Can Exercise Help Manage Hashimoto’s Disease Symptoms?

Hashimoto's disease is a common condition. It can affect as many as ten million individuals¹ in the United States alone.

What is Hashimoto's disease?

Hashimoto's disease, also referred to as Hashimoto's thyroiditis, is an autoimmune disorder that involves chronic inflammation of your thyroid. Your thyroid gland's ability to create hormones can become impaired over time, leading to a slow decline in function and, eventually, hypothyroidism (underactive thyroid).

Hashimoto's thyroiditis can be seen in individuals of any age, but it often affects middle-aged women².

Causes and risk factors

Causes

The reasons why some individuals develop Hashimoto's thyroiditis are not fully known, but thyroid disease does commonly run in families³. Various factors can play a role, such as viruses like hepatitis C⁴.

Other factors can cause hypothyroidism, such as:

• Iodine-containing medications to treat irregular heart rhythm

• Certain medications to treat mental health problems like bipolar disorder

• Exposure to toxins, such as nuclear radiation

Risk factors

Around 10% of women over 30 years old¹ have Hashimoto's disease. This condition affects women up to ten times more⁵ than it does men. If another family member has Hashimoto's thyroiditis, it increases your risk.

Your risk also increases if you have another autoimmune disorder⁵, such as:

• Lupus, which is a long-term (chronic) condition that impacts various body parts

• Celiac disease, a type of digestive disorder that can damage your small intestine

• Type 1 diabetes, which is a condition that occurs when your blood sugar (blood glucose) is too high

• Rheumatoid arthritis, which is a condition that affects your joints

Symptoms of Hashimoto's disease

There are no symptoms or signs that are unique to Hashimoto's disease. Since the disease typically progresses over many years, people with this condition may not experience any early symptoms, even when blood tests detect the distinguishing thyroid peroxidase (TPO) antibodies. Thyroid peroxidase is an enzyme that contributes to thyroid hormone production.

If Hashimoto's thyroiditis leads to cell damage that results in low thyroid levels, you may eventually end up developing symptoms of hypothyroidism, such as:

• Muscle aches

• Weight gain

• Fatigue

• Increased cold sensitivity

• Constipation

• Depression

• Dry skin

• Reduced tolerance to exercise

• Heavy or irregular menstruation

Sometimes, the inflammation will cause a goiter (enlarged thyroid), which can cause trouble swallowing or neck discomfort.

Diagnosing Hashimoto's disease

A Hashimoto's thyroiditis diagnosis may be made if you have hypothyroidism symptoms, particularly when accompanied by:

• a goiter verified by physical examination, and 

• elevated blood levels of thyroid stimulating hormone (TSH) with or without decreases in thyroxine hormone (T4) levels.

Complications

If Hashimoto's thyroiditis is left untreated, it can lead to complications, including:

Heart issues

This condition can cause high LDL cholesterol which contributes to heart failure, coronary artery disease, and other forms of heart disease⁶.

Mental health problems

This disease increases your risk of depression⁷ and can slow your mental function.

Goiter

This condition can cause the growth of a large goiter, which can interfere with breathing and/or swallowing.

Premature birth, miscarriage, and stillbirth

These conditions have been linked to untreated conditions of the thyroid⁸, such as hypothyroidism. Often women who are having trouble becoming pregnant aren’t aware they have this condition.

Myxedema

This is a severe complication related to hypothyroidism that some people with untreated Hashimoto's disease can develop. It's a life-threatening but rare complication of hypothyroidism.

Hashimoto's disease prognosis

With an accurate diagnosis and treatment, Hashimoto's-related hypothyroidism can be managed with medication, and exercise and diet can help you stay as healthy as possible. However, there aren’t many studies on the impact of exercise on Hashimoto’s disease.

Can exercise help with Hashimoto's disease?

While exercise can't substitute for thyroid replacement medicine, it may help with hypothyroidism symptom management and enhance your health in the long term.

What are the benefits?

Exercise may have positive effects on thyroid function⁹. Hashimoto’s disease may decrease your ability to exercise, especially when compared to hypothyroidism from other causes, but thyroxine hormone replacement therapy may help rectify that.

However, it is worth noting that some people may remain intolerant to exercise even after such treatment¹⁰. Once your thyroid gland is working normally again, exercise can enhance thyroid function and improve your physical and mental state. It may even help you lower your dose of thyroxine in replacement therapy.

One study¹¹ showed a significant reduction in issues like constipation, fatigue, and weight loss following an hour a day of yoga for three months.

Incorporating yoga into your regular exercise routine may help improve your thyroid function symptoms, but keep in mind that this is not a cure for your condition.

Other benefits include:

Improved energy levels

You may often experience fatigue if you have hypothyroidism or an underactive thyroid. However, routine workouts will help tackle your tiredness.

Improved mood

Depression commonly occurs¹² with thyroid disorders, particularly hypothyroidism. Physical activity helps stimulate your endorphins ("feel good" hormones).

Boosted metabolism

With hypothyroidism, your metabolism drops and causes you to gain weight. This will likely be one of the first signs you'll experience. You can use exercise as another tool, combined with your thyroid medication, to support your metabolism and give it a boost by gaining muscle and burning calories.

What type of exercise is best for Hashimoto's disease?

If you manage your condition well, you should be able to exercise in the same way as anyone without a thyroid disorder.

But, if you're just beginning to exercise or if you're experiencing symptoms, low to moderate-intensity strength training and low-impact aerobic exercise moves are best.

Low-impact aerobics won't create too much pressure on your joints and muscles, which is important, since hypothyroidism can lead to swelling and pain.

Here are a few activities you can try:

Water aerobics

If you're experiencing swelling in your feet or ankles, certain types of exercise can be painful. Water aerobics may be a good option in these cases. The water will hold you up and lessen the impact you experience on your joints.

Walking

Walking is an easy workout, which only requires you to have a comfortable pair of shoes. Plus, it gets your heart pumping and burns calories.

Yoga

This helps strengthen and stretch your muscles and helps you focus on your breathing. A study¹³ found individuals with hypothyroidism who practiced yoga breathing for six months had better lung strength.

Tai chi

This is a slow-motion type of martial art described as "moving meditation." It helps reduce stress and improve:

• Mood

• Balance

• Strength

Strength training

Whether you're using your body weight or lifting weights, you can burn more calories and shed extra pounds by burning muscles, even when you sit still. Having strong muscles can also help ease joint pressure.

What to bear in mind with exercise for Hashimoto’s disease

While exercising can help you manage your symptoms like weight gain, fatigue, and joint pain, there are precautions you still must take, including:

• Starting slowly, particularly if you're experiencing new symptoms or you're new to exercise

• Listening to your body

• Not overdoing it

• Engaging in low-impact or non-impact exercises

Also, always speak with your doctor before you try any new exercise program. If you're new to exercise, your doctor will assess any potential problems that may make it difficult to exercise or that will place you at risk for injury. They'll also look for any underlying disorders.

You'll also want to work closely with your doctor to determine the right dose of thyroid hormone medicine you should be taking before you begin an exercise routine.

If your dose of thyroid medication is too high, you can experience a very high heart rate while performing moderate-to-intense exercise. You can find general target age-based heart rate guidelines by checking the American Heart Association website.

The lowdown

It can feel like you're in a vicious cycle when you're living with Hashimoto's disease with hypothyroidism. The disease can cause achy joints, fatigue, and weight gain. Weight gain can also cause fatigue and achy joints, which can make it more difficult to exercise.

With Hashimoto's thyroiditis, you may have times where you lack energy, making it challenging to get up and start moving. But, since exercise can help manage your symptoms, regularly exercising plays an essential role in your Hashimoto's disease and hypothyroidism management plan.

While doctors and physical therapists agree there's not a single exercise regimen that's perfect for everyone, they do agree it's important for individuals with hypothyroidism to get regular exercise.

Exercising regularly doesn't just help manage symptoms of the disease, but it boosts your metabolism. Not to mention, you can still reap all the benefits of exercise without having to run a marathon. Low-impact exercise has many benefits too. Just remember to start slowly and don't push yourself too hard.