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HYPOTHYROIDISM – Physical activity

If you have an underactive thyroid or a condition called hypothyroidism, exercise is probably the last thing on your mind. After all, symptoms like fatigue, swelling, and pain in joints and muscles do not encourage you to just get up and start exercising. However, according to the experts, physical activity can help you feel better.

John C. Morris, MD, a professor of medicine and endocrinology at the Mayo Clinic School of Medicine, says that if your condition is well controlled, you should be able to perform the same physical activity as someone who does not have a thyroid disorder. However, if you are just starting out with exercise planning or are still struggling with symptoms, low-load aerobic exercise and strengthening movements are the best options. “Exercise with low loads does not put as much pressure on the body,” says Norma Lopez, MD, Professor of Endocrinology and Metabolism at Loyola University Medical Centre. “Hypothyroidism can actually cause pain and swelling in muscles and joints.”

HOW PHYSICAL ACTIVITY CAN HELP

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It improves your mood. Too little thyroid hormone can cause feelings of depression and anxiety, the exercise, however, reduces stress and helps the body increase the endorphins. It lifts your mood and alleviates sad and anxious feelings. Aerobic exercises such as cycling, walking, elliptical training and swimming help boost metabolism, improve energy and relieve depression.

It helps you lose weight. A slow metabolism can lead to weight gain. Exercise burns calories and builds muscles, and it helps you lose weight. While cardio (aerobic) exercise can help lose weight, activities such as weight-lifting and strength training help against weight-gaining as our muscles need more energy to maintain than soft or adipose tissue – you burn more calories to build and maintain muscle than you do to maintain fat. Therefore, you can add a weight training program to your routine. Although weight-lifting helps prevent weight-gain, it can also help boost your metabolism and improve overall strength.

It increases your muscle mass. In addition to increasing strength, increasing muscle mass can also help improve balance and stability. To increase your muscle mass, try using fitness machines with weights, free weights, or just your own body weight. Pilates and more intense types of yoga, such as Ashtanga, Bikram and Vinyasa, also work well. An extra benefit is that muscles help eliminate osteoporosis, which is a common concern of women who have the highest incidence of hypothyroidism.

It reduces joint pain. When you first start an exercise routine, choose gentle stretching or yoga, especially if you feel joint pain. Swimming and even walking in the pool are also great options as the water reduces stress and pressure on the joints. Later, you can add exercise for muscle-strength, which has been proven to reduce strain on the joints.

It increases available energy. Fighting fatigue or laziness? Low intensity aerobic exercise can help you. People who ride a bike for at least 20 minutes, three times a week, have more energy and less fatigue. Walk, bike, swim, jump on the road – whatever you do, the most important thing is to move. The results of a minor study published in March 2017 in the journal Physiology & Behavior even showed that young women with a lack of sleep were more energized after a 10-minute climb up the stairs than with 50 milligrams of caffeine.

BEFORE YOU START

Before starting any exercise routine consult your doctor.

You need to make sure your hypothyroidism is under control. Before you start, you should have a thyroid that works normally with the help of thyroid hormone replacement medications. If not, you can worsen your condition. For example, running can make the pain in already sore joints much worse. Also, before taking any nutrition supplements such as protein powders for better effects, consult your doctor.

Further, you should change or adjust your diet. Some nutrients, such as soy, prevent your medications from working properly. Also, poor digestion can further affect your mood. Consult an expert, browse the internet for the experiences of people with similar problems, or simply try for yourself what works best for you and what makes you feel worse.

Like with any new exercise routine, start slowly. Take a break if you need it and stop if it hurts. When you feel more comfortable, gradually start with longer and more strenuous workouts.

EXERCISES

Exercise is not a substitute for hormone therapies to treat hypothyroidism. Some studies even suggest that despite prescribed medications, people with hypothyroidism may experience greater discomfort during exercise. Nevertheless, many forms of exercise offer particular benefits to individuals with hypothyroidism. Before starting a new routine, always discuss your exercise plan and goals with your doctor or a specialist.

WALKING

Walking is the easiest exercise that everyone can perform. All you need is a pair of comfortable shoes. It increases the heart rate and burns about 280 calories per hour.

WATER AEROBICS

If you have swelling in your ankles or feet, some exercises can be painful. In this case, water aerobics is a good option. Water lifts you up and reduces the pressure on your joints.

YOGA

Yoga can stretch and strengthen your muscles. It also helps you focus on breathing. One of the studies showed that people with hypothyroidism had better lung power after practising yoga for 6 months.

TAI CHI

This slow form of martial arts is described as “moving meditation”. It has been proven to reduce stress. Studies show that it can help improve strength, balance and mood.

STRENGTH TRAINING

Whether you’re lifting weights or using your own weight, building muscles helps you burn more calories – even when you’re sitting still. As the hypothyroidism slows down metabolism, people with this condition gain weight easily and, consequently, may have secondary problems caused by obesity. Building muscles with strength training can prevent these results. Also, strong muscles help relieve pressure on the joints.

HOW TO START?

In the beginning, 5 to 10 minutes of stretching exercises or simple yoga is enough.

Examples of stretching exercises:

Start with a 3-5 minute warm-up, which can be stepping on the spot or stepping up to a higher surface (15 cm is enough).

Hold each stretch for 20 to 30 seconds. Repeat several times if you wish.

1.     Hamstring stretch

With a straight back, reach out and grip the toes of one foot. Stretch the leg to feel it. The standing leg remains slightly bent.

2.     Standing quad stretch

With one hand hold on to a stable surface. The standing leg is extended. With the free hand, pull the other leg towards you by trying to touch the buttocks with the heel.

3.     Chest opening

Hold hands behind your back. With your back straight, bend towards the ground, your hands trying to follow.

4.     IT band stretch

Cross your feet while standing and reach towards the ground with the opposite hand of the front leg. The other hand reaches upwards.

5.     Down dog

As shown in the picture, try to keep the ears in the line of the arms and alternately stretch the legs.

6.     Runner’s lunge

Perform a lunge in which the hind leg is extended. Lean with your hands and push away from the front, bent leg.

7.     Lunge with reach

Similar to the runner’s lunge, now one palm rests on the ground next to the front foot and the other one reaches upwards.

8.     Kneeling quad stretch

Perform lunge and lower the knee of the hind leg to the floor. With one hand, reach for the foot of that leg and pull it towards you.

9.     Seated quad stretch

With a straight back and outstretched legs, try to lean and pull yourself towards the toes.

10.  Seated twist

In seated position, place the foot of one leg on the outside next to the thigh of the other leg. With the hand on the side of the outstretched leg, grip the bent one and pull the torso into rotation towards the bent leg.

11.  Figure four

Lie on your back and bend your knees towards your torso. Place the foot of one leg in front of the knee of the other leg. Pull the legs towards you with your hands.

12.  Low-back release

Lie on your back. Bring your knees towards your torso and keep them there. Pull your head up towards your knees.

13.  Laying low-back twist

Lie on your back. Stretch your arms to the side. Bend your legs and cross them. With your shoulders touching the floor, lower your legs to one side, then continue to the other side.

14.  Child’s pose with reach

Kneel and sit on the heels of your feet. Lean your forehead against the floor and extend your arms forward.

15.  Shoulder stretch

As shown on the photo, use your arm to pull the other one towards the opposite shoulder.

16.  Triceps stretch

Reach for your neck / back with one hand. Push the elbow down with the other hand.

17.  Standing side bend

Stretch your arms above your head and cross your fingers. Bend the upper torso to the left, then to the right.

When you feel fit enough, you can start with strengthening exercises.

Examples of strengthening exercises.

1.

12 – 15 repeats with each leg. Kneeling and with your hands on the floor, stretch one leg, lift it up and lower it back down.

A more difficult version:

10 repeats with each leg. Alternate your legs.

2.

10 stretches with each leg. Lie on your back. Bend one leg in your hip and knee at a 90°angle. Alternately stretch your legs without them touching the floor.

Make the exercise more difficult with lifting the upper part of your torso. Put your hands behind your head, and then reach with the opposite elbow towards the knee of the bent leg.

3.

6 repeats with each arm. From the starting position (as shown on the photo), lift from your forearms up to your hands, and then get back down to your forearms.

A more difficult version of this exercise is performed in the same way, however, the support is no longer on your knees, but on your toes.

Repeat 6 times with each arm (alternate the arm that starts the exercise).

4.

5 repeats with each leg. From the starting position, leaning on the floor with your hands and knees, bring one leg closer to the arms, then the other one. Get up to a straight position. Get back to the starting position in the opposite order of movements.

10 repeats – When your muscles get stronger, you can try a more difficult version of this exercise. Start in the position with your hands and toes leaning on the floor (plank on hands), jump forward to bring your feet towards your arms and get up (name of the exercise: burpee).

When you start feeling the effects of exercising, the feeling of available energy should increase. If you think you are able to do more, you can upgrade the exercises with an increased number of repetitions, faster performance, or additional exercises. Furthermore, you can start with more difficult strength trainings, weight trainings or start with other activities that we mentioned before, such as cycling, yoga, tai-chi, water exercises or swimming.

Vita Jeraj, kinesiologist

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