Fatigue & Hashimotos: Should You Avoid Exercise?

Fatigue Disturbed Energy Field


Have you ever wondered HOW are you supposed to exercise when you’re so fatigued that you almost can’t get out of bed? The truth is that resting too much is a contributing factor to fatigue. We were made to move but when it comes to Hashimoto’s hypothyroidism, fatigue is often more than a small struggle. The truth is there’s no fatigue like “thyroid fatigue.”

However, this doesn’t mean that we do nothing while waiting for the day to arrive when, like magic, we have enough energy to get started. Movement is one of our primary physiological needs as a human and yet it is one that is often overlooked.

Fatigue Related to Thyroid Disease 

There are several potential underlying factors related to the type of fatigue experienced by people with Hashimoto’s hypothyroidism:

  • Vitamin and/or mineral deficiencies
  • Suboptimal adrenal function
  • Low iron levels
  • Steal infections:  Yersinia enterocolitica, Epstein Barr Virus (EBV), Helicobacter pylori, C, pneumoniae, Lyme disease
  • Hormone imbalance
  • Heavy metal toxicity
  • Blood sugar imbalance, metabolic syndrome
  • Mold
  • Insomnia
  • Muscle and joint pain
  • Food and chemical sensitivities
  • Secondary chronic inflammatory/autoimmune conditions
  • Too little / too much thyroid hormone replacement therapy, resulting in lab ranges that may be in the “normal” range but a aren’t optimal

Insights about exercise and moving the body from the perspective of the integrative functional health model:

  • Exercise and movement have positive effects on physical and mental health and are effective interventions to promote wellness and prevent illness.
  • Exercise and movement are the physical expressions of the whole person.
  • A person’s energy expenditure reflects patterns that are intertwined with his or her mind-body-spirit.
  • Exercise plays an integral role not only in disease prevention but also in health promotion and well-being.
  • Physical activity can release endorphins resulting in a sense of well-being and can elevate mood and promote a positive outlook.
  •  Exercise lowers the risk of chronic disease by exerting anti-inflammatory influences that prevent diabetes, cardiovascular disease, arthritis, osteoporosis, chronic obstructive pulmonary disease (COPD), several types of cancer, and premature death.
  •  Even light to moderate exercise improves immunity and protect against upper respiratory illness, the most prevalent infectious disease worldwide!

Exercise used to be viewed as something that was only for people who wanted to improve their appearance. It was thought to be something that had to be difficult to do, too challenging, and you also had to have the “right” clothes for exercise. There was also a time when exercise was competitive and people compared themselves to others. Also, the old view of exercise, in general, was that of a “compliance-focused system” which meant you had to comply with a certain regimen to benefit from it, and people exercised out of a sense of obligation and often with dreadful rigor.

Fortunately, the new paradigm for staying healthy and maintaining fitness now emphasizes more on enjoyment, engagement, and adherence. The goal today is to promote achieving your personal best, promote self-awareness, self-acceptance and uses the breath to energize and calm the body and mind throughout physical exercise.

There are many types of activities to choose from such as aerobic, nonaerobic, group classes and individual exercise. Today we recognize and value the cumulative effects of engaging in activity throughout the week instead of a “must do it every day, for a specific length of time” type of belief system.

The key to adherence is finding something you enjoy and look forward to. Here are a few of my personal favorite forms of exercise for women with Hashimoto’s:

  1. Water aerobics – this is excellent for women with Hashimoto’s whether you are just starting an exercise regimen or have been at it for a while. The water is healing, you get benefits no matter how light or rigorous your workout is, it’s a great social activity, and no one can see your body because you’re in the water! I remember feeling extremely self-conscious when I started exercising because of the way I looked. But then I realized, “who do I think I am that people are looking?” And, I got over myself. Wearing a towel over my swimsuit and dropping it next to the pool as I enter and exit the pool works just fine 🙂
    Seriously though, water aerobics is excellent for flexibility, muscle tone, improved sleep, energy, endurance, strength, and mood.
  2. Yoga – has been shown to improve glucose regulation, balance, flexibility, and stress reduction. It can also reduce mild to moderate depression, muscle pain, and fatigue. Anybody of any body size can do some form of yoga. The key is to not compete or imitate exactly what the next person or your instructor can do, but what YOUR body can do. Learning to modify a pose is something everyone who has done yoga for a long time would agree you must do. It’s what moves you along the path of progress. My favorite form of yoga is yin yoga and occasionally I’ll do a vinyasa class if I feel like it. Praise Moves is also FABULOUS.
  3. Strength training – this is a form on nonaerobic activity and I love to use flex bands and weights. Muscle strength is the contracting power of a muscle and the benefits are many. As you develop muscle strength, daily activities become less strenuous, strong and lower back muscles help prevent low back pain & problems, posture improves, postural stability and balance improve. If you fall you’re less likely to break a bone and you’re more likely to get up without assistance.
  4. Stretching – I used to do videos in the early 80s with produced by a lady named Jody Gregans (sp?) and I remember every day she said: “stretching is all you really need to do to stay in shape.” I’m not sure I believe that 100% now – but then it was all I needed to hear, lol. Flexibility is the ability to use a joint throughout its full range of motion and to maintain some degree of elasticity of major muscle groups. The benefits included increased resistance to muscle and joint injury, prevention of mild muscle soreness before and after activity, and it just feels good to stretch while deep breathing. 
    I also wanted to mention that as women age, we tend to get tight in our sacroiliac/hip area. As a younger woman, our hips naturally moved side-to-side as we walked. The loss of this movement happens subtly over time – so I encourage you to think about your hips when you’re walking and intentionally move them. You can also try belly-dancer figure eight movements when you wake up in the morning to encourage flexibility in the hips and low back. It if amazing for eliminating and preventing low back stress!
  5. Aerobic & Respiratory training – the heart is a muscle and with the lungs, these organ systems are responsible for maintaining blood and oxygen delivery 24/7 whether we are at rest or during exercise. How efficient would you think these systems are if they never get a workout? Not exercising at all is one of the main causes of fatigue. The benefits of cardio-respiratory endurance are increased resistance to heart and vascular diseases, improved ability to maintain activity levels (endurance), high-energy return from daily activities, and more. Walking is excellent, as is an elliptical machine. Just be sure to start slow, wear a heart rate monitor and make sure you’re stable enough health-wise to start any exercise program that gets your heart rate up.

At a minimum, try walking at least 10 minutes a day. It may seem counter-intuitive to walk when you feel tired, but physical activity actually increases your energy level for up to 2 hours. Walk the stairs at work, take a stroll on your lunch break – however you can squeeze it in, JUST DO IT. This will make a huge difference in your energy level as well as your overall sense of well-being.

If you’re not sure where or how to start, I recommend seeking the support of a trainer. I like to work with female trainers who are somewhat educated on the unique issues associated with autoimmune disease and women’s health. They are more likely going to understand the nuances of adrenal, thyroid, immune system, and hormone health and understand why you shouldn’t work out too hard. Quite simply, they’ll be more apt to listen to you and understand your unique concerns. You definitely don’t want a trainer who is going to work you too hard. This will not only be upsetting but it will set you up for failure.

Back in the days when I once fell into the “exercise more” mindset, I worked out with a trainer whose regimen was so hard that I would start bleeding soon after and would be confined to bed for the next couple of days. DON’T MAKE THIS SAME MISTAKE. – but don’t make the mistake of avoiding some sort of regular exercise.

If working with a trainer doesn’t appeal to you, perhaps a friend can join you as an accountability partner.

Safety Issues & Exercise

To reduce the risks associated with exercise, you must know not only how often and how long to exercise, but also how vigorously to exercise. Although the target pulse range allows for a heart rate within 60-80% of maximal capacity, the American Heart Association states that regular exercise of a moderate level, or from 50-75% of maximal capacity is sufficient. Maintaining the target pulse rate during exercise for 15 to 30 minutes 3 to 5 times per week reduces the risk of over-exertion, enhances enjoyment, and results in good cardiovascular fitness. Actually, the sweet spot for my cardio workout is 21 minutes and I have my music set up to align exactly with 21 minutes.

  • If you can talk but not sing while exercising, you’ve reached moderate intensity.
  • If you can only say a few words and then need to catch your breath while exercising, you’ve reached vigorous intensity.

Be sure to warm up for at least 5 to 10 minutes and cool down after exercising.

You should STOP exercising if any one of the following occurs:

  • Pain – exercise triggers something to hurt and is more than mild discomfort
  • Significant fatigue occurs
  • You feel dizzy or nauseous

To ease your heart rate into the training range, you should begin with 10 minutes of low-intensity, warm-up exercise. I do the hula-hoop or dance to music for a few minutes when at home or walk on a treadmill when at the gym. To cool down, do 10 minutes of the same activity but at a much slower pace.

Do you get enough exercise and movement? What’s your favorite activity or activities?
If you’re never getting any exercise and movement what’s holding you back?

Take some time to assess what the obstacle is.

Keep a journal and assess your fatigue level the day after exercise. If you’re exhausted, you may have over-exercised. This will serve as important information and help you gauge how much you should decrease exertion. Likewise, if you feel exhilarated the next day, you may consider upping your game slightly.

Always listen to your body and care for it as it’s the only place you have to live 🙂

Oh – and one more thing. Be sure to have a light snack (protein-fat-fiber) before exercise, otherwise, the activity may be too much stress for the adrenal glands and you don’t want that.

Read Next:

Hashimoto’s and Taking Care of Your Adrenals


Thyroid Fatigue Report

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