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Can working out help an underactive thyroid?

Micele C. Hollow By | January 13, 2020
Medically reviewed by Anis Rehman, MD

If you have hypothyroidism, heading to the gym is probably the last thing you feel like doing. When that little butterfly-shaped gland in your neck malfunctions, it makes you feel tired, causes joint aches, and affects your muscles. It’s not exactly a recipe for crushing your fitness goals.

On top of all that, an underactive thyroid slows your body’s metabolism, which means it’s likely you’re gaining weight, but just don’t have the energy to work out. In short: hypothyroidism and exercise don’t seem like a natural combination. But, when your condition is well-controlled with medication, exercise can help you feel better.

Can exercise cure hypothyroidism?

No, exercise won’t make your thyroid produce more thyroid hormone, or reverse the condition. 

Changing one’s exercise plan or diet won’t affect the course of an autoimmune disease, says Marie Bellantoni, MD, who specializes in endocrinology, diabetes, and metabolism at Mercy Medical Center in Baltimore. She’s quick to tell her patients, “If someone knew what caused an autoimmune disease or how to selectively control the immune system, that person would be collecting their Nobel Prize in medicine.”

RELATED: Hypothyroidism treatment

Treating hypothyroidism with medication

The appropriate treatment is the medication that replaces the hormone your body doesn’t produce.

“We treat hypothyroidism with synthetic thyroid hormone medication,” says David Bleich, MD, professor and chief of endocrinology, diabetes, and metabolism at Rutgers New Jersey Medical School in Newark, New Jersey. “It’s simple, safe, and effective and you need to work with your doctor to find the right dose.” 

When treated properly, medication can improve symptoms of hypothyroidism, including: low energy, fatigue, dry skin, thinning hair, weight gain, elevated cholesterol, depression or mood changes, aches and stiffness in joints, muscle weakness, irregular or heavier than normal periods, infertility, increased sensitivity to cold, constipation, slowed heart rate, impaired memory, hoarseness, or having an enlarged thyroid gland.

Foods to avoid with thyroid medication

People with hypothyroidism usually take thyroid hormone replacement medications daily for the rest of their lives. It’s best to take the pill on an empty stomach. Dr. Bellantoni recommends 30 minutes before or four hours after a meal and at least two to four hours apart from any iron or calcium containing supplements. “That way your body will be better able to absorb the medication,” she says.

That’s because some foods can interfere with the absorption of your thyroid medication. The two that people commonly avoid are soy and iodine-rich foods. A study, however, shows either no adverse effects or only very modest changes in effectiveness.

“Nothing bad will happen to you if you forget and take your meds and supplements at the same time,” explains Dr. Bellantoni. “But that day you may only absorb between 60% and 70% of the levothyroxine pill.” This explains why people will have lower thyroid levels despite taking their thyroid medication. 

RELATED: 5 things that can mess with thyroid medication

Hypothyroidism and exercise

Daily medication is the only way to return your thyroid levels to normal. Yet, exercise can have beneficial effects for people with hypothyroidism—and help fight negative effects of certain symptoms, such as weight gain, depression, stiffness, joint aches, and muscle weakness. 

“The most important thing that one can do for hypothyroidism is to follow-up with your doctor and make sure that you’re placed on the right dose of thyroid medication, but the next step on your list of things to do should be exercise,” says Yasmin Akhunji, MD, a thyroid specialist with Paloma Health. “Regular exercise is a vital part in managing hypothyroid symptoms.”

When you have an underactive thyroid, committing to an exercise routine can help to:

1. Improve energy levels. 

One of the first symptoms people notice about hypothyroidism is tiredness, or low energy. The condition can make you feel sluggish. Medication can help alleviate that. In addition, some research shows that low impact exercise can reduce fatigue. Just be sure not to push yourself too hard. It’s important to start slow, and gradually increase your activity levels so you don’t overdo it and end up exhausted.

2. Lose excess pounds.

Weight gain is an unfortunate side effect of low thyroid. It slows your body’s metabolism, which makes it hard to lose weight—even when you eat right. “Exercise burns calories and can improve weight gain which can counter sluggish metabolisms,” explains Dr. Akhunji. 

3. Build muscle mass.

Hypothyroidism can breakdown muscles, and cause muscle cramps or weakness. When you’ve got your condition under control, it’s time to build them back up—with strength training. Lifting weights or using your body weight as resistance strengthens your body. “This will help you build muscle mass. Muscle burns more calories than fat, and this benefit continues on even during rest,” says Dr. Akhunji.  That can help weight loss along, too. 

4. Ease joint pain.

Joint pain is an unfortunate side effect of hypothyroidism. Low impact exercises, like swimming, tai chi, or yoga, can help ease that painful feeling. When you build muscle with exercise, it lifts some of the stress on your joints, making movement less painful.

5. Relieve symptoms of depression.

Depression can go hand-in-hand with hypothyroidism. Exercise is a natural remedy for low moods. Studies show that 45 minutes of moderate intensity aerobic exercise, three times a week has a significant effect on mood. “Workouts also increase your body’s release of endorphins, which are known to enhance mood,” says Dr. Akhunji.

Once your condition is under control (with medication), you’ll have more energy to tackle a workout regimen. 

What type of exercise is best?

Choose an activity you enjoy. It can include walking, hiking, running, swimming, or working out in a gym. “A program of low impact aerobics exercise and strength training is probably the best type of exercise for hypothyroidism,” explains Dr. Akhunji. “Low impact aerobics can increase heart rate without putting too much exertion on your joints. A recumbent bike, elliptical machine, or even just walking is great choices for cardio workouts.Yoga and Pilates also can improve core muscle strength and help ease some back and hip pain.” 

Try to stick to your fitness plan for 30 to 60 minutes three times a week, and combine that with healthy eating. “As always I recommend starting slowly and building up as you progress—always talk to your doctor about what is safe for you,” says Dr. Akhunji. “Remember, if you injure yourself early, you’re much less likely to stick to your routine. Progression, not perfection should be the goal.”

Exercise won’t change your thyroid. However, with a regular fitness program, you’re likely to have more energy, be more agile, and feel happier.