Tag: Thyroid beginner series | Page 7 | Shop Thyroid Support Supplements for Hypothyroidism, Hashimoto's & Hyperthyroidism
is synthroid gluten free?

Is Synthroid Gluten-Free?

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Are you actively trying to avoid gluten-containing foods? Do you also have hypothyroidism? If so, then this article is perfect for you.  I’m going to jump the gun and tell you that Synthroid is indeed gluten-free, but it may contain other ingredients that can cause issues.  We are going to discuss the gluten content of …

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does taking thyroid medication cause high blood pressure

Does Taking Thyroid Medication Cause High Blood Pressure (Hypertension)?

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Thyroid hormone absolutely does impact both your blood pressure and heart rate.  But what are you supposed to do if you feel good on your thyroid medication but you still have high blood pressure? How can you manage high blood pressure on medications like Cytomel, liothyronine, or Armour thyroid (which are actually amazing for thyroid …

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Thyroid Cyst: Treatment, Testing, Causes & More

Thyroid Cyst: Treatment, Testing, Causes & More

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Most thyroid cysts are completely benign and nothing to worry or stress over.  But some cysts may contain cancerous cells that require more aggressive treatment.  This guide will teach you everything you need to know about thyroid cysts including symptoms, management, and how to determine if your cyst is cancerous or not.  What is a …

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TRH and TSH How they Impact Thyroid Function & More

TRH and TSH: How they Impact Thyroid Function & More

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TRH is an important hormone produced by your brain which regulates thyroid function in your body.  But most doctors aren’t ordering this important lab test! In addition, certain problems can result in reduced levels of TRH which may manifest as hypothyroid symptoms.  Learn more about TRH including what it does, how it works, what causes …

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Is it safe to exercise when you have thyroid problems_

Is it Safe to Exercise When you have Thyroid Problems?

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Is it dangerous to exercise if you have thyroid disease?

How much is “too much” exercise?

Will exercise help you lose weight or will it hurt your metabolism?

All of these questions and more will be answered in this post which is all about exercise and thyroid problems. 

You will learn the best types of exercises, how much you should be exercising, and the best way to lose weight

Let’s jump in: 

Understanding Metabolism, Exercise, and Caloric Burn

We really can’t have a discussion about exercise without at least touching on the idea of metabolism. 

The term metabolism is often used when referring to the number of calories that your body burns throughout the day. 

It’s also commonly referred to as resting energy expenditure (REE) and resting metabolic rate (RMR) (1).

And it is your metabolism that accounts for the largest number of calories that you burn each and every day (not how much you exercise!). 

Your metabolism is responsible for around 50 to 90% of the total amount of calories that you burn (2) each day. 

Your body uses this much energy because it must keep you alive by beating your heart, helping you think, helping to digest your food, and so on. 

These things MUST happen every single day and they are very energy intensive (meaning it requires a lot of energy). 

So if around 70% (I’m taking an average between 50 and 90% here) of the calories you burn each day is from your metabolism, what accounts for the other 30%?

That other 30% really depends on your activity level and it can change from day to day (3) (which alters your appetite!). 

Activities such as stress, extra walking, going shopping, doing chores around the house and so on all require more energy, and these factors account for the other 30%. 

It may be helpful to look at a 2,000-calorie-per-day example to drive this information home. 

Let’s assume that you burn 2,000 calories per day (on average). 

Using the figures above we know that about 70% of the calories that you burn each day will be from your metabolism. 

This accounts for around 1,400 calories per day. 

Around 50-60% of your metabolism is controlled by your thyroid (4)!

Just keep this information in the back of your head, we will come back to it later. 

The remaining 30% of the calories that you burn comes from other sources and your activity level which accounts for 600 calories per day. 

So, when most people want to lose weight they think they can burn more calories simply by increasing the amount that they exercise (5).

But let’s consider another example here. 

What if your thyroid is sub-optimal and you aren’t being treated appropriately?

If your thyroid is responsible for around 50% of your metabolism and your thyroid is not functioning well that means you may be losing out on an extra 400 calories per day from a damaged metabolism!

It may be far easier to simply address your thyroid problem to help increase the number of calories you burn by an extra 400 per day because trying to burn an extra 400 calories per day would take a significant amount of time through exercise

Does that mean you should avoid exercise?

Not by a long shot!

But it does mean you may want to ensure that your thyroid is working properly before you jump into serious workout routines. 

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Should you Exercise if you have Thyroid Issues?

It may sound like I’m discounting the benefit of exercise and I don’t want that to be the case. 

Exercise is critical to living a long and healthy life (6).

It’s also incredibly helpful if you have thyroid disease and can help manage your hormones. 

So the answer to the question as to whether or not you should exercise is a definite YES. 

But what you need to understand is the amount and type of exercise that you use will vary from individual to individual

It also means that there isn’t one single “best” exercise routine that you HAVE to do. 

Exercising is beneficial to your body (and your thyroid) because it can help improve your metabolism

It does this by increasing the activity and size of your muscles. 

And it takes a considerable amount of calories to keep your muscles happy and active (7).

Increasing muscle mass will help you improve the overall amount of calories that you burn in that 70% portion. 

In addition, exercising also has the benefit of increasing the number of calories that you burn day to day. 

This will help increase the number of calories that you burn in the 30% portion. 

Another point worth mentioning has to do with your goal when you exercise.

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If you are like most people you probably only consider exercising as a means to manage your weight.

And this is the wrong way to look at it. 

You want to exercise because it will help your body manage your hormones, manage the flow of calories, and which tissues utilize those calories as a way to improve your muscle mass

Many of these things may help with weight loss, but that shouldn’t be your goal! 

As you exercise more and more, you may notice that your muscle mass increases accordingly. 

This increase in muscle mass is often associated with a decrease in fat mass (this is a good thing) but it may keep your weight “neutral” or the same. 

And this is NOT a bad thing. 

Your goal when losing weight should be to lose fat mass, and that’s exactly what exercise will do. 

Exercise and the Stress it Causes to Your Body (And your Adrenals)

One of the questions I get asked from people on this blog has to do with adrenal function and exercise. 

Many patients with hypothyroidism also happen to suffer from the symptoms associated with “adrenal fatigue” and many of these patients also have abnormal or sub-optimal serum cortisol levels

If you fall into this category is it still safe to exercise?

You have to consider that exercise is a stressful event for your body (8).

The whole goal of exercising is to break down the body slightly while allowing it enough time to heal so it grows back stronger than it was before. 

When you keep this in mind it’s easy to understand that true exercise is not something that you want to do every single day. 

If you do not allow your body sufficient time to heal then your exercise may just be adding more and more stress to your body (this is a bad thing!). 

This element of stress can compound other sources of stress such as lack of sleep, a poor diet, social stressors, and more. 

The net result?

More stress to your body and the worsening of your symptoms such as fatigue, weight gain, crashes in the midday, and more

This means, contrary to popular belief, that doing spin classes for 1 hour each day may not be the best way for you to lose weight and feel better!

So what are you supposed to do? 

You should aim to match the intensity of your exercise routine to your personalized energy level. 

By matching the intensity of your workouts to your energy level you can stay within the “optimal” range of exercise without risking damage to other hormones. 

As you match your intensity to your energy level you will find that your energy level IMPROVES, your fatigue REDUCES and you start to feel better overall. 

I will go over how to match this in a bit but first I want to focus on the types of exercises that you can (and should) be doing. 

Is there a “Best” Type of Exercise if you have Thyroid Problems?

There isn’t a single “best” type of exercise for your thyroid. 

There also isn’t an exercise that will improve your thyroid function!

But, there are several types of exercises that would be considered “approved” and helpful if you have a thyroid problem. 

In general, you want to look at two basic types of exercises:

#1. High-intensity interval training.

Exercises that fit into this category include:

  • Circuit training (body weight)
  • Circuit training (9) (weight training with resistance)
  • Cycling
  • Strength training
  • Virtually any exercise can provide this benefit if taken to the extreme

#2. And low-intensity exercise.

Exercises that fit into this category include:

  • Yoga
  • Pilates
  • Walking
  • Swimming
  • Household chores

How Often Should you Exercise? 

Most people probably know the various types of exercises available to them, but they struggle when it comes to frequency. 

Meaning, how often should you be exercising?

How often should you do high-intensity interval training and/or low-intensity training?

The answer is actually quite simple:

You’ll know if you are exercising at a sufficient rate if you feel energized after you exercise

Exercising should lift you up, it should increase your energy, and should make you feel good. 

If you are exercising and you find that you are wiped out for several days afterward then that is a sign that you are over-exercising! 

You will want to avoid this behavior as much as possible because it can lead to more metabolic damage in the long run. 

If you are new to thyroid-related issues and you want to get started then the goal should be to start low and slow. 

Starting with high-intensity exercise for 15 minutes 1-2x per week is usually a safe bet

As you progress, and as you listen to your body, you can increase both the duration and frequency with which you exercise. 

Something like 15-20 minutes of high-intensity interval training 2-3x per week usually works very well for most people

This can be supplemented with daily low-intensity activities. 

As you determine which exercises you should be doing it’s worth pointing out that you should put preference on those types of exercises that help to build muscle mass in your body. 

The more muscle mass you have the higher your metabolism will be. 

You can do this by focusing on the major muscle groups in your body:

  • Chest
  • Legs
  • Back
  • Shoulders/arms

Focusing on these muscle groups will give you the biggest “bang for your buck” so to speak. 

If you focus on weight training just make sure that you do not exercise muscle groups that are already sore from previous exercise regimens. 

Adding Intermittent Fasting & Sauna to Your Exercise Routine 

Lastly, you can also supplement your exercise routine with a couple of other therapies which have the capacity to enhance your results. 

It may be tempting to take pre-workout boosters, thermogenics,s or caffeine-laced supplements but do your best to avoid these supplements if you have thyroid issues

They can actually make your fatigue worse in the long run by putting excess stress on your body as you exercise. 

As you avoid these therapies you can also consider adding some others. 

Specifically sauna therapy and/or intermittent fasting

You can add sauna therapy to the end of your workout session which will act to increase your body temperature (10), help you sweat and detox and improve circulation (11) to your muscles. 

Intermittent fasting will help you burn more calories and impact your hormones (especially insulin and leptin) if combined with exercise (particularly HIIT). 

As always, proceed with caution if you have never tried these therapies before. 

They certainly have the ability to improve your results but they also may cause side effects if you aren’t sure how much your body can manage. 

Conclusion

Exercising with thyroid issues is an important and complex topic!

Exercising can help benefit your body, help with your weight, manage your metabolism, and more. 

But in order to get these benefits, your exercise routine must be targeted to your body. 

You can do this by listening to your body. 

If you aren’t sure where to start you may find benefit in looking for a functionally minded health coach to help guide you along the way. 

Now I want to hear from you:

Are you struggling with exercise as a thyroid patient?

Have you been able to realize any benefits from your workout routine?

What workouts have helped you? Which have not?

Leave your comments or questions below! 

#1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3424457/

#2. https://www.ncbi.nlm.nih.gov/books/NBK218769/

#3. https://www.ncbi.nlm.nih.gov/pubmed/21178922

#4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4044302/

#5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639963/

#6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395188/

#7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3661116/

#8. https://www.ncbi.nlm.nih.gov/pubmed/18787373

#9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562558/

#10. https://www.ncbi.nlm.nih.gov/pubmed/3218894

#11. https://www.ncbi.nlm.nih.gov/pubmed/1837250

the best exercises for thyroid problems
can hypothyroidism be cured (1)

Can Hypothyroidism Be Cured Permanently? 3 Treatments Which Help

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Almost everyone with hypothyroidism will wonder at some point in time whether or not their condition is curable.  What do I mean by curable? I mean that the condition can be treated to the point that it completely disappears and you are back to normal.  Can this actually happen? The short answer is maybe.  The …

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T4 basics: the test, the medication, the hormone

T4 Thyroid Basics: The Test, The Medication, The Hormone

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This is video #3 in my thyroid beginner series and today it’s all about T4. 

T4 is essential in understanding your thyroid because it’s actually 3 different things in one. 

T4 is a prescription medication, a hormone that your body produces naturally, and a test that you can order. 

Learn the differences, what they mean and how they can help you manage your thyroid: 

What is T4?

T4 is the most abundant thyroid hormone that your body produces naturally (assuming it’s working properly). 

It’s also known as Thyroxine which is the “official” or scientific name. 

If you hear someone refer to thyroxine just realize that they are referring to T4 and vice versa. 

So what’s the big deal with T4?

T4 is important in understanding your thyroid because it’s involved in the thyroid feedback system. 

T4 thyroid hormone molecular structure

T4 is produced by the thyroid gland after the gland is stimulated by TSH from the pituitary

T4 then circulates through the body where it is converted (on demand) by your cells into the active T3 thyroid hormone. 

If you have low circulating T4 then you will have low circulating T3 and this will cause the symptoms of hypothyroidism!

Let’s dive into the various definitions of T4 and how understanding what they mean can help you as a patient…

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T4 the Hormone

As I mentioned previously, T4 is the most abundant thyroid hormone in your body. 

Your thyroid produces two major thyroid hormones: T4 and T3

About 80% of the thyroid hormone that your thyroid produces is T4 or Thyroxine. (1)

This leaves around 20% left as T3 (the primary active thyroid hormone). (2)

But why does your body produces so much T4 relative to T3?

The reason is most likely related to the control of the thyroid system. 

For instance:

T4, by itself, is not an active thyroid hormone. (3)

It must be activated, by enzymes, into the active T3 thyroid hormone. (4)

So your thyroid spits out some amount of constant T3 (directly from the thyroid gland) and then converts the rest of T3 that it needs from the abundance of T4 in the bloodstream. 

This way it can control how much thyroid hormone your cells need based on the demands that YOU put on your body. 

I think it’s most helpful to consider the analogy of a dam. 

In this analogy the dam is thyroid conversion (T4 to T3 conversion), T4 is the water behind the dam, and T3 is the water that is allowed through the dam

By setting up this system your body can titrate and carefully control thyroid function. 

And this makes sense, considering how important your thyroid is to your entire body! 

T4 the Test

But what about T4 as a test?

It should come as no surprise that we can test the amount of T4 that your body produces naturally (or the amount that you take by medication) through the blood. 

Doctors can do this by ordering what is known as a “free T4” test. 

High free T4 and low TSH in hashimoto's

This test is incredibly important in understanding how your thyroid is functioning because it is THE primary hormone that your gland produces. 

In many cases, I believe that the T4 (and T3) hold more value than the TSH when evaluating thyroid function. 

You can read more about how and why TSH can fall short as a predictor of thyroid function in thyroid beginner series #2 here

But what does T4 tell you when you measure it?

Several very important things:

#1. It gives you an idea as to how your thyroid gland is functioning. 

Your thyroid gland is stimulated by the pro-hormone TSH. 

This hormone tells your thyroid gland to produce both T4 and T3. 

If you test for T4 and find that it is low then it can tell you how responsive your thyroid gland is to TSH. 

The normal hypothyroid lab pattern is usually a high TSH accompanied by a low free T4

And this makes sense if you think about it:

If your thyroid can’t produce T4 then it responds by increasing the amount of TSH to try and overstimulate the gland to produce more hormone. 

But if your thyroid can’t produce thyroid hormone because it is damaged then the TSH will remain raised and your T4 will remain low. 

This is the “standard” pattern that most patients who have hypothyroidism or Hashimoto’s present with. 

#2. It gives you an idea as to how well your body is converting T4 into T3. 

We’ve already discussed how important T3 is for thyroid function in your body. 

And testing for Free T4 can help you identify issues with this conversion process. 

How does it help?

You can test both Free T4 and Free T3 and look at the ratio between the two of these hormones. 

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Your T4 should be in a “healthy” range (usually the top 50% of the reference range) and your T3 should be in about the same range. 

If you have issues with T4 to T3 conversion you may see your T4 increase while your T3 decrease. 

In cases where your body isn’t able to produce thyroid hormone, you may see both the T4 and the T3 low. 

But both situations may be a clue that your body isn’t converting as well as it should. 

#3. It gives you an idea if you are absorbing or utilizing thyroid medication that you are taking by mouth. 

T4 can, and should, be tested when you are taking thyroid medication by mouth. 

It goes without saying, but in order for your body to actually “use” thyroid hormone that you take by mouth, it must be absorbed by your body. 

There are several factors, including the time of day that you take thyroid medication, (5) that can impact the rate at which you absorb thyroid medication. 

You can easily determine if you are absorbing thyroid medication by checking Free T4 before you start medication and 8 weeks afterward. 

You should see your Free T4 increase as you take thyroid medication and you should see your TSH drop. 

If these things don’t happen then you may need to consider that you are not adequately absorbing your medication. 

Other factors such as supplements, calcium, (6) and food intake can all impact how well you absorb thyroid medication (and this is why it’s generally recommended that you take thyroid hormone on an empty stomach). 

You can learn other tips and tricks to help maximize thyroid hormone absorption here

T4 the Medication

T4 is also the most commonly used thyroid medication. 

Prescription thyroid medications, especially those used by conventional doctors, contain T4 thyroid hormone. 

Medications that fit into this list include Synthroid, levothyroxine, Tirosint, and Levoxyl. 

These medications contain ONLY T4 or Thyroxine and should be compared to other medications which contain either combinations of T4 and T3 or just T3 alone. 

T4 has become the most commonly used thyroid medication over the last 30 years or so (7) because it is felt to be the most “consistent” thyroid medication and because it has the longest half-life (which means it stays in your bloodstream the longest). 

But it should always be remembered that your body naturally produces both T4 and T3 and that replacing only T4 may be part of the reason that so many patients remain symptomatic despite taking thyroid medication. 

Doctors only use T4 because they assume that your body will have no issue in converting T4 into T3. 

But this logic doesn’t take into account that each person converts T4 into T3 at a different rate and that we aren’t all equal in that regard. 

The problem with T4-only medications is that newer studies have shown that many people who use T4 have a lower than normal T3 (8) (the active thyroid hormone) even though they have a normal TSH. 

This approach to thyroid hormone replacement may be part of the reason that so many patients remain symptomatic despite having a “normal TSH”. 

It should also be noted that you can safely use T3/T4 thyroid medications without negative side effects provided they are used appropriately. 

Conclusion

That concludes our discussion on T4 basics!

Just remember that while T4 is an important thyroid hormone for your body, it is not as powerful as T3 thyroid hormone. 

But it still has value in terms of testing and using T4-only thyroid medication. 

Some people are able to use T4 thyroid medication and feel great while others may need some T3 to feel optimal. 

If you have thyroid problems make sure that you can differentiate between T4 the test, T4 the hormone, and T4 the medication

Now I want to hear from you:

Have you had your T4 tested? Was it low or normal?

Are you taking T4 medication? Is it working for you?

Why or why not?

Leave your comments below! 

#1. https://www.ncbi.nlm.nih.gov/pubmed/12915350

#2. https://www.ncbi.nlm.nih.gov/pubmed/12915350

#3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699302/

#4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673746/

#5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4650787/

#6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3092723/

#7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4980994/

#8. https://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-125064

what you need to know about t4 thyroid hormone
Thyroid Deiodinase How D1, D2 & D3 Enzymes Alter Your Thyroid

Thyroid Deiodinase: How D1, D2 & D3 Enzymes Alter Your Thyroid

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Thyroid deiodinase enzymes serve to manage thyroid hormones at every level of metabolism.  Even more important is the fact that these enzymes can become dysregulated by everyday common medical conditions.  Understanding the importance of these enzymes is critical to understanding how to further treatment, especially if you are taking thyroid medication such as levothyroxine or …

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Thyroid Surgery What to Expect After the Procedure

Thyroid Surgery: FAQ & What to Expect After the Procedure

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No one wants surgery but sometimes it’s necessary.  This post will walk you through everything you need to know as a patient about thyroid surgery.  You’ll learn what conditions it is recommended to treat, the complications of the surgery, why some people gain weight afterward, and what you can do to prevent this side effect: …

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Can medications cause thyroid problems

List of Prescription Medications That Cause Thyroid Problems

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It’s estimated that at least 70% of Americans take at least one prescription medication and that up to 20% of Americans take five or more medications (1). We know, if you read this blog, that up to 15% of patients in the United States also take thyroid hormone (2) (a prescription medication) for thyroid disease.  When …

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