Hyperthyroidism – Yoga for Graves Disease

A question from a reader:

“What sort of yoga should one practice for Graves disease? (a friend wants to know and I have zero idea).”

pink lotus

Graves is a disease of the immune system. The body begins to make an antibody to itself. The formed antibody circulates in blood and seeks out and finds the thyroid gland. There it activates the thyroid receptor causing stimulation. Stimulation of the thyroid gland causes symptoms like anxiety, insomnia, weight loss, muscle loss, and bone loss.

Many well-intentioned Yoga teachers recommend sarvasangasa (shoulder stand) for Graves. This asana is NOT a good idea! It increases blood flow to the thyroid gland, carrying increased amounts of the antibody towards its target and causing more stimulation of an already over-stimulated gland. There’s an Indian medical study showing sarvangasa stimulates the thyroid gland, and the authors of a 1969 medical paper report they found an increased basal metabolic rate after patients performed sarvangasana or halasana. The increased blood flow with its detrimental antibodies overly activates the thyroid gland.

Don’t recommend inverted asanas for your friend.

The best news is that the immune system (the primary dysfunction with this disorder with thyroid dysfunction being secondary) is highly susceptible to mind-body therapies. It is one of the body systems most amendable to healing through Yoga as the mind-body connection with the immune system is very strong. Decreasing stress through Yoga is of paramount importance.

Anxiety is often a big component of Graves, and plenty of science shows that Yoga is very helpful for management. Meditation, calming pranayamas like nadi shodhana, and Yoga nidra are excellent. Viparita karani and pavanamuktasana with both knees to the chest are great choices for postures.

I also recommend surya namaskar and standing asanas. Those with Graves disease often lose muscle tissue and bone density. Counteract this by actively engaging the muscles and encouraging weight bearing.



    12 Comments to “Hyperthyroidism – Yoga for Graves Disease”

    1. James on May 29th, 2011 4:59 pm

      Hi Kathleen,
      I’m really enjoying the intelligence you use to fuse western and yogic philosophy, science, understanding, and treatment plans. Keep up the good work!
      Much love

    2. Dr. Summers on May 29th, 2011 5:16 pm

      Thanks, James. Just checked out what you’ve been up to at blindfoldedmarathon.com
      That’s awesome – and inspirational!

    3. Michela on June 18th, 2012 10:03 am

      It is of pivotal importance to point out that what might be good for hypo (sarvangasana and inverted poses) is generally not good at all for hyperthyroidism, and it seems to me that most of the info that is found online is mistifying, to say the least…so, thanks a lot for this post :)
      Only one thing…as for myself, I felt the burning in my throat much more intense after performing some of the poses in surya namaskara…I wonder whether that’s normal or it’s just me…

    4. cckiwi on September 3rd, 2012 7:46 pm

      I have a student with graves and I have read so many articles about how good
      sarvasangasa is for actually balancing the throat chakra.
      It seems that people with hyperthyroidism have used this posture to their benefit.
      I am confused and am steering clear of including this pose into her sessions until I am satisfied it wont do her any harm.
      How can I confirm what you write in the above article please?
      Do you think that chanting, bee breath and Ujjaji breath can be beneficial?
      any further comments appreciated

    5. Dr. Summers on September 4th, 2012 12:22 am

      That’s a great question! I love it that you’re interested in getting to the truth for yourself by looking at the data rather than simply accepting and repeating what’s out there on the internet and in books.

      Here’s my take and some references:

      First off, balancing the throat lotus (chakra) is subtle energy and a different issue from addressing full blown physical body disease of the thyroid gland. That’s a great topic, too, but one for another post.

      Second, it’s important to realize that most people with a thyroid gland problem have an under-functioning gland, not a hyper functioning one. Even those with Graves often get their gland ablated as a treatment for the disease – and thus become clinically hypothyroid even though their disease is one of hyperthyroidism. If you want to generalize, then you can say that sarvangasana is good for the thyroid and you would be correct when it comes to the vast majority of people.

      Third, there is a real paucity of data out there. What we have are studies from India and a lot of conjecture either way:

      Regan, [first initial unknown]. The effect of sarvangasana and halasana on the basal
      metabolic rate. Postgraduate thesis, Jiwaji University, 1969.
      “. . . reported that the practice of sarvangasana and halasana raises the BMR probably by
      activating the thyroid.”

      Udupa, K. N., R. H. Singh, and R. M. Shettiwar. Physiological and biochemical
      studies on the effect of yogic and certain other exercises. Indian Journal of Medical
      Research, 1975, 63(4).
      “. . . observed that sarvangasana activates thyroid function as measured by increased
      protein bound iodine (PBI).”

      As far as chanting, bee breath, and Ujjiya – they are wonderful additions to a Yoga therapy session for Graves. They are calming exercises that destress and help to balance the immune system, which is the real underlying problem with Graves. There is no indication that they will increase blood flow to the thyroid gland the way that inverted asanas appear to do, which is the issue for the antibody delivery from the blood stream. In the long run, addressing the immune system is the most important aspect of therapy whether or not sarvangasana is included.

    6. cckiwi on September 4th, 2012 2:39 am

      thank you for that, yes, I will put the focus on addressing the immune system without the use of Sarvangasana or other inversions.
      what a fantastic website you have with lots of valuable information.
      glad i found you!

    7. linda jaseck on March 7th, 2013 8:45 am

      Hi, I really appreciate this intelligent and important information. Just for more further clarification – I completely understand the importance of NOT doing inversions for someone diagnosed with HYPERthyroidism. My question is would it still be safe to do poses such as Vipariti Karani [legs up the wall] for example as this pose is so wonderful for the overly stressed & anxious person? It’s more of a modification on the inversion but yet still an inversion. I could also suggest legs on a chair – even more modified but the practitioner still reaps the benefits of the pose. I guess the real question is next to Uttasana [and not holding for anything length of time-merely as a transitional pose], are ALL inversion type poses contraindicated? Thanks so much!

    8. Dr. Summers on March 7th, 2013 5:43 pm

      Yes, vipariti karani as practiced as legs up the wall (not the classic mudra which is a mild version of sarvangasana) is a great pose for those with hyperthyroid. When the hips are on the ground, you can still get many of the benefits of an inverted posture. As far as I know, it’s only sarvangasana and halasana that have been looked at in a laboratory.

    9. linda jaseck on March 8th, 2013 8:41 am

      great. thank you for your reply. i am only interested in teaching safe and intelligent yoga. it’s great to have your site as a resource. thanks again.

    10. Dr. Summers on March 9th, 2013 9:48 pm

      Linda, wonderful to hear. Thanks for the kind words. Doc

    11. MGB on March 18th, 2014 12:18 pm

      The example you gave about people with Graves who have had their gland ablated as a treatment for the disease – and thus become clinically hypothyroid even though their disease is one of hyperthyroidism – this is my case. I apologize if I am making you repeat yourself, but can you please clarify if someone should be doing inversions if they were hyperthyroid and after treatment are now hypothyroid. Many thanks.

    12. Sophie on June 13th, 2014 6:22 pm

      Speaking as a person with Grave’s Disease who does yoga, I have to agree with Dr Summers.

      I’ve had teachers ask me to do a simple restorative halasana with props, and it’s always ended badly. I’ve been awake for 3 days straight, or hyper-anxious, or had nightmares … in other words, all the signs of hyperthyroid. I still have my thyroid, but I’m on T3 medication which tricks the thyroid into stopping production without removing the gland itself. So, even with a “stopped” gland, I experience hyper symptoms.

      It all depends on the individual of course, but if you try an inverted pose and end up having hyper episodes, avoid them for a while at least. I’ve tried halasana and other inverted poses periodically over the last 6 years (I’ve had Graves for 30 years), and I always have the same bad result.

      There are 100s of yoga poses. If your teacher doesn’t respect you listening to your body and telling them, this pose doesn’t work for me, get a new teacher. I find half-moon pose, which is cooling, is the perfect in-class replacement pose.

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