My client has Graves disease and is being treated for it with medication. He has not been able to see the results he would like. He is seeing a nutritionist for his eating strategy, and he sees me four times a week for his resistance training. He also does cardio five times a week. I’m concerned he might be catabolizing his muscles. What can I do?
This can be a little tricky when we are missing some of the pertinent information. First, what are the goals he isn’t seeing? I am assuming he wants to put on some muscle but isn’t able to with the Graves disease and possibly his workout. Graves disease is the most common form of hyperthyroidism. In other words, his metabolism is set too high. I feel as though you have done many things correctly. Your client is seeing a doctor for his condition. That is the first step. Your client is seeing a nutritionist for his eating strategy and is seeing you for his resistance training. It sounds like this guy is really serious about getting into his ideal shape. When you have a client who tends to go everywhere and see everybody about everything, you may have to actually slow him down from doing too much. This is usually the exception to the rule. Most of our clients won’t even do what we ask. Would your client allow you to talk to his nutritionist and doctor? You, the doctor and the nutritionist need to be on the same page. Does the nutritionist know that your client wants to put on muscle mass? After you are all on the same page, you can present a united front. This will help the client hear the same thing from all professionals involved.
You asked if the client is catabolizing his muscles. What have you done to help determine this? One simple way to find out if he is in a state of ketosis is to purchase ketone sticks at the local drugstore and have him urinate on them. If ketosis is occurring, the sticks will tell you. If your client is not in a state of ketosis, we have to look at his energy expenditure versus his caloric or energy consumption. This is what his nutritionist should be doing. You have to determine what his metabolic rate is and plan accordingly. Any nutritionist worth his/her weight will have done this already. Be sure to have added in the resistance training and cardio training values plus five percent calories to have extra calories for growth. The next question I have to ask is if he is over training. Is your client a professional athlete or someone who is used to such an extreme exercise commitment? Five days of cardio and four days of resistance training will take its toll on anyone. I would recommend he take a week off to relax. Once again, I don’t have all the information. If all things are set, I would decrease the amount of cardio training. Five days of intense cardio training is quite extreme. Remember that cardio training is the same as low intensity resistance training. It is just a manipulation of variables. Whether you use light weights and high reps or no weight and really high reps, it is all about heart rate and oxygen consumption. Without knowing why he is doing so much training, it is hard to say what we should adjust. If he is trying to put on some muscle, I would suggest lowering the amount of cardio, which will give you more ability to increase the intensity of resistance training. All weight gain or lose comes down to calories in versus calories out. If he isn’t gaining weight, either he isn’t eating enough or he is working out too much. You and he must decide.