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Update – Case Study: Keto-Induced HypothyroidismAugust 20, 2018
Interested in exercise for the thyroid gland, or exercise to reduce thyroid problems? We are all familiar with the numerous benefits exercise has on our lives.
Whether it is stress reduction, lowering the risk of cardiovascular disease or improving metabolism/body composition. Indeed, weight gain and fatigue are common struggles of thyroid disease. For those wanting to lose weight or get in shape, the common thought is, ‘the more exercise the better.’
For those struggling with thyroid disease, and looking for the best exercise for an underactive thyroid, what I am about to say is shocking – sometimes exercise is not good for you and can actually put the brakes on weight loss. Yes, you read that right!
Want to stop right there and deal with your thyroid? This should be your first stop…
The Stages of Thyroid Disease
There are several stages of thyroid disease. For instance, in Hashimoto’s, these stages range from genetic predisposition (low grade) to subclinical hypothyroidism (medium grade) and then progressing on to overt hypothyroidism (high grade).
Depending on the stage of hypothyroidism, certain types of exercise can either work for you or against you. The good news is we will clear this all up here as we explore:
- The different types of exercise
- Their benefits
- Who they work best for
- When they should be avoided
The Main Categories of Exercise
There are four main types of thyroid exercise and exercise for hypothyroid patients, which are as follows:
Taking each of these in mind, let’s get to work (and break a sweat) while breaking each of them down…
Endurance exercise (otherwise known as “aerobic” or “cardio”) involves increasing both your heart rate and breathing rate for an extended period of time (delivering oxygen to working muscles).
Consider some of the common examples of endurance training include:
- Brisk walking
- Stair Climbing
- Sports – basketball, soccer, racquetball
The Advantage of Endurance Training
The main advantage here is that endurance training lowers the risk of cardiovascular disease. The American Heart Association recommends roughly 20 minutes of moderate endurance a day1.
A long-term study in a 2014 issue of the Journal of the American College of Cardiology showed that runners had a 45% lower risk of death from heart disease than non-runners2.
Additionally, it also improves mood and brain/cognitive function as oxygenated blood3, while helping with weight loss4.
Burst & Interval Training
Burst training (otherwise known as high-intensity interval training – or HIIT) involves short bursts of high-intensity-style exercise for 30 – 60 seconds followed by one to two minutes of recovery periods5.
Instead of walking or jogging for an hour, a burst exercise may look like this:
- Warm up for a few minutes at an easy pace.
- Sprint as hard as you can for 30 – 60 seconds.
- Recover by walking or jogging for 1 – 3 minutes, allowing your heart rate to come back down.
- Repeat steps 2 and 3 for a total of 4 – 8 minutes.
- Cool down for a few minutes at an easy pace.
The Advantages of Burst Training
This type of exercise is great for:
- Boosting metabolism
- Building muscle
- Burning fat
Key Insight: In fact, a 4-minute workout can achieve the same fat-burning as a 20-minute endurance workout.
A more recent study in the Journal of Diabetes Research supports this6. They compared female subjects performing moderate-intensity endurance to females performing HIIT. Both groups worked to the same degree of energy output.
The study revealed that the HIIT group achieved this energy output in a shorter time than the endurance groups. Both groups lost the same amount of fat, but the HIIT group spent much less time in order to achieve the same results as the endurance group.
While both endurance and burst exercises raise your stress hormone, cortisol, burst exercises immediately allow the body to recover and allow those levels to come down.
As you repeat this cycle, this trains your body to be able to handle higher levels of stress hormone and recover faster. This is different from endurance exercise which keeps cortisol elevated and when cortisol stays elevated for too long it prevents fat burning.
On top of that, another plus is no gym or equipment is required, so you can do this anytime, anywhere. Also, you can easily add a lot of variety to your workouts – you don’t always have to run/sprint. Try this same principle with some of your other favorites, like:
- Stair climbers
Strength training builds up your muscles by increasing their ability to resist force (via free weights and other devices or by using body resistance).
Some common examples include:
- Lifting weights
- Resistance bands
- Calisthenics/body resistance – push-ups, pull-ups, crunches, and squats
The Advantages of Strength Training
Muscles require a lot of energy in order to maintain themselves and so their presence alone is important in boosting metabolism.
Higher muscle mass improves insulin sensitivity, making it easier to access stored fat for burning. Coupling the higher energy demand of muscle with insulin sensitivity improvement advances the argument that higher muscle mass helps with burning fat.
Furthermore, improving insulin sensitivity is one of the more natural approaches to addressing thyroid disease, as thyroid disease and insulin resistance are closely connected7.
Flexibility & Balance Training
Flexibility training includes stretching exercises for the purpose of increasing one’s range of motion, and lengthening muscles.
Some common examples of these include:
- Tai chi
The Advantages of Flexibility & Balance Training
This increases the range of motion of joints which in turn helps prevent injuries and improve muscle and athletic performance.
Therefore, it improves muscle strength output by improving muscle imbalances and their length/tension relationship.
Ultimately, this allows muscles to generate force more effectively and thus increase strength capabilities.
Exercise and Thyroid Disease
As you can see, there are many types of exercise and each has their role in keeping the body in top shape, in different ways.
Now that we have explored the main types of exercise, let’s see how each one may pertain to different cases of thyroid disease.
Untreated Thyroid Disease and Exercise
For someone with hypothyroidism, weight gain and fatigue are common struggles. Intense/prolonged exercises are not recommended because they will put further strain on your already struggling thyroid gland.
Furthermore, at this stage intense exercise is seen as a stressor. This causes the release of stress hormone, cortisol, which lowers the effectiveness of T3.
So, what little amount of hormone your thyroid does produce, the efforts are being thwarted by the cortisol response. Also, cortisol lowers other beneficial hormones that help your body build muscle and burn fat.
Key Insight: Cortisol puts the brakes on any fat burning – quite counterproductive to the amount of time and effort you are giving!
For someone with hyperthyroidism, weight may not be the issue but the excess energy may be. Some will exercise to try to burn up that energy or continue their normal exercise regimen because they “know how good exercise is for the heart.”
Interested in the status of your thyroid levels? Here’s a great place to begin…
As good as exercise is for the cardiovascular system, those with hyperthyroidism should avoid exercise that increases heart rate. It is quite dangerous to exercise in this state and can cause very rapid heart rate, palpitations and lead to heart failure.
Bottom Line: Intense exercise during untreated thyroid disease can worsen your symptoms. It can also put more strain on your thyroid and other body systems, and hinder fat burning.
Light-intensity exercise, including flexibility/balance training – like an easy evening stroll, restorative yoga – can typically be safe.
- Avoid high intensity/prolonged Endurance & Burst Training
- Strength Training (proceed with caution)
- Flexibility/Balance Training
New to Thyroid Treatment?
Commonly, patients new to thyroid treatment will want to start exercising right away, especially those with hypothyroidism. Suddenly being on your new thyroid medication is helping you feel more energized and you want to work at losing weight.
Beware of jumping into intense exercises right away, especially if you are wanting to lose weight. Remember from earlier? This can deplete your thyroid further and also secrete stress hormones, halting any form of weight loss.
Bottom Line: It is important to heed caution before jumping into new and more intense exercise. Wait for your Integrative Health doctor’s clearance for exercise (typically when the thyroid is stabilized and your adrenal health has been optimized).
How to Increase Exercising Safely
Start with maintaining your normal activities and add in 10% increments of exercise time per week at the most. Adding more than that will stress the body and block any fat or weight loss.
It is always prudent to underestimate what your body can handle than to overshoot and pay the consequences, especially when in the recovery stage of thyroid disease.
To fit within a normal body rhythm, calisthenics and light strength training can be great to do in the mornings, and then a light after-dinner stroll for 10-20 minutes.
Stretching, chi-gong and yoga can be restorative for the thyroid and safe exercises to start with when you are in the recovery stage of thyroid disease (1).
After you exercise, gauge how you feel the days following your activity. Did you feel better or worse? If you felt worse, it’s a sign you may have pushed yourself too much and you need to lower your workout intensity and time.
If you felt better, you could consider maintaining that level for a while longer or again increase another 10% of the time for next week’s activities. Every time you do so, check in on how your body felt to gauge whether you can keep increasing activity or not.
Key Insight: Check out this great video about how to add exercise back, gently, into your routine (2).
When Your Thyroid is “In Good Health”
When our savvy doctors at Integrative Health have stabilized your thyroid, and you feel comfortable with the duration of your exercise you could try to increase the difficulty or intensity of your workouts by 10%. Perhaps adding in a lighter-intensity burst training, and assessing how you feel.
Variety is key when in comes to exercise types because they all have their unique benefits and advantages for our bodies to keep fit, healthy and safe. Our bodies can easily adapt to the routines of exercise, so keep the body guessing by changing it up!
Once your thyroid is “in good health” and you have worked up your exercise tolerance, you can follow the below chart to add variety to your workout routine:
||3 – 5x/week, alternate days
||3x/week, alternate days
||4 – 8 minute burst cycle
||2 – 3x/week, with a 48-hour rest period between muscle groups. Can couple with burst/interval training or endurance
||30 – 60 minutes
||15 – 60 minutes
The Main Points For Exercise
Here are some of the main points that you should consider and take with you:
- Intense exercise is not encouraged with uncontrolled thyroid disease.
- After thyroid disease is managed, if wanting to burn fat and lose weight, gently increase the duration and frequency of exercise in 10% increments per week.
- To follow normal body rhythm, keep higher intensity workouts for earlier in the day and light intensity exercise for the evenings.
- Create a schedule and stick to it.
- Variety is key to exercise, add different types of exercise to keep your body guessing and also to optimize the safety and effectiveness of the exercise.
Interested in learning more about your health and exercise for thyroid gland issues? Schedule an appointment at IH to discuss what steps you can take to optimize your thyroid health, Click Here.
Written by Dr. Raquel Espinol of Integrative Health. Dr. Raquel Espinol, Associate Physician with Integrative Health specializing in Thyroid, Adrenal, Male/Female Hormonal imbalances and weight loss management.
Learn more about Dr. Espinol here.