An Athlete with Hypothyroidism

The diagnosis: there’s something terribly wrong with me. But we all suspected that a long time ago. HAHA GOOD JOKE KENNETT.

I just found out that I have hypothyroidism. It explains a lot. Don’t worry, it’s not contagious. It can’t be spread by a cough or anal. It’s genetic, just like herpes. Read along to find out what it is, why you should send me a get well soon care package filled with chocolate and smoked herring, and how the rest of my life will be ruined now that I have a disability other than being a white, upper-middle-class male of above average height.

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Choke her out!
“How to remain incredibly calm while being choked out”

As the first image shows, your thyroid is a gland in your throat that has one purpose: to secrete thyroid hormones. Thyroid hormones (the main ones being T3 and T4) control your basal metabolic rate, bone growth (in children), protein synthesis, metabolism of fat, carbohydrates, and protein, and how your body uses and reacts to other hormones. Basically, it does a lot of important shit. Mine, however, has fallen asleep on the job. Permanently.

Science talk

The hypothalamus, located up in your head, is the first in the chain of command when it comes to your endocrine system (hormones and stuff). When hormones need making, your hypothalamus gets called up and, like any good manager, delegates the work to other body parts–first the pituitary gland. Don’t bag on the hypothalamus too much. It’s got other, more important stuff to do anyways.

So, the hypothalamus releases TRH (thyrotropin-releasing hormone), which lets the pituitary know that it should start making TSH (thyroid-stimulating hormone). TSH tells the thyroid gland to start pumping out thyroid hormone, which as I described above, tells the rest of your body how to use energy. There’s a lot of middle management in the endocrine system, which is why I believe there are so many problems with it.

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Wikipedia, you so smart. Thanks for making me smart to.

Anywho, my thyroid no longer works. It might be that it’s been out of order for a long, long time. According to my doctor, my thyroid is essentially useless and has “shut down.” I discovered this when, a few weeks ago, I went in to get a prescription for sleeping meds. I’ve been having a lot of trouble sleeping lately, especially the past three or four months. My insomnia goes back at least a year but had been getting unbearable more recently.

The doctor decided to test my thyroid, with the initial inkling that it might be producing too much thyroid hormone, called hyperthyroidism with an E, which can lead to difficulty sleeping and an overly active metabolism. I ended up having hypothyroidism with an Ohhh–the opposite problem, but it can also impair sleep.

To test your thyroid function, they suck out some blood and count how much T3, T4, and TSH is in it. TSH, as you may recall, acts as a signal for your thyroid gland to produce thyroid hormones. So the higher your TSH, the more thyroid hormones your body craves. The lower your TSH, the less thyroid it craves. The normal TSH range for a healthy person is 0.5 to 5 microunits per milliliter. With a TSH of 5 to 10, you’re considered to have subclinical hypothyroidism, which means you probably don’t need to be medicated unless you’re experiencing a lot of the symptoms of hypothyroidism, which I’ll get into in just a second. If your TSH is over 10, you have overt hypothyroidism, meaning you should definitely consider getting treatment since your thyroid is currently on a downward spiral to hell. If left untreated over the years, subclinical hypothyroidism may eventually become overt, and once it’s overt it’s likely that it will eventually shut down altogether. I think. Remember, I’m not a doctor so you should definitely take everything I say as fact.

My TSH was “greater than” 150. One hundred and fifty. What the fuck. Apparently that particular lab’s test only goes to 150, meaning I was off the charts. My doctor tested me again just to be sure, and the second test came back the same.

Hypothyroidism is usually due to Hashimoto’s disease, which is a genetic disorder. Something like 90% of people with overt hypothyroidism have Hashimoto’s. As an autoimmune disease, Hashimoto’s confuses your body into attacking the thyroid gland until it’s dead. You can also have hypothyroidism if you’ve had thyroid surgery, thyroid cancer, not enough iodine in your diet, an inability to absorb iodine, or a few other equally rare scenarios. In my case, it’s Hashimoto’s, as I later had it tested and came back positive with a crap load of thyroid antibodies.

Symptoms

There are a lot of them. The blue ones are ones that I’ve noticed.

Fatigue
Muscle weakness
Inability to focus
Carpel Tunnel Syndrom
Decreased libido
Hearing loss
Dry skin
Hair loss/dry hair
Depression
Trouble falling asleep and staying asleep
Night sweats or hot flashes during sleep 
Slow heart rate (mine is 28)
Weight gain
Trouble losing weight
Constipation
Irritability
Intolerance to the cold
Memory loss
Abnormal menstrual cycles (hypothyroidism is much more likely to strike women than men by the way)
Muscle cramps and aches
And even more. Basically it fucks you right up.

As you read through this list, you can see how I never thought anything was wrong with me, since these are all basically symptoms of training hard.

How did this happen? 

You can’t get Hashimoto’s without a genetic predisposition, which only a small percentage of the population has to worry about. 3.5% of the population has Hashimoto’s (and 5% of the population has hypothyroidism), with women being 8-10 times more likely to develop it than men. It’s also very rare in young people, with post-menopausal women being the main victims. So why do I have it?

There is a hypothesis that if you’re genetically predisposed to Hashimoto’s (my mom and grandmother have it too), hard endurance training or stress may bring it on earlier in life. So I got it when I was in my 20s instead of my 50s due to hard training, or so the thinking goes. This has not been proven. Another way you can give yourself hypothyroidism is by taking a lot of testosterone or HGH.

Which brings me to the next chapter…

Doping

There is a growing number of elite runners that apparently have hypothyroidism. Galen Rupp is on that list, along with a bunch of other Nike runners. You may have come across this Wall Street Journal article that describes the unconventional approach that a certain doctor by the name of Jeff Brown uses when it comes to diagnosing elite athletes with hypothyroidism. Read: “doping doctor.”

At the time of the above article’s publication, Alberto Salazar had coached 30 elite Nike athletes, and 17% of those had been diagnosed with hypothyroidism by Dr. Brown. As you may recall, only 5% of the population actually has hypothyroidism, and most of those people are older women, not young males, and many of them do not need to be medicated as they do not have overt hypothyroidism. My theory is that Brown is replacing thyroid that was originally lost due to testosterone and HGH doping (testosterone and HGH both stunt the thyroid’s output). That, or there may be a small advantage for a healthy, non-hypothyroid person to microdose with synthetic thyroid. This is debatable, as google will tell you. In his rational, Dr. Brown believes that a TSH of 2.0 or higher requires medication. He is virtually alone in the medical world when it comes to this standard. Remember, 0.5 to 5 is considered healthy. My TSH is +150 and I’m still kicking, so I find it very hard to believe that someone with a value of 2.0 needs meds.

Note: synthetic thyroid isn’t even on WADA’s banned substance list since it hasn’t actually been shown to be a performance enhancer. That’s the part that leads me to question if Brown is covering up as well as fixing some of the health problems caused by HGH and testosterone doping.

So how do I deal with it?

Thank you baby jesus for the pharmaceutical industry and America, the land where taking a pill solves all your problems. As long as you have money for insurance. And your problems consist of restless leg syndrome and ED.

I have to take a pill every morning for the rest of my life called levothyroxine, which is synthetic thyroid. It’s the thyroid hormone T4, which the body converts to T3. It takes a few weeks to start kicking in, then a few months to dial in the correct dose. I’ll have to have my TSH values monitored two to three times a year for the rest of my life as well, to ensure I’m continuing to get the right dose. Taking too little levothyroxine will leave me fatigued and depressed. Too much and apparently it’ll be like I’m on crack, without any of the good side effects.

Training as an elite athlete who has hypothyroidism, even while medicated, is supposedly much more difficult than a healthy person’s training. I found some great info about hypothyroidism and endurance athletes from the smart words of world-renown running coach Steve Magness. Check out his website for the goods. His book The Science of Running is incredibly good too. Even if you’re just a cyclist you should still read it.

Anyways, as a runner who has had hypothyroidism since he was 14, Magness, claims that training is made extra difficult by this disease. One day you’re up, the next you’re down. There’s little consistency and it sometimes takes a lot longer to recover from hard workouts than it would for a normal athlete. Looking back, I’ve noticed this.

Since the hypothyroid sufferer’s body doesn’t get a natural, steady flow of thyroid hormones when it needs it, recovery becomes significantly impaired. I’ll take a pill every morning, but I won’t get that steady drip like a regular person, telling the body how to respond minute by minute throughout the day as it encounters stress and physical exertion.

But I’m optimistic. I think that this diagnosis means that I’ll be able to get back to where I was in 2013, and maybe even better. I’ve most likely had this going on for years now, since it’s a disease that develops over a long period of time. If I had to put a date on it, looking back I’d say that I really started noticing that something was a bit off in 2007. I had trained really hard that winter and could never kick the fatigue that came with it. I ended up taking most of the year off to recover, summing it up as just some severe overtraining. While I don’t doubt that I was severely overtrained, I think a part of the reason I wasn’t able to recover was due to my messed up thyroid.

While I continued getting stronger over the years, I’ve always struggled with going too hard and not being able to recover. One week I’d be great in training, then the following week I’d be dead by day two, even on the off chance when I decided to take adequate rest. I’d be shit for two months for some reason and then magically be fast again. This is a natural occurrence for any athlete, especially in a sport like cycling where the season is so long and the training and racing are so stressful. Again, that adds to the difficulty of self-diagnosis.

Things really didn’t start going downhill until 2014, which is when I believe my thyroid might have shit the bed altogether. After a really good season in 2013, I signed for a crappy little pro Swedish team that went belly up part way into 2014. I came home to the States half a year early and really depressed since my dream had been shattered, and I could never get my legs going again that year. I’m wiling to bet that a large part of that lingering depression and lack of fitness was due to my good for nothing thyroid, not just the team folding.

Then in the fall of 2014 my wife Adelaide was out training for an upcoming triathlon and was hit and almost killed by a reckless driver. She was put in a coma for five days and her face was literally torn off. The recovery process took months and months and is still ongoing. My training was essentially non existent that fall and winter, which resulted in even more depression on top of the huge emotional black hole caused by the crash. My complete lack of fitness when the cycling season began in March made me even more depressed. To make things worse, later in the season when I should have finally been able to train hard and consistently, I found that I didn’t have the mental, physical, or emotional energy to do so. I simply couldn’t go for more than a few weeks without cracking. That’s why I switched to an easy sport. Triathlon.

As you can see, from 2014 on it would have been very hard for me to distinguish between the depression/fatigue from all those external issues, and the depression/fatigue caused by something chemically imbalanced within me. Now it seems obvious, but even a few weeks ago, before I even knew what the thyroid gland was, I chalked all those symptoms (depression, fatigue, poor sleep, etc.) to just the regular stress of training or Adelaide having been hit nine months ago. As I’ve said before, I’m sure there is quite a bit of cross over. But damn does it feel good to learn that there really is something wrong with me and it’s not just all in my head. It’s in my throat.

So to all the cyclist, triathletes, runners, and other sports enthusiasts, remember that sometimes things can actually go wrong in your body and what you’re experiencing might not be the normal side effects of hard training. We think that as athletes we’re more in tune with our bodies, but at the same time we’re deaf and blind to anything that we don’t perceive as training related. That feeling of constant fatigue might not just be from the big hours you put in the past month, and that enlarged testicle might not be caused by your worn out chamois.

*Edited January 6th, 2017:

About six months ago, long after I wrote this blog, my brother was also diagnosed with Hashimoto’s. He’s almost six years younger than me (he’s 25 years old as of this writing) and is not, nor has he been, a high level endurance athlete, though he is an elite level rock climber. But his more serious training for climbing didn’t start until he was about 23, so he hasn’t had that much time to “develop” hypothyroidism from training. His TSH was 22. That’s high, but not that high.

After he was diagnosed, I was forced to ponder whether high level endurance training and dieting were actually as large of factors for developing hypothyroidism as I thought (for someone who is also genetically predisposed to Hashis, such as myself). If his TSH is 22 at the age of 25, and mine was +150 at the age of 29, maybe that four year difference was all it took for my TSH (or his if he remained untreated) to rise to +150. Maybe it wasn’t the training at all. Maybe his TSH would have skyrocketed just like mine, whether he was doing high level endurance training or not. I guess the real test would be for him to go off medication for the next four years and get remeasured when he’s 29 and compare the numbers.

Last Hurrah

We obliterated the Steamboat Springs stage race the weekend before last. It was such a dominating performance that I almost felt bad being on the giving end (though in reality the team could have given just as much without me there).

The bike racing season is over and since it was my last race with the team, this will be the last time I’m singing the praises of GS CIAO. If I race bikes at all next year, I’m sure I’ll be cursing and moaning about them like everyone else. So, I thought I’d enlighten my future self and the rest of you about what it’s like to be on a team like this–one that (at local events) is pretty much unstoppable and makes a mockery of nearly everyone else’s race.

#1 None of us take pity on you. We’re a bunch of greedy dick heads who look down on the rest of the field.

#2 It makes us feel good of ourselves when we get to sit on and not work in breakaways, since we have four equally strong teammates back in the field. Spitting on us and yelling for us to pull through when that particular breakaway doesn’t work to our advantage only strengthens the urge to mess with your brake calipers. It doesn’t make us want to pull through. Besides, working in the break is for posers. Trying is for posers.

#3 Winning feels good even if it isn’t you who crosses the line first.

Just so I don’t piss anyone off too much, a bit of that was sarcasm. (It feels best when you cross the line first yourself).

Okay onto the race.

Stage one was a 22km time trial. I sucked, majorly. I started out at an overly optimistic pace, which I held for about four minutes. After that I watched helplessly as my average power dipped down, down, down to China town. The one exciting bit of my TT occurred mid way into the race as I approached a railroad crossing. I heard the warning ding-ding-dings of a train crossing and looked up to see red lights flashing and the barriers starting to lower. I looked left and right and didn’t see a train yet, though there was a a bit of curve to the tracks as well as a high berm that blocked the view. Plus I was going 30mph, was somewhat cross-eyed, and had a sweat-streaked TT visor blurring my vision. I had a split second to make a decision. Should I risk my life for 25th place and duck below the lowering barriers, or do I slam on the brakes and get 75th place and live to see another day?

I swerved around the barriers as they lowered into place and made it across alive, immediately thinking OH FUCKING SHIT THAT WAS STUPID! But really, I think it’s a bigger risk than that just riding to and from Sprouts during rush hour traffic. I finished 25th, only two and a half minutes down on Adrian Costa (Cal Giant). Definitely worth it.

Going into the 80-mile road race the following day, we had Burleigh sitting 2nd on GC just six seconds behind Costa, George at 5th, Josh at 10th, and Chris in 13th–all within striking distance of 1st. Mitch and I would be the domestiques for the day and do what we could to further the other guys’ chances, either pulling our brains out in a breakaway if it was the right mix, or pulling on the front of the peloton if we needed things back together and re-shuffled.

I got the race going with the first attack of the day. Off to a good start. I could have pulled out of the race then and there and been happy with my performance. Instead, I continued trying hard, which I knew was lame but I did it anyways. I went again about half a dozen times but really, deep down I knew that my chances were very slim. I wasn’t even close to being strong enough to be a threat to Costa or Andrew Clemence (Colorado Collective), and I’d need a big size group (with Josh, Chris, and/or George in tow) to be able to work with if I was going to last even half the race off the front.

That scenario didn’t happen. Instead, race leader Costa attacked with Burleigh and Drew Christopher (Champion Systems) on the first “major” (4-minute) climb about 12 miles into the race. I was already blown up from attacking earlier and was sitting 5th to last wheel when this went down. Not an ideal spot to be, though since the climb curved to the left it did offer a good view of things.

The field shattered and I saw the life of my personal race flash before my eyes, but found a burst of anaerobic anger to propel me onto the tail end of the last large group just as they crested the climb. A twisting descent ensued, followed by a few hard minutes of chasing on the flat before we caught onto the field. Burleigh, Costa, and Drew were long gone.

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Photo: Bob Simpson

Our plan had been to make Costa work, with the hope that we could put Chris, Josh, and/or George up the road with Mitch or I. This would put pressure on him and hopefully wear him out a bit while keeping Burleigh as fresh as possible to attack in the last 20 miles of the race. In bike racing, things rarely go as planned.

Colorado Collective sent all their guys to the front to pull the trio back for Clemence, who was 3rd on GC. Their efforts, though gallant, weren’t even close to enough. Costa was strong as fuck. Burleigh was just sitting on Drew and Costa the entire time since there was no reason for us to want that break to succeed. Despite that, the gap kept going up, eventually peaking at three minutes. Again, Burleigh was just sitting on so it was only Drew and, predominantly, Costa who were doing the damage.

I spent my time back in the field sitting behind/to the side of the Collective, helping to keep the rest of my team out of the crosswind and yelling about how tired I was. I was pretty certain that I’d be dropped on the main climb of the race at mile 50 and I knew that in order to be of help at all, I needed to do my part sooner rather than later. They probably didn’t need me sitting up there but it gave me something to do. Even 90 minutes into the race, I was hurting.

Up the road, Drew got dropped as they started the climb and it was just down to Costa and Burleigh. Costa attacked again and again, but Burleigh stayed glued to his wheel. No amount of angry snot rockets blown directly in his face could pry him loose. PS: ummm, fuck you for being a douche bag Adrian?

Back to my story: I got dropped on the climb and rode in for 30th or something with Mitch and a few other guys. I took pride in showing everyone else how strong I was and doing more than my fair share in the gruppetto. I attacked a few times to shed some dead weight. Everyone was super impressed when I rode off with one other guy and went as hard as I could to the line. In case you couldn’t tell, I’m talking about someone else.

And now back to the heat of the action: Burleigh attacked repeatedly in the final 15 miles, won, and put a few seconds into Costa, who finished 2nd. Josh attacked 20 miles from the finish to go solo, was joined by Chris six or seven miles later, and the two of them came in 3rd and 4th. To cap it all off, George took the field sprint for 5th. The field at that point was down to about 9 guys.

We celebrated that evening with burritos made by Faith, then sauntered on over to the Moots factory so Burleigh could win a $3000 Moots frame at the BBQ/podium presentation/Moots frame raffle. Everyone booed when he won, including me.

I won’t go into all the details of what we needed to have happen in the crit in order for all of our plans to work out, but here are 99% of them. Nick lead us in a six-hour long pre-race meeting the night before the crit and this is what we’d come up with:

1) We needed Burleigh to win the overall
2) There was an intermediate time bonus (three-deep) that we didn’t want Costa to get since he was just three seconds behind Burleigh
3) There were time bonuses at the finish (10, 6, and 4 seconds), and unless Burleigh got an intermediate time bonus, we couldn’t let Adrian finish 1st, 2nd, or 3rd unless Burleigh beat him.
4) We wanted the stage win also because we’re greedy
5) We wanted to keep Josh in 3rd, Chris in 4th, and move George up to 5th GC

In order to do all this, we had to have a break up the road for the intermediate sprint, as long as Costa wasn’t in it. We’d leave it be for the whole race if that was the case. Or if no break had managed to get away before the sprint, we’d have to do a big, mid-race lead out and make sure George and Josh went 1-2 and hopefully someone other than Costa was 3rd. After the intermediate sprint we could just leave whatever breakaway there was off the front if that was the case, or if things were still together we could just sit on the front and make sure it didn’t get too far out of control since I think we still wanted George to win the stage. Or something like that. I’m forgetting exactly what we wanted and even at the time it was a bit confusing since we’d discussed so many different options given the race scenario.

The next day:

During our warm up, George asked me when the last time I’d done any intensity was after I’d told him how hard the first 20 minutes of the road race had been for me. “Uhh, that would have been Winston-Salem,” I replied. George laughed and did a one-legged sprint at 1700 watts. Apparently he didn’t think the fitness I’d gained from a one-day race in May would hold me over till September. Well I’ll show HIM, I thought.

By lap two I was at the very back of the race, breathing like an out of shape, asthmatic bike racer who hadn’t done any intensity for over two months and was racing at an altitude of 7,000 feet at the Steamboat Springs stage race criterium, in the year of 2015. I like accurate metaphors.

I’d pull my brains out for half a lap, get shelled to the back for a lap, work my way through the field for two more laps, pull for half a lap. Repeat.

Amazingly, all of what we wanted to have happen, happened. Just barely. My teammates are all very strong. And smart. Costa, who was also incredibly strong for the third day in a row, almost spoiled our fun. If he’d been one place higher in the crit (3rd instead of 4th) he would have taken a time bonus and moved in front of Burleigh on GC. But that didn’t happen. In some other universe it did, but not in this one. Our secret weapon, The Monster From Fort Collins, won, Josh took second, and Burleigh held onto the lead by the three second margin he started the day with. The Monster also moved into 5th GC. Icing on the pancake. It couldn’t have possibly gone any better.

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Photo: Bob Simpson

As an elite amateur team, we get our asses kicked in the NRC.  We know how if feels to be dominated by teams like UHC. It feels pretty shitty. Those guys are the worst. They act like they’re god’s gift and move about in the peloton like none of us even exist. But the same thing happens to them over in Europe, so that makes me feel a little better. There’s always someone bigger and better than you. So on the days when there isn’t, it’s pretty damn nice to win, even if it’s only a local race. You have to soak those moments up. GS CIAO, it’s been a pleasure. I’ll miss the amazing team work we did this year. And Faith’s cooking. Especially Faith’s cooking.

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