Hey Docs,
Question, my mother has Graves disease and one of her symptoms is weight gain, muscle fatigue, and muscle soreness. I started programming for her this past December 2022 at an even lower dose than the beginner’s prescription. She currently walks 1-2 times per week for about 30 minutes, and resistance trains 2-3 times per week. We have SLOWLY exposed her to more volume over the last 9 months or so. We have incorporated deloads when life stress and fatigue were higher than she was comfortable with.
We live in the suburbs of Chicago and her favorite thing to do is to walk and hike (especially when we travel as a family). I don’t want to use the word ‘excuse’ because that’s not what she’s doing but the muscle fatigue symptom that she keeps reading about and doctors telling her to stay away from intense exercise is always in the back of her mind.
She has been to probably 5-7 doctors, receiving various different blood marker tests, and even though her tests have improved immensely her newest doctor now told her she may not have Grave disease anymore and may have hypothyroidism.
What would BBM recommend for the next steps to take? I have been encouraging her to meet the physical activity guidelines but the fatigue and soreness always wins.
ZT,
In general, an individual whose thyroid (or other) condition is appropriately treated does not require unique exercise considerations beyond what you’d do for anyone else. Movement preferences, available resources, current fitness levels, response to the program, etc. are the big players here.
Based on the limited medical information here, it sounds like your mom’s condition may be currently over treated given the report of “hypothyroidism”, which can certainly cause fatigue, decreased exercise capacity, etc.
I would recommend following up with the doctor to make sure she is appropriately treated, expressing concerns over the fatigue she’s experiencing and how it’s impacting her life, ability to exercise, etc. It is possible her medication regimen needs some adjustment. Her endocrinologist should be able to suss this out.
In the interim, she should aiming to meet/exceed the current physical activity guidelines. The RT component you mention may be sufficient, but the conditioning is under-dosed from both a volume and intensity standpoint. Of course, fixing the the thyroid situation is likely to improve her ability to meet/exceed the guidelines.
-Jordan
Yeah, this is a complex topic where specific recommendations are difficult to make via the forum here, especially without having knowledge of her specific treatment regimen and lab data. It is quite common for patients being treated for Graves’ to end up in a hypothyroid state, and subsequently needing thyroid hormone replacement, but again - there’s a lot to consider here. With that said, the management of Graves’ is relatively straightforward in most situations and should not need the attention / opinion of 5-7 different doctors.
Additionally, any patient with an autoimmune condition is going to be at an increased risk of other autoimmune conditions – so even if her thyroid situation were being perfectly managed, the muscle symptoms may not be related to the Graves’ at all, but rather may be related to another (potentially undiagnosed) condition. This is why more detailed consultation would be needed.