title: Thyroid status and exercise tolerance. Cardiovascular and metabolic considerations.
abstract: Both hypo- and hyperthyroidism are characterised by exercise intolerance. In hypothyroidism, inadequate cardiovascular support appears to be the principal factor involved. Insufficient skeletal muscle blood flow compromises exercise capacity via reduced oxygen delivery, and endurance through decreased delivery of blood-borne substrates. The latter effect results in increased dependence on intramuscular glycogen. Additionally, decreased mobilisation of free fatty acids from adipose tissue and, consequently, lower plasma free fatty acid levels compound the problem of reduced lipid delivery to active skeletal muscle in the hypothyroid state. In contrast, cardiovascular support is enhanced in hyperthyroidism, implicating other factors in exercise tolerance. Greater reliance on muscle glycogen appears to be the primary reason for decreased endurance. Biochemical changes with hyperthyroidism that would favour enhanced flux through glycolysis may account for this dependence on glycogen. Deviations from normal thyroid function, and the ensuing exercise tolerance, require appropriate medical therapy to attain euthyroid status.
authors.affiliation: Department of Veterinary Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: McAllister
authors.forename: M D
authors.initials: MD
authors.lastname: Delp
authors.forename: M H
authors.initials: MH
authors.lastname: Laughlin
mesh_terms: D002320:Cardiovascular Physiological Phenomena; D004734:Energy Metabolism / Q000502:physiology*; D017079:Exercise Tolerance / Q000502:physiology; D006801:Humans; D006980:Hyperthyroidism / Q000378:metabolism*; D007037:Hypothyroidism / Q000378:metabolism*; D018482:Muscle, Skeletal / Q000378:metabolism