Expert Advice

Body & Fitness
Body & Fitness
Ease into Fitness and Fight Fatigue with These Exercises

Acella Pharmaceuticals, LLC., is partnering with Angila Berni, M.S., SFG II, RYT to bring greater awareness to the importance of thyroid care and education. This post is sponsored by Acella Pharmaceuticals and should not be construed as medical advice. Please talk to your doctor about your individual medical situation.

Disclaimer: The information provided is for educational purposes only and does not substitute professional medical advice. Consult a medical professional or healthcare provider before beginning any exercise, fitness, diet, or nutrition routine.

The thyroid plays a role in regulating our body’s energy demands. So it's no wonder that fatigue is one of the most frequent complaints from patients with thyroid disease.1,2 Fatigue can appear both on a mental and physical level. In some cases it can be so severe that it interferes with their ability to function day to day.

Hypothyroidism patients experiencing lethargy and fatigue should consult their healthcare provider for a full treatment plan, and see if a thyroid replacement hormone is right for them. For most, incorporating daily exercise may also benefit them. It may seem counterintuitive, but in fact starting a regular fitness routine is an excellent way to fight fatigue. Plus, patients may also experience improved mood, cognition, and cardiovascular function, not to mention build strength and balance.

It's essential for anyone starting an exercise routine to start slow and build gradually. So you don't need to jump into anything too strenuous or exhausting. Here are a few tips on easing into fitness and essential exercises that I recommend to help fight fatigue, improve mood, enhance cardiovascular conditioning, build strength, and increase metabolism.

Getting Started with a Fitness Program

First, choose a workout schedule. Check your calendar and schedule your workouts. Make yourself a priority. Create a plan based on the days and times you are willing to commit to your fitness routine. Your goal will determine how much time you must devote to exercising. For example, if strength is your goal, you must commit three to five days a week to lifting heavy weights. If your goal is to increase flexibility, you want to spend at least three days stretching or practicing yoga.

Next, you want to ease into a new routine and avoid doing too much, too fast. One of the ways to do this is by simply walking. You can walk for 15 to 30 minutes in the morning and again in the evening. This will allow your muscles, tendons, and ligaments time to adjust to the impact of the movement. Increase the walking time each week by 5 to 15 minutes. Try walking at an incline on a treadmill for an increase in intensity. You will burn more calories walking uphill than you would if running on a flat surface, and it has less impact on your joints. Bonus!

Beginner Exercises

Below are some beginner exercises that I recommend to help patients get started. These are compound movements to help build strength, boost metabolism, and increase energy.

1. Squat

A strength-based staple for any program is the squat. We perform this functional movement several times a day while sitting and standing. To perform this movement at home, start by sitting and standing in a chair. Try holding a weight at chest level to increase the intensity. Use a gallon of water or canned goods if you need additional resistance. Form is essential, so be mindful of the following cues:

• The feet should be shoulder-width apart
• Toes turned out slightly
• Knees should be in-line with the toes and never allowed to cave in
• Maintain a neutral spine and try not to round the shoulders.

2. Romanian Deadlift

The Romanian deadlift is often called the stiff-legged deadlift. This movement can be done with a barbell, kettlebell, or dumbbell. Here are some cues to perform this movement correctly:

• Begin with feet shoulder-width apart
• Knees in line with the feet
• Pick up the weight and keep it close to the body
• Maintain a neutral spine and core contraction (pulling your belly button towards the spine)
• Knees should slightly bend as you pick up and lower the weight

Start light and work on proper technique.

3. Burpee

The burpee is a full-body movement that can be completed anywhere and anytime. It is a bodyweight exercise; therefore, there is no equipment required. Begin this exercise by standing tall. Next, squat down, place your hands on the ground and walk both feet back into a high plank position. Next, step both feet back towards the hands and stand up. Add a jump at the top of the movement if your joints will allow for the impact. To increase the intensity, quickly jump back into the plank position and then back into the squat position. You can also add a push-up to make this exercise even more effective.

Some things to keep in mind when starting a new exercise program:

• Always listen to your body. You should never be in pain. Mild discomfort is okay, but pain is not.

• Ask for help if you are unsure how to perform an exercise or create a program.

• Always receive approval from your doctor before starting an exercise program.

REFERENCE: 1. Fischer, S., Markert, C., Strahler, J., Doerr, J. M., Skoluda, N., Kappert, M., & Nater, U. M. (2018). Thyroid Functioning and Fatigue in Women With Functional Somatic Syndromes - Role of Early Life Adversity. Frontiers in physiology, 9, 564. 2. Chaker, L., Bianco, A. C., Jonklaas, J., & Peeters, R. P. (2017). Hypothyroidism. Lancet (London, England), 390(10101), 1550–1562.


Note that DTE products, including NP Thyroid®, have not been reviewed by the FDA for safety or efficacy.

Important Risk Information

Drugs with thyroid hormone activity, alone or together with other therapeutic agents, have been used for the treatment of obesity. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects.
  • NP Thyroid® is contraindicated in patients with uncorrected adrenal insufficiency, untreated thyrotoxicosis, and hypersensitivity to any component of the product.
  • In the elderly and in patients with cardiovascular disease, NP Thyroid® should be used with greater caution than younger patients or those without cardiovascular disease.
  • Use of NP Thyroid® in patients with diabetes mellitus or adrenal cortical insufficiency may worsen the intensity of their symptoms.
  • The therapy of myxedema coma requires simultaneous administration of glucocorticoids.
  • Concomitant use of NP Thyroid® with oral anticoagulants alters the sensitivity of oral anticoagulants. Prothrombin time should be closely monitored in thyroid-treated patients on oral anticoagulants.
  • In infants, excessive doses of NP Thyroid® may produce craniosynostosis.
  • Partial loss of hair may be experienced by children in the first few months of therapy but is usually transient.
  • Adverse reactions associated with NP Thyroid® therapy are primarily those of hyperthyroidism due to therapeutic overdosage.
  • Many drugs and some laboratory tests may alter the therapeutic response to NP Thyroid®. In addition, thyroid hormones and thyroid status have varied effects on the pharmacokinetics and actions of other drugs. Administer at least 4 hours before or after drugs that are known to interfere with absorption. Evaluate the need for dose adjustments when regularly administering within one hour of certain foods that may affect absorption.
  • NP Thyroid® should not be discontinued during pregnancy, and hypothyroidism diagnosed during pregnancy should be promptly treated.


NP Thyroid® (thyroid tablets, USP) is a prescription medicine that is used to treat a condition called hypothyroidism from any cause, except for cases of temporary hypothyroidism, which is usually associated with an inflammation of the thyroid (thyroiditis). It is meant to replace or supplement a hormone that is usually made by your thyroid gland.

NP Thyroid® is also used in the treatment and prevention of normal functioning thyroid goiters, such as thyroid nodules, Hashimoto’s thyroiditis, multinodular goiter, and in the management of thyroid cancer.
Revised 10/2023