Thyroid advice

Is anyone else out there racing with thyroid problems? I have been getting treatment for the last 4 years or so and after an initial significant improvement after many years of never seeming to get anywhere I have dropped back a lot with only occasional better performances. My Doc is pretty good but doesn't necessarily understand a runners perspective on this issue such as referring current medication to resting heart rate and as long as my blood tests come back in what seems to be a broad range of 'normal' he is reluctant to see a need for changes to my dosage. The medication affects my metabolism and if my RHR strays consistently outside the range of 48-52 I know its not quite right. I know one local runner who has the same medical problem but he is actually very good and doesn't seem to have the same difficulties with it as I have. To give an idea when the treatment was going well I ran Anniversary Waltz in 2.09 - this year I think I was about 2.35. Its pretty frustrating! Is anyone else dealing with this and in particular does anyone change their medication according to activity levels? I'm convinced the same dose every day cant be right for days when you do nothing and others when I might be running for five hours, but I'm told its a background thing rather than something you can or need to alter such as the amount of food you eat or (for example) insulin dosage for someone with diabetes.

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Originally Posted by COUGAR

Is anyone else out there racing with thyroid problems? I have been getting treatment for the last 4 years or so and after an initial significant improvement after many years of never seeming to get anywhere I have dropped back a lot with only occasional better performances. My Doc is pretty good but doesn't necessarily understand a runners perspective on this issue such as referring current medication to resting heart rate and as long as my blood tests come back in what seems to be a broad range of 'normal' he is reluctant to see a need for changes to my dosage. The medication affects my metabolism and if my RHR strays consistently outside the range of 48-52 I know its not quite right. I know one local runner who has the same medical problem but he is actually very good and doesn't seem to have the same difficulties with it as I have. To give an idea when the treatment was going well I ran Anniversary Waltz in 2.09 - this year I think I was about 2.35. Its pretty frustrating! Is anyone else dealing with this and in particular does anyone change their medication according to activity levels? I'm convinced the same dose every day cant be right for days when you do nothing and others when I might be running for five hours, but I'm told its a background thing rather than something you can or need to alter such as the amount of food you eat or (for example) insulin dosage for someone with diabetes.

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Cougar do you keep a record of your TSH(thyroid stimulating hormone) level? If you don't then my advice is as follows: Ring the doctor and ask for all your TSH results over the past 4 years. Write these down including the dates. Compare your running performances at the time of each blood test to the TSH result.

If for instance your TSH was 4.0 when you were running poorly, and 2.0 when you were running well, and currently it's back to 4.0, then you'll need to increase your thyroxine by 25micrograms a day( Thats provided your thyroxine dose was the same for each test).

What you've got to remember when dealing with doctors is very few realise the significance of the thyroid tests. They forget that the 'normal range' is a statistical measurement, and so as long as you're within that range they expect you to be alright. Unfortunately for you, you don't feel alright.

One last point. You will always go through low periods, even if the dosage of medication is right. You've got to expect that from an autoimmune system problem. Most of the time though you should feel ok and full of energy.

Had an underactive thyroid for about 9 years, currently on 150mg a day. To be honest, i don't feel any different to when i didn't have the condition. Christopher Leigh is the man to take notice of, all the best COUGAR, and hope your running and feeling well soon mate;)

The problem is the limitations of a blood test done on one occasion. Its rather like taking a picture of next doors dog and using it to make assumptions on its behaviour. Comparrison of multiple tests will give a more accurate picture of how thyroxine reacts with physiological states.

Thanks everyone for the replies and good wishes, I'll definitely take your advice Christopher and arrange to get the results of my tests over the last few years and see if that gives any correlation. I know that getting medical advice over the internet is not necessarily a sound idea but you all do seem to know what you are talking about! Bearing that in mind and speaking generally rather than specifically looking at my own particular circumstances do any of you think there is any likelihood that daily alteration of doses according to activity levels might be beneficial, or is it a case of building up a background level of TH in your body that it draws on as and when needed? Presumably the only way to find out would be to do daily tests over a longish period and examine the results but I cant see my doc being prepared to fund that. I just find it hard to accept that I should take the same dosage if I'm doing nothing or running hard for hours. I have found that in general morning RHR below 48 = need to increase thyroxin, RHR above 52= need to decrease, and I'm currently on 200mcg daily with RHR within that range, but still unable to get back to the brief period of running really well (by my standards) that I enjoyed at the start of all this. To be fair that was when I was taking carbimazol (not sure about the spelling) to reduce thyroid activity before I had radioactive iodine treatment which I was told at the time would make things pretty straightforward to sort out afterwards - that doesn't seem to be the case from a running perspective at least.

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Originally Posted by COUGAR

Thanks everyone for the replies and good wishes, I'll definitely take your advice Christopher and arrange to get the results of my tests over the last few years and see if that gives any correlation. I know that getting medical advice over the internet is not necessarily a sound idea but you all do seem to know what you are talking about! Bearing that in mind and speaking generally rather than specifically looking at my own particular circumstances do any of you think there is any likelihood that daily alteration of doses according to activity levels might be beneficial, or is it a case of building up a background level of TH in your body that it draws on as and when needed? Presumably the only way to find out would be to do daily tests over a longish period and examine the results but I cant see my doc being prepared to fund that. I just find it hard to accept that I should take the same dosage if I'm doing nothing or running hard for hours. I have found that in general morning RHR below 48 = need to increase thyroxin, RHR above 52= need to decrease, and I'm currently on 200mcg daily with RHR within that range, but still unable to get back to the brief period of running really well (by my standards) that I enjoyed at the start of all this. To be fair that was when I was taking carbimazol (not sure about the spelling) to reduce thyroid activity before I had radioactive iodine treatment which I was told at the time would make things pretty straightforward to sort out afterwards - that doesn't seem to be the case from a running perspective at least.

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I know what you're thinking Cougar, but messing with your dosage on a daily basis will cause you even more problems. For instance, if you feel bad one day, that may tempt you to increase the dose the next day. The reason for feeling bad in the first place, may well be due to your thyroxine levels being slightly too high, and you've gone and raised them even more!

The key to running well with hypothyroidism is to get your TSH at a level that is right for you. Too high and your metabolism will be slow, too low and your metabolism will be fast. In both cases you'll have no capacity to exercise effectively, as well as experiencing other problems like loss of sex drive and mental dulling.

So ring your doctor today and get your TSH results. You'll also need to know how much thyroxine you were on at each time. When you do this and if you're happy to, post the results on here and I'll go through them with you.


P.S Almost forgot to ask. Has your weight remained constant over the 4 years?

Thanks for that, very much appreciated. I'm away from home for a few days but I'll get on to it next week and I would value your comments.

I went to the docs a few years back complaining that I felt tired more than normal. They then sent me for a suite of blood tests and found that I had an under active thyroid. My Thyroxine levels were normal but my TSH levels were high. This was all before I took up running and was around 17st - 18st in weight.
I took the meds and it didn't really make much difference to the way I felt. I was still tireder than I used to be and the weight didn't change.
About 3 years ago I took up running and lost 3stone in about 4-5 months and now I stay around 14.5st (i plan to try an lose more, but it never works). I'm running slightly worse this year than I was last year but I wouldn't put it down to medication. Occasionally I forget to take my tablets for a few days but I feel no adverse affects from that and when I remember I just carry on.

When I went to the doctors last I had hoped that all this exercise and weight loss would have made a difference to the dosage I should take but it didn't. Should it?

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Originally Posted by peawet08

I went to the docs a few years back complaining that I felt tired more than normal. They then sent me for a suite of blood tests and found that I had an under active thyroid. My Thyroxine levels were normal but my TSH levels were high. This was all before I took up running and was around 17st - 18st in weight.
I took the meds and it didn't really make much difference to the way I felt. I was still tireder than I used to be and the weight didn't change.
About 3 years ago I took up running and lost 3stone in about 4-5 months and now I stay around 14.5st (i plan to try an lose more, but it never works). I'm running slightly worse this year than I was last year but I wouldn't put it down to medication. Occasionally I forget to take my tablets for a few days but I feel no adverse affects from that and when I remember I just carry on.

When I went to the doctors last I had hoped that all this exercise and weight loss would have made a difference to the dosage I should take but it didn't. Should it?

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If you are forgetting to take your tablets then the test results aren't what they should be. With this condition you can't afford to forget to take your tablets. Missing doses in the short term may seem to have no deleterious effects, because of the long half-life of thyroxine. In the long term though, missing doses will have an affect on the fine chemical balance of the body, resulting in certain medical problems like heart disease.

I'll get back to you with my results when I have them Christopher but just to show how unpredicatbale this all seems to be I had my slowest ever Ben Nevis followed by what for me was a really good run in the short LDMT and I've just got back from running what I think was my fastest 3 Shires for years!
peawet - I sometimes struggled to remember to take the pills so I now start a new packet on Monday morning (I take 200mcg, two 100mcg tablets daily, 14 in a pack so if I'm not sure if I have taken them its easy to count up and check). Last time I forgot was the morning after Jura and by mid morning I was feeling cold and lethargic, even when I got to the pub at Port Askaig waiting for the ferry having soup and brews etc I felt 'off' and cold - might just have been the aftereffects of Jura but I dont normally feel that bad and when I realised and popped the pills I was feeling fine soon afterwards and warmed right up. It might just have been psychological especially bearing in mind what Christopher says above about 'half life' but I know how I felt! When my meds were off I went up to 11 stone, after last adjustment I've got it down to just over 10.7 but I seem to be stuck there and cant shift the last couple of pounds i would like to.