Discovering that you have Hashimoto’s disease can be a life-altering moment. This autoimmune condition affecting the thyroid gland often brings fatigue, weight gain, and muscle weakness into one’s life and makes tasks of daily living a challenge, let alone pursuing a sport one loves. For Alexandra, the love for running persisted, but it was years since she had been able to run consistently without debilitating fatigue. Together we worked on shifting this athlete’s mindset and created a more supportive training plan that allowed her to complete three half marathons in a single year! She proved, with some adjustments, that running with Hashimoto’s can be not just a possibility but a powerful tool in reclaiming her health. In this case study, I will share the five essential strategies we used to help this former athlete with Hashimoto’s achieve her goals without sacrificing her health and well-being.
1) Shift focus from elimination to inclusion
In the quest for improving thyroid health, it’s common to scrutinize diets, leading to an ever increasing list of restricted foods and nutrients. The most commonly prescribed diet for autoimmune conditions is extremely restrictive and largely unsustainable without physical and psychological consequences. While Alexandra had broadened her foods consumed and was only avoiding gluten, dairy and soy, we shifted our focus to nutrient density instead, and broadened the variety of foods she consumed to ensure she included foods that nourished her thyroid and met known nutrient requirements for her stage of life.
Among these were foods abundant in selenium (such as Brazil nuts, oysters, cod and mussels), iodine* (found in seafood and seaweed), and zinc (available in red meat, organ meats and oysters). While red meat consumption was frequent, to really rebuild nutrient stores we shifted to highly concentrated foods such as liver, oysters, salmon, and mussels and seaweed. Prior to seeing me, Alexandra ate seafood infrequently and was not consuming liver at all. Together we found ways to incorporate these foods that were palatable and her commitment to finding a way to make it work was essential to the process!
2) Dial in and stabilize medications
Medication plays a pivotal role in managing Hashimoto’s. Collaborating closely with your healthcare provider to determine the appropriate medication and dosage is crucial. Achieving stable thyroid hormone levels is essential for enhancing your energy levels, stamina, and overall quality of life. Fortunately, Alexandra had found a doctor she was working with who had gone outside the box a bit and dialed in her medication such that her energy levels had improved, her motivation had returned and she could consider the possibility of running again. It took several doctors and a 3-4 years to find a combination that worked. I include this because 1) many people on the internet will state that one ‘should’ be able to get off of medication and that is not always correct or appropriate and 2) it is not uncommon to need to see several doctors before finding one willing to think outside the box and work with you to help you regain your quality of life. If you do not have that, keep looking!
I encouraged Alexandra to work with her doctor to monitor her hormone levels throughout training to keep tabs on her thyroid’s reponse to the stress of training. The right balance can make a substantial difference in running performance and recovery needs, and her doctor was willing to run labs more than once a year to help her monitor her body’s response to the training.
3) Take a slower approach
Running with Hashimoto’s usually requires an adjustment in your training methodology. It’s essential to recognize that your body may need more time to recuperate and adapt. Instead of pushing your limits prematurely, success is dependent upon adopting a more measured approach to your training.
Alexandra utilized more low-intensity, steady-state workouts into her training and worked much longer establishing a base before beginning to work on speed. This slower, steadier approach helped reduce the risk of worsening symptoms and allowed her system time to adapt to the load. Additionally, she began really honoring fatigue and the need to rest that she had previously been able to push through and I believe this made all the difference.
4) Adopt a mindset of exploration
Hashimoto’s can undoubtedly be a source of frustration and unpredictability. COming into training, Alexandra was worried about how her body would respond and if she was capable of running a half marathon again. In our time together, we worked together to shift her perspective from one of limitations and looming disease to one of exploration and curiosity. She began using her running as an opportunity to maintain an open dialogue about what her body could achieve and how it responded to various training techniques, nutrition plans, and lifestyle changes.
I encouraged her to maintain a journal to track running performance, energy levels, and symptoms. This allowed us to make better decisions regarding her training and nutrition. Through this process she discovered that cornflakes did not work well for her before runs but oats did, and that after a month without liver and seafood, her condition began to deteriorate, and that she needed an extra day of recovery after speed workouts than she did before her condition developed. Without a willingness to observe with curiosity rather than slipping into a story of the futility of disease and aging, she was able to find workarounds that brought her half marathon times within ten minutes of where they had been a decade earlier, before her diagnosis!
5) More rest is needed!
Running with Hashimoto’s means that your body might require more rest than what is typical for an athlete. Always pay heed to your body’s signals and prioritize ample rest and recovery. Overtraining could worsen Hashimoto’s symptoms, lead to injuries from lack of time to rebuild or worsening form while running under fatigue, and will impede your progress.
Mindfulness and relaxation techniques are also important. Alexandra had done a lot of work previously to decrease the stress in her life so that she no longer felt she was burning teh candle at both ends. She also began using her runs as a moving meditation, focusing on breath and body awareness rather than letting her mind wander. Stress is a known factor in exacerbating Hashimoto’s symptoms, and running itself is a significant stress upon the body, so we really ensured that she build an effective sleeping ritual, additional stress reduction techniques, and more physical rest into her life while she was training.
With these changes underway, Alexandra was able to run a half marathon within a year and proceeded to run two more in that 12 month cycle! During her training, any perturbations in the thyroid were addressed with additional rest and dietary shifts which were effective in resolving her symptoms.
After a several years away from it, Alexandra was able to relish the physical and mental rewards of running while successfully managing her Hashimoto’s symptoms. The impact of a nutrient-first approach to her nutrition coupled with a strong commitment to honoring her body cues and trusting rest would not lead to becoming ‘unfit’ were, in my opinion, absolutely essential to her success. It was not by any means easy, but reclaiming her athleticism was something she was uncertain she could achieve when she began, and she has been very pleased by the results (and is now a liver covert)!
*Iodine is a hotly contested nutrient when it comes to thyroid health. There were specific reasons revealed in Alexandra’s health history that led to my encouragement of more iodine containing foods, but this may not be best for everyone. Additionally, iodine in the form of seafood, alongside known and unknown nutrients which balance it out, are far different than supplementation and these two cannot be viewed as equal.