Having recently read here lots of posts mentioning, in various forms, degrees of exercise intolerance, I happened upon this paper. Quite astonishingly it uses terms like "quality of life" and "forgotten area", and it absolutely recognises different systems working in concert to produce the effects suffered by so many.
(All too often everything to do with sports and medicine seems to concentrate on elite athletes. Really good to see something for the rest of us.)
Res Q Exerc Sport. 2014 Sep;85(3):365-89. doi: 10.1080/02701367.2014.930405.
Impact of overt and subclinical hypothyroidism on exercise tolerance: a systematic review.
Lankhaar JA1, de Vries WR, Jansen JA, Zelissen PM, Backx FJ.
1a University Medical Center Utrecht .
This systematic review describes the state of the art of the impact of hypothyroidism on exercise tolerance and physical performance capacity in untreated and treated patients with hypothyroidism.
A systematic computer-aided search was conducted using biomedical databases. Relevant studies in English, German, and Dutch, published from the earliest date of each database up to December 2012,
Out of 116 studies, a total of 38 studies with 1,379 patients fulfilled the inclusion criteria. These studies emphasize the multifactorial causes of exercise intolerance in untreated patients by the impact of limitations in different functional systems, with cardiovascular, cardiopulmonary, musculoskeletal, neuromuscular, and cellular metabolic systems acting in concert. Moreover, the studies affirm that exercise intolerance in patients is not always reversible during adequate hormone replacement therapy. As a consequence, despite a defined euthyroid status, there remains a significant group of treated patients with persistent complaints related to exercise intolerance who are suffering from limitations in daily and sport activities, as well as an impaired quality of life. An explanation for this phenomenon is lacking. Only 2 studies investigated the effects of a physical training program, and they showed inconsistent effects on the performance capacity in untreated patients with subclinical hypothyroidism.
A limited body of knowledge exists concerning exercise tolerance in treated patients with hypothyroidism, and there is an insufficient amount of quantitative studies on the effects of a physical training program. To enhance exercise and sports participation for this specific group, more research in this forgotten area is warranted.
physical activity; physical performance capacity; quality of life; thyroid dysfunction
PMID: 25141089 [PubMed - indexed for MEDLINE]
Full paper, as so often, behind a very high paywall.