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.

thyroid-symptoms-and-solutions-s2

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.

800px-Thyroid_system.svg
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.

16 thoughts on “An Athlete with Hypothyroidism

  1. Interesting details about the thyroid. I would
    never have guessed that yours is low. I didn’t know that Carolyn has it too, and I admit that I too have that malady. Be sure and take the ills as directed, and you will be all right. Grandma Paula

  2. Hey Kennett
    I also got the diagnosis of Hashimoto in february 2014, with its irreversible trait … but my blood values finally came back to normal which is totally against all the medical theory/dogma.
    I won´t develop more here, I just wanted to send you a message of hope.
    (contact me if you want to talk more about it )

  3. Pierre that’s actually very uplifting to hear that from you since you’re still so strong on the bike. Thanks for sharing.

  4. Nice to see an athlete doing so well while surviving this shitty disease, kudos. Three years after being diagnosed I’m still struggling to get out of bed, I haven’t been able to run or swim for almost 16 months now! I seem to be able to build some bike fitness over a couple of months only to be stopped in my tracks by massive downward spiral just when I start to get quick again!! Currently I’m on 100-150mg thyroxine, multiple natual supplements & a strict gluten, dairy, soy & legume/grain free diet!! I am so lucky to have a beautiful supportive wife who pretty much keeps me going. She researchers most nights & communicates with my doctors on my behalf, if it wasn’t for her I’m not sure I’d still be here. Every doctor, holistic gp or specialist I seek help from all tell me to STOP training all together! To me that’s like giving up and I will not do that, I wanted to go around 10:30 for my first IM in Melbourne March 2015 my race didn’t go to plan & thats ok I will get back a high level soon, thanks for posting up your experiences with this.
    Its really refreshing to see someone do so well, keep up the great work & I’ll look forward to following you.

  5. Daniel, that sounds really, really rough. I can’t imagine how depressing it must be to be so messed up for over a year while still on meds. I wonder if there’s something else going on physically that’s holding you back. Some other hormone imbalance. Or, if you have some brain chemistry imbalance. Depression and other mental disorders can be a result of poor dopamine or serotonin reception, and I know that if I’m not mentally feeling well, I can’t put out any power on the bike. I’ve dealt with some mental disorders with friends/family and I think that those can be much more difficult to deal with than even severe physical injuries. In the mean time, keep on pushing. I’m right there with you that you have to continue training and racing if that’s what you’re passionate about. Who knows, maybe the meds will finally kick in or you’ll stumble across the right dosage or type of meds. Keep me updated.

  6. I was diagnosed today, after a month or so of extreme fatigue, night sweats, lack of motivation, and random joint pain. As a trail runner and amateur triathlete in Connecticut I assumed Lyme, maybe even mono, after hearing it was hypothyroidism, something that will leave me possibly dependent on medication was daunting. My levels weren’t nearly as high for TSH, being categorized as subclinical, it’s still unnerving, but hearing how well everyone hear is doing with this gives hope and knowing I’m not alone as a young athletic male makes it a little easier to wrap my head around. Just wanted to say thank you to all who have shared, it’s much appreciated.

  7. Hi!
    I was just diagnosed this week. I’ve been doing a lot of research about it and I’m trying to figure out if this has anything to do with the fact that I have been working out for about a year now (crossfit) and I have made very little progress. I get through my workouts but I haven’t gotten stronger. My weights haven’t increased much. I am okay with my endurance (I was able to run a half marathon with no problems) but my strength is just horrible!! I keep reading that muscle weakness is a symptom of the disease. Has anyone else had this issue?

    Thanks!

  8. Muscle weakness is a symptom of both hypo and hyperthyroidism, but usually more so with hyper. If you’re properly medicated I don’t think hypothyroidism should hold you back in crossfit or general strength to a very large degree. How are your numbers looking? (TSH, T3, T4). Hypothyroidism effects metabolism, your ability to recover from hard training, and how your body digests iron (less stomach acid means we don’t absorb iron from our food very well), among other things. Again, muscle weakness can be but is not usually as much of a problem for hypothyroid people as hyperthyroid people. I would suggest the following if you haven’t already done so. Try to do as many of these things as possible on a regular basis:

    Get your medication dialed perfectly to what your body needs. Go back in every 5-6 weeks until your TSH is below 1 and your T3 and T4 are within a good (high) range.

    Make sure you’re consuming 150-200 calories of food within 30 minutes of your hard workouts (should be 3 parts carb and one part protein–or 75% carb 25% protein). This could be in the form of real, solid food or a recovery drink. Don’t skip on the carbohydrates after a hard workout. Everyone knowns to have protein, but carbs are actually just as important and you need more of them in this recovery window.

    Cut out gluten

    Cut out or drastically limit dairy, aside from whey isolate

    Limit your processed foods and stick to a diet high in vegetables, fruit, legumes, rice, eggs, whey protein, nuts, avocado, coconut oil, and a little bit of lean meat

    Get 7-9 hours of sleep on average

    Stay hydrated. Drink at least 2 liters of water every day, if not more.

    After a hard workout, try to get your body and mind to calm down. Listening to soothing music and de-stressing go a long way towards reducing cortisol levels.

    Let me know how this works out for you. My wife is a sports nutrition coach if you want any more help along the way with this.

  9. Grandma, how has Hashimoto’s affected you throughout your life? Did you notice an improvement when you started taking the medication?

  10. I am so glad to find your and other articles that isn’t necessarily uncommon for endurance athletes to be hypothyroid. I, too, have recently been diagnosed with hypothyroidism (along with other things). I was feeling so frustrated because I was in the midst of training for a few Ironman’s and while I know training can be tiring, this just felt different. Mornings were unbearable, I could barely get myself out of bed before 8am. Which while I don’t particularly love mornings I at least am no stranger to 4am wake up’s to train. I could’t describe the fatigue I felt, which was frustrating when you tell something how “exahausted” you are and they say “me, too”, but you know it’s not the same…just difficult to put into words. And my usually super fability to focus and multi-task (are the two together contractidory? ha!) seemed non-existent. I almost feel numb. I felt lethargic and heavy- and my sleep is not good. I am at least happy to know there’s a culprit and, like you, it’s not all in my head. I’m hoping there is light at the end of the tunnel- and think there is. I’m supposed to be in the higher volume training wise right now, and I feel like training is hit or miss. I’m hoping maybe the meds will kick in soon so I can continue as planned. I do have moments where I feel small improvements, but that has also been tied with some setback. So thank you for sharing your experience and thoughts- this gives me hope!

  11. Ally, I’m glad this post helped and there is definitely light at the end of the tunnel. Give the medication time to kick in (it takes many months) and really be on top of your doctor to have your blood work done every 5-6 weeks until your numbers balance out. Most people with Hashimoto’s feel best when their TSH is consistently below 2.0. It takes a while to get there, at least it did for me. You may want to consider getting your adrenals checked also since you’ve been training hard throughout all of this. For that, you’ll probably have to see a naturopath or order a test on line, as your regular doctor will just say, “Your adrenal glans are find. If they weren’t, you’d be in the hospital right now.” I actually recommend seeing a specialist for all of this. An endocrinologist would really help. A general practitioner’s job is to make sure you don’t die. A specialist will give you back those last few percentage points that really matter for an athlete.

  12. Thanks for the reply. It’s funny/interesting you mentioned adrenals. You’re spot on there. I have actually been working with a Naturopath. She did a variety of tests and my adrenals are also completely shot. There were other tests, too, but just all in all, seems a lot of reasons for the extreme fatigue. So interesting how one little gland can cause so much destruction if it’s off!

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