How to Exercise with Hashimoto’s


There is no question that exercise is a very important part of any healthy lifestyle. This is especially true if you have an autoimmune disease. However, when you exercise with Hashimoto’s you must be careful to do it properly or you can wind up doing more harm than good.

In this post we examine new research on exercise and look at the best type of exercise program for people with Hashimoto’s.

 Exercise with Hashimoto’s Has Many Health Benefits

Exercise has many health benefits and many of these are hugely important if you suffer from Hashimoto’s. In my last post, I mentioned a lecture I attended that was taught by Dr. Datis Kharrazian, here is some additional information I learned and how I think it applies to Hashimoto’s people. According to Dr. Kharrazian, the benefits of exercise include:

* Growth Hormone Release

* Opioid Response

* Nitric Oxide Synthase (eNOS) Responses

* Brain-Derived Neurotrophic Factor Release

* Insuline Receptor Sensitivity

* Immune Enhancement

Growth Hormone

Growth hormone stimulates cell reproduction and regeneration, and growth in our bodies. It also has a number of positive effects on our nervous, endocrine, and immune systems

A lot of growth hormone’s effects are felt in the liver where it can improve the burning of body fat, improve blood glucose levels and increase protein synthesis.

It also has important effects on the nervous system where it can improve synapses in the brain. It also improves heart function, immune function and decreases recovery time.

In addition, it has been found to increase calcium absorption and improve bone density.

Studies have shown that growth hormone release is increased with increased exercise intensity. (So walking on a treadmill and watching t.v. probably won’t result in much being released.)

Hypothyroidism can cause increases in body fat and alter lipid metabolism, and can lead to poorer absorption of calcium and protein. So these effects can be very beneficial for Hashimoto’s patients.

Opioid Response

Exercise has been found to release the body’s natural opioids called endorphins and enkephalins. This is commonly known as the “runner’s high” or that blissful feeling that you get after certain kinds of exercise and sports.

Endorphins have many positive effects including pain relief, stress reduction, and improving our moods. Exercise can also result in the release of more dopamine and serotonin both of which are responsible for happiness and satisfaction with life and relationships.

Studies have shown that moderately high to high intensity exercise stimulates the release of these natural proteins. It also seems to depend on the individual with some people needing to do more than others.

Hypothyroidism can lead to declines in dopamine and serotonin and to feelings of depression and overwhelm. Some of the most widely prescribed drugs for Hashimoto’s people are anti-depressants, so exercise can have huge benefits for these people, as well.

Nitric Oxide Synthase

Nitric Oxide Synthases (NOS) are enzymes that can do both good and bad things in the body. Increased eNOS (endothethelial NOS) increases blood flow which can get more blood to the brain, can improve heart health and can get more nutrients and oxygen to our bodies’ cells. This results in tissue repair and more energy.

Increased nNOS (neuronal NOS) causes more muscle contraction and brain focus which results in improved performance in various activities.

On the other hand, increased iNOS (inducible NOS) can result in a host of bad things like: surges in destructive immune cells called cytokines, damage to mitochondria and inflammation. Too much of this can lead to injury, muscle wasting and breakdown and pain.

(Arginine is an important nutrient for iNOS and should be avoided before exercise.)

NOS plays a key role in cardiovascular, immune and brain function. All things that can be compromised in Hashimoto’s people.

It seems that the right amount of exercise is key for getting the right amounts of the right kinds of NOS. Too little and you won’t get the benefits, too much and you get the damaging consequences mentioned above. One again, the key is high intensity, but not for too long.

Brain Derived Neurotrophic Factor (BDNF)

BDNF helps with nerve growth and differentiation in the brian. It is very important in building new nerve pathways and preserving and keeping healthy old ones. So it is critically important in maintaining a healthy brain and in slowing the destruction of nerves in the brain that can lead to dementia and Alzheimer’s.

Exercise increases levels of BDNF and also improves brain function. Once again (are you seeing a trend emerging?), the amount released is dependent on the intensity of the exercise.

Brain fog and neuro-degeneration are very common complaints from people with Hashimoto’s. This is caused by numerous things, but the underlying mechanism is inflammation caused by immune cells and the destruction of brain cells.

Insulin Receptor Sensitivity

Problems with insulin resistance are very common in today’s society and are a driving force in the initiation of Hashimoto’s. It can also prevent people from getting any better once they have developed the disease.

Insulin normally helps sugar get into cells, when people become insulin resistant because they are exposed to too much sugar, the cells of the body start blocking insulin because they can’t deal with so much sugar.

This person feels like she needs to nap after every meal, and may actually fall asleep after eating a carbohydrate rich meal. This person will also have belly fat and will complain of insomnia.

Insulin resistance can drag down thyroid function and contributes to diabetes, heart disease, sleep apnea, hormone problems, obesity and certain types of cancer.

Aerobic and strength-training exercises improve insulin sensitivity by increasing the number of protein molecules called glucose transporters (GLUT), which allow your cells to better respond to insulin.

Immune Enhancement

Hashimoto’s is an autoimmune disease. The immune system has short circuited and attacks the thyroid as if it were a foreign invader.

Exercise can be very beneficial for improving immune function. The right kind of exercise can be helpful in healing the gut and in improving gastrointestinal immunity. Since 70% of the immune system lives in the gut, this can be very beneficial.

But, excessive exercise can actually cause major problems with immune function. And if you have Hashimoto’s it is very important not to overtrain or you can wipe out all of the benefits and actually make many things worse.

What Kind of Exercise Is The Right Kind?

It is clear that exercise can be very beneficial for Hashimoto’s patients, but what is the right kind and the right amount?

According to research, the optimal exercise level to achieve all the health benefits described above is high intensity: when doing this you will:

* Break a sweat after 3-5 minutes

* Breathe deeply and rapidly

* Only talk in short phrases while you are doing this.

You want to go hard enough to achieve 70% or greater of your maximum heart rate. This can be calculated by this simple equation: 220 – your age in years = your maximum heart rate.

Fine Line Between Just Right and Too Much

There is a fine line between the right amount of exercise which can really improve health and too much which can actually cause more health problems.

The key point is this: The more intense the exercise, the greater the potential for health benefits that include everything mentioned above, but also the greater risk of doing too much and this results in the loss of all those benefits.

This is especially true if you suffer from an autoimmune disease like Hashimoto’s because you may not be able to exercise like a normal person and you may reach the threshold of maximum benefit sooner than people who do not have this condition.

Certain Factors Can Make You More Vulnerable to Overtraining

Dr. Kharrazian also noted that there are a number of things that can make exercise not work for you. If you have any of these conditions, you must be very careful not to overdo it when working out.

These conditions include:

* Pre-existing high or low cortisol levels

* Pre-existing systemic inflammation

* Pre-existing immune weakness

* Pre-existing intestinal permeability

* Pre-existing hormone imbalance

* Pre-existing nutrient deficiencies

* Pre-existing obesity

People who suffer from Hashimoto’s often have a majority of conditions from that list, which means they are very vulnerable to getting worse as the result of exercise.

How Do You Know If You are Doing Too Much?

There are a number of signs and symptoms that can help you identify if you are working out too much.

Performance Signs and Symptoms

If you have a hard time recovering from workouts, can’t complete your workouts, notice your performance is declining or that you have more injuries then you may be doing too much.

Psychological Signs and Symptoms

If you are exercising frequently and you notice a loss of motivation and enthusiasm, a loss of competitive drive, depression, irritability or aggression for minor reasons then you may be doing too much.

Physical Signs and Symptoms

If you are exercising regularly and you notice that you have a weakened immune system, a loss of libido, loss of menstrual cycle, decreased muscle strength or unexplained increases or decreases in weight then you may be over doing it.

The Best Workout: Maximum Results With Minimal Energy Expenditure

An article in the May-June issue of the American College of Sports Medicine’s Health & Fitness Journal offers an example of an optimal 7 minute workout that can be used as a starting point for Hashimoto’s patients and can be utilized to achieve all the health benefits without causing any of the negative effects of overtraining.

I really like this workout because it can help you achieve all the health benefits we have discussed in a very short time, it works on your entire body and it can be modified so that you can do more or less.

This entire workout can be done at home, in a hotel room or anywhere that has an open room and a chair. You don’t need to purchase any equipment and you can do it by yourself without having to hire a personal trainer or therapist.

The entire workout is 7 minutes and you can repeat the circuit up to 3 times. It consists of 12 different exercises each done at high intensity for 30 seconds.

For people with Hashimoto’s, I recommend starting with one cycle and seeing how you feel. For some, even a 7 minute workout will prove to be too much. If that is the case, cut the 30 second intervals in half.

If you are able to do all 12 exercises as suggested for 30 seconds then do one interval for one to 2 weeks (a minimum of 4 times per week). Repeat the entire sequence after 2 weeks and then add a third repetition after an additional 2 weeks. If pressed for time, you can simply do 1 round of 7 minutes.

When Is The Optimal Time to Exercise?

The optimal time to get most benefit is within 10 minutes after you wake up, before you have had breakfast. This is the perfect time to exercise because you can take advantage of your body’s natural cortisol surge and exercising before breakfast will also help you burn fat more efficiently and help reduce insulin resistance.

Nutritional Support Before and After You Workout

For my patients and myself, I recommend taking a drink that provides electrolytes (not Gatorade – which is loaded with sugar). Here’s a recipe for a simple Electrolyte Lemonade:

Electrolyte Lemonade:

3 organic lemons, peeled, but leave white pith intact

3 tablespoons coconut oil, olive oil or flax oil

1 organic pear, cored

1 tablespoon Celtic sea salt or Himalayan Salt

6 cups filtered water

Blend everything well in a Vitamixer, makes 1 pitcher

Drink 1 glass before your workout.

It is also recommended to support nitric oxide synthase production. The following nutrients and co-factors can do this: ATP, N-Acetyl L-Carnitine, Huperzine A, Alpha-GPC, Vinpocetine and Xanithol Nicotinate. This will help boost eNOS and nNos.

After the workout take something that will reduce inflammation and support the immune system like turmeric and/or resveratrol and another glass of electrolyte lemonade.

The 5 Elements of Thyroid Health System

Hashimoto’s is a complicated condition that can impact all the major systems of the body. In order to treat it effectively, you really need to adopt a lifestyle that supports you with the right kind of diet, exercise and supplement regimen to get you feeling your best and to slow or stop the destructive progress of the autoimmune disease.

Would like help in designing the right kind of diet, exercise and supplement regimen from someone who has worked with over 2,000 people with Hashimoto’s?

I offer a free 30 minute Hashimoto’s Healing Strategy Session. In it you can share where you are, where you want to be and I can give you some recommendations that will help right away.

Book your session now:


The Neuroendocrine Immunology of Exercise, Dr. Datis Kharrazian, 2013

Relationship between exercise intensity and growth hormone intensity, Journal of Applied Physiology. 1999 Aug.; 87(2):498-504

Opioids and Exercise. An Update. Sports Med. 1989 Feb;7(2):109-124

Effect of different intensities of exercise on endothelium-dependent vasodilation in humans: role of endothelium-dependent nitric oxide and oxidative stress. Circulation. 2003 Aug. 5; 108(5):530-535

The effect of acute exercise on serum brain-derived neurotrophic factor levels and cognitive function. Med Sci Sports Exerc. 2007 Apr;39(4):728-34

Intense physical training decreases circulating antioxidants and endothelium-dependent vasodilation in vivo. Atherosclerosis, 1999 Aug. 145(2);341-349

Life Food Recipe Book, Annie Padden Jubb and David Jubb, North Atlantic Books, 2003, page 186, Electrolyte Lemonade

About the Author Marc Ryan

Leave a Comment:

Beth says

This is a wonderful article! Thank you!

I love weight lifting (heavy weight lifting). It gives me a lot of energy. I also like walking…I find I have to take it easy here. I tried HIIT a few times and I had a hard time recovering.

Thank you for this information,

    Marc Ryan says

    Hi Beth,

    Thanks for your comment. Short bursts of high intensity seem to help the most.



Kimberley says

GREAT article – I was an avid Crossfitter with Hashimoto’s and never knew why I had such a hard and long time recovering vs. others. I get it now though I miss the positive side of the intense workouts especially the Olympic lifting. I’m focusing on healing and gentle exercise like walking and yoga now.
thanks for this article.

    Marc Ryan says

    Hi Kimberly,

    Thanks for your comment. You know, you can still do crossfit like workouts, but just do them them for short periods of time. I don’t know if you saw the workout mentioned in the article that I linked to. But it had what was essentially a full body (mellow by cross fit terms) workout that you do for 7 minutes. This way you get all the benefits of intense exercise but none of the diminishing returns of overdoing it.

    Best, Marc

Kimberly says

Thanks for the great article! Any tips for muscle weakness and running? I get so frustrated because I can’t seem to feel any stronger in my legs which means getting passed 3.5 mph is super hard. I would love to do a 5k, but have been really discouraged because of my inability to progress with my speed. I recover normally, but I really think it’s because my leg muscles refuse to work harder to begin with. I am definitely going to try the 7 minute workout you posted above! I used to play tennis and now I can’t even climb 3 flights of stairs without being really winded and needing a nap afterward…

    Marc Ryan says

    Hi Kimberly,

    Thanks for your question! With regard to muscle weakness. You must ensure that you are getting enough of the building blocks for muscle: protein, electrolytes, vitamins and minerals, etc. One common problem with Hashimoto’s is the tendency to have poor digestive function. Hypothyroidism can lead to lower stomach acid, and intestinal permeability and the breakdown of the intestinal lining. What all of this leads to is poor absorption of all the things that build muscle. So, if you want to improve muscle mass and strengthen muscle, work on your strengthening and healing digestive function.

    This is something I do with my patients. It is very important to understand that this is much more than just a thyroid problem.


Julia says

This is a wonderful article.

I am a Beach Body coach and am doing T25 and drinking shakeology. I workout in the evenings because I just cannot get myself to wake up at 4am to workout. I have managed to lose weight but I have noticed that my anger issues have returned. I am not certain if this is due to the workouts or my meds. I have had a really hard time losing weight and I still don’t know where else to head. I have two kids and I just want the energy that I used to have.

    Marc Ryan says

    Hi Julia,

    Thanks for reaching out! Fatigue is, of course, a major problem for many people with Hashimoto’s. The reality is that this is much more than simply a thyroid disorder. It is a multi-system disorder that requires a multi-system approach to healing. Thyroid meds and Shakeology while helpful, are probably not enough and are only dealing with part of the problem. I don’t know if you are ware of it, but I offer a free 30 minute Hashimoto’s Healing Discovery session. In it you can share where you are and where you want to be and I can share some resources that will be helpful right away. We can also discuss how I may be able to help. If that interests you, you can use the link in the right column of the home page to schedule a time.
    Best, Marc

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Michelle says

I had cervical fusion (C5,6,7) back in 2002 and live with chronic pain, along with fibromyalgia, but have just found out through my Holistic doctor that I DO NOT HAVE HYPOTHYROIDISM (diagnosed over 15 years ago and on synthroid) , but rather Hashimotos. I’m being treated with Acupuncture, supplements, diet restrictions of wheat/gluten for over 3 months. I was going to check out the Health & Wellness Center here in Roseville as they are medically approved and more than a regular gym; 5 years ago I was swimming every day and lost 40 pounds and I felt so good; but after reading this site, and now knowing I have this “Hashimotos Disease” am so afraid to do anything. I’ve looked at the article you referred to on HICT but have difficult time lifting arms, push-ups, etc., due to this neck issue. HELP!!!!!

    Marc Ryan says

    Hi Michelle,

    I think you have to tailor this to your unique set of circumstances. If you can’t do those exercises than you must make adjustments. However, you can still apply the same basic principles. That is high intensity for short duration. That is the key element to getting the best return on your exercise.


      Michelle says

      I usually dance in my own homej for about 10 minutes and then rest. It sounds as if I should “just listen to my body” as I have been doing. However, I have an appt. with this highly recommended gym because I need some guidance; I will just show them this article and hope for the best. I may be moving back to L.A. soon….are you still in Gardena or San Pedro or both?

      God Bless

        Marc Ryan says

        Hi Michelle,

        Yes, that’s right, always listen to your body. It’s ok to exercise for short amounts of time. My concern about the gym is that they might not get it and push you too hard. You really need to work within your limitations. A good 10 minutes might just be enough for you right now. Make sure when you show them the article that you also explain that you have an autoimmune disease and that doing too much, too hard can exacerbate your symptoms and really set you back. I am in Gardena now. We closed that office in San Pedro. Part of my own learning what I can do, I had to downsize.


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