The PT's Guide to Training Clients on Medication

A significant number of your clients are on medication. Statins for cholesterol. Metformin for diabetes or PCOS. Levothyroxine for thyroid. SSRIs for anxiety or depression. Beta-blockers for blood pressure. Each of these affects how the body responds to exercise, how it processes food, and what side effects might mimic overtraining or poor compliance. If you do not know about them, you are coaching with incomplete information.

Metformin is prescribed for Type 2 diabetes and PCOS. It improves insulin sensitivity and helps regulate blood sugar. What PTs need to know: Metformin can cause gastrointestinal side effects, especially when starting. Clients may feel nauseous during training if they took it too close to a session. It reduces B12 absorption over time — if your client is fatigued despite good sleep and nutrition, B12 deficiency could be a factor. It should be taken with food. And carbohydrate timing matters — spreading carbs across meals helps manage blood sugar more effectively.

Levothyroxine replaces thyroid hormone in people with hypothyroidism (underactive thyroid). What PTs need to know: It must be taken on an empty stomach, at least 30 minutes before food. Calcium, iron, and soy can interfere with absorption — so a morning protein shake with a calcium-fortified milk taken with Levothyroxine reduces its effectiveness. Weight loss can be slower with thyroid conditions even when medication is optimised. Energy levels fluctuate. Clients may need longer warm-ups and more recovery time.

SSRIs are prescribed for depression, anxiety, and OCD. They are among the most commonly prescribed medications in the UK. What PTs need to know: SSRIs can cause weight gain or make weight loss harder — this is a common side effect that frustrates clients. They can affect appetite in either direction. Fatigue and drowsiness are common, especially when starting. Exercise is actually one of the best complementary treatments — but pushing too hard when a client is struggling mentally can backfire. Be sensitive to energy levels and mood.

Statins lower cholesterol and are extremely commonly prescribed, particularly in clients over 40. What PTs need to know: The most relevant side effect for PTs is muscle pain and weakness (myalgia), reported in up to 10% of statin users. If your client reports unusual muscle soreness that does not match their training load, statins could be a factor. Grapefruit interacts with some statins — worth mentioning if you are doing nutrition planning. CoQ10 supplementation is sometimes recommended alongside statins, though evidence is mixed.

Beta-blockers are prescribed for high blood pressure, heart conditions, and anxiety. What PTs need to know: Beta-blockers limit heart rate response to exercise. A client on beta-blockers will not reach the heart rate zones you expect — heart rate-based training zones are unreliable. Use Rate of Perceived Exertion (RPE) instead. They can cause fatigue and cold extremities. Sudden withdrawal is dangerous — never suggest a client stop taking them.

When a client adds their medications to Dinara, the AI coaching system automatically factors in every interaction. It knows that Metformin affects B12. It knows that Levothyroxine needs food timing consideration. It knows that beta-blockers make heart rate zones unreliable. As the coach, you can ask Dinara about any client's medication interactions and get instant, evidence-based guidance. You do not need to Google it. You do not need to remember every interaction for every client. Dinara also includes an AI medication scanner — clients can photograph their medication box and Dinara reads the label, extracts dosage information, and adds awareness notes about common side effects and interactions. No other PT platform offers medication awareness at any level. This is a genuine differentiator for coaches who take their clients' health seriously.