Bottom Line/Health: Everyone thinks that exercise is good no matter what, and that any movement is good movement. But you and I were talking; the truth of the matter is, if you have Hashimoto’s disease, you could actually be exercising wrong. Can you explain that?

Dr. Brooke Kalanick, ND: There’s a couple of things to think about with all autoimmune diseases, but particularly with Hashimoto’s because you’ve also got a thyroid condition. What you’re really after is lean metabolic mass. Many women are just not strength training – and I don’t mean with like a 5-pound weight. We’re talking doing some squats, getting under some weight, deadlifts – of course, at your fitness level and, hopefully, with some coaching. Bigger movements like that with heavier weights, it’s not the thing most women gravitate towards.

So the goal is getting more lean mass with larger muscle groups involved through full body exercise. A good template is doing that three times a week. But moving towards a point here you’re using heavier weights is very important for your metabolism. Leave the lighter stuff and leave the excessive cardio behind and trade that for some weights if you want to get a jump on the fat loss.

Now, that said, if someone is strength training with Hashimoto’s and with a thyroid condition and they’re doing a lot of high repetition – so let’s say their trainer or their workout routine has got them doing 20 of something with a light weight – people with thyroid conditions have a really hard time recovering; their metabolism just does not respond and does not recover as fast. So those constant repetitions, they get really bad tendonitis. You’ll see almost everyone with Hashimoto’s has a shoulder problem or Achilles tendonitis. This high repetition, high volume strength training can really exacerbate that for them.

Then the other thing is overtraining. When you’ve got someone with Hashimoto’s, you’ve got a lot of inflammation and they have a really difficult time recovering from anything. I’ve got patients that can’t walk more than 20 minutes or they spend two days in bed, or I’ve got someone maybe training for a powerlifting competition. So these are very unique situations, and you’ve got to just build yourself up.

If you’re someone with Hashimoto’s trying to get more exercise and you’re falling apart, dial it back. Rather than dialing back the frequency – so let’s say you’re committed to going three times a week – just dial back the time or the intensity a little bit, and get yourself to a place where you can recover from those workouts before you start adding more on.

Bottom Line: Define recovery for me. What is it that needs to recover? I always understand I sprint and then my heart needs to recover and come back to baseline. With regard to Hashimoto’s, what is it that you’re looking for the body to recover from?

Dr. Kalanick: Some soreness is normal from strength training and exercising, but what I’m talking about when I say recovery is that next day when you feel just wiped out. Someone may have gone for a 30-minute strength training session or someone else may have just gone for a 40-minute walk, and the next day they can barely get out of bed or they’re really, really dreading just the thought of working out again. That’s how you know that you’re overtraining and you’re not getting adequate recovery.

So look for how fatigued you are, how achy, how swollen, how difficult it is to get up and get going the next day, and then how much dread you have about the next workout session.

Bottom Line: When it comes to Hashimoto’s, they may not be able to go as long as they used to or as intense as they used to, so they need to dial it back and then get increased weight in that time, because you can’t do as many reps?

Dr. Kalanick: Yeah, you want to stay away from the higher reps and go towards heavier weights. But again, you’ve got to work yourself into that. So just gauge yourself, and if your trainer or your particular regimen is that you work out five days a week and you’re falling apart after two days, you know you have to take down the volume or the intensity. Just listen to your body.

Bottom Line: All right. Thank you, Dr. Brooke.