When people find out that I have hypothyroidism, they ask how that affects my ability to do ultra-endurance activities. The biggest effect is that I have trouble with my weight. Even while I was training for the Race Across America, I logged my food everyday to get my weight to where I wanted it. Now that I’m not riding as much and not logging my food, my weight is creeping back up. Although the weight is a problem for my performance, the fact that my metabolism is slow may actually help me since I don’t need as many calories. I also think my asthma hasn’t been as bad since my thyroid medication has been regulated to the point I feel better. It’s possible that it is at least partially responsible for some of my asthma problems.
I had hypothyroidism symptoms for a while before I was diagnosed with it. The main test for hypothyroidism is a blood test for TSH which stands for thyroid-stimulating hormone. It is produced by the pituitary gland to tell the thyroid to produce more hormone. The problem is in the past labs have said that a normal value was 0.5 to 5.5. In early 2003 the range was changed to 0.3 to 3.0. I think the first couple times I was tested I was near the upper end of the range but didn’t know enough to know what it meant. Free T4 and Free T3 are the other things tested for.
It took about 3 frustrating years to get my medication to the point of feeling good. By the time I was diagnosed with hypothyroidism, I’d have a deep fatigue feeling during the last hour of 2 or 3 hour mountain bike races and I would struggle just to keep moving. Even once my blood tests were within the normal range, I still didn’t recover well and would gain 5 pounds if I got sick with a cold. Now I’ve found that I don’t feel good unless my TSH is down near 0.5. I think the important thing is to use blood tests as a guide but make sure your doctor treats you based on how you feel and not be whether you fall within some range.
My TSH has been around 0.5 the last few years but when I was at the Emergency Room after dropping out of RAAM, my free T4 was low. Today I went in to get a blood test to see if that was because of the effort of RAAM or if I’m still that way. The ER doctor said my TSH was normal but of course without knowing the value of it, I don’t know where it was in the range or what range was being used. When we were at the ER, it was 2 in the morning and the first time in over eight days that I’d slept more than 3 hours at a time so I didn’t ask many questions. I need to get the full lab results sent to my doctor so I know what the TSH value was.
I also found that I didn’t feel good when I was on Synthroid and the other T4 only drugs. I had done some research and had read that some people do better with also supplementing T3. There’s a good article on About.com that talks about it and also has links to other good articles about hypothyroidism. Another good article discusses the a New England Journal of medicine report on T4 versus T4 and T3 treatment. I remember reading something that said athlete’s were more likely to need to take T3 but I can’t find it now. I started taking Armour Thyroid and in only a few days I could tell a big difference. My doctor actually planned to put me on Thyrolar but it’s expensive and the pharmacy I use doesn’t even stock it. The pharmacy said to get me regulated on the Armour Thyroid and then use a formula to determine how much Thyrolar to take. I’ve felt well enough on Armour Thyroid to not want to go through trying something else.
I’ve seen things about diet changes that are supposed to help if you have hypothyroidism. One thing that I’ve read is that cabbage somehow keeps you from absorbing the medication well. Eating healthy and avoiding sugar helps me feel better and recover faster from hard training rides but I think that would be true whether or not I had hypothyroidism. Honestly I can’t say that what I eat makes a difference because of my thyroid other than keeping my weight under control.