Episode - Exercise and Hyperthyroidism


Exercise and Hyperthyroidism

In this episode Dr. Eric discusses exercise and hyperthyroidism, including what types of exercise those with hyperthyroidism should do, and what types they should avoid.

During this episode you’ll learn:

  • Three types of exercise, and which ones those with hyperthyroidism should do, and which ones they should avoid
  • How exercise affects the immune system
  • How exercise affects the thyroid
  • The risks of overtraining and hyperthyroidism

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Here is the transcript for this episode:

Welcome back to the Save My Thyroid podcast. This is Dr. Eric Osansky. In this episode, I am going to talk about exercise and hyperthyroidism.

I’d like to start out by discussing the health benefits of exercise. Of course, exercise benefits cardiovascular health. By exercising, there is a decreased risk in incidence of and mortality from coronary disease. It can also help someone maintain a healthy weight.

Many times, exercise alone isn’t the answer. If someone is gaining weight, then exercise can help along with eating well, but sometimes you need to do more. With hyperthyroidism, we see a lot of people losing weight, which most people don’t want to do. Sometimes women or even men with hyperthyroidism don’t mind losing some weight, but in my case, I lost 42 pounds, so that was a little bit excessive.

Also, exercise can reduce stress and anxiety, which is a great thing. It increases bone density. Hyperthyroidism can have a negative effect on bone density, so certain types of exercise, especially weight-bearing exercise, can help here. I’ll talk more about that.

There are other health benefits of exercise. I’m not going to get into detail when it comes to the other benefits. I will say that if you’re physically inactive, if you’re a couch potato, this will increase the risk of developing cardiovascular disease as well as other chronic conditions. At the very least, you want to be active. You want to be moving regularly. I’m not going to talk too much about that here, but I’m mentioning it now. Even if you’re not on a regular exercise routine, you want to be on a regular movement routine. You don’t want to be sitting for real long periods of time and not moving.

When it comes to exercise, I mentioned how you want to move regularly. You also don’t want to overexert yourself. If you’re just moving around, you’re probably not going to do that. If you’re exercising, that can happen. Most people don’t know when they are overexerting themselves. You need to consider both the exercise duration as well as the routine.

Before being diagnosed with hyperthyroidism, I overtrained. I was going to the gym and specifically using the rowing machine for about 30 minutes. By the time I was done with the rowing machine, I was wiped out. I was really pushing hard. It’s not the rowing machine itself; I was doing some high intensity interval training and going all out. Nothing wrong with high intensity interval training, but it was probably high intensity without the intervals, just continuous high intensity for about 30 minutes. It’s been quite a while, but I was definitely overdoing it as I think back.

If you’re doing high intensity exercise, you want to limit the duration. There is high intensity interval training, where you go all out for 30 seconds or a minute, and then take a break for a couple of minutes. I’ll talk more about that shortly.

As far as moderate aerobic exercise, some people can do that for 30 minutes or longer. It really does depend on the person. A lot of people need to focus on light walking when dealing with hyperthyroidism. I’m not talking about in general; again, this is focusing on those with hyperthyroidism.

You still might be wondering, “Well, I have hyperthyroidism. What type of exercise should I do?” There are three types of exercise I am going to discuss here. Before getting into the different types, don’t forget to do pre- and post-stretching. I’m not going to discuss that here in detail.

There is high intensity interval training, also known as burst training. This involves repeatedly exercising at a high intensity for 30 seconds to a minute or two and then typically separated by 1-5 minutes of recovery. For 30 seconds, you go all out, and then maybe a couple of minutes, you’ll not go all out.  I do high intensity interval training on a stationary bike.

I didn’t do it when I was dealing with hyperthyroidism/Graves’, even though I mentioned before I was diagnosed, I was doing it. Now I’ll go on a stationary bike all out for 30 seconds to a minute, and then I’ll take it easy on the bike. I’ll still be pedaling, but I’ll be going for two minutes. Then all out for another 30 seconds to a minute. I’ll do 5-7 cycles of that.

High intensity interval training, the research has shown it to help people with insulin resistance, to reduce fat and oxidative stress, to improve antioxidant status. If you don’t have those intervals, if it’s just continuous high intensity training, then that’s actually going to increase oxidative stress, which I’m sure happened when I was rowing like crazy without much of a break.

As far as how you can do it, there are different ways to do it. You don’t need equipment. You can go on a treadmill and run, or you can go outside and run. You can use a stationary bike or a regular bicycle or the rowing machine. Sprinting is an option, too. If you go online and do some searching, you will find other ways.

As I suggested earlier, if you have hyperthyroidism, I really do think you should avoid any type of high intensity training. That also includes high intensity interval training. When you are in a healthier state, it’s something I do recommend. Get checked by your doctor to make sure there is no underlying issues even if the hyperthyroidism is in remission. It is something I am definitely an advocate for when someone is in a healthier state.

There is continuous aerobic exercise. Research shows the long-term health benefits of aerobic exercise. Even though some people say don’t bother with it, I don’t agree with that. The research backs me up. You could do walking, jogging, bike riding. You could go on a treadmill or ride an exercise bike. An elliptical machine, a rowing machine. There are other things you can do. Once again, you need to be cautious with the intensity and the duration. If you go too intense, that’s high intensity training. It is also continuous aerobic exercise. They overlap. But you want to make sure you don’t overtrain.

Then there is strength training. I would recommend doing this at least 2-3 times a week. You could do it an extra day or two if you wanted. I usually like to take a break in between. Do it on a Monday, and then on a Wednesday, etc. But you could alternate different muscle groups. Just do upper body Monday, Wednesday, Friday, and then lower body Tuesday, Thursday, and Saturday, and then take Sunday off.

When you are dealing with hyperthyroidism, go light if you are going to lift weights. Again, you want to work out all the major muscle groups weekly, but alternate, as I explained before. Give your body a break in between.

You might even want to consider hiring a personal trainer if you’re new at this. It’s not just about increasing muscle mass and bone density. While doing this, you want to have the proper posture. You don’t want to hurt your back or neck. If you’re doing light weightlifting, you’re less likely to do this. It still might not be a bad idea to get some guidance initially.

It doesn’t just have to be weights. There are other ways to do weight-bearing exercises. You could do pushups, or you could do wall pushups or half pushups if you can’t do the full ones. Weights are nice, but you don’t have to use weights. You could improvise.

Next, I’d like to discuss how exercise affects the immune system. Regular exercise does have a healthy effect on the immune system as long as you don’t overtrain. The research shows that exercise can cause a reduction in chronic inflammation. Overtraining syndrome results in suppressed immune function. That’s another reason you don’t want to overtrain.

Overtraining can cause a decrease in secretory IgA, which lines the mucosal surface of the body, including the respiratory tract and the gut. When you have lower secretory IgA, oftentimes that is correlated with a leaky gut. However, it’s not a specific leaky gut marker. In my patients, when I have seen that low—in the past, I did leaky gut testing, so I was able to make that correlation. You don’t want that decrease. That secretory IgA is protective. You want healthy levels of that.

Exercise affects the cytokines. There are anti-inflammatory cytokines and pro-inflammatory cytokines. You don’t want to increase the pro-inflammatory cytokines because they promote inflammation. As a result, overtraining can potentially be a factor in the development of autoimmune conditions such as Graves’. Not to say that is the main cause if you’re overtraining, but in my case, it was definitely a contributing factor. Not just the effects on the cytokines, but it also drags down the adrenals as well.

How does exercise affect thyroid health? Some studies show that the thyroid hormones are only transiently, temporarily, or insignificantly changed during strenuous exercise. Other studies have shown that maximal aerobic exercise greatly affects the levels of circulating hormones. Another study showed that maximal treadmill exercise didn’t greatly affect the concentration of circulating thyroid hormones. Yet another study suggested that a longer recovery period is necessary for hormone levels to normalize when you’re doing high intensity interval exercise. Just some things to consider.

This can be important when testing. If you’re doing a thyroid panel, you probably don’t want to exercise before doing the thyroid panel, especially high intensity interval training. Even if it’s jogging in the morning, I probably wouldn’t go for a morning jog and then an hour or two later test your thyroid hormone levels. I would say don’t do it for the rest of the day as far as testing your thyroid. Do it first thing in the morning if you’re thinking about exercising. You can get the blood draw and then exercise once you’re done going to the lab.

Let’s go ahead and summarize. Most people with hyperthyroidism, including Graves’, toxic multinodular goiter, subacute thyroiditis, any of these conditions, you need to be very cautious when exercising. I mentioned already that you should avoid high intensity interval training. Limit the aerobic exercise to some light walking. I know it’s discouraging to some people; it was for me because I was in an exercise routine, and I hated not being able to do what I normally did at the time. It’s something that’s temporary. As you regain your health, you can go back to doing more from an aerobic exercise perspective. Eventually, high intensity interval training, too.

As far as the weight-bearing exercises, I definitely recommend doing some of this, whether it’s light weightlifting or another type of weight-bearing exercise. I mentioned maybe considering getting a personal trainer. You will want to start slow, and then eventually increase the intensity and duration.

That is all I want to discuss with regards to exercise and hyperthyroidism. I hope you found this episode to be valuable. I look forward to catching you in the next one.