Thyroid Strong

Hashimoto’s and Sarcopenia

by | May 26, 2022 | Symptoms

Most women don’t think much about growing muscles because we don’t want to look like bodybuilders. But muscles are actually vital for your health and your functionality and survival as you get older. 

Since age-related muscle loss (sarcopenia) starts in the thirties for most women, and Hashimoto’s can accelerate it, you really need to pay attention to it and start working on your muscle mass as early as possible. 

With Hashimoto’s, muscle loss can worsen joint issues and contribute to weight gain. Conversely, having strong muscles can stabilize your joints, minimizing pain and injury, while maximizing your wellbeing. The right training can also help boost your energy and manage your overall Hashimoto’s. 

This article will introduce the concept of sarcopenia, why you need to pay attention to it, and science-based ways to combat it.

What is sarcopenia and why does it matter for Hashimoto’s?

If you have Hashimoto’s, sarcopenia is much more problematic for you than for other women. Low levels of thyroid hormone cause your metabolism to shift toward muscle loss. [1-3].  

Sarcopenia is a normal process that happens to all women beginning in our thirties due to the following aging processes:

  • Declining ability to digest, assimilate, and use proteins
  • Hormonal changes
  • Increasing inflammation

As a result, your muscle mass, strength, and the ability to gain muscles go down. You may not notice how muscle loss affects your health in your 30s and 40s aside from the metabolic slowdown that starts around this age. 

But as you get older, muscle mass can become critical for your well-being and survival. Muscles keep you mobile and prevent falls and bone breaks, which are leading causes of morbidity and death in the elderly. Not surprisingly, muscle strength predicts health-related quality of life and mortality in the elderly [4-5]. 

Also, muscles and strength are key to managing many Hashimoto’s symptoms, including joint pain, hypermobility, fatigue, weight gain, and more.  

Now, let’s go over five best ways to combat sarcopenia, backed by the latest evidence, and my personal and clinical experience.

How to beat sarcopenia with Hashimoto’s

Although you may not feel any major effects of sarcopenia now, you should combat it as early as possible because it’s easier to build strength and muscles when you’re younger. Also, prevention is the best medicine.

1) Train with the 7 essential functional movements 

If you want to build or maintain muscles, manage Hashimoto’s symptoms, and age well, perform functional movements. These 7 essential functional movements include:

  1. Hinge or deadlift: bending at the hip and pushing them backward
  2. Squat: bending at the knees and pushing your hips downward
  3. Push: pushing weight away from you with your upper body
  4. Pull: pulling weight toward you with your upper body
  5. Carry: holding a weight while you walk 
  6. Lunge:  squatting with one leg in front of you and one behind you acting as a kickstand
  7. Anti-rotation: resisting rotation in your core muscles

Many popular exercises such as biceps curl, leg lifts, bench presses, and side raises are not considered functional movements because they don’t help you function better in your day-to-day life.

Why are functional movements better to combat sarcopenia with Hashimoto’s? 

First, they are real-world movements that involve multiple joints and muscles simultaneously, which are how your body is made to move. Second, they relate directly to your ability to painlessly perform day-to-day tasks, such as picking up a toddler from the ground and carrying your groceries. Third, they train your nervous system and multiple muscles simultaneously, so they’re much more efficient than isolated exercises.

Form is king

So I say functional movements, I mean performing them correctly and without pain.  For example, to squat in full range, you’d need the flexibility in your ankles and hip to dip below parallel. Also, you’d need to be able to breathe, stack your spine, and brace your core to correctly stabilize your body. 

Without the flexibility and stability, your body will compensate when you push it to move in that direction. This is a recipe for pain and injuries, especially if you already have joint pain and hypermobility associated with Hashimoto’s.

Most people nowadays, especially ones who don’t exercise, lose the ability to do functional movements correctly or without getting hurt. Our lifestyles tend to have us sit all day, mostly hunched over, and almost never move in full range. We all sit driving, working, relaxing, eating, and on the toilet. As a result, our bodies can “forget” how to do functional movements by losing the mobility, stability, and nervous system coordination we were born with to properly do these functional movements.

So, the first step to safely performing functional movement is to learn to prime your nervous system and get your form right, and work on restoring the lost stability and mobility. These steps have helped thousands of Thyroid Strong students safely lift and gain muscles. 

2) Train with the right level and intensity

If you have Hashimoto’s, it can be confusing to figure out the right exercise intensity to get results. Too much and you can be couch-bound for days. Too little and you may not achieve the desired results.

When you lift weights, think of it as a stimulus that tells your body to adapt, in this case, by getting stronger and building muscles. It doesn’t work like the calorie counter on the cardio machine. 

So, you just need to stimulate it just enough. For beginners or those who are out of shape, the sweet spot is less than you think.

Previously, exercise physiologists used to believe that you needed to perform 6 – 12 reps of any given exercise to gain muscles. But the latest research shows that you only need to feel an 8 out of 10 perceived exertion (difficulty) by your last rep, regardless of the total number of reps [5].  

That means you can get results with fewer reps more efficiently, leaving you energized after a workout, not depleted and exhausted. If you’re still learning to get the form right, avoid exhausting yourself because the form tends to get sloppy when you’re exhausted.

Many Thyroid Strong students start out being out of shape so they start from 3 – 5 reps. But they quickly improve their form and get stronger. Also, the workout programs provide ample rest time and only last 20 minutes, so you walk away energized. In my experience, this balances all the factors that affect women with Hashimoto’s and still provide results. 

3) Eat optimal amounts of protein in each meal

Protein provides key building blocks and signals for your body to build muscles. It’s critical to eat enough complete protein at each meal, especially while doing a strength training program.  

After you eat a protein-containing meal, certain amino acids trigger an anti-aging pathway called the mammalian Target of Rapamycin (mTOR), which helps build muscles [6]. 

Because mTOR and our digestion slow down as we age, it’s best to eat at least 30 grams of protein per meal to support muscle growth [7].

4) Eat enough calories to support your muscle growth

Gaining muscles takes calories, so you need to eat enough to feed your muscles.

Some people can achieve body recomposition–simultaneous fat loss and muscle gain–at maintenance calories once they start lifting weights. Their weight stays the same, but they look smaller and more defined.

However, recomposition is rare. For most women, gaining muscles requires a small caloric surplus to fuel muscle gain [8]. 

But not all calories are created equal, and you want to give your body clean fuel. Eating junk foods or lots of high-carb foods won’t give you the building blocks your muscles need to get stronger. Inflammation from unhealthy food can inhibit muscle gain [9]. 

That’s why I recommend the autoimmune paleo (AIP) diet with a slight caloric surplus. Not only will it improve your Hashimoto’s symptoms and numbers, the high protein, low inflammation, and nutrient-density will support your muscle growth.

How to know if you’re gaining muscles:

Most beginners will gain muscles and get stronger when they start lifting. Your clothes may fit more loosely than before, even though the number on the scale might not budge. 

So, don’t rely on the weight scale alone for progress. Measure your body composition, since weight alone won’t tell you how much muscle you’re building [10]You want to track the relative amounts of muscle and fat your body is carrying.  

Ideally, you’d get a Dual-Energy X-Ray Absorptiometry (DEXA) scan or skinfold caliper measurements every month or two. For the latter, try to use the same trained professional and device each time. 

If these two measurements are not possible, track your waist, hip, and arm circumference and pay attention to how your clothes fit. These are great indicators of whether you are losing fat and gaining muscle mass. 

Am I going to get too big?

Many women fear they’ll get too big by lifting weights. This is a persistent myth, but it’s actually impossible. We just don’t have enough testosterone to get so big.

On top of that, getting big requires a tremendous amount of work and food, even for men. You’d have to spend hours and hours lifting each day to achieve a bodybuilder’s physique. 

That is not what most women with Hashimoto’s can handle. Each workout in Thyroid Strong only lasts about 20 minutes so that you finish your workout energized. You will gain some muscles, but not enough to look like a hulk. 


Sarcopenia is a big concern for women with Hashimoto’s, whose metabolisms are already shifting toward muscle loss. With the proper diet and exercise tools, such as those provided in Thyroid Strong, you can combat sarcopenia and gain muscles while improving your Hashimoto’s symptoms. These will help you live a long, healthy, and pain-free life.

Cheers to you and your health,

Dr Emily Kiberd

How do you know if you have a Thyroid Issue?

Learn the 10 telltale signs you’re struggling with a thyroid issue.

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Article References

1 Bloise, F. F., Oliveira, T. S., Cordeiro, A. and Ortiga-Carvalho, T. M. (2018) Thyroid Hormones Play Role in Sarcopenia and Myopathies. Front. Physiol. 9, 560.

2 Sheng, Y., Ma, D., Zhou, Q., Wang, L., Sun, M., Wang, S., Qi, H., Liu, J., Ding, G. and Duan, Y. (2019) Association of thyroid function with sarcopenia in elderly Chinese euthyroid subjects. Aging Clin. Exp. Res. 31, 1113–1120.

3 Szlejf, C., Suemoto, C. K., Janovsky, C. C. P. S., Barreto, S. M., Diniz, M. de F. H. S., Lotufo, P. A. and Bensenor, I. M. (2020) Thyroid Function and Sarcopenia: Results from the ELSA-Brasil Study. J. Am. Geriatr. Soc. 68, 1545–1553.

4 Rodrigues, F., Domingos, C., Monteiro, D. and Morouço, P. (2022) A Review on Aging, Sarcopenia, Falls, and Resistance Training in Community-Dwelling Older Adults. Int. J. Environ. Res. Public Health 19.

5 Li, R., Xia, J., Zhang, X. I., Gathirua-Mwangi, W. G., Guo, J., Li, Y., McKenzie, S. and Song, Y. (2018) Associations of Muscle Mass and Strength with All-Cause Mortality among US Older Adults. Med. Sci. Sports Exerc. 50, 458–467.

6 Ochi, E., Maruo, M., Tsuchiya, Y., Ishii, N., Miura, K. and Sasaki, K. (2018) Higher Training Frequency Is Important for Gaining Muscular Strength Under Volume-Matched Training. Front. Physiol. 9, 744.

7 Saxton, R. A. and Sabatini, D. M. (2017) mTOR Signaling in Growth, Metabolism, and Disease. Cell 168, 960–976.

8 Layman, D. K., Anthony, T. G., Rasmussen, B. B., Adams, S. H., Lynch, C. J., Brinkworth, G. D. and Davis, T. A. (2015) Defining meal requirements for protein to optimize metabolic roles of amino acids. Am. J. Clin. Nutr. 101, 1330S–1338S.

9 Aragon, A. A., Schoenfeld, B. J., Wildman, R., Kleiner, S., VanDusseldorp, T., Taylor, L., Earnest, C. P., Arciero, P. J., Wilborn, C., Kalman, D. S., et al. (2017) International society of sports nutrition position stand: diets and body composition. J. Int. Soc. Sports Nutr. 14, 16.

10 Ono, Y. and Sakamoto, K. (2017) Lipopolysaccharide inhibits myogenic differentiation of C2C12 myoblasts through the Toll-like receptor 4-nuclear factor-κB signaling pathway and myoblast-derived tumor necrosis factor-α. PLoS One 12, e0182040.

11 Kubala, J., MS and RD. (2018, August 5) Body Recomposition: Lose Fat and Gain Muscle at the Same Time.

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