EXPLORING EXERCISE POTENTIAL TO COMPLEMENT THYROID MEDICATIONS THROUGH RECEPTOR MODULATION: A SYSTEMATIC REVIEW AND META ANALYSES

Abstract

Thyroid disorders are experienced by millions of people worldwide, and hypothyroidism is a condition which requires the use of lifelong hormone replacement. We performed systematic review and meta-analysis to assess the effect of exercise intervention on thyroid hormone level and their possible as an adjunctive therapy. We conducted a search on Google Scholar, Web of Science, PubMed, and EBSCO using the search terms ‘exercise and thyroid stimulating immunoglobulin (TSI), TSH, T3, T4' in English after 2010 (followed the PRISMA guidelines). Using ROB2 guidelines, the risk of bias was evaluated; using MedCalc software for data analysis with standardized average deviation under fixed & random effects models. Eight studies with 266 participants were selected and utilized using a variety of exercise modalities (aerobic, resistance, water-based, core strengthening) and diverse populations. Meta-analysis revealed significant TSH reduction (SMD= -0.567, p<0.001) and T3 elevation (SMD=0.768, p=0.010), while T4 changes remained non-significant (SMD=0.218, p=0. 324). There was significant heterogeneity (I²=61.65- 72.63%) but no publication bias was found. The majority of studies were found to be of low risk. The results indicate that exercise is a clinically significant adjunctive therapy for the management of thyroid disorders with a marked beneficial effect on TSH and T3 levels for different types of exercises. But due to the small sample sizes and brief duration of the interventions and heterogeneity of the populations, larger, well-designed trials are required to determine optimal exercise prescriptions for particular patient populations.