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Four years after the birth of my second child I was eventually diagnosed with hypothyroidism and Hashimoto’s Disease. It was a long journey to get the diagnosis, as although I felt very unwell, I was regularly advised that there wasn’t anything wrong with me. So, I just presumed all my symptoms were related to being a busy mum who ran a business.

The symptoms I was experiencing were:

  • Lethargy / Fatigue
  • Weight gain and fluid retention
  • Depression / Low mood
  • Sleep disturbance
  • Breathlessness
  • Dry skin
  • Poor concentration
  • Muscle pain and weakness
  • Decreased libido
  • Menstrual changes

Other symptoms that people with Hashimoto’s Disease experience are:

  • Increased sensitivity to cold
  • Thinning of hair and eyebrows
  • Constipation
  • Enlarged thyroid (Goitre)
  • Decreased fertility


Hashimoto’s Disease is now considered the most common Autoimmune diseases and affects the thyroid gland (Beynon, & Pinneri, 2016). It usually causes hypothyroid symptoms, however, it is possible for Hashimoto symptoms to swing between hypothyroidism and hyperthyroidism.

Hypothyroidism (underactive Thyroid) is more common in women than men, with estimates that 10 times more women than men are affected. Hypothyroidism is typically gradually progressive, with symptoms increasing as thyroid function deteriorates.

Hyperthyroidism, or overactive thyroid, occurs if the thyroid gland produces too much thyroid hormone, causing every function in the body to speed up.

For me, the medication made a huge difference, but being a physiotherapist, I wanted to know more about my condition and what else I could do – especially in the areas of exercise and movement.

Exercise has been shown to be effective in improving thyroid-stimulating hormone (TSH) levels. Studies have shown that medium-intensity aerobic exercise (classified as 70% of a person’s maximum heart rate) produced the best results for improving TSH.  However, if exercise is too intense, too lengthy or too frequent, there may not be enough time for the body to restore normal levels of thyroid hormones T3 and T4.

Correlation between physical activity and signs of autoimmune flare-ups varies from one person to another.

For me, the perfect exercise turned out to be Pilates – I could work hard enough to get the intensity I required to support and stimulate TSH levels, without producing the negative reactions associated with over-exercising.  The other addition I made to my exercise routine was to start training with an Exercise Physiologist for my weights training and cardiovascular workouts. My EP was able to monitor me and understood the pathophysiology of Hashimoto’s Disease (I highly recommend Natalie Soldatenko at The Body Refinery).


Ten years on, I am feeling the best I have ever felt – I feel like I am 20 again. My advice to women experiencing any of the symptoms listed earlier, is to get your thyroid tested, and if a thyroid issue is identified, see an endocrinologist and start to exercise appropriately by training with someone who has the training to properly understand autoimmune conditions.


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Written by Susan Cottrell, Physiotherapist and Director of The Body Refinery