studies done on hypothyroid patients as because most studies were on patients doing acute and stressful exercise Fortunato et al., Hackney et al. ,

Conclusion

Hypothyroidism reduces exercise capacity but after hormone replacement with thyroxine exercise capacity can be attained back. After being euthyroid on hormone replacement regular physical exercise can improve thyroid function and thus improve mental and physical status of hypothyroid patient and concomitantly decrease dose of thyroxine replacement therapy. So every young to middle aged hypothyroid patient should do regular physical exercise to improve his/her thyroid status.

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3. Yen PM. Physiological and molecular basis of thyroid hormone action. Physiol Rev 2001;81:1097-142.
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5. Available from: http://www.livestrong.com/article/523900-can-exercise-help-an-underactive-thyroid/. .
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7. Hackney AC, McMurray RG, Judelson DA, Harrell JS. Relationship between caloric intake, body composition, and physical activity to leptin, thyroid hormones, and cortisol in adolescents. Jpn J Physiol 2003;53:475-9.
8. Miller RG, Boska MD, Moussavi RS, Carson PJ, Weiner MW. 31P nuclear magnetic resonance studies of high energy phosphates and pH in human muscle fatigue. Comparison of aerobic and anaerobic exercise. J Clin Invest 1988;81:1190-6.
9. Koistinen P, Martikkala V, Karpakka J, Vuolteenaho O, Leppäluoto J. The effects of moderate altitude on circulating thyroid hormones and thyrotropin in training athletes. J Sports Med Phys Fitness 1996;36:108-11.
10. Fortunato RS, Ignácio DL, Padron AS, Peçanha R, Marassi MP, Rosenthal D, et al. The effect of acute exercise session on thyroid hormone economy in rats. J Endocrinol 2008;198:347-53.
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