Walking for Hypothyroidism Trial (WHT)

A Randomized Controlled Trial of a 12-Week Walking Program on Metabolic and Psychophysiological Outcomes in Women With Hypothyroidism

Women with hypothyroidism often report persistent fatigue, weight gain, autonomic dysregulation, and stress despite stable levothyroxine therapy. This single-center, parallel-group RCT will test whether a structured, supervised 12-week walking program improves basal metabolic rate (BMR) and psychophysiological outcomes compared with usual activity. One hundred twenty women aged 35-55 with stable primary hypothyroidism will be randomized 1:1 to intervention or control.

This trial evaluates a pragmatic, low-cost aerobic intervention-walking 30 minutes/day, 5 days/week at 55-65% HRmax for 12 weeks-as an adjunct to standard pharmacotherapy. Expected benefits: ↑BMR, ↑HRV, ↓cortisol, ↓fatigue, and improved mood. Outcome assessors/statisticians are masked; allocation is concealed. Safety monitoring covers musculoskeletal events, cardiovascular symptoms, and thyroid-related issues.

Inclusion Criteria:

• Female, aged 35-55 years
• Primary hypothyroidism with documented prior TSH >4.5 mIU/L
• Stable levothyroxine dose for at least 6 months
• Sedentary lifestyle (<150 minutes of moderate-vigorous activity per week)
• BMI between 20-35 kg/m²
• Able to walk unaided
• Willing and able to provide written informed consent

Exclusion Criteria:

• Pregnant or lactating, or planning pregnancy during the study period
• Use of beta-blockers, systemic corticosteroids, or medications significantly affecting heart rate, HRV, or metabolism
• Uncontrolled hypertension, insulin-dependent diabetes, symptomatic cardiovascular disease, or orthopedic conditions limiting walking
• Major psychiatric hospitalization in the past 12 months
• Participation in another interventional trial within the past 30 days