I Have A Hormone Imbalance & Thyroid Issue. Here's What My Exercise Routine Looks Like
My sluggish thyroid and crazy inflammation symptoms from my Hashimoto’s disease created a vicious cycle. I was gaining weight, and my body desperately needed movement to stay healthy, yet I had an aching, inflamed body and no energy or desire to exercise. And as a personal trainer, nutrition coach, and wellness lifestyle blogger, I was—ironically—left not knowing how to create a training program for myself.
Every time I would try doing what I used to do in the gym, it would sideline me for days, and I’d frustratingly gain more weight the more I tried to push myself. And so, I set out to find the best exercise protocols for someone like me. Unfortunately, I was dismayed to find that the only advice on the internet was to do gentle, low-impact exercise. As a former competitive figure-skater who loves to deadlift twice her body weight and is a kettlebell maniac, I didn’t love this prognosis. I set off to dig deep into researching how to control inflammation through the combination of food, exercise, and recovery. I wanted to understand everything there was to know about the effects of exercise on our endocrine system and which variables I could manipulate while training to achieve the desired effects for my body’s new needs.
My training philosophy had always been, "Train smarter, not harder," but I had to take this concept to a whole new level. I had a lot of ego that needed to be checked. Even for non-athletes, there is still a prevalent mindset of thinking that you don’t get anywhere if you’re not horrendously sore or depleted by the end of a workout; yet for those of us dealing with autoimmune (AI) or hormonal issues, that thinking can be totally counterintuitive.
So what do you do if you love to stay fit but are struggling with chronic inflammation and hormone issues? You'll be happy to know that you can absolutely still train hard. In fact, intensity is a key variable that can be used to your advantage. It's all about learning how to utilize it and building up to that point.
When it comes to working out, inflammation (which causes fatigue, poor recovery, and soreness) and endocrine (hormonal) regulation (which creates cortisol spikes, insulin resistance, and poor recovery) are going to be your two most important factors to manage. So while there's no one-size-fits-all when it comes to exercise, the following five pillars will be helpful when approaching exercise with autoimmune and/or hormonal issues:
1. Be consistent and flexible.
This is the most important pillar of all: Be consistent with how much physical activity you’re getting every single day. Whether it be a long walk, yoga, or strength training, it’s just important that you’re moving your body and breaking a little sweat each day to engage your sympathetic nervous system. Short, moderate-intensity exercise is proven1 to stimulate your immune system to produce an anti-inflammatory cellular response. Consistent exercise will also help manage insulin resistance2 (especially for those with PCOS and diabetes) and sleep quality,3 leading to improved systematic recovery and decreased inflammation.
2. Warm up and cool down properly.
This is one of the simplest and most effective alterations you can make to your workout, yet it's one of the most underutilized. When it comes to warming up, think of your body as a car during the wintertime—you turn on the engine and let it warm up for a few minutes before you take it for a drive. It’s important to do the same with your body; warming up helps increase your heart rate, core body temperature, and blood flow along with engaging your neuromuscular and nervous systems to be able to execute movements more safely and effectively. This is especially important for those of us with AI and hormonal issues, as inflammation and fatigue can make us extra prone to injury when just jumping into things cold. When your thyroid hormones (T3 and T4) are sluggish, you’re at a higher risk for soft tissue injuries4 (think tendinitis, sprains, strains). For those with certain AI diseases like Hashimoto’s, your body temperature can also run a bit lower, making it difficult to break a proper sweat, which is important for your body’s natural detoxification processes in your liver.
When it comes to cooling down, you want to be triggering your parasympathetic nervous system to be jump-starting recovery. Much of the effectiveness of your workout can be helped by proper recovery, and by stretching properly, self-myofascial release (most commonly done through foam rolling), and slowing things down. By engaging in a proper cool-down, you’re also able to decrease your cortisol levels that were spiked (in a good way) during your workout.
3. Be mindful of duration and intensity.
Exercise is absolutely amazing for the body, but do you know what it also is? Stress. And even though it's a good kind of stress, it still triggers spikes in cortisol and stokes your sympathetic nervous system. This is why many autoimmune warriors and those with hormonal issues such as PCOS, endometriosis, adrenal fatigue, and thyroid issues will find success when they shorten the duration and volume of their workouts and focus on lower-impact exercise. I always tell my clients, keep things "short and sweet." In other words: Keep your workouts anywhere from 20 to 40 minutes rather than dragging it out for an hour. Focus on the intensity of your exercises rather than volume (think heavier weights or increased difficulty rather than a million reps), and lower impact on your joints and ligaments (running and plyometrics are higher impact in this regard).
4. Progress steadily.
It all depends on where your starting point is. When I was experiencing the height of my symptoms just before getting diagnosed, there was no way I could engage in the types of exercise I do now. Practicing patience isn’t easy—especially when you’re used to being able to throw down in a gym—but it's of utmost importance to respect where you currently are so that you can get where you want to be. If you push yourself too hard and strain yourself, it can absolutely trigger an autoimmune flare, which just sets you back. So take it slow and steady, and you’ll be rewarded in the long run.
5. Listen to your body.
Look out for signs of fatigue, slow recovery from a workout like extended soreness and no energy, lightheadedness, difficulty sleeping, feeling wired but not energetic, and joint aches. You’ll know that you’ve pushed too hard. At first, you may have to stick to more restorative and lower-intensity exercises like walking, gentler yoga, and bodyweight training, but the more consistent you are with exercising every day and focusing on proper nutrition and recovery, the more you will be able to progress to higher-intensity activities. For me, a sweet spot now tends to be three days per week of higher-intensity strength training and then two or three days of yoga, walking, SMR, and stretching. It took me some time to build up to this—I had little desire or energy to do kettlebell circuits or anything of higher intensity in the beginning—but once I checked my ego and focused on gentler exercise for a while, my body told me it was ready because I couldn’t wait to get back to my weights and intervals, and I actually had the energy to do so.
6. Prioritize recovery.
Proper recovery is pretty much nonnegotiable when you have an autoimmune disease or hormonal imbalances. Stress management, sleep, nutrition, and supporting your body’s natural detoxification systems are all key. The better you are with your recovery, the more you will be able to push yourself during exercise, and vice versa. So if you're going through a particularly stressful time in your life and not sleeping very much, you may need to take your foot off the gas pedal until you are able to find balance. If you are getting seven to eight hours per night, nailing it with your nutrition, it should give you more license to go for more intense, strenuous exercise.
Find out how to prevent a hormonal imbalance here.
A jill of all trades, Minna Lee is a personal trainer, nutrition coach, wellness lifestyle blogger behind Living Minnaly, and founder of Live 24k. She holds a B.A. from New York University. A former competitive figure-skater, she tried the office life before reconnecting to her athletic roots and affirming her calling: coaching people to live fuller, healthier lives. This passion deepened after hip surgery and an autoimmune disease diagnosis at 24 years old, and she became determined to use her experiences to help others. You'll find Lee running around NYC, adopting too many plant babies, and trying not to steal other people's dogs. Follow along with her adventures @livingminnaly.