Going on thyroid meds.... what to expect?

Triathlon Forum
1

Hey peeps. Posted this in the womens and hypothyroidism generally is a chick thing. I need your advice please:

I know I’ve been hypo for about 6-8months now. I was on some powdered bovine thing but haven’t been feeling great since the new year. Turns out my thyroid has just about stopped functioning despite being on ‘meds’ and I’m now showing as pre-diabetic/glucose intolerant. I’m hoping the diabetic/glucose thing will disappear once my thyroid gets a jump start.

I’ve been training really hard and seeing some great results until the last few weeks where work has meant I haven’t been able to train and just wanted to sleep all the time and felt depressed again. My training goes great for a week - 2 weeks then even with 1 to 2 days off/week, I find I need 2 or more in a row.

I’m just wondering what to expect when I go on thyroxine or whatever drug the thyroid specialist prescribes - am I going to see better times? Be able to train harder/longer?
Are there any downsides to the drugs? E.g. breaking in period, or do they work instantly?

Any advice much welcomed. I have my first warm up tri of the season this week having only swum once, biked twice and ran twice in the last 3 weeks (I’m calling it an extended taper??!).

2

I was diagnosed with hypothyroidism in oh early 2007. It took a few years to get the meds really dialed in, but even with a few months I felt a lot better. Yes, you read tyhat right: MONTHS. It will take some time to get back to normal. I had finished my first IM (IMWA) in late 2005, and was starting to train for Comrades (aiming for 2008 entry). I was going through a lot of personal stress at that time, and thought my fatigue was due to that. So I reduced my training. And reduced it some more. Eventually I had to stop running. But when I couldn’t climb a set of stairs without having to lay down after wards, I knew something was really wrong. Once diagnosed, I started on the generic “synthroid” at 100mcg. After 6 months, even though my test results were looking a lot better, I was still having a hard time running or doing anything really. I got bumped up to 125mcg, and off the generic and onto the actual Synthroid. MUCH better. I recall doing sprint tris in 2008, and some 10ks, one half marathon; 2009 was a lot of racing including IMC, and I just finished IMNZ last month.

Things I found that helped: being religious about taking your meds and NOT eating for at least an hour, avoiding calcium during that meal (it affects the ability to uptake synthroid); reducing stress as much as practical (sometimes hard to do but very important); making sure you get tested probably every 3 months until you feel “right”, and then every 6 months or so; working with your GP and Endo to make sure any side effects are reviewed.

It is likely you will feel like shit for up to 3-6 months longer. Suck it up now and reset your expectations. You don’t have a choice in this situation anymore (i.e.: training harder will not yield any better results), so just work on getting you better and ready for your future racing challenges. Consider this year the “rebuilding season”.

Good luck. You can do it, just don’t beat yourself up about it.

AP

3

Thanks - it’s nice to have some realism and know what to expect.
I’ve already reduced my season - now just doing 2x 70.3s, 2x middle distance and 2x sprint. Was originally doing another 2 halfs on top of that, but withdrew during a depressed point last month whilst wondering how on earth I was going to manage it all feeling how I was.

A lot of the last 3 weeks have been due to work and I’m hoping I can pick up my training again. Just need to balance it carefully I guess. I’m looking forward to getting on the mend as it’s been a roller coaster since last summer when I got diagnosed officially (it was bad on a blood test in 2009 but my MD failed to mention it to me - it wasn’t until I moved with work and got a new MD that it was pointed out to me (one year on)).

4

Wow that really sucks about not being notified. I mean, you could have been on the mend all right. Booo!

You might want to reconsider the remaining 1/2IMs. Keep working towards them, but make it a game time decision i.e.: keep your goals, objectives and expectations realistic and open-ended. If you are the kind of person who can do a 1/2IM and be OK with say a 7+hr finish, then go for it and just have fun with it. But if you are Little Miss Overachiever and looking to go sub 5:15, you might want to rethink it. With the medical condition you should be able to get a refund (unless its WTC those jerks - ok maybe a partial refund).

Keep us in the loop on your progress.

5

Will agree with AP about the months. It’s not an instant relief kind of medication - takes a while for it to get your body back on track and to get the dose right for a lot of people. I take Levoxyl - did not react well to Synthroid at all, guess I’m one of the weirder ones in that regard, but don’t be afraid to try a different drug if the one presribed is still not working 9-12 months down the road (i.e. my numbers were ok, but still felt off - had been on Levoxyl for 4 years and switched due to a pharmacy/doctor prescribing error, but I didn’t mind trying the synthroid, by 6 weeks in, I was back on Levoxyl).

I also take mine and wait an hour to eat - max absorbtion is what I aim for! Sometimes that is really hard to do, but I find that if I leave it right next to my bed with a glass of water, the first thing I do when I wake up in the morning, is take it. Then shower, get dressed, etc. A lot of times I had to eat breakfast at work to get the hour under my belt. If I wake up in the middle of the night, I take it then - then I can eat as soon as I wake up. You’ll figure out what works best for you.

Good luck - hope you bounce back quick!!

6

Hi all,

I can identify with some of you who posted the lack of energy, sleeping all the time, climbing a flight of stairs and having to lay down afterwards, etc.

I didn’t know where to post this, but, since I have some symptoms that maybe related to my thyroid, I thought I would check in here first.

I’m currently having tightness in my left chest area, specifically the shoulder, armpit, neck, sometimes the sensation travels up the side of my head on the left side. It is very difficult to get a deep breath during any exertion, whether that’s swimming, biking, running, even going up stairs, picking things up off the floor repeatedly (at home or work). I feel like there is a blockage, and it is interfering with my ability to do any form of aerobic exercise.

I also experience this tightness in these areas whenever I eat. I do not drink with my meals and I chew my food well (into a cream) in an unhurried manner.

I also have severe morning stiffness, and anytime I’ve been at rest during the day, like sitting in a chair, then stand up to move again. The morning stiffness feels like I just played tackle football all night without any pads. The stiffness (in my back, legs, feet, neck) stays with me all day, I just don’t notice it much when I’m at work because I’m distracted by other duties.

I eat a vegan diet, tried a plethora of supplements over the last seven years, along with different shoes (currently in Newtons, which are great), different beds, stretches, exercising, not exercising. These symptoms have culminated over the years, only beginning with one in 2003 that started the whole process. In January of that year, I woke up in the middle of the night because my right knee felt like it was on fire. Years before, I always felt twisted from my right ankle, the knee and hip whenever I was clipped into the pedals. The left foot always felt fine. Over the years, after that knee issue, I experienced slow and gradual body stiffness in the back, neck, general lethargy.

I completed two Sprint distance and one Oly distance tris in 2002. I finished IM Branson 70.3 in six and half hours (first attempt at this distance) last September. My run was extremely slow because I dehydrated on the bike that culminated on the run. I took myself to the medical tent after the finish and took two bags of IV solution. I felt 1000 percent better and noticed the soreness in my legs lessened substantially.

Also, I tend to hover around 150-155. A couple of days after IM Branson, I was at 145 (I’m 5’8"). Ever since then, last September, I’ve gained about 20 pounds, and it does not appear to be muscle. I’ve been trying to get back on my training plan that I create for an entire year, but, these symptoms in my left chest area and severe muscle soreness set me back every couple of weeks. Right now, the symptoms are worse.

Any feedback would be greatly appreciated,

Scott

7

First thing I would do would be to go see a doctor and explain everything to them you just wrote to us - especially the blockage feeling. Something sounds off. After they do their thing, see what tests they want to run, run them and go from there if there is anything abnormal. If all is normal, then come back here…

8

How’s your goiter? I had something similar, mostly in the neck area - I couldn’t wear a turtleneck sweater for ages - I stopped eating goitrogens (or drastically reducing them) and upped my iodine intake (i.e.: switched back to iodized salt from kosher salt). The feeling went away.

I still have continued stiffness, and cramping in the lower legs in particular. I’ve also developed huge sensitivity to cold in my hands (Reynauld’s). All of these things, while annoying, are not particularly problematic from a medical standpoint - they are side effects to meds, and to hypothyroidism itself.

Your case sounds like you need additional testing/monitoring. Talk to your Endo about getting tested for TSH, T3 and T4, you might also want to get your repro hormones tested (testosterone, estrogen, etc.) Your synthroid might not be enough (may need different dosage or additional complimentary meds).

If you’re vegan and at that height/weight, you really need some more investigation.

Good luck tho, it’s hard. Don’t stop asking questions.

AP

9

Thanks for the info, AP. :slight_smile:

Goiter? I have had one naturopathic doctor note in 2003 that it was enlarged more than usual. I’ve read things about hypothyroidism that makes me think maybe that’s it. Some of my symptoms also sound like rheumatism, fibromyalgia, lyme disease, candida, etc. Here’s the lastest synopsis from my check in today:

I’m back from a physician’s clinic where I had blood work, x-rays and an EKG done. All the tests came back “normal.” Whatever that means, as I still feel something is wrong. Even eating causing these symptoms to flair up, as if I’m not getting enough air. There’s a feeling of blockage. I feel like I’m breathing through a snorkel and mask when I’m swimming, biking, running or just walking along the street or down a hallway at work.

My resting pulse rate was 59 (in the morning it hovers around 50-55; at the end of the training season in September it drops to around 42), weight with clothes and my Newton Momentums (love 'em, and no, they are not paying me to say that) was 171, blood pressure was 90 over 60 something (I actually forgot the lower number).

No alarms went off for the physician, but, she referred me to a cardiologist to have a battery of tests done on me, namely one where I will be monitored while I run on a treadmill. I’ll know more about this appointment this week.

I’ll keep you posted, as this information may help someone else.

Scott

10

hi chez -

well, i’m a guy so there will be some limits to how this maps over, but anyway, here’s my go.

at age 20, i started noticing more and more fatigue. i’d been in tri for over 5 years at that point, and knew my body very well. i was performing badly, recovering slowly, and even after 10 hours of sleep at night i’d need a nap after breakfast. the student clinic wrote it off as “exam season flu.” the sports clinic were on it, and noticed my thyroid was the size of a melon. some bloodwork, and i was diagnosed with hashimoto’s disease.

i started in right away on .175mg of synthroid. the dose has changed many times since and 10 years later i’m now on .125mg - my lowest ever.

as the others have said, hormone changes are SLOW changes. adjust the dose tomorrow and it’s weeks/months before blood levels settle in. especially in the first year or two, i’d suggest re-testing TSH/T3/T4 every few months until you figure out which dose is right for you. remember that more than anything (time of day, diet, etc) you have to be consistent in when/how you take your drugs.

although i don’t have that massive fatigue any more, i’d say i really haven’t felt 100% since i first developed thyroid disease. at my best i’m still a 95%, i think. on the other hand, i guess i’m older! what i do get, though, are the emotional side effects - the first symptom that my thyroid’s off is if i start feeling cranky, depressed, or short-tempered. if that continues for very long, it’s almost a sure sign that i need another blood test.

i’d also suggest to be a little wary of your doctors. not trying to be disrespectful, but i’ve had several docs tell me “oh, you don’t need to test your thyroid more than once every couple of years!” sure enough, they test it and it’s out of whack and needs changing. . . again. there’s almost zero research on how thyroid’s affected by things like triathlon training, and lots of conflicting research on how it’s affected by diet and other medications. can’t comment on the diabetes connection but i’d be talking to an endocrinologist if you can.

anyway, not to be too depressing. the great news is that thyroxine is cheap, stable, easy to get all over the world, and side-effect free. it’s a pain to have to take it for the rest of your life, but a relatively minor one all told and since the alternative is sleeping 20 hours/day, it’s practically a miracle cure! this summer won’t be your best racing season ever, but in a few months you’ll be ready to rock again. in a few years you’ll hardly even remember this whole thing.

good luck and keep us posted!

-mike

11

i’m no doctor, but as soon as you say pain/tightness in left chest, that’s a huge alarm bell for me. get that heart looked at stat, and rule out any problems there. after that, you have the luxury of moving down the list a bit more slowly - if you’re feeling sluggish and gaining weight, thyroid’s a good candidate. TSH/T3/T4 are all quick, cheap tests and a dead easy way to rule out thyroid problems - no reason not to do it at your next appointment.

-mike

12

Hi Chez!

As I’m off to get my bloodwork tested in about a half hour for my quarterly thyroid testing I thought I’d just add to what others have so accurately described here. I was diagnosed with Graves Disease (Hyperthyroid) and ended up having my thyroid removed in 2001. Since then I’ve been on hypothyroid medicine.

The one thing I have to add is that if you don’t feel like you have a doctor/endocrinologist who listens to you then find another one. There are plenty of doctors out there who, after you are put on medicine, will tell you that you’re in the normal range and just need to continue on even if you feel terrible. However, “normal” is a very wide range and most people find that they operate best in a narrower range within that. It took me several trips to different doctors until I found one who believed me when I said that I felt terrible (started crying in her office the first time I met her I was so drop-dead exhausted). Working with her we’ve identified the range that is my “normal” but, as others have pointed out, it takes time. And then as you age that range changes somewhat so it’s a continual tweaking of medicine with your doctor.

One thing that really helps is that after a few years you will be able to tell when your meds are ‘off.’ I can usually get in to my doctor pretty quickly for bloodwork when things just aren’t feeling right to me rather than waiting 4-5 months for the next bloodwork round.

It’s definitely not the end of the world but it does take some managing and some time for everything to kick in and start working correctly.
Best of luck!

13

I think I have similar: I had another blood test done and my throid antibodies were well out of normal range! 1300 - so indicative of Graves/Hashimotos or similar. Will see what endo says in May. Have been on meds now for 7 days and feel much much better. Have more energy, am sleeping through the night and my hair, wow! So silky and shiny!
I have more muscle tone again and my bike and run times are down. All my digestion/stomach issues have nearly gone and I’m not permanently hungry/thirsty. Also no longer showing as pre-diabetic.

So so happy! It’s so lovely to be able to train without feeling like death for days after.

14

My symptoms started with extreme fatigue, cold hands & feet, slow recovery, and my doc said my levels were “just” low normal…and I had Hashimoto’s but he wouldn’t treat me. I quit racing…and was literally too tired to seek another opinion. Fast forward many years, I just couldn’t get going enough to train regularly, and then when I did was slow to recover. I still ran/biked/swam, but just when I felt like it. I became depressed (which is not typical for me) and a new doctor started me on a small dose of T4 & T3. I felt slightly jittery and medicated. Then the weight started piling on–and would absolutely wouldn’t respond to diet and exercise. I finally found a practitioner who was more holistic. She found my thyroid levels were still “low normal” despite the replacement–but also had me check my basal temperature each morning which was shockingly low. I switched to Armour thyroid with a small dose, and slowly upped the dosage over the next 2 years or so. I feel NO side effects. Finally when I was at a fairly high level, I felt good again and fully normal. I am THRILLED that I can actually recover from workouts not to mention getting out of bed!

ps…my weight is back down & my metabolism seems to be normal. And yes, my hair/eye brows are much fuller, and I have muscles again!

15

I’ve pulled out of 3 races already this season. Got my first on in 2 weeks now as I finally feel up to it. I could barely manage 2 weeks solid training without needing a week off. Cycling in the winter was unbearable. The cold was so bad, right through to the bone!!!

16

Just be warned that the sensitivity to cold/heat doesn’t always go away. I still get a very bad reaction to cold in my hands (Reynauld’s) so I wear gloves - a lot. Just don’t let them get cold to start with.

Good luck with your race in 2w, post a RR please!

AP

17

Agree with Andy - I stupidly got cold yesterday (mainly my feet) and just couldn’t warm up all day. This means I have to pack lots of extra layers when we go camping.

Also, (at least since I have no thyroid - though I’d suspect the same would be true when your thyroid is underfunctioning) - it is very hard for me to effectively cool my body if it gets too hot. The only time I’ve run into issues with this is summer races where the temps are 90+ and my heartrate will spike so I have to be very careful about keeping myself cool. My favorite trick is to stick some ice or a cold sponge in the front of my jog bra. Not so attractive for race pictures but it really does help keep my temperature regulated.

18

Yep the heat too. Trying to run in Mexico, not so successful haha… maybe all that rain at IMNZ was a blessing, albeit a soggy one :wink:

AP

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I’m usually ok in the heat but find it impossible to control my HR if doing intervals in the gym when it gets hot. Like have to walk to get out of z5, and feel rubbish. I am possibly the only person who relished going to Afghanistan in the summer months - I felt amazing.

20

I had graves disease and was treated with raidoactive iodine, I have no functioning thyroid and have been on Levoxyl for close to 20 years. Its no big deal, no side effects… I can go 2-3 days without taking it and not notice. Longer then that and I start winding down and getting tired easily. I’ve had no long term issues with the drugs…