What is your TSH?
I did best with my TSH really low.
I use Armour and I love it- Synthetic thyroid did not work for me.
It took me 2 years to work this out.

TSH .078
T3 1.8
T4 .92

Seems pretty low.
See if your doctor will let you try Armour?
Pay attention to symptoms as much or more than blood markers.

Synthroid got my numbers where they should be - but I felt terrible. I switched to Levoxyl (name brand) and felt so much better! Still synthetic, but numbers stayed good, but I just felt better. Name brand Levoxyl is off the market at the moment, so I've been on the generic (Levoxylthyrine) for about 9 months now, and I saw no change in numbers or how I was feeling on the generic, but when the name brand comes back online, I'm going back to it as dosage is more reliable in the name brand (per my doc).

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Harry: "I expected the Rocky Mountains to be a little rockier than this."
Loyd: "I was thinking the same thing. That John Denver's full of shit, man."

I'm hypothroid and I've used armour thyroid for 10 years. I love it- it was prescribed-never stopped training, never felt tired again. What kind of symtoms does the synthetic evoke?

thank you for starting this thread

I had half my thyroid removed in oct 2013. now dealing with constant fatigue (nap 2x per day) and when running I'm good for an hour. once I hit the hour mark legs get heavy, body hurts and this comes on fast. yes i am running 5-6 days per week and all easy to moderate as sitting still drives me crazy.. i have a follow up with my doc in may to review and curious to hear details of others as all of this is new.

any feedback is welcomed.

thanks
jim

What's your reaction when you get too low? I've been on Synthroid for about 10 years, long before triathlon, and my numbers are pretty stable now. One thing I have to be very careful about is fueling -- snack before workout, gels or Gatorade during, and a snack after -- otherwise I will drop low enough that I will get the shakes and nausea and need to sleep for about an hour and a half while my body rebuilds my levels. (We have tested for and ruled out diabetes and I didn't, you know, die the first time it happened.) If I wait too long, I feel sick for the rest of the day and probably the next morning, so I really have to be on top of not letting my blood sugar getting too low.

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http://mediocremultisport.blogspot.com

I had my right thyroid removed about 4 years ago. TSH went back to normal reading, no medications and I feel as fast and strong as before.

I regularly work out 1-2 hours at a time, a 3 hour bike ride or two hour run is no problem. I do not swim more than an hour at a time, mainly due to extreme boredom!

Is that TSH a typo? Or are we talking different units here? That seems really low, which would indicate that you're well into being hyperthyroid. Though your T3 level seems on the low side.

I have a long thread on here (you can search my posts) about my problems with hypothyroidism. I don't know that I ever wrote a final summary of everything but I will try to sum it up for you and others here. It took me a long time to get everything sorted out (close to 3.5 years). The best advice I can give you is to never accept a doctor telling you that you are fine when you don't feel fine. They can read labs, but they cannot feel how you're feeling. Only you know how you used to feel and how you feel now. You have to be your own advocate. That's not to say that you shouldn't trust your doctor of course. Now that said, here's my best advice from my experience:

• To start, I'm currently on 100mcg of Synthroid and 5mcg of Cytomel (both daily)
• I see you're already on cytomel, which is good. Especially since your T3 seems middling. A lot of people will tell you to focus religiously on your TSH, but IME if your TSH is between 1 and 2 start focusing on your T3 levels. Cytomel was the last thing added to my treatment, but it made all the difference in how I felt throughout the day. This got my T3 level up to the very top of the range (~4.2?), and it's been my experience (and others) that's where you really want to be assuming your TSH is not ultra-low already. If that's the case, ask your doc about backing off some of your synthroid and replacing with more cytomel.
• You need to look at your diet. T3 levels are highly correlated with your diet and carbohydrate intake. You are going to have to be more conscious of fueling your workouts and making sure you're taking in adequate carbohydrates pre and post workout.
• In addition, it's worthwhile to try a month eating gluten-free to see if it helps you. I had a total crash about 1.5 years after my initial diagnosis (which is when I started a large thread here), and out of desperation cut gluten out of my diet, which changed everything for me and allowed me to get back to a full training load. There is an increasing amount of research correlating hypothyroidism with undiagnosed celiac and non-celiac gluten intolerance.
• Another diet item that also helped me significantly was re-evaluating and reducing my sugar intake.

Edit: Here's my thread from a few years ago if you want to read through it. http://forum.slowtwitch.com/...rch_string=;#3621572

landyachtz

thanks for your post and link. it helps to see what others experienced and an outline of what to look for.

jim

I was diagnosed with Hashimotos in 2005 and am currently going through my second bought of fatigue which came about 2 years ago after a DNF at a 70.3.. I have done a ton of research and trials over the years and can share info on what I've learned. Feel free to message me with any questions or concerns. Here are some suggestions based on what I've learned over the years.

T3 - try and get your T3 into the higher end of the range. I've noticed that I'm able to train better when my T3 levels are higher. Your Endo will try and convince you otherwise and will focus on your TSH. You should focus on your Free T3 levels.
Adrenals - have your Adrenals checked through saliva testing. There are several places who offer mail in test kits. My issues from '05 - '07 and for the past two years have had nothing to do with my thyroid. It's my Adrenals. Endurance athletes with Thyroid issues tend to overstress their Adrenals due to training and stress. I went through two years of hell trying to figure this out including a week long visit to the Mayo Clinic in AZ where the only medical diagnosis they could make was depression. I could have had a new Tri Bike for what we spent at Mayo.
Naturopath - do some research and try and find one in your area who is highly recommended. I spent countless hours and $$$ seeing Specialists from 05 - 07 and it was the Naturopath that was able to pinpoint my issues and find resolution. Most however do not take insurance so it's an out of pocket expense.
Diet - as mentioned in an earlier response, do some research on diet for thyroid patients. Gluten free is certainly the way to go if you can manage that into your daily life and training. Also, consider adding Sea Salt to your diet.
Remember, It's a process - there's no overnight fix here. It's going to take some time and trials. Be your own advocate. The problem with most medical professionals is that they do not understand the needs of an endurance athlete and will base your lab work on the standard range. It's important to try and figure out what works for you!
Armour - I am another fan of Armour and have been on it since 2006.
Training - if your levels are off or your Adrenals stressed, intense training can magnify the problem. Try scaling back on the intensity until you figure out what's causing your fatigue.

There's a ton of info out there so continue to be proactive and continue asking questions.

Hope this helps.
Pat
Henderson, NV .

I agree with this- Many (not all) endocrinologists are very conservative and treat Thyroid issues in a conservative nature.
A naturopath will be more likely to treat the symptoms, consider alternate medications, alter dosage, etc.

My experience may not be a good thing to compare with. I found out that I had Thyroid Cancer about 7 years ago and fully had mine removed. I have struggled with medications for a while now. When I had cancer, my weight ballooned up to 230 pounds from 170 (5'10"). At one point after removal and reasonable meds I was down below 200. This year I switched off of synthetic Synthroid to Naturethroid at 1.25 grains. I feel better overall, but I have been gaining weight still, up to 230 again, feeling crappy. A combination of Naturethroid, synthroid at 25mcg and cytomel at 5mcg and I function fairly well and can train.
Lesson: It takes a combination of different things to make it work out. No one pill is going to work perfectly. There is even a difference in 12mcg, yes we are that sensitive on this hormone.

Thanks for all the helpful responces!

Nope, the TSH is not a typo. I don't think my doc wants to up my medication anymore since the TSH is so low, even though my T3 and T4 is on the low end of normal.

Symptoms I get post hard training are swelling legs, puffy face, tired, depressed, weight gain, muscles feel like bricks and don't want to work. Not really fun.

Seems to me like there's likely something else going on. Are you seeing an endocrinologist or your primary care doctor? Your TSH being so low while your thyroid hormones are low/average could mean a problem with your pituitary (which is the gland that produces TSH along with a host of other things). What other labs have you had done?

As I said earlier, the best piece of advice I can give you is to be your own advocate and be vocal about your symptoms. If your doctor is only treating you based on your labs and not your symptoms then it might be time to research top endocrinologists in your area and change doctors. Or if you're still seeing a GP, have them refer you to an endocrinologist. If you happen to be in the Phoenix area, I can give you some good recommendations, otherwise Google is your friend.

Thanks for posting this topic. I've been hypothyroid since the early 1990s, it surfaced about a year after I started running marathons. I do not follow my numbers closely, but my endocrinologist does, and I've had just two docs in about 23 years. After the first bouts of terrible fatigue and night sweats, I got medication -- Synthroid -- and have been mostly stable ever since.

One thing my doctor has recently been stressing is to take Synthroid on an empty stomach and not to follow it with food or any other medication for about a half hour. She also has me taking Vitamin D, and she says those two steps have improved my levels.

I do several marathons and other long distance events a year, and hypothyroidism has very rarely been a performance issue for me.

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Sharon McN
@IronCharo
#TeamZoot
Clif Bar Pace Team 2003-2018

welcome to the club - there have been a few posts on this over the years here at ST. i was diagnosed as a teen; i'm in my 30s now. i've definitely raced well and gotten fast after being diagnosed, and done both intense short-course/draft legal stuff, and some very high-volume stuff too.

so, it's possible.

on the other hand, i'm still struggling to get my dosing just right, and have changed it many times. i still have annoying symptoms, too. i suspect training loads might increase my needed dosage, but i'm not certain; anyway you'll not find much medical literature on this. there's some evidence about training and blood values, which is frustrating: most MDs are basing your entire treatment regime on just a few data points (blood draws that are happening basically at arbitrary points a few times a year, tops). if you've done a tough workout just before getting your blood drawn, if might throw up some flags and send your doctor on a wild goose chase for months until the next bloods come in.

the lab ranges for TSH and T3/T4 have changed over the years and can vary place to place, so my general advice is to treat your symptoms rather than your 'numbers.' take the drugs you need to feel well and be productive again, in short. however, depending on your age, history, and numbers, you might want to read up on TSH and the heart - you can risk burning out your ticker if you rev the TSH motor indefinitely.

anyway, that's my few cents for now. good luck and keep us posted!

-mike

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https://lshtm.academia.edu/MikeCallaghan

http://howtobeswiss.blogspot.ch/

I don't have any suggestions, but glad to see a thread current. I am new to this too, just diagnosed a couple of years ago. I am not having problems when I'm working out, but I am terribly overweight and I am having a hard time balancing enough calories to feel good working out and eating few enough to lose weight. It has become much harder as I increase distance. Right now training for HIMs and I love it so I don't want to shorten back to sprints to lose weight.

You guys got any insight on weight loss with this?