Effect of Exercise and Yoga on Mental Health in Patients with Hypothyroidism: A Systematic Review

A BSTRACT Background: Hypothyroidism is a common endocrine disorder linked with persistent depression and anxiety despite hormone therapy. Non-pharmacological approaches like exercise and yoga may help address residual mental health symptoms. Objective: This systematic review evaluated the effects of exercise and yoga on mental health outcomes in adults with hypothyroidism. Methods: A systematic search of PubMed, Web of Science, Scopus, PEDro, and CENTRAL was conducted up to May 2025. Randomized controlled trials (RCTs) reporting mental health outcomes were included. Methodological quality was assessed using the PEDro scale and ROB 2.0. Results: Five RCTs ( N = 293) were included. Interventions included yoga, aerobic and resistance training, Pilates, and combined exercise programs (12–24 weeks). All studies reported significant improvements in depression, anxiety, stress, quality of life, or sleep ( P < 0.05). Methodological quality was moderate to high (PEDro 6–8/10) with low risk of bias in most studies. Conclusions: Structured exercise and yoga significantly improve mental health in hypothyroidism and may be used as adjuncts to medical treatment. Larger trials with standardized protocols and longer follow-up are needed.