Exercise and T3/T4: Can someone clear up the... - Thyroid UK

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Exercise and T3/T4


Can someone clear up the mechanism of thyroid hormones and exercise for me please?

I keep reading conflicting things. Aside from exercise using up T3, what else can happen? Im thinking in terms of cortisol increase - what happens there? If using T4 (I’m using a tiny bit) what happens to that? Is it of use if you’re a poor converter, or just it convert to rT3 and become a hindrance?

If low levels of T4 are present should you take a little more before exercise or should you take a little more T3? Or neither!

I’ve spent about 4 days now researching this and I’m no further forward. It seems there are some people out there who can exercise and it makes no odds but for others, what worked, or not, for you?

I’m fed up of hearing we can’t exercise. It must be possible once meds are right, so what things do I need to consider?

An edit: if I had high cortisol rather than low, what difference would this make?

And yes, following my previous post regarding taking up more exercise I’m now having issues. Muscle weakness/fatigue/jumpiness back with a vengeance. Feel like I’m full of lead. No I told you so’s please! I will beat this.

100 Replies

From my own experience, I remember wanting to exercise but frustratingly, just couldn’t manage it, couldn’t even manage the stairs some days for heavens sake.

It was only when my vitamins and minerals were optimal and then taking my thyroid treatment, I found I could actually go to the gym at last! Even then, I was conscious not to go overboard.

I’m afraid I’m not able to comment on the specifics that you ask with regards T3 & T4. Hopefully someone can explain.

I do, absolutely feel your frustration.

All the best

in reply to Veritate

I agree. It’s taken me two years to get my thyroid meds right and tons of various forms of magnesium to get those levels up (I presume) and I suddenly find myself willing and able to run again. Joint pain and muscle twitches and cramps mostly gone. Ran 3 times this week building up to see if I am knocked out by it - 16 mins, 24 mins and today 36 minutes - and I feel fine.

in reply to JAmanda

It’s great you’ve been able to take up running. I can just about manage a power walk on the treadmill at the moment. But I’m just grateful that I feel I can do a bit of exercise. Keep up the good work 😊

in reply to JAmanda

How much magnesium do you take?

in reply to ZoBo

Well it feels like tons. It says to take 1-2, 1-3x a day which is impossible with it being impossible to take any in the morning due to levo. If I took the max of six it would be 300 elemental mag. Is that a lot? I also throw in a mag oxide just to use them up.

in reply to JAmanda

I think (trying to work it out from the various forms of mg contained in each capsule) that thats what I take

I don't think exercise uses more hormone to any noticeable extent. Exercise can raise TSH a little and I suspect this is to enable a faster metabolic rate.

Aside from exercise using up T3, what else can happen?

Exercise doesn't 'use up' T3. But, if there's not enough of it, post exercise, when recovering, may be a little difficult. Remember, every single cell in your body needs T3, so unless you're taking/have in your cells enough to go round, those cells that aren't getting enough will have a hard time recovering from exercise.

What else? Well, exercising does use up calories. And, given that you need good levels of calorie in-take to convert, that will make recovering from exercise even more difficult. Just as every cell needs T3, every movement you make needs calories to fuel it.

If using T4 (I’m using a tiny bit) what happens to that? Is it of use if you’re a poor converter, or just it convert to rT3 and become a hindrance?

Nothing happens to it. It's just stocked for about a week and then used or disposed of. But, even if you're a poor converter, your probably convert some. Whether or not it converts to rT3 would depend on the level of your FT4. But, rT3 is not any sort of a hindrance.

If low levels of T4 are present should you take a little more before exercise or should you take a little more T3? Or neither!

I would say neither. Given that an increase in T4 takes about six weeks to make full impact, that wouldn't be much help, would it. And, chopping and changing your dose of T3 isn't helpful, either. Your body needs a steady amount of exogenous T3 coming in, not more one day and less the next.

It seems there are some people out there who can exercise and it makes no odds but for others

It would depend on their levels of FT3, as well as nutrition and general health. Hypothyroidism doesn't hit everyone the same way. This could possibly depend on how long you were hypo before being treated, but could also depend on a whole heap of other things. It's not helpful to compare yourself to others.

I’m fed up of hearing we can’t exercise.

Who said that? On here we generally advise that if your FT3 is low it's best to stick to walking or swimming until your level rises. But, you know your own body best and you know what you're capable of. If you exercise and then are bed-bound for the next three days, then you're obviously doing too much too soon. Increase slowly, pace yourself, don't exceed your limits - it's not worth it in the long-run. Listen to your body and heed what it tells you. There's only you inside. Others can advise but not tell you what you need to do.

what worked, or not, for you?

Honestly? Nothing! lol I've always hated exercise of any kind, even as a child. Games and gym at school were pure torture for me - and that's only got worse, not better. I can't breath well, and if I try to run I always have the feeling I'm going to fall flat on my face! Neuropathy and asthma, I suppose. But, that's just me. And, I think I've been hypo since I was a child, and probably have a lot of irreparable damage somewhere, to my muscles or to my nerves. So, one just does what one can. I've bought a rebounder - well, several years ago, now. All I have to do is summon up the energy - and get rid of the apathy - and actually try it. :D

😂 each to their own greygoose!

Thanks for this, as always. Och, I just get so frustrated. And I know I’m not the only one ever to have struggled with exercise. It’s just with this you can’t just power through, stiff upper lip and all that and it drives me mad.

After my workout (which is quite gentle!) on Wednesday my whole body felt like lead. I’ve been taking a small amount of T4 as I said but I realised that one day last week I took a 100mcg instead of a 25. Erm yes, not great but I’m beginning to wonder if that’s had something to do with it, hence the T4 question. And I didn’t think taking extra would work either, but had seen it posted somewhere else so thought I’d ask! Despite knowing better really.

So basically I’m probably still slightly under medicated then? My last bloods T3 was about 6.5 so fairly high, though I suppose we all know it’s how you feel really, not the bloods that matter.

I have another blood test to do, just to try to help work it out but I can’t do it until after the holiday weekend by which time things might have changed.

So we’re fairly certain I’m probably a bit on the low side to cope with the exercise, if anything. I’ve felt like this when my levels have been too high there’s no reason my T3 levels would’ve increased, is there?

I realised that one day last week I took a 100mcg instead of a 25

Well, that's not such a terrible thing as a one-off. But, did it make you feel better or worse? Maybe you need an increase in levo? As to whether taking extra before exercise would work… difficult subject. Did you see the discussion the other day about whether or not T4 can give an instant reaction? Logic says it can't. But, some people say it does for them. It certainly doesn't with me, but my reactions to any kind of supplement or medication are so slow and dull that you have to hit me with a sledgehammer for me to feel anything. So, it's difficult for me to imagine having an instant reaction to anything except morphine! But if they say they do, then one has to trust that they do. Wish I did! lol

So, what I'm getting at is: whatever works for you, go for it! If taking that extra levo before you go to exercise means you can exercise painlessly, then do it. But, I still would recommend you do that with T3, not at your stage of the game, anyway, you're still in recovery mode. Maybe later…

So basically I’m probably still slightly under medicated then? My last bloods T3 was about 6.5 so fairly high, though I suppose we all know it’s how you feel really, not the bloods that matter.

Well, even that is subjective. Could easily be you do need your FT3 higher than that. The top of the range is not set in stone, it's just based on statistics, not individual need. Or, it could just be that you need a higher FT4 now.

So we’re fairly certain I’m probably a bit on the low side to cope with the exercise, if anything. I’ve felt like this when my levels have been too high there’s no reason my T3 levels would’ve increased, is there?

Who knows. It's always a possibility. Maybe your need for T3 has just decreased. All things are possible. And, it's all trial and error.

The levo is perplexing me. I always thought I needed it until before Xmas I dropped it totally.

I felt amazing. For about 10 weeks I felt great but then the peaks n troughs of the T3 started to become more obvious, so I put a bit back in.

Since then I’ve kept it very low but I wonder if I split my T3 more often i wouldn’t need it at all? I can’t help but think that’s it’s doing more harm than good.

I agree with logic btw, that it can’t act immediately but just for interest I would say that I always could feel a difference within a couple of days of a levo increase but I found out eventually that it take me personally around 15 weeks for it to settle completely. So very different to any literature I’ve ever read on it! Just proves we’re all different.

I’m guessing you meant to say “I wouldn’t” with regards to an extra dose of T3?

Yes, I did mean 'wouldn't'. But my keyboard doesn't like negatives! lol Well, that's my excuse, anyway.

I'm really not surprised that you felt amazing one dropping the levo. Just about everyone has that reaction. Trouble is, it doesn't last. And it's difficult to know if you don't need it at all, or if you need more of it. As I said, trial and error…

I think we discussed splitting the dose before, didn't we? Or was that someone else? Have you never split it before? If not, give it a try, see how it goes.

We are all different, and it doesn't surprise me that you need 15 weeks for the dose to settle. I need at least four weeks for a change in T3 dose to settle. I reduced my T3 at the beginning of lockdown, and felt really great at first. Now I'm thinking hmmmmmmm maybe I should be putting it up again. :( It really is a life-long struggle.

Ugh, it really is!

With the levo, I think I had it higher than it should have been almost all of last year, I didn’t always drop it in response to a T3 increase. It was a bit of a “duh” light bulb moment when I decided to drop it completely.

As you say, the trick now is finding do I need it, or not? The endo seemed to think that was up to me and if I split my T3 up to 5 times a day, it wouldn’t matter. I’m not convinced.

I have never split my T3 more than twice. I felt if I did the smaller doses didn’t seem to do anything. I’m going to try three times now, well, I have for the last couple of days, no effect yet. We’ll see.

5 times a day is a bit much, because I don't see how you could take it away from food that often. And, I'm really convinced that does make a difference to absorption - plus you wouldn't be able to fit in any supplements! So, if you didn't absorb it properly, you'd have to increase the dose, and that just seems like a waste of time, to me. But, sometimes we have to do what we have to do, and if someone really does feel better taking it five times a day, then they just have to adapt. Maybe I'm blessed with my insensitivity because I can take it all in one go. lol

She said she had someone who took 60mcg split 6x per day because it worked for them. Indeed, whatever works for you but I actually laughed at that and asked how they fitted life in round about taking meds!

I can’t take my T3 all in one go, if only. I have tried but got a crazy heart rate, v uncomfortable. I will try 3 x a day though, that’s doable.

As always, onwards and upwards....

It's the only way to go! :)

in reply to Murphysmum

But most people feel “better” initially, after stopping Levo (well recognised phenomenon) ....but that doesn’t last

Initially...you have Ft4 in body (left from when taking Levo) ....But as you drop the Levo...Ft4 drops and conversion improves in an attempt to maintain same levels ....but obviously you run out of Ft4 to convert

Geez! This is not helping! 😂

But on the whole, I’ve been more active for longer and have had no symptoms for the last 6/7 months on really low levo and 45/50 T3. This is the longest stretch of good health I’ve had (until I tried to get fitter, silly me)..... would that suggest I’m around the right dose?

Any other “ups” have been much shorter lived.

in reply to Murphysmum

"it take me personally around 15 weeks for it to settle completely"

I've twice had to take a decrease in Levo, the first time very much under protest as I knew I was still undermedicated even on 100mcg, but they insisted on reducing as TSH was low. But each time it took at least 3-4 months to be certain that there was a deterioration.

in reply to greygoose

Greygoose, can you please explain "This could possibly depend on how long you were hypo before being treated." What are the consequences of being hypo for long before being treated? Is there irreversible damage, even if you get optimised?

in reply to Canu

Yes, there can be irreversible damage, meaning symptoms you can never quite get rid of.

in reply to greygoose

So how can you know whether you have irreversible damage or whether you are just not optimised yet? I have read that when you're trying to get optimised, you shouldn't make conclusions just from the blood tests, but more importantly from your symptoms. But if some symptoms may be permanent, it makes it all much more complicated.

in reply to Canu

Oh, it's certainly complicated, alright! But, it depends. Do you think you were hypo from an early age? I do. And it took me nearly 50 years to get diagnosed. That is a long, long time, although not typical, but that's the sort of long time I was talking about. So, it wouldn't be surprising if some permanant damage had been done to me. And, I know I'm not the only one on here that feels they were hypo for a long, long time before anyone took any notice!

in reply to greygoose

Wow, that's VERY long! No, I was talking about maybe 3-4 years before I was diagnosed. But my body really collapsed in the two last weeks before I started taking levothyroxine. It was like my thyroid completely shut down. I could hardly move my hand to pick up the glass of water on my bedside table. I couldn't digest food so I couldn't eat, I became very skinny (I know it's not what usually happens in hypothyroidism) and I had about a dosen other horrible symptoms.

in reply to greygoose

Excellent information. I know the feeling - re the rebounder - I bought one 15 years ago. I found it was great for storing handbags. I used to hang them from its feet when it was propped up on its side.

in reply to Redlester

Oh! I haven't tried that. I put mine on top of the wardrobe, but I'll give your system a go. Good idea! :D

in reply to greygoose

Must be a massive wardrobe!!! I am a bit ashamed I have led you astray with my suggestion. Much better idea would be to have a bounce on it from time to time. I know, hard to muster up the enthusiasm sometimes. I veer between bouncing on it 3 times a day to the current position where it is providing a nice nestling place for my seedlings in the sun room!!!

in reply to Redlester

Funny you should say that about the wardrobe. It's only the small one, where I keep my coats. But, I bought a new handbag today! lol It's going to get crowded. Actually, handbags can be found in most rooms in this house. I must make an effort to keep them all together. And the rebounder would be ideal for that! If only I can get it out of the dining room…

in reply to greygoose

At last - I have found someone who is worse than me!! [re handbags!]

in reply to Redlester

I have had so many handbags in my life! Some really nice ones, too. And, I have no idea where half of them have gone! I suspect my psychopath of an ex husband, who's greatest pleasure was throwing other peoples things away. Since the divorce, I've had to restart from scratch, because I left the house with just an old shopping bag and a duvet! Now, I have my new collection, and took possession of the best of my mother's handbags when she died. So, it all mounts up! My granddaughter is the same, and at 12 years old, has an impressive quantity of bags that she has begged, borrowed or cajoled. Maybe I should buy her a rebounder to keep them on…

in reply to greygoose

In those circumstances [imagine denying a woman the pleasure of her handbags?] you deserve every new handbag you treat yourself to. I, on the other hand have had to call time, for now at least, on my habit. It has expanded beyond the available storage space. For me it is enough just to gaze online at things of beauty and tell myself "one day...". We have digressed badly from T3/T4 and exercise!!!

in reply to Redlester

We have, indeed! My apologies to Murphysmum. :)

Talk of handbags is allowed at anytime tho, isn’t it? Forum rules... 😜

Oh yes! I forgot that! :D

in reply to greygoose

And it is always good to talk :)

in reply to Redlester

Indeed it is! :)

Are they spring onions?

LOL - no tomatoes [no sign of germination so far] red peppers [ditto] and some flowers for the garden - with some success there !

I don't see thyroidism as something to beat. We want to reclaim as much of our life as we can certainly but we have to work with our body. And our body let's us know when we are pushing it too far. Often it is then a case of waiting for levels to improve or the body to catch up but, as our body has changed with thyroidism, sometimes we have to change our old habits too.

I can hear the real you trying to kick your way out of this . you remind me of me.

I think there is a fine balance to find in learning to deal with this bloody disease .

On the one hand ~ if you try and kick it out, it will just kick you back every time...... and some acceptance of this reality is good , because when you stop kicking you don't get knocked on your ass every few days, and so you can keep moving forward steadily EVERYDAY . which means you travel further... the more time you spend feeling like lead with porridge for brains, the less active you are , so i reckon you down regulate your system resulting in using less T3 (just my theory) ,which is a vicious circle of muscle / stamina loss

Somehow, to prevent this happening , you need to keep sustainable daily activity patterns.

I'm much better at that now, but it has required a painful personality transplant to get here.

On the other hand~ too much acceptance will mean you don't fight the inadequate medical system enough , don't learn enough , don't push to try different hormones / minerals /vitamins, meaning you get put in a corner and forgotten.......... which is where i went wrong , i should have pushed that door harder, and now i just hope i haven't left it too late.

So you keep fighting , AND accept it, do both.

I hear you tattybogle . And I agree.

I just thought I was nearly “there”. I felt as if I had steadily been increasing things and had a bit of extra capacity, maybe.

Apparently not!

All my vits and mins are good, ferritin needs a bit of an increase but it’s a bit.

I’m eating healthily and I’m not calorie restricting or anything like that.

Slowly, slowly. I know, thanks 😊

Morning murph , i'm pleased you 'get me'. I was worried you'd think i was saying 'told ya so!'

Sometimes i feel like this disease has visited some of us to force us to learn self regulation, cos i sure wasn't any good at that until i had no choice ;)

I agree with GrowingVeg below, ..... find someone to teach you some chi gong or proper tai chi , there's a lot more to it than just waving your arms about, but you need an authentic master not someone running 'happy classes', to learn its full power.

You'll be amazed what hard work it is,, for every single muscle /tendon you have, including some you didn't know you have! but if you're doing it properly it just looks like you gently moving. The breathing and the movement need to work together, if someone doesn't teach the breathing, find someone else.

Tai chi /chi gong was the only way i could ever get into anything like meditation, couldn't abide all the sitting still and not thinking!

Only mistake i made, was not keeping it up daily when i had to accept not to push too hard , my ego got in the way when i wasn't superhuman anymore....... so i sulked! .........silly me, i'm paying for that now with me creaky knees.

I also agree with growing veg !! .... brilliant steady exercise with free organic vitamins !

Wishing you all the best on your journey, don't beat yourself up when you go wrong , this thing is as much of a 'head' challenge ,as a body one .

Now i need to take a lesson from you and push to get the treatment i deserve. ,(and try to remember 5 minutes of chi gong !)

Tat x

I run and exercise without a problem. I'm optimized on meds, have fibromyalgia also. But no problem. Earlier when I wasn't optimized I couldn't exercise with the same intensity I used to do it.

So I don't know if you're optimized, if you have other illnesses, if you smoke, drink alcohol, eat healthy, we are all different and have very little info about you.

I don't look at my t3 t4, not necessary for me. I have no problem whatsoever with exercising.

Good luck

I thought I was pretty much optimised estrellaliliana

I don’t smoke, I drink if you count a couple of glasses of wine over a weekend.

I have a bad hip but that’s a life long thing and partly the reason I need to keep fit. It’s been slowly getting more problematic over the last couple of years and has improved greatly recently with the little bit extra movement.

I guess I’m not optimised. Work to be done.

What exercise/workout did you do? How used to workouts are you? If it’s been a while and you’ve done a workout it’s standard response. If it’s a hefty workout and you have the ‘DOMS” but you’ve done that particular regime several times before it could be a dose adjustment it really depends on what you’re doing. I exercise at what would be considered a high level and on workout days I’ll take 1/4 grain NDT more. At the moment I’m trying to lose a little lockdown flob so I’m taking 4 grains daily and doing well. If I took 4 grains and was sedentary then I would be over dosed. It really depends on your output. It’s surprising to see how little calories are burned through exercise and it’s where a lot of people fall down. I am of the opinion T3 does get used especially in weight bearing exercise which is why bodybuilders take it.

in reply to Jodypody

Ok so throughout my “illness” I’ve pretty much managed to walk every day. Maybe not at the beginning but after 6-8 weeks I could manage a much shorter version of my regular walk, and things increased from there.

It’s around a 5k across fields, sand dunes and beaches so not a mosy round the park. I’ve struggled in the past but now I can do this at a pace and everyday.

More recently I’ve started cycling again with the kids. So nothing strenuous, my little one is 7. But again this has been fine and has been in addition to the walk some days.

Alongside these I’ve pretty much always (apart from at the start) done some floor work, abs, plank, press ups. This might sound impressive but honestly, it takes about 5 minutes and is very minimal. No sweat or increased heart rate!

Then I decided I would like to improve my cardio. So, knowing it has been a while, I started couch to 5k. It’s meant for complete couch potatoes, total beginners so I thought it would be a way to start at a low level and increase gradually.

Apparently thyroid problems are a step worse than even fatty couch potatoes! I feel fine when doing it, I feel fine after it. I have had no DOMS.

But, my muscle weakness and feeling as if I’m wading through treacle have returned.

If I’m honest, I can’t really work it out. I guess I need a bit of an increase but totally or an extra bit before exercise, I don’t know. As greygoose said, I’m not too keen on adding a bit extra beforehand but wonder if it would work. Like you, I just feel in my gut that I’m using up my T3 but just can’t find a consensus anywhere.

in reply to Murphysmum

Thyroid medicine isn’t poison as the admin bods remind us. Why don’t you just try a little increase and see if it makes a difference?

One thing I always wonder and search the forum for clues about: Can most people get back to 100% on thyroid hormone replacement, or are people getting to more like 80%, and always reduced in what they can do in comparison to a person without thyroid illness? I suspect that most people at their most well are falling short of 100% and just managing to get somewhere near that.

The exercise you're comfortable doing is already a lot, probably well above average for the population as many people don't exercise at all. It sounds very plausible to me that doing the couch to 5K could be too much for a lot of well treated thyroid patients. Being a thyroid patient is definitely a bigger deal than being a couch potato, because our cells have a hard limit in how much T3 they can get which means how much energy they can make. A person with a healthy working thyroid doesn't have that limit.

It's also possible you might be able to get to the 5km run but it might take your double or even 10x as long as it would take the healthy person. Or maybe you can run 2km or whatever and have to be happy with that. Even the members who do manage to achieve more extreme exercise will be needing more rest and recovery time and won't be pushing as hard as their companions. We have to listen to our bodies a lot more and maybe following a planned out program isn't as simple for us.

Thankyou SilverAvocado

Deep inside I guess I know this. I’m just feeling it because I felt I was ready for a bit more and also there’s a group of us started together, and I felt sure I could handle the pace! I genuinely thought I’d get past week two before I struggled.

Annoyingly there are (lovely), by their own admission couch potatoes doing it, who have easily twice the body weight I do and quite frankly haven’t worked out since PE classes at school. (I’m not having a go, this is their honest confessions!) Whilst they’re tired and sweaty, they’re fine, and barring any heart attacks in the coming weeks, will probably manage it to the 5k, whilst healthy “looking” me, can’t cut it. It’s just dead frustrating!

I could drop back and repeat weeks until I feel like I’m handling it better but I wanted to be part of it. Hummpphh.

I definitely get what you mean while looking at others who look like they aren't as fit but actually can do more than you :(

For me this can be one of the things that feels the worst, too. I first got very sick in my early thirties, and meeting people who were thirty or forty years older and doing so much more has been one of the most painful things for me :(

Agreed. I regularly (well, pre COVID) see an older lady - she must easily be in her early to mid 70s - A slight lady but out in her leggings and fleece, jogging away, not sweating profusely, not bright red, just jogging like it’s the most natural thing in the world.

And there’s me, trudging along like lifting my feet takes all the effort I have. Just embarrassing!

Hi Murphysmum, I was a very physically active person until this hypothyroid got to work on me. It's really got me down. So recently I have started doing daily Qi Gong. It's gentle enough to not exhaust me, and makes me feel good. I had tried mindfulness meditation before but didn't even have the concentration for that! Anyway here's a link if you want to give it a try....

I like this clip, reminds me of when i used to sneak into an abandoned garden to practise my form every morning, one day this copper walks up and says 'what do you think you're doing?' ..... 'it's called wave hands like clouds ' says i without stopping...... He was not amused...

Thanks GrowingVeg, you've inspired me to find some woods to sneak into in the mornings again .



I joined this forum because I wanted to know about exercise too. Years ago now!

I can’t help you with the answers, but in my own experience, I feel when I step up my activity it can wipe me out a bit, maybe a day or two feeling very jaded. However once my fitness level has increased I can maintain it without feeling too wiped out until I step it up again. I do tend to go for an electrolyte replacement drink after exercise and would increase activity very gently.

I’m not terribly fit these days as I have a hip problem, but for years I kept up my running, cycling, swimming etc.

There are so many positives to exercise, I hope you can find a way that works for you.

in reply to Ruby1

Thank you. I’m really hoping this is the case with me too!

I have a hip problem too and the recent increase in momvement has really helped. The last few years of much less mobility really haven’t.

I hope I can find a way to maintain it. Maybe I just need to reset and try again.

in reply to Murphysmum

I replied above but I’m interested in your and the poster above s hip problem. I’ve also had a terrible hip (and sore glutes) which is what’s stopped me exercising. I was low on magnesium and was prescribed salts then tried citrate then oxide and never seemed to raise my magnesium level but I recently tried mag glicinate and think it’s possibly that which has finall sorted me out and got me bouncing out of bed to run. (Could be something else of course, there’s so many factors.)

in reply to JAmanda

my hip problem has been since birth JAmanda , I was born with hip dysplasia. It was fixed when I was 6 and didn't really bother me until my twenties. Recently its become worse but this is a combination of age (it was only supposed to last until I was 30, now 43), weight gain and lack of fitness.

I have no doubt though that the magnesium is helping everywhere, that included.

If its still bothering you you should check out exercises to strengthen/stretch your glutes. They're renowned for causing problems especially after being relatively inactive or sitting more ;)

in reply to JAmanda

Sorry I didn’t spot this before. I think my hip problem is a genetic issue. My Mum had problems - she died at 46 so I don’t know how hers would have progressed, but my older sister has now had two replacements.

I have very limited movement if I twist my knee outwards and I have arthritis at the back of the joint, which I believe is unusual. It affects my back too because I think the sacro iliac joint gets stressed due to the lack of everything else moving.

I’m currently a bit miserable about it and am on max dose ibuprofen. I think I must have tweaked it. It will settle in a few days, hopefully!

My glutes are still reasonably toned and I think this is because they clench when I walk, to protect my hip. The rest of me is not toned at all now 🙄 maybe your glutes are also tensed?

Would be great if you can find something to help you. Have you had an x-ray?

Well I'm undertreated and have fibromyalgia and have periods of both being able to push myself through the fatigue and pain to exercise and not being able to will myself out of bed or climb the stairs without immediately wanting to fall asleep. It's like living on a SeeSaw.

Any decent amount of exercise results in a 'blowback' extreme fatigue and pain. Yet if I do nothing, I also feel worse mentally and physically and my muscles aren't happy either as they just get weaker and stamina hits the very bottom. It's like being on a washing machine cycle. Rinse, repeat. Cannot win.

Recently I decided I would take more levo immediately either before or after exercise and I have been doing this also on days I really cannot sleep. I only do it on those days and those times. I just take more levo in the evening. I go by how I feel. Starting with 25mg and increasing by a quarter etc as I feel. It varies by day.

Call it a placebo effect but it works for me. Recovery is quicker. No 'jumping muscles' or 'cracking joints' not to say there still isn't a price to pay, there most definitely is, but its just enough to keep going. It's the difference of being able to still do the shopping and cook after a workout or not even able to scroll through Just Eat for an order.

I got a bit worried and stopped doing this (whilst still exercising) a few weeks ago and I ended up this week, crying in bed too weak and too tired to even cook my children dinner and in mega pain.

So I am going back to doing what I was doing.

I do not know why dosing in this ad hoc way helps, because anytime I have tried to raise my levo on a regular ongoing basis I am unable to tolerate it. But I'm past trying to understand it all and until I can get to a decent endo (covid sigh) I'm happy to take any grace I can find at the mo.

in reply to Alanna01

That’s really interesting, thank you.

I guess we are so very individual. If it works for you, and helps you achieve the way of life that you want, go for it.

I’ll bear this in mind, thank you 😊

in reply to Alanna01

yes - I too find that interesting as I am experiencing similar to you and could weep at knowing what you are going through and how difficult it is. I am struggling round the ground floor of my home at the moment - stairs are a once a day affair and I haven't been for a walk since Wednesday. I would say that at the minute the most I am capable of is keeping myself alive - just. I am on T3 but don't know what would happen if I took a little bit extra after activity.

Start a new post with your most recent results in. The experts on here will be able to help I’m sure.

Two years ago I was in your position, don’t give up. Get help 😉

in reply to Murphysmum

Thank you for your kind words! So sorry you are going through similar. Yes, perhaps try increasing T3 on more active days. It doesn't sound like you have a lot to lose trying does it?! I am hoping things improve for you xx

You’ve had a lot of great advise from respected members.

I wanted to start going the gym last Oct. I started off going 3 times a week and slowly building up with cardio stuff. First just walking uphill on treadmill. Then increasing speed on the flat. I did this for a few weeks. After a while I found that I needed to increase my T3 from 2 doses a day to 3 a day. I queried this first with my private only Endocrinologist. He said spread it out due to the afterlife of T3. That really worked for me. I’m also on a small amount of T4. Within 5/6 weeks I could run on treadmill for 20 minutes flat out. I never thought I’d manage that before. I’m 61 and not run in decades. My cholesterol also came down from 6.7 to 4.9 during this time. I was feeling really good. This then continued until early March this year, when I decided not to go the gym anymore due to the virus. After a week or so I went over medicated with T3 and needed to drop it back again to 2 doses a day ( I go very heavy and fatigued if I go over). It took a short while to feel optimal again. I’m now walking fast daily for my exercise and feel great. In all I’ve lost 3st from this time last year now, although I’ve plateaued recently, I’d put on 2st previous year from being very Hypo. For myself I definitely needed an increase in T3 to support more exercise and decrease if that stopped. I have had low cortisol issues but this was due to lack of T3. Maybe also lack of T3 negativity effects your mitochondrial energy cells. I’m a poor converter with positive DIO2 gene test.

in reply to McPammy

Thank you for this.

So when you said you added an extra dose, what did you do? Ie, I’m on 50mcg split twice... did you add an extra 25? Surely not.

I am thinking of increasing mine to 55 or maybe even 60mcg but that would almost certainly be too much on non exercise days. Like you, I go very heavy with muscle weakness when my dose is too much which I why I’m confused.

In theory my dose should be low if I’m exercising, but my heavy limbs tell me it’s too high. I surely can’t reduce it and exercise?

See what I mean?! It’s a minefield.

in reply to Murphysmum

Yes, it is a minefield for sure.

Well I only need 5mcg twice a day or three times a day if I start to exercise for a long period. So max I take is 15mcg I guess we are all different. Maybe you need to lower your dose. Do you split and take 8hrs apart. That’s what I do.

Maybe think about how your life has been recently, are you doing less activity due to lockdown. If that is the case maybe your T3 has become too much. If so, lower slightly and see how you feel after a week. If I go over it normally takes about 3 days to level out again. It’s all about balancing input with output really, I guess you already know that.

in reply to McPammy

its so hard to tell!

At first I'd have said I was less active, but only for a week or so. Then it was probably about normal as we started biking most days but not any more strenuously than my normal walk.

Then we started doing much more DIY and I was busy all day so I felt the need for an increase from 45 to 50. This has been fine and because of the nice weather, we've continued to be busy one way or another.

Then two weeks ago I started the couch to 5k and was fine until tues/wed this week when my limbs became crazy heavy and I struggled to raise my arms above my head. All vitals are much the same, heart rate still ~50-55 resting, bp normal and tbh I've only really started watching my temperature but because its been so warm its proving quite hard to see any pattern. I know I get very cold when my next dose it due though.

I cannot work it out. In theory I should need an increase but usually get this heaviness when over medicated. Im trying a 3x split and Ill see if that works. If no change I'll try an increase, though 60mcg at this point seems quite a lot.

Funny! I have been wondering if my surprisingly high t3 levels have been due to the fact that I’ve been more sedentary than usual.

Make sense to me!

You need to run around the garden/living room/stairs 😂

I would if I could get the energy up! 😂


Joking aside I do wonder. I increased my levo by 25mcg on alternate days and my t3 levels have gone over range for the first time ever. From 65% through range to 105%! Seems to be a huge jump for such a small increase and I did wonder if it was to do with lack of exercise and a sedentary period

Probably. I'm no expert as you'll have worked out from this conversation, but it would seem sensible that if you were "ok" before and you've done an increase, your levels will have gone up, slightly.

but then factor in not using up any of it and it's gone much higher than you'd expect.

Seems sensible

Thanks. That’s what I thought. Seemed very big a jump in levels for a very small dose increase.

Hello. Getting back to exercise was difficult for me too. I have exercised all my life and suddenly found I was easily exhausted and constantly getting muscle and joint pain, and injuries. Since starting T3 I have improved greatly. I do tend to need my T4 and T3 near the top level to keep my energy levels up. I am now able to run, play tennis etc. Trouble is we are all different, but be patient, listen to your body and Im sure you will get there. Good luck.

I wasn’t aware about the exercise at all. I normally do yoga and swim to help keep me 'fit' but since lockdown I’ve found an amazing exercise program that helps to strengthen muscles and improve balance. It’s the brain child of Sarah Goldsack who suffers from muscular dystrophy but is also a fitness trainer. She devised the program to help strengthen her muscles as doctors expected her she would be in a wheelchair by now! She says the exercises are great for anyone who has a disability however large or small it happens to be. Diabetes, thyroid issues, polymyalgia, fibromyalgia and the list goes on. She has a FB group but you can find out more at paracise.com

Hi @Murphysmum, I totally get what you're asking, as I wondered the same thing for a while but have now found myself in a good place and I'm able to exercise as much as I want (long may that last!)

I've been a keen runner for the last 10 years, usually going out 2-3 times a week. It was my thing and I loved to do it. But about 18 months ago things changed and I couldn't run never mind exercise, just walking and going up the stairs would be too tiring. It was a general decline in my health, with bad fatigue, migraines, constipation, breathlessness, etc and I had many tests. I found it more frustrating not to feel like myself and wondering when I could do any kind of exercise again.

Just over a year ago I found out that I had hypothyroidism with low levels of TSH, Free T3 and Free T4. After trial and error, I'm now on 75mg Levo and 25mg Liothyronine and have made good efforts to improve my vitamin levels. As I'm feeling so good at the moment I can only hope that I've hit my optimal levels! Just 2 months ago I was on 50mg Levo and 20mg Liothyronine, whilst I could exercise, I often felt wiped out afterwards so couldn't do as much as I would have liked. But since increasing my dose I can really feel the difference.

For the past year I've been going to the gym more and doing strength & conditioning and HIIT classes. I think this has helped to improve my core strength and got me back into good condition. But with the gym closing during lockdown I'm now running a lot more and have been steadily increasing my distance and speed. I've been taking it slowly and building up over the last few weeks which has helped.

The only other change that I've made is to stop drinking for the past month. I used to have a few glasses of wine over the weekend, but I also take 70mg Amitriptyline in the evenings for migraines which is quite a high dose so would often wake up feeling groggy with heavy legs and not really feeling up for running. Now when I wake up I feel totally refreshed and could go for a run every day.

Sometimes the smallest changes can make the biggest difference, but as each of us is so different it's hard to know what to do for the best sometimes. I really hope that you can find whatever works for you to exercise as much as you want, good luck!

Gosh! Reading through all the replies you’ve had clearly emphasises the fact that we are all different. We all have different bodies and conditions, plus different types of medication and supplemental needs. So it’s no wonder that we all need to do different things to get the best outcomes for ourselves.

So we can’t just follow anyone’s guidance and expect it to work. How wonderful it would be if the doctors understood this!!!!

For me, personally, with no remaining thyroid gland, and as a poor converter:

when on T4 only, and a much reduced capacity to exercise, an extra 25mcg thyroxine before a day out on my bicycle helped a little, but I still couldn’t walk more than 2 or 3 miles.

Since adding a little T3 every day (privately acquired), I can cycle further and with much less effort, and after 4 years of hard work, can walk 10 miles on a good day.

I have always needed a little extra medication before heading out for a long day on the bike or on foot. T3 top-ups work much better than T4 as the result is immediate. If I’m doing this on consecutive days, I need to top up T4 a little as well.

Finally, as a very poor converter, I have worked out (over 17 years) that conversion within my muscles is vital for me, and I need to exercise to stimulate my muscles to do this. The less I do, the worse I feel. It’s a daily balancing act to do enough but not too much, and to know when I need to have a rest day!

I hope this helps!! Good luck!

in reply to dolphin5

This is very interesting too, thank you.

I am in this very strange conundrum, where doing nothing makes me feel tired, cold and rubbish. Exercising makes me feel much better but then it seems I can't sustain it at the moment.

Walking isn't an issue for me know, Ive always measured my recovery against my long time beach walk, which as above, is a mix of hills, sand dunes, flat beach and fields. Its quite a workout and if I do this, I don't/can't do any more exercise that day, but I can still be active (gardening, housework etc).

Now, after a workout, I feel knackered. My limbs are heavy and I feel almost kind of nauseous, I can't really describe it, yet, I feel better than doing nothing!

Logic suggests I need more meds for this which I will try in a process of elimination, yet when Ive been over medicated in the past, I get the same heavy limbs etc.

My symptoms are very much muscle driven. When I'm exercising, very early I get the feeling of lactic acid build up, yet I've only just started. Clearly my muscles need more of something but what to do without being over medicated the rest of the time, I don't know!

We are all different and this makes finding a solution so much more complicated!

If only some techy sports performance research was done on us we might learn something...... maybe we should be trying to interest some furloughed football trainers in us !

Obviously we'd have to 'invent' a new name for our disease first though so they wouldn't go down the usual route of assuming we're depressed and scared of exercise......... !

Aw if only!

If I could be “plugged in” right now, maybe just before and just after I exercise, and someone could tell me what’s happening.

Wouldn’t it be so much simpler?

I clearly have something going awry, but is it cortisol related, T3, T4, rT3, other hormones, vitamins, moon phases?

Goodness only knows!

One other thing ...... taking the same amount of medication every day only works well for me while I’m doing the same activities day in and day out.

Since the current lockdown started, my activities have been different, and I’m struggling to feel well ie the same medication quantities are not working for me.

I use a Fitbit with a heart rate function to give myself a better idea of what’s happening. I know that if I’m under-medicated or over-medicated I get some of the symptoms. But, I can tell which it is by whether my resting heart rate is higher than normal or lower.

Establishing what’s your ideal heart rate range takes time though, I’ve been monitoring my heart rate since 2015, and have been able to check it against blood tests as well as how I feel. Also, you need to learn what else affects your heart rate eg if I drink alcohol on a daily basis (mainly at Christmas or on holiday) my heart rate climbs daily.

A bit more to think about!!!

Sorry to hear abour it. I do agree with someome above who said that we need to adapt sometimes. I actually think we, thyroid patients, are quite ambitious people, we put a lot on our shoulders. When you are in this whirlpool of things, it is very hard to see, I had to learn it the hard way. We are fighting something that we cannot fight. I was extremely fit, I used to do pull ups, lizard crawls, weightlifting, running races. I cannot do them at this momemt, none of it, and I am 13 kilos heavier. On a good day I do yoga, go for a walk. Until things stabilise, I have to take it slow. Recovery after any exercise, when you are hypo, is not easy and pleasant. Instead of fighting it, I just had to accept that this is how it is, for now. When I was medicated correctly, I was able to do anything I wanted and was recovering well,that was some years ago before doctors messed up my meds. I used to think about what other people do, but it doesn't matter what they do, how they look like and if they can run. They are not me. I was stressing myself more with these thoughts. I am doing my absolute best and it is out of my control, I can only sync with my body and do what it allows me. Hope this makes sense, these are my two cents from my own journey.

I do need good levels of levo to give me a steady day,t3 is a top up to that, it fills gaps. I'm in week 5 of my dose of 112 and 17.5, it is very up and down, but I understand it may be this way for another few weeks. It is hard, but you will get there, I wish you the best of luck! X

Ok, this has been a really useful post, thanks all who have commented.

One final question for greygoose McPammy Cuppaofcha and any others who want to comment...

So far today I’ve taken 40mcg of my 55mcg dose. One at 7am and another at 12 midday.

The last couple of hours I’ve had slight chest discomfort, let’s call it not pains, my hr is slightly higher than normal at a resting 55-60bpm and my temp has been in the high 36’s all afternoon.

This suggests my dose is higher rather than lower, right? Should I take my last 15?

You see why I’m confused! If anything I’m thinking I should need a higher dose to account for the exercise, yet my body is telling me otherwise. (Although I know you can get this on too low levels and I’ve had that too, but the hr and temp don’t fit with then).

Any ideas other than doing my bloods on Tuesday when the lab opens!

Thanks! 🙈

Couple of questions in order to help you better, how long have you been on 55 mcg roughly, which day of the cycle are you in and what is your normal HR? I know it is confusing, when I was overdosed I was so weak I wasn't able to lift my finger, when undermedicated - full of water, exhausted, demotivated, it was painful to do a squat!

Ok I’ve been on 55 for about 2 months now, I’m on day umm.... 13? And my normal hr is low 50s resting.

I’m starting to keep a closer eye on cycle related symptoms but the hr is unusual for me, even since introducing and increasing T3.

I have had crazy muscle weakness in my arms for about a week now and this is normally over medication for me.

I can’t believe that increasing exercise is increasing my levels though? It’s totally counter intuitive!

Gee, I don’t think I’ve ever been this confused! 😂

Thanks, this helps! I have a question, you have mentioned that it can take 15 weeks for you to stabilise, do you think that you may need more time maybe? Just a thought. I have higher HR and get anxiety before ovulation, now on ovulation day my arms and legs feel like they are made of lead. I have also can't lift my arms when overmedicated.

Have you taken your third dose yet? If you do, you will know pretty quickly if you are overdosed.

Exercising may have nothing to do with it in the end, we don't know, but my personal experience from 3 years ago has been that as I increased my ndt to 4 grains, which had almost 40 mcg of t3 along with 150 mcg of t4 (!!!), the dose has built up over many months, it wasn't an immediate effect. Then one day it hit me, I was severely overdosed, so yes, as your cells are taking the hormone at first is fine, once satisfied they may not need so much anymore.

I’ve just had a “STOP THE BUS” moment!

Duh. I have been reading Paul a Robinson’s CT3M method, and just moved my first dose to around 6am this week. Could this be it?

How stoopid can you be! I bet this is why I’m feeling this way 🙄

Thank you though. At this point I think I feel the full effects of T3 a lot quicker than on levo but a good reminder, thanks again

There you go! Have you not moved other doses along with it? This sousds correctly, as you are mainly on t3 now, you need it bang on time

What do you mean “ moved other doses”?

I take my first at 6am, next around 1pm and the last about 6pm (still working on it!)

Is that what you mean?

Yes, exactly, if you moved first dose to 6 am, have you moved other two doses too along with it? E.g. if you take your dose earlier, do you take other doses earlier too?

Yes, ok that’s what I thought.

Yeah so previously I’d have taken one dose on waking (7-730ish) and the next at around 4pm. I was fine on this until I started the exercise!

This might explain today’s hyper feeling but it still doesn’t account for the last week or so’s symptoms 🤷🏼‍♀️

Good to know something is working tho!

I think a change of schedule can throw things off a good bit, especially on t3 only, if you split etc.

“...my hr is slightly higher than normal at a resting 55-60bpm and my temp has been in the high 36’s all afternoon.

This suggests my dose is higher rather than lower, right? Should I take my last 15?”

Question: what is the relationship between your heart rate and hypothyroidism? What does the heart rate pulse reveal about whether your medication dose needs to be higher versus lower? Thanks.

Typically when your under medicated your heart rate goes lower than normal.

So, for me when I became very ill my hr was only done here between 30-40bpm. Typically got the last 10 years it’s been around 45-50bpm resting. Normal is 60 to around 80 I think 🤔

Now that I have T3 added to my levo, it’s typically around 50-55bpm which is better.

If you become over medicated it’ll go higher and become uncomfortable.

A simplified version but I hope that helps Meadowsmom


Have you thought about looking at the work/research of Ari Whitten - website The Energy Blueprint. Particularly mitochondrial health (our energy creating organisms hundreds and thousands in each and every cell, except blood cells) Supporting mitochondria is key to energy and health. Try to support mitochondrial health . Try to ensure your mitochondria have not switched into cell danger response and if with fibromyalgia or other symptoms you may have, and you think you have then learn how to switch back into energy creating mode. Do everything you can to create the safe microcellular environment, so that yur mitochondria can reproduce and flourish and feel nourished and safe. Mitochondria feed and respond to the nutrients you provide to convert to ATP (energy) but they also respond and feed on light (new scientific research) Near infrared light is really beneficial to mitochondria ( see Ari Whittens book - Red Light Therapy) I bought my near infra red light from redlight man .co.uk (lots of info on website re thyroid/other conditions) Many top athletes use near infra red light to heal quickly following training. See Nicki Gratrix work - 'Cell Danger Response' re any fatigue issues. Mindset is key (similar to fight or flight, sympathetic/parasympathetic only at the cellular environment level

in reply to LynneG

Thank you, I’ll look into this.

I hadn’t hear of that particular site, or the red light therapy.

Thanks 😊

in reply to LynneG

Interesting info thanks!

Hi there - sorry to hear you are unable to exercise (YET !) - exercise puts a strain on the adrenal glands and if that is the case then the thyroid will take a hit - or the other way around depends on what your levels are.

Good suggestion re magnesium as magnesium keeps adrenaline in check which will help calm the adrenal gland response and put less strain on the muscles etc.


Hope this helps

In my opinion I would raise a very small dose of T3 before exercise. T4 takes longer to have an immediate affect .

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