Guidance Requested: Health and Training

Medical Q&A [Moderated]
1

First off, I apologize if this gets a little long, or is outside the purview of this forum.

Current stats: Male, 39, 198 lbs. Bodyfat unknown, but my waist is 39" at the umbilicus. Current lifts are not worth mentioning due to not training consistently for >1 year, so we’ll say novice. For what it’s worth, I have never been very strong - my 5rm at their best have been: Squat - 255, Dead - 305, Bench - 185 and Press - 135.

Issue #1: I am 1 month post complete thyroidectomy for the removal of a >4cm benign nodule that was pushing my larynx to the side. Taking 125mcg of Synthroid daily. Current hormone levels are unknown, as I have not been back back to test my levels yet (scheduled for 2 weeks from now). I have been back to full activity for 2 weeks, including lifting. Feeling generally OK: plenty of energy to lift, run, cycle whatever. Recovery appears to be unimpaired right now. I don’t have data on my prior T3 or T4, but my TSH steadily climbed from 1.9 in 2015, to 4.75 just before surgery. Weight has been steady since surgery.

Issue #2: I have always had elevated cholesterol levels (my parents both have elevated cholesterol, as well), but just prior to surgery, they topped out at 311 total, broken down as follows:

Total cholesterol - 311
HDL - 70
Triglycerides - 119
LDL (calculated) - 215
Non HDL - 241

Compared to my levels from a year and a half ago:

Total cholesterol - 261
HDL - 83
Triglycerides - 92
LDL (calculated) - 158
Non HDL - 178

In light of the latest lipids, my doctor put me on 10mg simvastatin, which I finally relented to. I have been taking it for 2 weeks. However, the past 4 or 5 days, I have developed very noticeable muscular fatigue, unlike anything I have ever experienced. I notified my doctor, and she is switching me to a pravastatin, which I will start in a day or two. Based on a few papers I have read, TSH can have a direct impact on cholesterol levels, so I am unsure if the statin is something I will be taking long-term.

With all that out of the way, I want to start training in earnest, but I’m not sure what kind of training protocol and diet I should be looking at, based on the needle I need to thread: potential energy and recovery issues as my thyroid levels are sorted out, cholesterol issues, and need to reduce waist circumference.

Any and all advice would be greatly appreciated, and please let me know if I can provide any additional information.

2

I’m not entirely clear on what your specific question is, but from the best that I can tell it seems you’re asking whether you need a special / specific training program and/or diet based on your history.

We would not recommend any sort of “special” program or diet in this situation, but rather an approach consistent with our general health recommendations laid out here: Where should my priorities be to improve my health?

In your situation, the top priority should be to get your waist measurement down below 37" through diet and exercise. Take special note of the specific discussion of dietary patterns and physical activity outlined in the article above. In essence, whatever program you can stick to that meets those guideline recommendations would be totally fine. If you would like specific / one-on-one guidance in setting this up, our consult/coaching services would be the way to go.

I suspect that by doing this, your lipid panel would normalize (or at the very least demonstrate significant improvement) and your doctor would likely feel comfortable discontinuing the statin. Our programs incorporate the use of autoregulation using RPE, which is our recommended way to manage fatigue/energy/recovery issues regardless of health status.

3

Thank you, Austin. I appreciate the response!

You are correct about my general question, and I definitely could have been more precise in posing it. I will read through the article you linked, and follow up if I have any other questions.