S2 E31 What is the Best Exercise for Hashimoto’s?

Excessive fatigue and weight gain are the most typical symptoms of Hashimoto’s. Is it true that we should only do gentle movement exercises if we have Hashimoto’s? Dr. Kiberd and I will answer the following questions:
Is it OK to push myself?
Is it true that HIIT exercise and running are bad for Hashimoto’s?
Should you stay away from excessive cardio if you have Hashimoto’s?
What is the best exercise to lose weight with Hashimoto’s?
I get extremely fatigued after exercise. How to optimize energy?

And many more, so tune into today’s episode.

Dr. Emily Kiberd’s contract info HERE

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Nataliia: Dr. Kiberd, thank you so much for joining Thyroid Hair Loss Connection podcast. We’re so excited to have you here. 

Emily: Thanks so much for having me. 

Nataliia: We’ve never had a chiropractor on this podcast, so we are excited to hear your take on exercise and Hashimotos. What is your 

Emily: perspective? So most patients, when they see a practitioner, they’re experiencing sitting across from them, reviewing lab work. Going over supplements, going over a game plan and seeing someone in, maybe three to six months.

I look at the autoimmune population, specifically women with Hashimotos through the lens of how are they moving, what’s not moving enough? What’s moving too much how are they stabilizing? How’s their core strength and how is their muscle tone? And just overall, Full body strength. If women don’t know this, joint pain and muscle aches is a common symptom of Hashimotos and.

Part of that is from, if they’re hypothyroid, not enough thyroid hormone reaching the receptors in the muscle tissue. But, and the other thing that happens is we have lower muscle tone being hypothyroid, so it is just harder to keep muscle on the bone if we’re hypothyroid or with Hashimotos.

And so I help women get strong. Keep muscle on the bone. When we have more muscle, we have more energy. We born more calories at rest, and I really try to frame. Having an autoimmune condition. Obviously there’s a functional medicine and naturopathic piece, but through the lens of how do we feed our muscle appropriately to maintain our muscle mass?

Cuz I think you know, the big two biggest struggles with Hashimotos are fatigue and difficulty losing weight, and especially the weight loss piece. It usually comes from a place of deprivation, caloric restriction, stepping on the scale every day and like being a little disappointed. And, weight loss typically if you do it right, about a quarter of weight loss is a loss of muscle tissue if you don’t do it right, like you’re just putting yourself in a caloric deficit and not maintaining your muscle tissue with protein and resistance training you could lose even more muscle tissue if you’re just putting yourself in a caloric deficit.

So I try to really reframe the conversation, especially around weight loss and fatigue, right? Because the more muscle tissue we have, the more mitochondria we have, and the more energy we’ll have through this lens of the muscle. And instead of thinking, oh, I need to lose weight, or I’m too fat, or I need to lose the fat tissue, reframing it through this lens of we need to feed our muscle tissue more.

Like our, we don’t have enough muscle tissue. So that is my approach, which I usually co-treat with functional medicine docs because they don’t know the exercise piece and sometimes the, their exercise recommendations aren’t that great. So 

Nataliia: yes, it makes complete sense. And I love how you. Reframe everything.

Instead of losing weight, like losing fat. Let’s feed our muscles, right? Let’s grow our muscle cells. And it’s interesting that we are having this podcast episode, we’re talking about Hashimotos, which is an autoimmune condition and exercise. Why? Because you never hear headlines like, best exercise for celiac disease, which is another autoimmune condition, right?

But yeah, there’s no such thing. So why are we talking about Hashimotos and exercise? And you partially said that. Yes, it’s a muscle. Loss, fatigue and everything else. What else is out there that is so special about 

Emily: Hashimotos? Other than the hypothyroid piece of maintaining muscle mass, and I think from a practitioner level if you’re seeing people with bilateral joint pain, so I used to see this a lot, like people who have bilateral knee pain, so pain in both knees or.

Quote, unquote overuse injury that kind of moves around the body and there was no clear mechanism of injury. For years, I would just treat what I saw. I was like, okay, bilateral knee pain, let’s strengthen the quads. Let’s get muscle. Any muscle imbalances worked out, imbalanced, and people would get, a certain percent better, but, Only so far.

And there’s even research out there around practitioners considering hypothyroidism if patients have bilateral joint pain or have overuse injuries that are not resolving over kind of a normal course of duration. So when we think of Hashimotos there are these things called mykines that get released from the muscle tissue and.

Sometimes the message is confusing because you’ll hear this message that exercise causes inflammation as and is inflammatory. And then you’ll hear the message that exercise is anti-inflammatory. And you’re like that’s confusing. Which one is it? Especially if I have Hashimotos, which I do. I’m currently in remission, but I have Hashimotos.

I was diagnosed in 2016. Low-grade inflammation. Now do I wanna add more inflammation, more inflammatory load through exercise. But then I hear that exercise is anti-inflammatory as well. It’s actually both. And the reason is because when we contract a muscle, it releases proteins called mykines and Mykines help regulate our hormones and our immune system. And when when we exercise one of the mykines, interleukin six i l six is considered inflammatory. It’s an inflammatory cytokine that the immune system uses, and when I l six is released from the muscle, it’s actually anti-inflammatory because I l six stimulates another interleukin called i L 10, which when.

It comes from the muscle tissue is anti-inflammatory. So I think the message is very confusing around exercise for the autoimmune population. From the conventional medicine angle, it’s, you’re diagnosed with Hashimotos, here’s some meds. I’ll see you in a year. You wanna lose weight, move more, eat less.

Everyone’s okay, I’ll try that. I tried that. I had a coffee and croissant in the morning, didn’t eat all day. I was seeing patients, which is like a very physically active profession. And then at night I’d have a little bit of steak and a little bit of broccoli, and I’d try to go do like a 90 minute spin class, and I couldn’t lose the weight at that time.

Changed how is training? And so that’s one end of the spectrum is this conventional medicine messaging. And then I think on the other end, for functional medicine, maybe even naturopathic doctors who are. Also considering, okay, how is a patient’s adrenal health? Are there, is there a system overburdened with toxic load, environmental toxins, mold, parasites, underlying gut infections, right?

More holistic approach, which I love, but sometimes the message is don’t do too much. Take a walk, do low impact exercise, do some yoga, maybe chair yoga, do some Pilates, and I think. That applies to a certain population. Maybe someone who does not have their thyroid hormones managed, does not have their inflammatory load.

They’re not working on that piece yet. But I think for the long term that recommendation is not enough because none of those things maintain your muscle tissue or feed your muscle tissue in a way, especially if you’re hypothyroid and you already have a hard time keeping your muscle tissue on.

It’s not enough. And I think there’s if you think of those two ends of the spectrum, there’s kind of this Goldilocks middle ground where you can lift a weight, you could do it heavier. Do less reps you’re still getting the benefits of the burn. And we could talk about that as what is fatigue when you lift a weight?

And then you could take a nice long rest break, which for people who are like professional listeners, they take two to three minute breaks between sets, sometimes five. If you go to a traditional workout class, that doesn’t happen. You don’t take a break till 50 minutes in when the class is over and.

Doing that three days a week and maybe your workout is 20 to 30 minutes and then you maybe start to work up to longer. It doesn’t have to look like this two hour workout that I think, or one hour at the gym that some of us think about. And so I think when you reframe this idea that. If you stimulated your muscle tissue appropriately, not too little, not too much, that you could get tremendous benefits from an immune system repair perspective, from, burning fat, building muscle and potentially regulating your hormones.

And so when you start to frame it around that versus, oh, I need to lose fat. I’m too fat. It’s such a healthier, it’s less depriving and more of a nourishing mindset. 

Nataliia: You made so many great points and we know that one of the main benefits of physical activity is that it lowers inflammation.

And like just, you just said that it stabilizes the immune system or function and we know that Hashimotos, it is an autoimmune disease, right? So we have to address our immune system and we know that physical activities regulates our T-cells. You touched on that. And we know that T-cells are crucial for dampening the inflammation and.

Our clients, I’m sure people come to you and they’re so concentrating on lowering their T p O antibodies, but what most people don’t realize is that the TPO O antibodies number doesn’t indicate the severity of your disease, your T-cell activity does. Now it’s almost impossible to measure T-cell activities via just a normal blood test.

It has to be very specialized. It’s expensive, so we just don’t do that. But yes, exercise is one of the best ways to regulate those T-cells activity. And that’s where it comes this stabilization of immune system. And of course, you touched up on some hormones. We know that exercise. Has positive effects on thyroid health.

Now, it’s a little different with Hashimotos because if you are at the end stage of Hashimotos when your thyroid gland is completely destroyed, there’s not much you can do exercise wise to improve your thyroid gland function. But a lot of people are still either at first stage through the third stage of thyroid disease and exercise can have a positive effect on the actual gland.

Of course we know how exercise helps depression, right? Physical activity helps. Stimulate endorphins. Those are our the feel good hormones. And of course, we know that a lot of people with Hashimotos have insulin resistance and exercise can increase insulin sensitivity, which is a good thing.

It means that your body becomes more efficient at using insulin to transport glucose from. Blood cells or from bloodstream into the cells. And this effect can last for several hours after exercise, and only if you do. Something more than just a walk or a gentle movement. So we’re gonna have to address that, that walking and yoga is great, but man, it does not last long in your body as far as improving insulin resistance.

And that’s the same goes with glucose utilization. If your blood sugar is running high or you have type one or type two diabetes, it’s recommended that you go for a walk 20 minutes after your meal. That’s your glucose utilization. That’s your you decreasing glucose circulation in your body.

And then what we, or what most people don’t talk about is how. Exercise improves glycogen storage cuz regular exercise help improve the storage of glucose in your muscles, in the form of glycogen. When your body stores more glycogen, it can effectively remove access glucose from the bloodstream, not only contributing to better glucose control, but also losing weight.

Yeah. And that’s a big one. And we don’t want to concentrate on, oh, let’s exercise for weight loss. But this is a nice side effect that a lot of our patients with Hashimoto’s needs, because they all, most of them have unintentional weight gain that Hashimotos is driving like a driving force, right?

Yes, it affects everything. All the ho, almost all the hormones. And we can spend a whole podcast episode talking about what it affects, right? So let’s talk about this gentle movement exercise, that yoga is great, right? But it doesn’t last long in your body. So what is the best exercise for somebody with Hashimotos?

Emily: Yeah, I love resistance training, which is, picking up a weight, amazing form, putting it down and doing it again, I think. Some of the older research, especially around muscle hypertrophy, was that you had to hit eight to 12 reps. Newer research talks about hitting that perceived exertion or fatigue, on a scale of zero to 10 by the last couple reps you wanted to be in, seven to eight outta 10.

So you’re feeling a burn. The other way to think about it is by the last couple reps, Do you have two more in the tank? If you’re like, actually I could do 10 more or I could do five more, then you haven’t hit that fatigue that is needed to stimulate that muscle tissue. So you want some heat, you want some burn, you don’t want it.

The kind of fatigue that I think we culturally think about, which is like a hot, sweaty mess and laying on the floor, you’re like, oh, I got such a good workout. I think it’s More of this rate of perceived exertion. So in the training world, we call it R P E, and doing that three times a week minimum would be a great kind of cadence to work up to.

About only 20% of women engage in resistance training two times a week. So there is not a lot of weightlifting going on in the world right now. 

Nataliia: They don’t want to look like a man. 

Emily: Yeah. So I know a lot of people worry about like the bulk, and I think the two things that I always bring up is we don’t have the testosterone to bulk.

It’s actually very challenging to bulk up, even when you’re trying bulking requires an increase in calories. And it’s actually really challenging. Like it, it take, you have to eat a lot of protein. And I think the other thing, if someone does feel like they’re bulking up is to get honest about the conversation.

Is it adipose tissue on top of your muscle tissue that’s making you look bulky? Maybe that is a different conversation versus is it just muscle tissue? So really looking at body composition versus. Bulk. I personally I don’t see any downside in trying to have, as as much muscle tissue as you can.

But I can understand why women are like, Ooh, I’m a little scared. Maybe I’m scared of injuring myself. I’ve never picked up a weight before. Cuz like, where do we ever really learn how to lift a weight unless you’re, through weights around in high school and in the weight room, which was, usually intimidating.

First of all, a lot of the research is not on women, looking at research, the majority is on men when it comes to resistance training, cuz they don’t have to take into account all the hormones that you know in a menstrual cycle. And the research that is there isn’t directly correlated to necessarily autoimmune conditions, but, increase in exercise, specifically resistance training has been shown to reduce risk of chronic disease, heart attack, stroke increased bone density.

And I think, some of the research around there that is in women is around endurance training or over training. And a lot of endurance athletes can have a higher incidence of thyroid disorder, which I’m sure cortisol plays a huge factor in that. But there’s not a lot of. I couldn’t find any. I was actually researching last night for research articles.

Some of the things, the research out there is around menopause and type two muscle fibers, which are fast twitch, explosive power muscle fibers, and we have less of those as women compared to men. And then as we go through menopause, we lose those very quickly. So it’s always nice to. Once you build a base of strength to start to train that explosive power, I think if you take someone who’s deconditioned and start with that and they already have, joint pain and muscle aches will have probably more joint pain.

So I like to start with moves that can be slow and controlled and are not necessarily explosive. And are functional. So carry over into how we move our body through our day. So deadlift some sort of squat and lunge, which those two are actually very challenging for women with Hashimotos cuz the knee pain can be increased.

Because with Hashimotos we have slower tendon turnover. We have slower regeneration and replenishing of our tissues, especially at the tendon. So like the info patella tendon or the rotator cuff tendons can get really achy. Some sort of push, move, pull. Some sort of carry, like we’re carrying groceries and then some sort of controlling of the core rotation.

So those are how I build a program is introducing those moves, slow controlled, and then eventually we start to address that type two fiber loss through explosive power moves. Maybe it’s Like a dynamic step up or eventually working up to a box squat or like a ball slam to a box squat. So sorry, like a box jump, not a box squat, box jump.

So you’re starting to train that explosive power. But it’s interesting, a lot of the research is on men and then of course, and then a lot of the, there’s not really much research on the autoimmune component. There’s a lot on like heart disease, stroke. Bone density. There was a study with, I think it was about 2,500 women was in medicine and science and sports and exercise.

They found that these women who did strength train had like a 40 to 70% reduced risk of developing heart disease, stroke, or death related to some sort of heart disease. That was really interesting. But again, not necessarily for the autoimmune population. Some of the things that I was looking into was again, around over-training endurance athletes, and I think women with Hashimotos, again, go on the spectrum.

There’s the woman who might be diagnosed later in life, like through menopause, which is when most women are diagnosed and they are deconditioned. Maybe they hit 5,000 steps a day. If they’re lucky they don’t really weight lift, they’re a little bit more sedentary. And then on the other end of the spectrum is the type A perfectionist go CrossFit six days a week.

Yeah, me too. And needs to dial it back again. Coming back to okay, how can you like meet both of those women who both have Hashimotos but are very different? In their activity level. And going back to this idea, there was a study it was the open access Journal of Sports Medicine in 2016 where medical conditions such as anemia, asthma, infection, but also thyroid disorders occurred more frequently in endurance athletes, which makes sense, right?

There’s that probably some cortisol stress component Yeah, I was digging through the research. There is one study about frozen shoulders. So women with Hashimotos might not know this, but being hypothyroid less hormones going to all tissues, it’s very common to. Especially during the menopause age, maybe not very common, but higher prevalence of women menopausal postmenopausal, getting fr frozen shoulder syndrome, which is basically a contracture of the capsule where the arm goes into the shoulder socket and it is a V like you can’t lift your arm, you can’t wash your hair, you can’t put your arm in your jacket.

It’s very debilitating and I’ve, I saw women with this in practice and. It’s a very long road to healing like physical therapy three times a week for 18 months, so a year and a half. If it doesn’t get better, a lot of women will do manipulation under anesthesia where they. Put you out. They basically tear the tissue under anesthesia.

And then again, it’s you rehab. And what happened, and what I noticed was that a lot of women would get to this place where the shoulder was finally moving again, and then a year later, the other shoulder. Would have frozen shoulder symptoms and they’d have to go through this whole laborist process. And there was one research looking at known frozen shoulder cases.

They only drew labs for A T S H, but all of them had elevated t s H. So I thought that was really interesting. And now when I see frozen shoulder, I’m like, how’s your thyroid labs? It’s like one of the first questions I ask because once someone. It gets to thyroid, maybe managed properly. If it’s not even under medication, they could have the potential to recover quicker and not be suffering for a year and a half, three times a week, going to physical therapy, doing the same thing over and over again.

Nataliia: Of course. It sounds like it takes a village and I always say that, right? It does. So I love that you’re a chiropractor that specializes in Hashimotos because you are looking for it, you are just, Hey, how’s your thyroid? Even with a single mention I have a chronic

fatigue. What do I ask? How’s your thyroid? Let’s run more labs than just ts h And you keep saying premenopausal. Postmenopausal. It, a lot of Hashimoto’s diagnosis happened during that time, and we know that. Estrogen, which is the primary female sex hormone.

We know that regular exercise has been shown to help maintain healthy estrogen levels, especially in premenopausal women. So it may also help reduce the risk of conditions related to estrogen imbalance, such as our polycystic ovary syndrome p C O S. So the older we get, the less active we are.

And estrogen starts rising, right? So what I’m getting at is that, is estrogen rising that triggers Hashimotos, or is Hashimotos causing us to be less active? And we get diagnosed. Those things are so interconnected, and like I said, it takes a freaking village. It takes your medical doctor, functional doctor, or just a regular endocrinologist, right?

It takes a dietician. To address all the nutrition deficiencies, hormonal imbalances, and everything else. And it takes somebody like you to look at the person and work and put your, physically, put your hands on the person to improve the physical challenges, but with Hashimotos in mind, right?

To be more gentle. Now, if patient cannot come to see you in person. What can they do if they really have debilitating symptoms, if they can’t come see you, if they can’t go to the to the gym, what can they do at 

Emily: home? You could start with body weight exercises and I start this, we, going back to the idea of the spectrum, like the women who are more deconditioned, I start them with like squat to a chair, stand back up.

Versus like squatting with your seat below 90, just to start to create that muscle memory of the movement pattern. Like just greasing the groove of the joints. So I’ll start with that. I’ll start with things that are elevated. A, a plank off the kitchen counter versus getting on the floor.

Cuz especially women with knee pain who are deconditioned getting on and off the floor, they dread it. They’re like, I really wanna play with my grandkids but I don’t wanna get on the floor cause I don’t know if I can get up cause my knees hurt so much. So I’ll take things elevated. So a plank off the kitchen counter will progress that to a plank within pushups off the kitchen counter, and then eventually starting to lower.

The height of that. So those are the, there’s always modifications to help someone get some wins and feel successful. Some of the other things in terms of managing recovery would be looking at heart rate recovery. So if you did, Eight deadlifts, five deadlifts to then does your heart rate, and this is more technical, right?

Cause you have to be like, maybe you’re wearing a heart rate monitor. Does your heart rate drop by 20 to 30 beats over a couple minutes? Can your heart rate come back down? Can it recover properly? Some of the techniques I use helps stimulate the vagus nerve during rest sets. So I’ll have my women hum.

I’ll have them sing. I’ll have ’em put their tongue like kind of suction into the roof of their mouth and try and exhale out of their nose. Twice as long as their inhale. So in a dream world, it would be a four count inhale and an eight count exhale if you ever try it, it’s actually very challenging.

It takes a lot, but if you hum you can do that. You can like drop into that really quickly. And it just drops you into that recovery zone a little bit of like parasympathetic state. So I’ll have women do that so that they’re not in this kind of sympathetic overdrive in their workout.

Constantly, if they’re also potentially in that sympathetic overdrive in the rest of their life. So I know a lot of people will do like vagal nerve toning exercises. It’s why not use your exercise to do it? So you’re lifting a weight, it’s creating this stress or response. Your heart rate goes up, your breath rate goes up, and then train it quickly to drop back down during your rest set with.

The tools that I mentioned, and you can track it with tracking your heart rate. If you don’t wanna do that, they’re like, oh, that sounds too technical. Just try to slow your exhale down to twice as long as your inhale. So those, I’m just trying to give women tools, especially like you said, if they don’t wanna go to the gym, they don’t have the financial means to work with someone, you can still use everything around your house, right?

Like I literally have women. Put some books in a backpack and they lift with that. Don’t let the fact that you don’t have a weight, right? Because that’s an investment. Be the reason you don’t lift up something heavy, cuz there’s plenty of things around the house that you could do. And then you can use recovery tools in between to help. 

Nataliia: It’s all sounds great when you’re talking about it, but it’s also intimidating to start. Is there anything you have on your website that kind of starts your patients off or maybe, gives a little bit more guidance and help? 

Emily: Yeah, I have. Really affordable 14 day programs. I think one of ’em is $19, one of them is $47.

Amazing. And it’s a written program and then it’s individual videos like how-to videos. And I think one of the benefits of being a chiropractor since 2007 and seeing patients through that movement, strength perspective, not just adjusting people all day. Cause that actually gets really boring. Is that learning a cue.

It doesn’t work for everyone. So you have to constantly be like, okay, what’s gonna work for this person? So in those videos on my website by name, dr. Emily hybrid.com are different cues like where to put your feet, how to turn your toes out, how to get into a hinge before you pick up a weight. And there’s different cues that work for different people.

I teach things like foot dialing, which, people who lift regularly would know screwing your feet into the floor. Oh, okay. So when you deadlift let, we’ll just use deadlift, right? So you sit your hips back. As you stand up, you wanna think as if you’re screwing your feet into the floor.

So you could think of. Screen the feet into the floor. Another cue would be to like spread through the pinky toes. And what you’ll feel is this full engagement of the legs, like this tension building and your glutes, your glute max will squeeze. And if you are someone who feels you’re deadlifting your low back oh, I always feel it in my low back.

You should not feel it in your low back. It should be this full tension up the body, a glute squeeze, and then getting the whole body stacked. So like your ribs are over your hips, like everything’s stacked, and then you’re under load. So if you have really high arches screwing your feet into the floor or.

Kind of spreading the floor with your pinky toes. It doesn’t work. It’s just like your arches are high. I’ve seen a lot of people, which is really high arches, so the other way you could think about it is Almost like you’re like pulling a towel apart. Different cues for different kinds of feet.

That’s, 

Nataliia: and honestly, I’ve never heard that. Nobody ever explained that to me. And I deadlift all the time. That’s all I do. I don’t do cardio. I hate cardio. Me too. Really very heavy weights. And I absolutely love 

Emily: that. So you will be able to if you use that queue and you could do it on a lighter weight, just to Feel it, and you could do it standing like you’ll literally screw your feet into the floor and like all the tension will build, like quads will engage.

You’ll be able to lift heavier without necessarily doing a progressive overload program. Yes, progressive overload is important, but you’ll be able, like I’ve had women be like, oh, I can’t deadlift more than. Choose a weight. I’m like, okay, let’s foot dial. Do it a couple standing Now do a couple with your lighter weight.

And the lightweight just kinda pops off the ground. They’re like, oh, I need a heavier weight. And the only thing that changed was teaching someone how to dial into their own tension that they could build in their body. Absolutely 

Nataliia: such great points. You’re giving so many little titbits like this. I feel like I need to be taking notes.

But the good thing is that this podcast is being recorded and you can go back to it and listen over and over again. So we covered so much. Hormone imbalance physical aspects touched on medication, right? We’re not here to talk about medication, but we know that proper management of ha Hashimoto’s hypothyroidism with medication is maybe, I would say half of a battle, right?

We need to make sure that we take. The right kind of medication that we we’re on the right dosage and the administration of that medication is correct. So that’s something you have to think about. Of course, nutrition part of it. If you are not, and you mentioned that at the beginning, if you’re not fueling yourself correctly, you’re not gonna see progress.

Even if your goal is not to lift more. Even if your goal is just to lose weight, just undern nourishing and overn nourishing will hinder your healing journey. Of course, we know that a lot of people with Hashimotos have nutrient deficiencies, and let’s zoom in on, for example, iron and vitamin D.

If those two are low, you will have chronic fatigue, and ability to perform daily tasks so how do you correct nutrient deficiencies by following a balanced diet? Gut dysbiosis is common in Hashimotos, and that’s just imbalance of good and bad bacteria. Again, a balanced diet is the key here. Oxidative stress and inflammation. That’s a big one with Hashimotos. And we know that a lot of joint pain can actually come from oxidative stress and inflammation, not just from immobility. And I already talked about elevated fasting insulin. Again, diet is the major key here in, I think I saw statistics somewhere.

The most recent one that it says up to 40% of people with Hashimotos have either, elevated fasting insulin, or type one or type two diabetes. That’s 

Emily: crazy. That’s crazy. 

Nataliia: And the last thing is that a lot of people with Hashimotos tend to develop other autoimmune disease.

And you said, the study that showed how if you have an autoimmune disease, That you tend to develop others first and you tend to develop all the problems related to Hashimoto’s joint pain, even the frozen shoulder it seems to be 

Emily: unrelated. Yeah. I will mention something that I haven’t mentioned yet is in clinical practice, and I have probably looked in PubMed every week to see if there’s any research on this, is I noticed that a lot of women that I was working with Hashimoto’s, other autoimmune conditions as well, had this element of like tissue laxity or joint laxity.

Joint hypermobility, and it wasn’t in all the women, but it was in a high percentage, like probably 80%. And part of. Their complaints were they wanted to get a chiropractic adjustment, they wanted to massage everything that was like a release. And I was saying, you need to reign in these joints.

We need to create more joint integrity, not stretching, yoga, loosening of the joints. But they felt tight. So put ’em on a program of strength. I was like, no more yoga for eight weeks. And all of them at first felt tighter. They were like, Ooh, I don’t like this. But I was like, listen, this is just creating joint integrity.

And eventually they all felt better. And when they went back to the yoga practice or they went to stretch, it would actually create low back pain, facet joint pain. Si joint pain. And I’ve talked with this with There’s a physical therapist, Jessica Drummond, who actually noticed this in her long covid clients, was joint hypermobility.

That was also transient, which was really interesting. So I. Part of kind of my mission is not only to feed the muscle tissue through protein and resistance training, but also if there are women who do experience that ju that joint hypermobility or laxity to give them tools to overcome it. Because their first thought is gonna be, I wanna stretch because I feel tight.

And to give them tools to get stronger. 

Nataliia: It’s amazing that this slow movement or gentle exercise movement for Hashimotos can actually hurt our Hashimoto’s patients because, like you said, maybe yoga is actually a opposite of what you should be doing. And I know that because I’ve been told when I had my knee pain and I didn’t wanna, I actually stopped squatting because I felt like it was just It wasn’t doing me any good. My physical therapist said, no, you want to actually squat more, not necessarily with more weight, but do it daily to build the strength around your joints, and that’s exactly what you’re talking about.

So I stopped doing yoga in those stretching exercise, like you said. It just shows how personalized approach has to be implemented. There’s no way around it. 

Emily: To your physical therapist’s point. Like the joints have a capsule in fluid and they, there’s this concept called ambi inhibition, where as you load the joint, like in a squat It’s like a sponge.

It’s like you’re taking a dry sponge and soaking up water and it’s squeezing it out. It’s hydrating the joint. So if you’re not squatting or you’re not using that joint to a certain capacity, the tissue will become drier and more brittle because it’s not, soaking up the fluid in, squeezing it out.

Also happens in our discs, in our low back. That was a great recommendation by your pd. 

Nataliia: Thank you. I’m glad you confirmed, I’m glad I did something right. When it comes to exercise Dr. Keiber, we’ve covered a lot of information what is the bottom line? Is gentle exercise for Hashimotos a no-no.

Do we just need to lift and build muscles? What’s the takeaway? 

Emily: The takeaway would be, picking up a heavy weight at ideally three times a week, I think is like a non-negotiable to just have energy to if you wanna lose weight. I think the second thing is, getting zone two training in like getting 8,000 steps in a day and then trying to hit your protein targets, starting your day with protein.

And I have women do just that last one and they’re like, oh my God, I don’t know what to do with all this energy. And all I had them do was start their day with protein and try and hit 30 grams. I didn’t even have ’em pick up a kettle yet. And they’re like, they don’t, they’re like, oh my God, I have so much more energy.

So I think, from a dietary perspective, and then working with a great practitioner to manage their thyroid hormones and if they need more assistance and sex hormones or uncovering root causes and. I talk about the big three. It’s get your sleep, get your eating, get your exercise dialed in, and then once you start your journey, if you do go down that functional medicine route, it’s gonna be so much easier to address whatever comes up.

Nataliia: Those are all great points. Dr. Kier, we’re so lucky to have you on our podcast. I’m sure our listeners have many more specific questions and they will be able to ask you those questions because we gonna leave your contact information in this episode’s notes so they can reach out to you.

But yeah, again, thank you so much for joining us and until next time. Yeah, thanks so much for 

Emily: having me.