Working Out Without Burnout for Hashimoto’s

Introduction to Hashimoto's and Muscle Focus 0:00

A lot of women with Hashimoto's focus on losing fat, which can feel very depriving, shaming, blaming. And if you spin it of like, I'm gonna feed and nourish my muscle tissue, it's gonna give me more energy. The more muscle I have, the more calories I'll burn at rest. It's a more fulfilling way to look at Hashimoto's diagnosis, especially when it comes to energy and weight loss. This is Dr. Talks. Hi, it's Dr. Jen. We're back with a Heal at Your Thyroid and Reverse Hashimoto Summit. Today, we're going to talk to Dr Emily Kivert.

She has been a chiropractor and kettlebell enthusiast since 2007. How cool is that? Hi Dr, Emily. Thanks for being here. Can you tell us a little bit about your journey with Hashimotos? Yeah, so I've been a chiropractor since 2007 and I was pregnant with my first born in 2015. And all the new mom symptoms that people tell you are new moms symptoms were really Hashimoto's symptoms. So fatigued, difficulty losing weight, hair loss, especially that outer third of the eyebrow, brain fog. I would start a sentence and couldn't remember how to finish it.

Those symptoms lasted and people said, you know, new Mom, Well, 18 months postpartum, I was like, this cannot be my life. This cannot the new mom symptoms. And so I started to kind of walk that path of GP, endocrinologists, a couple of functional medicine doctors until I met my current functional doctor, Dr. Gabrielle Lyon. really just started to dive into changing how I was eating. I very New York, I eating coffee and croissant in the morning and then crashing at 2 p.m. surprise and also trying to lose I gained about 50 pounds of baby weight.

was pregnant and I was trying to lose it by doing back-to-back spin classes, or I'd go to a spin class and walk across the street and go into a high-intensity

Dr. Emily Kivert's Hashimoto's Journey 2:04

interval training and the weight was not coming off. I'm like, this makes no sense, I am not eating that much and i'm working out like a beast and my weight's not going off and so really it was kind of this pivotal moment of like I have to do this better. This cannot be my life. I was not present with my kid. My husband was like, who's this woman? She's always laying on the couch, tired, and just starting to walk those steps of changing how he's eating, lifestyle changes, some root trigger changes and then also exercise changes.

That's such an amazing story. And I think it's a common story, unfortunately, is that women, you have this newborn and they're like, oh, that's just normal. You're tired because you're a mom. How many times have your clients heard that? And, I've had patients come to me crying and I knew something was wrong. Thank you for looking. So, anyone out there that is a new mom and think they might have a thyroid problem and that why you are here listening to the summit, get tested, you know, make sure that you're listening to your body and don't let anyone tell you you are wrong.

So what should women with Hashimoto's focus on if they want to boost their energy and lose weight with hashimoto? Yeah, so I frame it around feeding your muscle tissue appropriately. Muscle tissue is mitochondria. The more muscle you have, the more energy you'll have. And I think a lot of women with Hashimoto's focus on losing fat, which can feel very depriving, shaming, blaming. If you spin it of like, I'm going to feed and nourish my muscle, tissue, it's going give me more. Energy, The muscle I have the calories I'll burn at rest.

It's just, it's a more like fulfilling way to look at your Hashimoto's diagnosis, especially when it comes to energy and weight loss. So I have women feed their muscle tissue through resistance training and then hitting their optimal protein targets at every meal. That's so important. Especially as I have crossed into my 40s, I've been obsessed with weight lifting. After I had my last son, he's three now. I'm like heavy, heavy weights.I'm going to increase my weight resistance. i'm gonna eat more protein.

So I think we lose sight of this and no one's telling women to lift weights and eat protein and they should be, right? So When women, like, why should they focus on resistance training? Like, what's the science behind that? And why Should they Focus on Resistance Training and kind of let go of that HIIT workout and that cardio? Yeah. So the hypothyroid component of Hashimoto's, right, every metabolic process in the body requires thyroid hormone, including our muscle tissue. And if we are hypathyroid, it is just harder to maintain our muscles tissue, to put it simply, is it's just hard to keep meat on the bones.

So if are focusing, let's say we're only focusing on cardio. Well, cardio, especially if you do long bouts of cardio will break down our muscular tissue And it's already hard for us to keep it on the bone. So why don't we focus on maintaining the muscle and maybe potentially building the muscles, which is actually very challenging. Women worry about bulking up, but it is very actually challenging to put muscle on. And so through resistance training, we can grow the muscle, we can maintain our muscle mass, it's gonna give us more energy, and it helps with the turnover of our thyroid hormones.

So I think it is so important, you know, I thing culturally maybe we're in this mindset of lose weight, put on our running shoes, right? Wherever that came from, or do more cardio. And yes, cardio is important for our cardiovascular health, our heart health. But what I've noticed is that when women build this foundation of strength, they feel better when they do do their cardio. So I've had women go for a walk and they're like right around the 30 minute mark. My SI joints hurt, my back hurts, and you put them on a strength program, a resistance training program three days a week, 30 minutes, you know, it's not hours at a time at the gym, thirty minutes each session, and they can walk further, right?

Why Resistance Training Beats Fat Loss Focus 6:32

Their back doesn't hurt, their joints are more stable, they have more energy, And they feel like they could even walk farther than 30minutes. So there's no detriment to building muscle, Right? It's only benefits upon benefits. It really is. And I'll see a lot of times in my Hashimoto's patients, if they're going to trendy, you know, orange theory or all these hit workout places that You want to keep your body in that stress, like that high impact zone. Sometimes it's harder to lose weight. It's hard on your adrenals.

And sometimes you need that rest. So with weightlifting, you're getting good benefits and you are breaking a sweat too, but you aren't putting that on stress on you adenals, which will then affect your thyroid. I really like weight training for my thyroid patients. Its so important. So it's not really talked about a lot. So that's why I love your space because you really hone in on this. Yeah, I think a important differentiator between a well-programmed resistance training, strength training program versus a high intensity interval orange theory is that there is proper rest, right?

So when you go to kind of that boutique fitness class, you're not usually getting a sufficient rest until 50 minutes later when the class is over and you are totally tanked out. And with a, well programmed strength, training Between each set, you might take a minute, sometimes up to three minutes rest, which a lot of women when they're not used to that. They're like, did to do like what am I supposed to during this rest period, but that is how you can lift heavier, you can build your muscle without that feeling of extreme fatigue.

I know same experience patients who have been going to that high interval intensity, that High Intensity Interval Training, and they're like, I feel like I can't get off the couch for three days. And it's like you are, you know, there's probably stress and other aspects of your life and you're kind of taking yourself out. You're burning the candle at both ends. Your probably giving yourself adrenal issues. And so how can you still get that exercise and maintain your muscle, not break it down with high intensity interval training and still have that energy, and not feel like, You can't get off the couch for three days after you exercised.

Right, that's definitely a red flag if you can't get off the couch long. And I think people have to realize, we do have look at everyone individually, right? And, I sometimes throw in one HIIT workout a week, but my Hashimoto's is in remission. So, it's not like we're saying, oh my gosh, you cant ever go to your favorite HIITT class again. We're not, like I'm not saying that, i'm just saying you need to do weights because we need muscle. And also, where are you at in your healing? Where are your at your menstrual cycle even?

Are you in luteal phase? Should you chill out and maybe take a yoga class instead? So I think when we look at it, it's not a one size fits all either. So Dr. Emily, when you program differently in trainer, you were kind of getting into this with the reps and the sets and moves. What do you think for Hashimoto patients? How does that look exactly? Can you run us through maybe Like a little workout or something that's ideal? Yeah, I like functional moves, full body moves that recreate what we're doing in life.

So I call them the essential seven. It's a hinge, like a deadlift, a squat, some sort of push, pull, lunge, carry, and then some anti-rotation. And with those moves... If you went to a traditional trainer, they might do three sets of 15. because kind of the older research was, you know, 12 and above starts to work on muscle hypertrophy. Well, the newer research shows it doesn't matter how many reps you do. You just have to hit fatigue, this perception of, if you rated it on a scale of zero to 10, maybe it's an eight, like a seven or eight by the last couple reps.

Another way to think of it is by last a couple of reps, You perceive like, I only have two more in the tank and that's it. So you want to hit that sensation, right? And so you have to choose your weight appropriately to kind of hit the perceived exertion. And then I like to do less reps, so, you could do a thousand reps with a light weight. You'll probably give yourself an overuse injury, or you can do last reps for the heavier weight and get to that perceived-exertion fatigue quicker. So I might, especially for the woman who's not on the, I'm doing HIIT training five days a week, they're more on that kind of deconditioned,

Programming Strength Work for Hashimoto's 11:30

like maybe they only hit 2000 steps a day and they need to build their strength slowly. I may do three reps of a deadlift and then take a break. And then next set scheme, four reps and build slowly but you want to hit that perceived exertion. This is the most important piece. You can call it fatigue, but people view fatigue differently of a seven or eight out of 10. So that's how I program. And then between those sets, I like to give long rest breaks. Your heart rate goes up, you're more breathy.

And I like to give a minute, sometimes up to three minutes, depending on what your goals are, how heavy you're lifting, if you are new to the lifting journey and you fatigue easily, or maybe your Hashimoto's is, you know, the inflammatory load isn't being managed, maybe you aren't in remission. I, I liked to play with how long you were taking a rest break based on those factors. How well you slept, what's your stress, all those things. And I find that women do really well because it's a very fine line to walk of, you know, some women work out and they feel those hushy flare up symptoms or extreme fatigue, but you still want to challenge your body enough to put on the muscle.

So it was a fine to line walk and you have to take in all those other stress factors. But I found that woman feel so much better their energy feels better, they feel more present, and they don't have as much brain fog. They have clarity of mind when they're lifting weights versus maybe the conventional recommendation, which I've noticed is almost do low impact. Do some yoga, Pilates, take a walk, do some chair stretching. And that is all great for the nervous system, but it's not enough. It's unfortunate that that's a common recommendation.

Sometimes I feel like you can look at your doctor and know if they work out or not, right? And kind of base, oh, their recommendation is walking. Well, you know, that's probably what my doctor does and not much more. So, yeah. Right exactly like practice what you preach right like I your Instagram videos I mean you're strong and and I think that that's what we have to realize we as we age and not just for Hashimoto's patients so if you've had Hashimoto's it's in remission I means you are still at higher risk of getting another autoimmune disease or having those antibodies come back so You wanna stay strong and muscle as we age is so important.

I think that women has really, it's been a disfavor to them, going through different body types and what's beautiful and whatnot. And you can lift a lot and still have an hourglass figure. It's actually gonna help with that. So I love that you are talking about this and it science-based too is also what people need to realize. So Dr. Emily, can you just touch on kettlebells a little bit? Because I recently, the last couple years, I think it was like during COVID that I ordered kettle bells and they're fun.

They're so fun to work with. So can tell us a bit about your kettle bell? Yeah. I love kettlebells because they are very forgiving when you are first learning form, right? Because I think that is the fear with women picking up weights is they're like, I don't know how to do it. Like we didn't do this in high school. This wasn't a class in college. So kettle bells are So for example, if you think about a deadlift, you did a dumbbell dead lift. It's kind of awkward because like the dumbbells are either too far away from your body and it's pulling on your back or they're kind rubbing on legs.

A barbell, You have to have your form dialed in your breath, your brace. You don't want to be rounding in back and your low back. And kettlebells just really forgiving when your first learning form. The other thing is when you have a kettle bell in you hand, And you can squeeze it, especially your ring and your pinky finger. You know, studies show that the more grip strength you have, the stronger your grip, not only the most shoulder stability you, but you age better. Like your longevity is optimized and kettlebells are great.

So for example, if you're carrying two kettle bells down towards your side and like a farmer's walk. The kettlebells don't bump on your legs like a dumbbells do so You can work on grip strength and shoulder stability like if you have neck pain you can literally do a farmer's walk or heavy carry and Get yourself out of neck. Pain because you're strengthening your shoulder another thing about the kettle bell is this idea of this offset weight so if your holding the Kettlebell and the bells on the back of your forearm and It actually activates certain, you can call them like neurological centers in the body that create stabilization that doesn't necessarily happen with a dumbbell.

So if you hold a kettlebell in their racked position, it will turn on just by having the weight offset to the back of the arm. It will turned on all your shoulder stabilizers, so like your serratus, anterior, your lat. that just doesn't happen the same way if you're holding a dumbbell and the weight is kind of centralized in the hand. So the last thing is that, you know, a lot of women really focus on like, I got to get my cardio. You can work up to learning kettlebell swings and ballistic moves, right?

So kettle bell swings, snatches, cleans. and get your heart rate up without that extreme fatigue that can happen if you're going for a 10-mile run. I used to do a lot of triathlons and marathon training, so I know this well. But it's a great way to get in those ballistic moves, to work on coordination, proprioception, that doesn't necessarily happen. It's really hard to kettlebell swing a dumbbell.

Kettlebells, Grip Strength, and Stability 17:28

And if you think about a barbell, bar bell snatches, that is a lot of technique and can feel really intimidating for the woman who already feels intimidated picking up a weight. So I really love them. They're great to travel with. I have literally flown to Brazil with kettlebells so I could work out. And yeah, it was during the World Cup. My husband's like, you're insane. It's necessary. Sure enough, when we were working out, he's, like can I use your kettle bell that you flew down here? And I was like I guess.

Well, we've done that traveling like to my parents for Christmas. I'll just put a couple kettlebells in there because they're just, they are more versatile, I feel like, than dumbbells. So I think, you know, if anyone out there has like a camper or something or you're going somewhere, that would be nice. Now I bring bands with me when I actually have to like check luggage because it's I'm still, I can't believe you brought kettlebells. I think that is so fun. But yeah, they're very just versatile.

And less intimidating, like you said. If you get confident, you could go to the gym and pick up a kettle bell there and show all the men your moves. Yeah, totally. So what do you notice looking at women with Hashimoto's from a movement and strength perspective? Yeah, and I think a lot of women with Hashimoto's don't get a workup or an analysis in this way, right? It's typically from functional medicine, blood work, lab work. They're sitting, they're chatting. And when I had my practice in New York City, I noticed that a lotta women that were coming to me had this element of hypermobility.

tissue laxity, joints that weren't stable. And it wasn't every woman with Hashimoto's, but it was a very, it probably 80%. And there's not research on it. You know, there was research earlier on Danlos and that kind of clinical diagnosis. But I just noticed a lot of the autoimmune population and the women with hashimoto were coming in with joint laxxity. And there's 10 points you can check in the body. It's called a Bait and Score in The Physical Therapy Land. And it's the elbows, the knees, you know, hyperextend kind of back behind the ankles.

The thumb touching towards the soft part of your forearm, The pinky bending back beyond 90. Then if you stood with your feet together, knees straight, bend forward, touch the floor, You could palm the And I know every yogi is like, I can do that, you know, but that's actually too much mobility. And there's biomechanical, like if you've been training it from a yoga perspective, and then there is a genetic autoimmune perspective. So these women were coming in with hypermobile joints, tissue laxity, they couldn't stabilize.

They kind of stand there and hang out on their knees and wonder why the back hurt. And they all wanted massage because their joints hurt and their muscles ache. And, they wanted to get adjusted. They wanted me to teach them stretching and foam rolling moves. I was like, that's the last thing you need. We need strength. we need joint integrity.We need to make you feel more stable and strong. And usually when I would put them on a strength training program, the first 10 days they'd be like, oh, I feel really tight.

And I was like is it tightness or is we're creating this joint integrity that you've never had before? And then after that, they would feel so much better. their anxiety would come down. They would feel stronger, they had more energy. And sometimes they would go back to a yoga class to fill the soul, right? Because it fills a soul. I'm a Yoga instructor too. Afterwards, it would fill destroyed. It was like this realization, oh, this strength training, like there's something to it. And so that was a clinical observation and I've bounced it off of some friends who are naturopaths and functional medicine docs and they're like, I haven't noticed that.

And I was like yeah, but you've never, you know, watched someone walk, taken them through a full body kind of functional movement assessment, had them step up to kettlebells, and have them deadlift and see what they do in their movement patterns. So that was a clinical observation. And you know, it's unfortunate. I wish Pilates or walking could clean something up like that, but it can't. Like the only way is to pick up a heavy weight with amazing form, put it down and do it again. And the hypermobility will kind of get reined in.

It's still there. But I think the bigger thing is that they have more energy. These women feel stronger. There's this element of hyper mobility that kind tanks your energy, like it's exhausting to kind not know where you are in time and space all day. So that was a clinical observation and the women who do resistance training on top of all the benefits of, you know, building muscle and maintaining muscle. That was one piece that I noticed clinically. That's really cool to hear. And that almost makes me want to start checking that when Hashimoto's patients come in.

But it kind of fits that whole perspective of autoimmune disease. I mean, it's all kind tied in and you get this hypermobility piece in there.

Hypermobility and Joint Support 22:48

So that's that really fascinating. Strength training? Yup. You just feel better. How do you help women build the resilience of their nervous system through strength training? Yeah. You hear a lot of people talk about managing their stress, that dysregulation of their nervous system is such a big piece and is sometimes the last piece that is addressed, right? So sometimes they're taking all the supplements, working on their gut health, and you know, there's different programs to help that dis-regulatio of the nervous systems.

And my approach is that we do the hard things in small doses, like pick up a weight, then you use your rest break to calm your nervous system through different techniques. So you could put your tongue on the roof of your mouth and extend your exhale through your nose, right? Because after you picked up a weight, your heart rate's up, you're breath rate is up. And that long, slow exhale will put you back into that parasympathetic state. I have women hum during their rest breaks between sets or sing.

It's just vagal toning, so a lot of people do this to help when they're in that stress state. Well, why not train it by adding a little stressor, which, you know, picking up weight and exercise is a stresser, but then training your nervous system between those sets to drop back into that, like, everything's okay, your vagal toning during those rest breaks, and then pick up a weight again. Because that's really the beauty in stress is like, how quickly can we experience the stress? It's always going to be there.

And then drop back into that, I'm okay state. I can't really think of a better avenue than to microdose some heavy weights and then use those techniques during your rest breaks to put yourself back in that calm state Yeah, so training your body with that resilience, that is really full. Maybe that some people sing while they're at the gym. I probably not, but if we're going to start doing that, you'll see me. I'm just going start putting on music and not listening to a podcast while I work out. Yeah.

But I don't know at the gym, if people would look at you like, what are you doing? But you could just say, I am training my nervous system. Then they would probably leave you alone after that. So this has all been so interesting. It's such a great talk. Is there anything else that you want to discuss about your workout or like where to start? Like, I guess that's the one question I would have is if someone's listening, their Hashimoto's patients, no matter where they are in their diagnosis, they have never picked up a weight before.

Where should they start? Because this is a little overwhelming if no one has picked up a kettlebell or weight before. Yeah, so I'll give two recommendations. One is to start with the breath. And I think as women, we focus on, like when someone says in class, engage your core, you don't really know what that means, right? You're like, am I doing it? How about now? Am I doin' it now, and so no one really teaches how do you engage you core when you pick up a weight. So you wanna breathe down and wide into your belly.

You wanna create a brace. And then when you exhale, you want to maintain that brace. And one of the best ways to do it is with an audible exhale. You can feel your core kind of go pew. A lot of women will pull their belly to the spine. They'll draw up and in. Kind of a Pilates cue. And you don't want to do that when you pick up a weight because you'll injure your back.

Nervous System Resilience Through Lifting 26:48

If you look at a baby, how a babies stabilizes, you never see a Baby suck their belly to their spine. They're always kind of breathing down and wide and then during doing their move. And that actually pushes the spine out of extension and creates a rigid spine for when do pick-up the weight. So every woman I teach, the first thing I teaches to get your breath down there, because a lot of women are breathing short and shallow. So to their breath, down and wide, and then to learn how to kind of keep that fullness in their belly on their exhale.

So that would be one place to start. Another place is start that I get a lot of questions is like, what way do I pick up? And I usually have women start with, you know, if it's some sort of pressing motion, an eight kilo or a 10 kilo. And then if that's a deadlift, I'll usually start women with two 12 kilos, which is 50 pounds. Which a lotta women are like you're gonna make me start at 50 lbs. Yes, because you need enough resistance to have your hamstrings and your glutes turn on. If you don't have enough, you're going to be using your low back, your form is going be off, so you need enough resistance to get the body to activate the muscles appropriately.

So that's two different places, two ways to start. Those are great tips. I'm sure everyone is just going to be all into weightlifting after listening to all the benefits. So thank you so much. Yeah, so I have a program called Thyroid Strong, and it was born out of my own journey with Hashimoto's and then treating women in person and sharing it online. So there's a six-week program and a 12- week program, from a beginner of how to pick up a weight. There's three workouts a week for six weeks. And the whole goal is to feed your muscle, to get you stronger so that you can have more energy to be present with the people that matter most in your life and things that are important to you.

And I think one thing that is maybe different than other exercise programs out there is the queuing. If one queue of how to do the form properly works for everyone, it would be a billion dollar business, but different women You know, you say one thing and it happens for one woman and another woman's like, I don't get it. So the cueing is very specific.

How to Start Strength Training Safely 29:28

It's how to step your feet, where to turn your toes, Where your knee should go, how does set your hips back, How to breathe before you pick up a deadlift. Like all that happens and then we cue. it's not just step up to the bells, sit your hip back stand up. so the queuing, from a medical person who's looked at form, with their patients for the last 14 years, that is all in the program. And it's really a place to, a portal of entry to get women into working out, right? To have them feel confident such that after six weeks, they can go to the gym and feel confidence picking up weights and be like, my form's on point.

I know exactly what I'm doing. That's the goal is to really give them that life skills so that they don't fear weights. They're confident around them. That's so amazing. I love what you're doing in the Hashimoto space. Thank you so much for being here and teaching us everything that you did today. Yeah, thanks so Thank you for tuning in to Doctor Talks. We hope today's episode has enlightened and inspired you on your path to optimal health. Each day is a new opportunity to make choices that empower your well-being.

For more insights and strategies, subscribe to our podcast and visit our website, www.doctortalks dot com. Stay connected, stay healthy, and join us next time on DoctorTalks, real talks from real doctors on the issues that matter to you most.