New Guidelines to Designing Interventions that Assess Resetting Thyroid Metabolism with the Integration of Nutrition-Based Exercise Programs

Background: Modifying lifestyle with exercise is generally used to manage preventative medical conditions but is not utilized to manage acquired thyroid disease. Few literature reviews have documented physical activity (PA) in successfully resolving thyroid conditions (hyperthyroidism, hypothyroidism, and autoimmune thyroid disease [AITD]). Purpose: We aimed to investigate whether PA or specified exercises can alter thyroid hormone activity to resolve disease conditions in patients with thyroid disease. Methods: Electronic databases were searched for clinical trials investigating the relationship between PA and thyroid disease. Clinical outcomes included the improvement of thyroid hormones or antibodies, health-related quality of life (HRQoL), or resolution of thyroid conditions. Results: Seven studies evaluated thyroid biomarkers or HRQoL in patients with thyroid conditions. Of the five studies that evaluated exercise programs on thyroid biomarkers, significant improvements were observed in TSH in three studies, T4 in three studies , and T3 in two studies. One study that evaluated AITD biomarkers demonstrated significant improvements in c-reactive protein, thyroid peroxidase, thyroglobulin, TBARs, and OPG concentrations. Other significant improvements included reductions in HOMA-IR in one study, systolic blood pressure in one study, heart rate in two studies, anthropometric measurements in two studies, and increases in VO₂max in three studies. Endurance, aerobic-resistance, and structured training positively affected patients with thyroid conditions. While medium-intensity exercise training and long-term durations (6mos) demonstrated statistical improvements. Two studies reported medication reduction and resolution of thyroid conditions, while two studies assessing HRQOL observed significant improvements across multiple domains. Conclusion: Endurance, aerobic-resistance, and structured training improved various thyroid biomarkers, HRQoL domains, and may contribute to resolving thyroid disease. Nutrition-based exercise programs should be designed to target the metabolic impacts of thyroid conditions. Further research should use comprehensive guidelines to test the reliability of such results.