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Studies may link athletes and hypothyroidism

Posted June 11, 2007 at 10:00 AM by Katie Drummond

Section: Her Fitness, Her Health, Her News, Special Features

My mood was great, my weight was fine, and my running times had never been better – I was in the best shape of my life. So why was I in my doctor’s office, being told I had hypothyroidism? How does a 21-year-old, daily runner with energy to spare wind up on medication to treat a condition commonly associated with middle age, lethargy and weight gain?

It might sound surprising, but my situation is far from unique. As more and more athletes are being diagnosed with hypothyroidism, medical professionals are starting to make the connection between intense training (around 50 miles of running a week) and a malfunctioning thyroid gland. Recently, elite athletes Galen Rupp and Adam Goucher were both diagnosed with the condition – surprising, considering they are two of the best competitive runners in the country, and they hardly fit the typical profile of people diagnosed with hypothyroidism.

But this image is starting to change, as many doctors are now calling hypothyroidism the “unsuspected illness” that may affect many more than the 5 million Americans currently diagnosed with a slow thyroid. Although the exact cause of its occurrence in competitive athletes hasn’t been determined, speculation suggests that the ongoing stress of training might interfere with the regulation of this important hormone – much like some female athletes develop amenorrhea when intensive activity suppresses estrogen levels. Because the thyroid is mainly responsible for metabolism, which is stimulated by exercise, enough physical strain might mean the thyroid loses its ability to slow down and speed up properly – which, for some athletes, means the development of a sluggish gland.

Further research shows that poor diet may also play a role – a 2005 study on the connection between intense exercise regimens and the thyroid gland also found that athletes whose caloric consumption wasn’t enough to fuel their workouts were prone to hypothyroidism. In fact, female study participants who ate insufficient calories for merely four days during which they engaged in their usual intensive training routine developed abnormal and suppressed thyroid levels.

The production and release of the thyroid hormone (called thyroxine) is complicated, and hypothyroidism can develop in several ways. For some, the pituitary gland or the hypothalamus doesn’t produce enough stimulating hormone (TSH) to get the thyroid gland pumping thyroxine through your body. The illness also occurs if the gland itself malfunctions – which seems to be the case in athletes. In this situation, a blood test of TSH levels will show them to be elevated, meaning the body is producing more TSH to speed up the thyroid. But because hypothyroidism can develop at so many stages of thyroxine production and release, other tests might be necessary to reveal a problem.

The list of symptoms associated with hypothyroidism is lengthy, and there’s no way of telling which ones a patient might develop, although more indicators usually crop up the longer it goes untreated. Early symptoms usually include weakness, depression, brittle hair and nails, and unexpected weight gain – unfortunately, these signs are vague and can be caused by a number of other health problems, making hypothyroidism particularly difficult to detect until more serious symptoms, like slowed speech and facial bloating, make an appearance.

Both Rupp and Goucher have cited low energy levels and sluggish training sessions as the first signs of trouble with their thyroid levels. For me, it took two years and several blood tests before my doctor suspected that the thyroid was to blame for my thinning, brittle hair – the only symptom I seemed to have, and one which can be caused by a number of other, more minor problems, like stress or changes in diet. While I didn’t have any of the risk factors for hypothyroidism, if you have a family history of the ailment or are over 50, your chances of falling ill more than double.

Fortunately, treatment for hypothyroidism is as simple as a daily dosage of thyroxine. That being said, it can take months for doctors to determine how much is enough – or too much. Too high a dosage can trigger hyperthyroidism, characterized by heavy sweating, shaking, weight loss and insomnia, and too low a dosage means you won’t be relieved of your original symptoms. Once you find the right dose, you’ll need a blood test every six months or so, as your body’s ideal thyroxine levels might change as you age or alter your lifestyle, eating, or exercise habits.

If, like me, your hypothyroidism can probably be blamed on your activity level, you don’t need to slow down – but you do need to recognize that treating athlete-induced hypothyroidism comes with complications. Some medical professionals suspect that exercising after taking thyroxine limits absorption, as digestion slows down during intense activity. Furthermore, many athletes eat a healthy, high-fiber diet – which can also reduce absorption. The solution for most is simply to take a higher dose of medication, but this might mean allowing more time for doctors to find the right dosage to suit your lifestyle.

Chances are, your sluggish workout can more likely be blamed on that late night out or that second piece of chocolate cake, but if you do notice ongoing changes in your performance, it can’t hurt to have your thyroid checked. Competitive athletes may not fit the description of one suffering from hypothyroidism, but if ongoing research into the link between intense training and a malfunctioning thyroid proves right, that description might soon need to change.

Further Information:
Study on the link between athletic training and thyroid levels:
Exercise intensity and its effects on thyroid hormones
Information on the thyroid and hypothyroidism:
www.allthyroid.org
www.endocrineweb.com
Adam Goucher and Galen Rupp:
Mensracing.com interview with Adam Goucher
USATF bio of Galen Rupp


14 Responses to “Studies may link athletes and hypothyroidism” (Leave a reply)
  1. Leslie said:

    This is a really fresh take on a much talked-about topic, Katie - thank you. I was Dx w/hypothyroid in 4th grade...and believe me, it was not from too much exercise :-) Been taking the medication ever since and has just become an everyday thing. Good luck!

  2. jodi jakubek said:

    Jodi, A good article I thought you would be interested in.  Dad

  3. Michele Arnold from Scottsbluff, NE said:

    Thank you for your attention to this matter!  I transformed by couch-potato self into a half-marathon runner over a 10-month period, only to thereafter have my running performances decline, associated with increased HR (180-186) even when running seemingly easy runs.  Thanks for the useful link!

  4. Lucy from Austin, Texas said:

    I’m a competitive runner as well and was diagnosed in 2004 with Hypothyroidism, even though my times were getting faster and I didn’t have a weight problem.  My doctor told me that because I didn’t eat breakfast before I ran, my body was being so stressed that my TSH levels couldn’t recover.  I exercised every day for more than 4 years before my body broke down enough to show signs that something was wrong… I’m still competing and taking my pill everyday, but sometimes I still have problems...I’m always looking for new links to read about Hypothyroidism and running...Thanks!

  5. hmm...thats an interesting outcome. I did hear some reports about it from a couple of friends but i thought it was more of fiction. thanks for the information.

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  8. Alice said:

    Thanks in advance!  I was amazed to find that there is a connection between hypothroidism and intense exercise.  I was Dx’d w/ subclinical hypothyroidism (elevated TSH 5.86) this past Fall.  I ran between 35-49 miles per week for about 2 years (2006-20007).  I then took about 6 months off (2008) because of fatigue.  I gained almost 45 pounds overnight.  I had no idea that it could be my thyroid, but luckily one of my doctors checked my thyroid/tsh levels.  I take levothyroxine now, but I am still having touble w/ fatigue and can’t seem to lose the weight.  My levels are normal now though.  I am now doing between 23-28 miles a week, but I feel overwhelmed by this condition (plus the weight).  Does anyone know if I will further hinder my thyroid/thyroxine production by continuing to do intense exercise?

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  12. Ex-Swimmer from Northern Illinois said:

    Doctors need to learn to listen to their patients.  If your thyroid level was normal, then you would feel good.  If you don’t feel good keep looking for a Doctor who will listen.  This thyroid level issue in athletes really needs to be studied.  What is the thyroid level of a healthy athlete?  Has anyone tested an Olympic swim team and published the results?  These bodies feel great!  The real question is what is the thyroid level in a body that feels Great?  Does anyone know?  Doctors keep using a reference range for thyroid determined by testing a cross section of the population.  Please note: I didn’t say “Healthy Population” I don’t want to feel like a cross section of the population, I want to feel Great!  Like the super-fit athlete, i used to be.  By the way, you can buy T4 in Mexico without an RX.  Just walk into any Pharmacia and write down “Levothyroxine” on a piece of paper and show the attendant.  They will bring you the different strengths that they have and you can select and purchase one or more.  They are make by Merck and most come in blister packs.  They are small white segmented tablets, no dyes, and less additives and fillers than the drug sold in the US.  Until the Doctors figure out how to make you well, you should try to make yourself well.  Just be well informed and tuned in to your symptoms and you will have great results.

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