Saturday, August 31, 2013

Hypothyroid disease: What about exercise?

First the sobering news:  Since the thyroid gland controls our metabolism, producing too little thyroid hormone puts us at risk for exhaustion.  Hypothyroidism can also cause neuromuscular and musculoskeletal problems, including muscle weakness.  Likewise, when you have thyroid disease, levels of certain beneficial chemicals, such as lactic acid, can build up too much in your muscles, leading to pain. As is well known, hypothyroidism can lead to weight gain. It can also up heart disease risk factors, such as high blood pressure and high cholesterol, and it can even lead to balance problems in older women with hypothyroidism.  I don't know about you, but, even though I like exercise, I find these symptoms can drain my usual motivation.

Of course, when treated properly, many of these effects are reversed.  Even when treated, however, a patient may be left with a reduced exercise capacity. We might still carry extra weight that we gained before treatment. We might have lost conditioning before being diagnosed and treated.  We may still have some heart risk factors that need watching by our doctor.  Additionally, some people find that even with treatment, they still feel fatigued.  I'm no expert, but based on my own experience, I believe that the underlying causes of hypothyroid disease -- such as Hashimoto's -- can still cause effects even when the thyroid is being treated.

Well, enough of that.  Let's move on to the good stuff.  Even though we may not feel as much like exercising as we did before we became hypothyroid, the right quantity and the right quality of exercise can help us combat some of the symptoms of the disease.  Of course, you first need a doctor's ok, especially since hypothyroidism does affect our risk factors for heart disease.  Most likely, your physician will find that you are well enough to exercise and, what's more, he will probably rejoice that you want to exercise, as it can help reverse the heart risk factors.  You do need to be sure that you are cleared for exercise, though.

Once you have your doctor's ok, it's good to evaluate your level of conditioning before jumping into a new exercise routine.  Questions to consider are:  How long has it been since you last exercised?  Has it been a while?  If so, do you need to start slowly?  Or, are you already exercising regularly, but feeling discouraged that you can't make progress?  Do you find that your current exercise program is too much for you, and do you have days of exhaustion?  Do you take a rest day at least once a week?  Is your current exercise routine too light to help you progress or is your body ready for a change?

I find that exercises that have a stretching component are helpful for the issues surrounding muscle aches. I love mat Pilates. One benefit of Pilates is that it was developed as an exercise system and is based on a study of human anatomy. However, since Joseph Pilates drew up his original system, scientists have discovered new information about the spine and spinal health. Some Pilates teachers take this newer information into account and have adjusted their teaching styles accordingly, and I advocate this newer approach. Others teach classical Pilates just as Joeseph Pilates did. If you do your research, you can modify either the classical or newer mat Pilates exercises for your needs. This is especially essential if you have osteoporosis. There are many articles that have been written about how to practice Pilates safely if you have osteoporosis. In addition to Pilates, I also love dance based stretching programs.

What about yoga?  I am not a huge fan, though that is an individual decision, of course.  Yoga was developed as a part of Hindu worship and not as a system of exercise for fitness' sake. Contrary to our popular American idea, it wasn't intended for stress relief or for physical conditioning.  Thus, yoga postures aren't necessarily designed with the needs of our muscular-skeletal system in mind.  In fact, yoga can worsen back and joint problems, which is counter-productive for those of us with muscular-skeletal issues. Likewise, certain postures are hard on the neck and, in ultra-rare cases, have even been known to trigger stroke.  If you do love yoga, educate yourself so that you know which postures are generally safe and which to avoid or modify.

One book that I find to be a great help is "Stretching" by Suzanne Martin, who is a physical therapist. She provides stretches that are designed to improve posture and also to correct certain physical problems. It is grounded in exercise science.  As far as I can tell, it avoids any problems that results from too frequent forward flexion of the spine as is sometimes found in both Pilates and yoga.  A physical therapist could give a more definite opinion on that.

Exercise DVD's that I find helpful are Ann Smith's exercise videos (This Amazing Woman is in her eighties!) and Fhinis Yhung's Ballet Plus.  I find it helpful to do at least a little stretching, even on days when my energy is lower.

Cardio exercise is where some of the biggest payoffs are for a hypothyroid patient. Exercise that gets us moving will help raise our metabolisms, burn calories, and, perhaps, lower insulin levels, all of which are beneficial to the hypothyroid patient.

Can cardio exercise help get rid of any unwanted gain due to hypothyroidism?  Absolutely.  In fact, we who have thyroid issues may need the boost exercise gives us, for we are unlikely to lose weight through dieting alone.  On the other hand, we probably won't be able to lose weight via exercise alone, either, and we will have to restrict our calories in some way.  It will take a balanced program for us to see weight loss.  The key is not to get discouraged, but to be happy about any progress.

You might want to investigate the 10,000 steps a day walking program.  All you need for this is a pedometer and a supportive pair of shoes.  To take 10,000 steps a day, you will likely do some walking that qualifies as cardio and some slower steps that you work into your day's routine.  Researchers have found that people, such as the Amish, who take as much as 14,000 steps in the course of an average day are likely maintain a healthy weight without thinking about it.  Be sure not to jump straight to taking 10,000 steps a day if you aren't already used to that.  As with any exercise program, start slow and ramp up as your condition improves.  If that doesn't appeal to you, you can probably see great results by a regular walking program.

There is some thought that overdoing cardio exercise (or any form of exercise other than light stretching) can put too much stress on the system of someone with hypothyroidism.  Our bodies are less efficient at recovering from exercise.  Additionally, stress, even physical stress, can make symptoms flare. You might want to keep an exercise journal and record how you feel each week.  If you find yourself becoming more exhausted rather than more energized, tweak your exercise schedule and try again.  Be sure to allow yourself the rest time that you need.  You may need quite a bit of rest in the beginning if you have been out of condition.  If you do cardio exercise for awhile and find yourself consistently run down, ask the advice of an exercise expert who truly understands hypothyroid disease. 

Don't forget the benefits of healthy movement, such as gardening or housework.  If you've really become weak and out of condition due to being hypothyroid, adding 15 minutes here and 15 minutes there of any task that gets you moving can help you slowly improve your health and fitness level.

Strengthening muscles can also benefit someone who has lost muscle tone because of hypothyroid disease. This may or may not mean working with weights.  Healthy activity and exercises that depend on body weight can help you improve your fitness in this area.  Pilates and dance exercise also strengthen certain muscles, so if you do exercises like these you can combine the benefits of stretching and muscle building. Cross training will provide all three benefits: cardio, strength and stretching.

Consistency in exercise is an important issue for hypothyroid patients.  It's better to do lighter exercise consistently than to wear yourself into the ground with a program that's too aggressive for you.  Additionally, if you have other autoimmune problems or a vulnerable immune system, you might find that you will exercise for a while, only to have a bout when you either can't exercise or you must reduce your exercise for a time. It's important not to let a setback make you give up, but to try again.                        

Note:  Thyroid disease, either hyper or hypo, can affect your resting and exercise heart rates. If you have any questions about the best heart-rate range for your exercise, ask your doctor or a qualified trainer to help you set a goal that is right for you.

Happy exercise!

No comments:

Post a Comment