I don't have a thyroid issue, but I have several other endocrinology issues that I am sorting out (leaching of bone calcium, hormones out of whack, intestinal issues). I definitely see a correlation with training. In fact, with my last 2 IMs there has been a distinct cut-off point where i just completely shut down. For IMFL in 06, it was constant diarrhea that left me weak, fatigued, and electrolyte-imbalanced. For IMAZ 07, it was a bit of that plus breaking down of my bones. One day, I can be fine. The next day, I'm a wreck. The IMAZ issues have taken me nearly a year to resolve, and I still don't think I'm 100%.

I was diagnosed with a gluten and casein intolerance last fall. Cutting gluten and dairy out of my diet has made the biggest difference so far. Still, I think everything has been pushed so far for so long that it's going to take more time and more tests to get it all worked out.

Coincidentally, I had a bunch of tests done last week that included thyroid (TSH). I have a lot of the symptoms of a thyroid problem, and I wouldn't be surprised if they come back positive.

Does your doc adjust the amt of your meds based on training? How often do you get your levels tested?

I am thinking I need to have her do that. I am in my 4th year of participating in triathlons. Before that was a bunch of bike tours. So for the past years I have only had routine TSH testing done annually. Then had the TSH tested during hospitalization for the seizures (and it was 11) (results this time 9.5). My GP is getting me to a different neurologist too. (separate isssues)

It stinks having smoldering med problems, doesn't it? My doc says "well you ARE 48". But age is not necessarily "a disease"... Look at Joe Boness! I went to an endocrinologist (who also bicycles), but I am small potatoes to him, I think, compared to his really seriously ill endo patients. I do feel I can talk to my GP about things and like her so will likely just stick with her. I do like your suggestion of more frequent testing/monitoring tho, so will bring that up with her next visit (2 months)

Good luck with unravelling your med stuff too! Thanks for replying.
C

that's not the issue in my case. this is something that has been going on for 15+ yrs for me and is related to my digestive issues.

I was diagnosed with this last April, after suffering a year of nasty and worsening fatigue. Only got to start meds in Aug, but have been training well since then. I get tested every 90 days. My endo said because of the recent diagnosis and because of my training that quarterly was a good idea. She said my problem was due to cumulative stresses, the largest part of those stresses being a divorce, not training load. She encouraged me to continue to train as long as I felt well, but she also put a lot of emphasis on recovery and diet. I am only training about 7-10hr/week now, and expect to get up to 15hr/week thru summer. Not much help for you sorry, except I know how it feels.

AP

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"How bad could it be?" - SimpleS

I was diagnosed with Graves disease in 2002 (hyperthyroidism) and had a complete thyroidectomy in 2003 so technically I now have hypothyroidism and am medicated with a nice little cocktail of Synthroid and Cytomel.

Interesting post b/c I did my first IM last Sept and have been a disaster from a blood test results standpoint ever since. Not only have my thyroid levels been all over the place but apparently a bunch of other hormones (mainly reproductive) are also a mess. My endo is fantastic and we're right now trying to figure out how much of it may be due to IM and IM training versus just my body going haywire. However, I think it's *really* important to make sure your endo understands what your training consists of. You don't just work out like everyone else they see (30 minutes a day 4x week) but are doing considerably more which obviously taxes your body. As such, my endo has me on semi-annual blood work but I can also call her up whenever I think I'm feeling "off" and she'll squeeze me in for more bloodwork.

Truthfully this entire thing is INCREDIBLY frustrating. I can't explain it how sometimes there are days when it literally takes all my energy and concentration to simply get out of bed and function in this world let alone try to throw training in on top of it.

Re: cytomel - if you're finding that your current thyroid replacement medication isn't working as well as you'd like you may want to do some research into Cytomel as some doctors like to put it together with Synthroid but many need some convincing to give it a try (my doctor included). It is a more immediate release medication whereas Synthroid releases more slowly over the day (some argue several days). I now take a little bit in the morning and a again in the afternoon which helps immensly with afternoon workouts since it give you a little "pick me up" (so to speak) just when you're absolutely fading at the end of the afternoon. Obviously it doesn't work for everyone but may be worth resaerching and talking to yoru doctor about.

If anyone has any other insite into this whole joy of thyroid issues I'd love more information. I'm really worried about the toll this is all apparently taking on my other hormones (and how awful I feel because of it) but my doc wants to "wait and see" and I don't go back to her until April.

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I have to echo the get tested more.....
I am both a doc and I have hypothyroidism and I find that even in NON athletes I often have to change doses in winter compared to summer.
but training demands could very well shift levels.

additionally estrogen etc and thyroid hormones both bind to sex binding globulin so fluctuations in one will affect the other....for those in perimenopause or menopause or training hard that will affect your levels - ie if your estrogen levels drop then the available amount of thyroid drops as well as more binds to SBG.

I always test TSH, FreeT3 and Free T4 and in someone like you would also throw in thyroid antibodies....

hope that helps

cat

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cat
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You know, you hit on something else there I forgot to include, the reproductive hormones. I have been suffering from breakthru bleeding while on the combo pill ever since I ramped up training. I was put on a estrogen only pill, but it hasn't helped much. Now any stress i.e.: a really bad day at work, and I spot. Two bad days in a row and my period starts. It's something I am still working thru. Likely perimenopause (I am 35), high estrogen. Who knows. This part is tougher to resolve it seems.

One thing I am glad has stopped since starting meds: While battling the fatigue, I used to sweat something fierce, to the point where I would permanently stain shirts. My perspiration level and "content" (for lack of a better word) seems back to normal now.

AP

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"How bad could it be?" - SimpleS

Cat, is there information about progesterone's effects on thyroid function or vice-versa? i was put on progesterone cream recently, but I had to stop taking it after 2 weeks. It was driving me insane, and I started to gain a lot of weight in a very short amt of time, felt like shit, wanted to sleep forever, etc.

All this stuff is pretty fascinating to me...

progesterone will definitely make you tired - I have women take it at night for that reason....

and yeah, it is another that binds to SBG....

but progesterone alone can cause fatigue and weight gain.

the whole axis is a tough one to balance out - and things can interconvert.....

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cat
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This is fascinating. I will push for more tests on the SBG and estrogen in my next set. It's just crazy. I'd go off the pill if the BF would get a vasectomy. Maybe an IUD. I just want to see if I can get my cycle back to normal. AP

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"How bad could it be?" - SimpleS

you might do better on nuvaring - constant levels....

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cat
Sponsored by Suntheanine, Lycored and Celadrin
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is it avail in Canada?

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"How bad could it be?" - SimpleS

I really appreciate your insight from a doc (and patient) perspective and everyone elses. Guess if nothing else it's always nice to know that I'm not the only one on this little rollarcoaster. Rather than breakthrough bleeding I actually stopped having my period for what has now been 10 months which is a little unnerving given that I'm hoping to start trying to conceive in the next year or so (31 years old). My doc decided to pull me off the pill entirely so that we can retest in a few weeks to determine whether the pill was making my hormonal levels artificially low. My husband and I are joking that if we accidentally get pregnant now then perhaps it was just meant to be!

On another note, my sister who also has Graves (and went the radiation route so is now hypothyroid) has a doc who typically does a FULL workup on all her hormones every year as he really believes that it's like a domino effect if just one is off. She's had really great results and has felt wonderful going this route so I'm thinking of asking my doc for more comprehensive tests next time even if it means I have to foot some of the bill that insurance won't cover.

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I am sure it is - Canada usually gets things before the USA does.

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cat
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i went to an anti-aging clinic in Cleveland a couple of weeks ago. the doc there is pretty holistically oriented for being an MD. they took about 20 vials of blood to test anything and everything. results this wednesday. she took a look at my fingernails and said that all those ridges and lines running through them were symptomatic of a sluggish thyroid. had me kneel on a chair and did some reflex thingys with a hammer on my ankles which did not respond, and noted that the soles of my feet are yellowish, all also apparently symptoms of a sluggish thyroid. she noted that the internists usually only test for TH4 which is apparently not the most definitive test around for sluggish thyroid --mine tested ok about 6 years ago even tho i was feeling like crud even then.

anyway, i left the office with a bunch of "nutriceuticals" in bottles -- appear to be vites, minerals, ALA, hyaluronic acid, CoQ10, fish oil, and a couple of proprietary *mitochondrialj* blends of a compounding pharmacy called Douglas Laboratories -- after getting an IV of god knows what in a yellow baggie with some other stuff shot into it for my sagging memory. (yes i'm that desperate/gullible/hopeful/foolish.) does this sound like hocus pocus? i can't say that i've turned anything around with the "nutriceuticals" in two weeks, but by golly my hands are a lot less dry and actually have some softness and tone to them. ditto for my neck. to tell the truth, a lot of what's in the proprietary stuff is the same stuff that Hammer sells, only pharmaceutical grade.

thanks Cat for being the resident lady-doc! terrific thread. glad to know i'm not alone out here with my hormone stuff.

How about this monkey wrench.... I have Hashimoto's Thyroiditis. No problems for a couple of years (Synthroid 150mcg). Periods however were horrible horrible horrible. So ob/gyn puts me on YAZ and not take a placebos so I don't get a cycle at all....again really no problems for 6 months. Then rest time from the coach....breakthrough bleeding for 4 weeks....stop the pill (per Ob/gyn)for one week then started back up. Stopped the cycle again, no problems....tired though, but blame it on winter dull drums...then out of no where heart palpatations, wierd though only when at rest...sitting in the car, watching tv....never ever during training. So we (GP and I) test TSH ugh!! NONE!! So she adds 25mcg to my already 150mcg and heart palpatations go away in a week no problem. 45 days later, heart palps again not nearly as strong or frequent, another blood test and still very little to no TSH so I see her on Tuesday of this week for a new plan of attack. I have gained 10lbs since since November 06 (but have totally ramped up my cycling in the last year plus - Trukweaz is my coach LOL)...have gotten boobs (pill?)...other than that a little tired but nothing I cannot attribute to the stress of life in general.

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Kat Donatello
2015 Betty Designs Team
RD, The Pumpkinman Triathlon Festival
http://www.pumpkinmantriathlon.com/

I get heart palpitations, too, at rest. I definitely noticed it happening more when I was taking the extra progesterone, but it sometimes happens during my cycle normally.

What the heck is wrong with all of us???

Austin, I don't want to hijack, but I wanted to tell you I am caregiver to a household of GF people. It is exhausting. If you ever want to discuss this, please feel free to PM, or start a GF thread.

a few things.
are you taking brand named synthroid or generic?
I find a huge difference and if I am starting someone who I diagnosed put them on branded. those who feel ok on generic or on levoxyl I leave them on it,but I know I feel awful on the latter two.

second, you may need some t3 - you can do cytomel if you dose it twice daily (short half life) or what I do personally and with many patients is have a compound pharmacy make a slow release version (and add acidophilus in with it as many hypothyroid types have digestive issues).

synthroid etc are all t4, the storage form of thyroid hormone. your body has to convert it to t3 for it to enter cells and be used (the active form). My theory is that over time we lost the ability to convert....I do NOT like the animal extracts (armour thyroid...) as they have too much t3 - on the order of 25%. Humans need more like 10%.

this is one of the reasons I test TSH, free T3 and free T4. Even someone whose TSH looks ok might not feel ok and if I have room to play I do.

As to the bleeding thing....yaz is ok but is ANTI testosterone - not my first choice for athletes....

So I am 45, and was basically bleeding to death every month a year ago - I mean there was no amount of iron on the planet to keep up. So I tried loesterin and I forget what else and then thought oh, I will use the mirena IUD - which worked, until after 6 months my body spit it out. I am not entirely unhappy because I was noticing that when my estrogen level dropped so did my speed and strength. So now I am using nuvaring continuously. I had spotting for about 10 days the second month but not the blood letting I used to get and I FEEL good - no estrogen drop.....I am a BIG fan of topical forms for athletes in particular - so patch or ring - the latter has no increased blood clot risk.

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cat
Sponsored by Suntheanine, Lycored and Celadrin
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Hashimoto girl here again.....I take Levothyroxine....I really feel ok with Yaz (I had my strongest season last year never less than top 5, and even one win). I did try the ring and could not deal with it, and I did try the 90 day pill (cannot remember the name) and it made me a pyscho mess.
If you have a concern regarding "yaz is ok but is ANTI testosterone" could you not take a supplement to offset that? And when I get my next blood test should I not have the testosterone tested too?

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Kat Donatello
2015 Betty Designs Team
RD, The Pumpkinman Triathlon Festival
http://www.pumpkinmantriathlon.com/

there are 2 90 day ones - seasonale, the original one, and seasonique - the latter is a better combo for most women.

yes you could test your testosterone levels, but no supplementing would not really work....it is the kind of progesterone used that is the issue.

there are TONS of pills to try.

how long did you try the ring for?

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cat
Sponsored by Suntheanine, Lycored and Celadrin
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(Will reply in separate posts)

AP-
I have used the IUD for ~12 years now. So the only repro hormones on board are my own. IUD indications * I THINK * are if you're in monogamous relationship and have had kids already. That was what I was told back when I had my "Copper-T" put in (the kind w/o hormones--- good up to 10 years but I never bothered to get it changed out since I am 48). So you could ask your Ob-Gyn about IUD.

CatisTriing alluded to the whole complicated hormone axis-- the communication btwn your brain, pituitary gland and all the endo glands in your body. Throw in the Adrenal Fatigue angle possibly (over training), perimenopause and menopause and what a mess!

So, Cat...
Should a perimenopausal triathlete with hypothyroidism and seizures be managed by an endocrinologist or GP? (hey! I could write a tri trainng book: instead of "slow" and "fat" it would be The Perimenopausal, Formerly-Seizuring, Gray-haired, Hypothyroid Triathlete! Paging Jayne...)

I kinda feel like there is more to the story then my GP is persuing, even though I do like her and she has always been a good listener. Never heard anything about the SBG's though. Are you a GP or endocrinologist? Or ob-gyn?

Thanks for being involved in this thread.

THIS is an example of why a forum for THE WOMENS is a great idea. :-)