Having played sport all my formative years and being a physical trainer instructor (PTI) in the defence force, I would have considered myself healthy, fit and full of adventurous energy, that was until my son was born (a prem weighing 900g at 26 weeks). Life as I knew it changed, suddenly I started developing insomnia and became very emotional about everything to the point that it took a toll on my personal relationships. I started complaining of fatigue, heart palpitations, and depression, joint and muscle pain, and put on heaps of weight. As I started to put weight on, I trained harder and longer.  I also noticed a difference in my exercise tolerance and was needing longer recovery periods between training. Thinking I had the baby blues and that it would all pass, I at first did nothing about it. In my final year of my PhD and after months of hearing “Gosh but you have put on a lot of weight”, “You need to watch your diet” and “You need to exercise more”, I paid a visit to my GP believing that maybe all I needed was an energy booster. I was diagnosed with hypothyroidism. By the time I was diagnosed, I was exhausted. Having hypothyroidism more than likely contributed to my lethargic condition, and I certainly was not listening to my body that was telling me to rest. 

Hypothyroidism is a condition in which the thyroid gland doesn't produce enough thyroid hormone. The thyroid gland is a butterfly-shaped endocrine gland that is in the lower front of the neck. The thyroid’s job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. The thyroid controls how your body's cells use energy from food, a process called metabolism. Among other things, your metabolism affects your body’s temperature, your heartbeat, and how well you burn calories. If you don't have enough thyroid hormone, your body processes slow down. That means your body makes less energy, and your metabolism becomes sluggish. Too little thyroid hormone can also mean too much LDL cholesterol, in your bloodstream. The thyroid hormone helps the liver break down the cholesterol circulating in your blood and stimulates other enzymes needed to get rid of the bad fat.

Hypothyroidism can be treated and maintained with a synthetic thyroid hormone that is taken orally every day to be affective. If left untreated, having low levels of thyroid hormones can reduce cardiac fitness. Those with hypothyroidism are also at a greater risk of ventricular arrhythmias, or a rapid heartbeat. In addition to medications, exercise also plays a key role in strengthening the cardiovascular system. On medication, and pushing myself to exercise I was still struggling with my energy and my reduced ability to exercise due to the fatigue I would experience after doing exercises. My joints and muscles would ache, my breathing was impaired, which led to short supplies of oxygen and light headedness. I was feeling very down and frustrated. Driven to overcome this hurdle and improve my health, I began to read and research into the pathology involved in my condition. Findings from research highlighted the main downside to hypothyroidism, in that during exercise there is a decrease of T3 availability at higher intensities (>70 % intensity) of training. Which means that training at higher intensities will cause you to have less energy and this is why some people crash when they train too hard. A lightbulb moment for me realising what I had been doing wrong, I was training at a higher intensity than my body could handle.  This meant that I would require a longer recovery time for my hormone levels to return to normal. By continuously training at higher intensities than I should have, I was also placing unnecessary stress on neurotransmitters such as glutamine, dopamine and 5-HTP, which in turn led to feelings of depression and chronic fatigue.  Another major effect that extreme exercise has on our bodies is an immediate increase in cortisol, the hormone that is released when the body is under stress. Chronically high levels of cortisol can increase your risk for a variety of health issues, such as sleep disturbances, digestive issues, depression, weight gain, and memory impairment. Excess cortisol also encourages fat gain, particularly around the abdomen. 

Whilst there is no question that exercise is a very important part of any healthy lifestyle, you must be careful to do it properly or you can wind up doing more harm than good. What's the best type of exercise for hypothyroidism you may ask? Research indicates that a programme of low-impact aerobic exercises and strength training is recommended to help regulate the body’s metabolism. The best types of exercise include a combination of both aerobic exercise and weight training. Aerobic training is recommended for around 30 minutes per day, 4 to 5 days a week. Weight training is highly recommended as it builds up muscle mass and keeps the basal metabolism active. Starting slow is crucial and as the symptoms begin to subside more vigorous activities can be undertaken. 

If fatigue is viewed as a major symptom it is recommended you use progressive relaxation training as treatment instead of exercise, at least until fatigue improves. Low-impact aerobics, such as, swimming, walking, and cycling, will get your heart rate up and your lungs going without putting too much pressure on your joints, which is important because joint pain is another common hypothyroidism symptom. A stationary bicycle and a low-impact elliptical machine are good machine choices for a low impact cardio workout.  Also, Pilates or gentle yoga can improve core muscles and ease the back and hip pain that can be associated with hypothyroidism. People with hypothyroidism can also benefit from strength training — exercises such as lunges, leg raises, and push-ups or those involving weight-training machines. Strength training builds muscle mass, and muscle burns more calories than fat, even when you're at rest. Building muscle can help counter possible weight gain from an underactive thyroid. Whilst I still battle with my weight, I am a lot fitter and happier now that I have found the right mix of exercises and levels of intensity that my body can cope with. To those who suffer with hypothyroidism never give up it does help to keep active, choose your exercise wisely and listen to your body.