Hashimoto’s and Exercise Intolerance

Hashimoto's and Exercise Intolerance

Note: The text below is a transcription from the video above. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors.

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Hashimoto’s exercise intolerance or exercising too much. So this is a topic that I have to address quite frequently. One of the main reasons is to my right, and if I point this way about that far, there’s about 30 miles is Lake Tahoe, which is one of the biggest beautiful, most beautiful places on earth, and lots of crazy people are up there. Those crazy people are people who run triathlons and run and run, what do you call them? Just decathlons and every athalon that there is. And there’s people out there that swim across the lake, which is insane because it’s so cold. And I’m tongue in cheek because this is just beyond my comprehension that people could do that. But I get a lot of them, I get a lot of people that are up in there, and they have problems and they’re over-training.

I also have people at the other end of the spectrum. I have people at the other end of the spectrum that come in here and if I go through the triggers for autoimmune thyroid disease, and when I get to over-training, they roll their eyes at me like, “Dude, I can’t even walk across my living room. You have no problem with me over-training.” So just to cover the spectrum there, over-training is a trigger for autoimmune disease, not just Hashimoto’s, by the way. If you have any other autoimmune disease, if you have psoriasis, if you have rheumatoid arthritis, if you have celiac, if you have ulcerative colitis, this applies to you too. Over-training is bad.

Exercise is good. So when you exercise, you do a lot of good things. Honestly, between exercise and sleep and diet, you can do so much with a person. And most of my patients can’t sleep. Most of my patients can diet and unbelievably some of my patients over exercise. So what happens when you over exercise? So when you’re sick, when you have fibromyalgia or when you have chronic fatigue, and as most of my oxygenated patients have some form of that, you’re putting a huge demand on your system through the mechanism of primarily inflammation. For all of you out there who goes, “It’s all inflammation.” It is all inflammation, but what’s causing it? Okay, that’s the ticket and how do you attack it and what’s the order and all that type of stuff. But in the end, inflammation is the bad guy and inflammation covers your whole physiology.

And then depending on what parts of your physiology aren’t working well or are available to be more attacked, then you start getting symptoms of that. But it definitely affects the mitochondria in your cells. Inflammation affects the mitochondria in your cells. What are mitochondria? They are the little organelles that are little energy factories in your cells. For those of you who are chemical nerds or biochemical nerds, this is the citric acid cycle, or those of you are not, they’re little energy cells. They take your glucose, they take your thyroid hormones, they take your CoQ-10, they take all of these things and they make energy. So when you have them under an inflammatory response, you’re generally usually fatigued. But for sure when you get up and start doing things, you’re putting a demand on them, whether you’re sick or not, you’re putting a demand on your cells to create energy.

But if you’re not feeling well, if you have fatigue already, if you have immune inflammation, if you have bad gut and all these things, they’re not as strong because they’re struggling to make energy to keep you in homeostasis, to try to make you well. They’re losing the battle, but they’re trying, which means they only have so much energy if you start exceeding their capacity. So let’s go down to the lower end. That patient that I just said, said, “I can’t walk across the living room.” So my next question will be, okay, do you have good days and bad days? Most all of my patients do. And on your good days, do you start trying to do all the things that you couldn’t do on your bad days and then crash? And they sit there and they go, “Yeah.” Because that’s what you’re going to do.

You got to get those things done, right? You’re exceeding the capacity of your compromised mitochondria. Does that make sense? That’s what you’re doing. So basically you don’t have as much ability and for your cells to create energy when you start doing things. All right? Now, when you’re that sick, you still would benefit by getting up and doing things up to the point of where you would crash. You go to the other end, maybe I have a triathlete in here. They just got to cut it down. For them, it might be that they can’t do the bicycling and the swimming and the running. Maybe they can’t run a marathon, maybe they can go out and run 20 miles and not get sick. So there’s scales of parameters of scale there as far as what constitutes exercise.

A lot of my patients who say, “Well, I can’t exercise. I can’t exercise.” Exercise is good for you. It strengthens your immune system. It strengthens your adrenal glands. It helps to stabilize blood sugar. It stimulates your brain. It does a lot of good things until you do too much. And then it creates something called oxidative stress in your cells. That’s when you crash. That oxidative stress, think of the old cars that were made of metal sitting on the side of the road in one of the humid areas of the country, and they’re start rusting out. That’s what over exercising is doing to your brain while you’re crashing. I said, brain, all your cells, while crashing. Okay? So we don’t want that, especially if we’re trying to treat you and we’re trying to get you there.

It’s like two steps forward, and one and a half steps back. It’s a big trigger, okay? It’s a big trigger. So back to that person who can’t exercise. I’ll usually say, “Can you slap on a pair of shoes, sneakers, and just walk five minutes out from your house and five minutes back?” I can do that. I can do that. Then do that. Can you do 10 minutes? I can do that. Okay, then do that. Can you go 20 minutes? I can do that. Then do that. Can you go 25? No, if I go 25 minutes, I crash. Then 15 to 20 minutes, you should do 15, 20 minutes every day. You don’t have to go to the gym, you don’t have to do everything. You just need to get it going. So exercise, good. Too much exercise, crash and burn. Literally, crash, burn, oxidative stress, inflammation.
You start damaging more tissues. You flare up your immune response, you flare up cortisol. That causes damage to your brain, your gut, your cells. That causes your blood sugar to go up and down. That’s what too much exercise does in an autoimmune thyroid patient. And frankly, in most autoimmune patients. At the other spectrum, again, for that person, it might be, no, I can still go out and exercise, but if I run three miles, then the next day I’m really fatigued. So that person has to go down to one mile or whatever’s right for them. So it takes a little bit of maybe writing it down. Yesterday I felt terrible, so today I went out and I went grocery shopping, and then I went to this other store and then I did this, and then boom, I crashed. Okay, what did that entail? The next time I have a good day, I’m only going to do this and this instead of this, this, this, and this.

So that’s over-training, that’s over exercising, and it’s a significant, of the 40 some triggers for autoimmunity, it’s a big one. It’s actually probably in the top six triggers as far as its ability to increase antibodies to your thyroid and then create more of that response that for those of you who are looking, who are thyroid patients that may get anxiety and panic attacks for no reason at all, and get inward trembling and night sweats and insomnia, and those types of, maybe even hot flashes, night sweats, more than hot flashes.

But over training in you could cause those, can cause those. So I think that’s probably as much as, it’s a little bit more than the Cliff’s Notes and a little bit less than a weekend seminar on over-training. And if you just follow those parameters, if you’re aware of those, you’ll find out that you feel better longer, because that’s one piece of the puzzle that you’re not exacerbating your immune responses against your system.


  1. I am thrilled to find Dr. Rutherford acknowledging that being unable to exercise is a valid part of my Hashy. I used to be a very active person with lots of energy. I’m 64 and the last few years, I can barely get anything done – even normal housework. The other day I went outside to use the leaf blower (a mandatory activity) and I felt like I could barely make it back into my house after I was done – and I worked about an hour. Exhausted.

  2. Wow!!! So much to know, that I didn’t yet know…
    Thank you Dr. Rutherford for sharing this valuable information!
    I am entering my 5th year since having been diagnosed with HASHIMOTOS in 2018.
    It was 12 years before this, that I was diagnosed and treated for low-thyroid disease.
    I am super active and push my limits when home improving, yard work, designing landscape or anything I put my mind and hands to, I do it with everything in me. I will have to really focus on not pushing myself so hard now. I usually end up with low cortisol/adrenal fatigue after summer’s end. Living in Northern Indiana affords me a few months to dial it down, but then the holidays keep me going for part of those months so it’s only about 2 solid months of nothing. Unless I start a project indoors, which is the common thing for me to do Jan-March. This year not so much, too tired still. I have got to get back on track and this trigger is one I have not addressed nor was I really aware of. Over working is like breathing for me so it will be challenging to be mindful and intentional, but I will have to now after hearing this. Thank you again and be well, we need you!

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