Thyroid advice

[CL]

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.

Cougar I don't think it was psychological. Judging by the wopping dose(200mcg) you're on, it seems you are sensitive to small fluctuations in thyroxine levels. Anyway I'll await the TSH results.

[peawet08]

Cougar,

I'm taking 100mg daily now however I don't notice any adverse effect if I fail to take them at all, maybe that is why I haven't really worried in the past about missing a day or so. I can't say I have ever felt tired after not taking my tablets.

Christopher Leigh,

When I was first diagnosed I was 18 stone and not really doing an exercise etc... Now that I am carrying less weight and exercising/racing as often as I get chance to should that affect the dosage I am taking?
I recall that when I was dignosed my thyroxine levels where normal but my TSH levels where high.

P

[CL]

Cougar,

I'm taking 100mg daily now however I don't notice any adverse effect if I fail to take them at all, maybe that is why I haven't really worried in the past about missing a day or so. I can't say I have ever felt tired after not taking my tablets.

Christopher Leigh,

When I was first diagnosed I was 18 stone and not really doing an exercise etc... Now that I am carrying less weight and exercising/racing as often as I get chance to should that affect the dosage I am taking?
I recall that when I was dignosed my thyroxine levels where normal but my TSH levels where high.

P

I asked a specialist some time ago, if exercise affected thyroxine levels. His answer was it had no effect. Since then there has been a study showing that intense exercise does affect thyroid hormones(both T3 and T4).

Does this mean one ought to 'anticipate' daily exertions, by altering the dose of thyroxine on a daily basis. I don't think so. In most healthy people the TSH is around 2.5. Their bodies are able to respond to minute to minute changes in metabolism, caused by training. This keeps TSH around the same level.

If a hypothyroid individual had a TSH of 2.5 when he was healthy, then this probably wouldn't be low enough when he was hypothyroid. The aim in such a situation would be to bring the TSH down to between 0.5 and 1.5. Such an individual would then find he had some reserves to deal with hard training.

On a general note, I've noticed that athletes(non hypothyroid) show a drop in TSH levels when taking kelp tablets. I think this demonstrates that the optimum level of iodine is higher than some people are getting in their diets. If that is the case it may be a reason for the increase in hypothyroidism in athletes.

[Mark G]

I'm only hypo because I was origianlly hyper and after the original tablets failed to sort the problem out I was persuaded that radioactive iodine treatment was the best option. That probably explains my comparatively high dosage - if the radioactivity zapped my thyroid sufficiently hard its maybe producing only very small amounts of natural thyroid hormone and possibly this fluctuates and may eventually settle down even if it takes a year or two. From that perspective it might have been better to have the op and have the whole thing taken out as I gather its then simpler to get the dosage right (presumably no fluctuations because nothing left!) but this still doesn't allow for exercise of course. Interested in your suggestion above of TSH 0.5-1.5, I'll look forward to seeing what you think of my readings when I get them.

[CL]

I'm only hypo because I was origianlly hyper and after the original tablets failed to sort the problem out I was persuaded that radioactive iodine treatment was the best option. That probably explains my comparatively high dosage - if the radioactivity zapped my thyroid sufficiently hard its maybe producing only very small amounts of natural thyroid hormone and possibly this fluctuates and may eventually settle down even if it takes a year or two. From that perspective it might have been better to have the op and have the whole thing taken out as I gather its then simpler to get the dosage right (presumably no fluctuations because nothing left!) but this still doesn't allow for exercise of course. Interested in your suggestion above of TSH 0.5-1.5, I'll look forward to seeing what you think of my readings when I get them.

I think you can assume a dose of 200mcg a day means that your thyroid isn't producing any thyroxine or triiodothyronine.

[Mark G]

Cheers Christopher, Docs now have the results in an envelope for me to collect next time I'm in town so I'll get back to you. Thinking about it some more I'm very interested in your comments earlier about getting TSH down and having 'reserves to deal with hard training' - so presumably you do consider there is a link between exercise/performance and the amount of thyroxine your body needs/uses?. Having been hyper to start with I know how ill that made me feel and how badly I was running at the time and having been hypo at times since I also know how that feels - I suspect that I am or have been fluctuating between these extremes with brief periods in the middle when the levels have been right and I have been able to run well. Last three races have actually been pretty good, maybe it is finally settling down but I'll be interested to see what you make of the results - thanks again.

[Mark G]

Christopher - I've sent you a PM. Thanks.

[Leaf]

I was very interested to stumble across this thread. I've been taking thyroxine for years (probably about 8 or 10?) and just have annual blood tests now to check my levels are OK. However, I've often wondered if my daily dose is sufficient - particularly later in the day after doing lots of exercise. I usually feel quite cold, have dry flaky skin and a low resting heart rate (34 bpm at times) but don't know if that's just because I do lots of running in the hills. I also really struggle to stay awake and to concentrate at work but that could be simply because I haven't had enough sleep. I struggle with my weight too but again I can put that down to eating too much!
So it's tricky to say whether my 'symptoms' are entirely 'innocent' or whether perhaps I should go back to my doctor.
After reading this thread, I'm considering the second option.

[Mark G]

Just a quick public thanks to Christopher for discussions via Pm (rather than posting some medical test results on a public forum).
Leaf - I'll be going back to my doc and asking for a change of dosage and another blood test in due course, I agree with what you say - its difficult to decide if symptoms are as a result of the illness or just from being run down/tired or eating too many pies! Shame that there isn't a home testing kit available instead of blood tests via the docs - I always feel reluctant to bother them too often but it would be interesting to see readings after a hard days running compared to a days resting. My wife is the closest thing I have to a home assessment - she always tells me when I am getting ill tempered and look knackered (she did last week).

[Mark G]

4 weeks on a reduced dosage so far (200mcg down to 175mcg) RHR down to 46 one morning after a rest day and put a little weight on but seem to be running fairly well. I'll be getting another blood test after a few more weeks and see how things look from there. Its hard to tell if its down to the dosage or just to having a better than usual spell of running because I did see some improvement before the change. Ben Nevis - slowest ever (from 8 races), Short Mountain Trial - had a good run. 3 Shires, Ian Hodgson and Langdale all a bit faster than last year but these overlap the period of change and the true test will probably be how I'm going a few weeks from now, or at the start of next season. If I can get under 2.10 at Anni Waltz again I'll tell the Doc he has finally got me sorted.
Read the Fellrunner profile of Aly Raw - my illness is nothing like as serious as hers potentially was but the treatment has the same effect, so if you visit the forum thanks Aly, its very encouraging to see that you are managing to do so well on it, nice one!