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Coaching and Thyroid issues (Read 1251 times)

khardrunner


    I have a decent runner who should be running around a 20 min 5k and is at least 2 minutes slower than that. She has been tested and found to have TSH levels that are off and likely has Hashimoto's. She has been taking supplements (OTC, not prescription) and her levels "seem" fine but she is still performing very poorly in races and still displays many of the symptoms.

     

    1) We are really struggling to find a doc who will work with her. They basically say that she should just not run if that's her problem. They will only test her levels every 6 months and even then they offer no real help. Anyone have any docs in southern pa or northern md?

     

    2) Is it possible that her bovine supplement is causing some unhelpful readings meaning her levels are up (3.5) but she really is not getting the benefit of the higher levels?

     

    3) Anythings else???


    Oh roo roooo!

      Wondering what the reason is for the doc not prescribing prescription thyroid meds such as Levothyroxine or Synthroid?  Usually it is nigh on impossible to get them to do anything BUT that.  And in my experience, they usually want to test blood levesl of at least TSH if not T3, T4 and free T4 every 6-8 weeks until they know the person has reached a "normal" level and is stable there.

       

      What you are describing seems odd to me, though.  I know there are indeed OTC thyroid supplements, and if that's truly what your runner is taking, maybe that is why the doc won't test any more often than every 6 months.  The prescription meds mentioned above are the standard treatment, and sometimes you can find a doc who will prescribe bioidentical hormones, which are also bovine in origin (like the OTC supplement you mention) but do indeed require a prescription, at least here in Wisconsin.  Again, in my experience, docs will usually test every 6-8 weeks when someone is using one of these prescription items.

       

      Also, you refer to your runner's value being "up to 3.5."  Looking at normal ranges for the various thyroid hormones, the only value that looks like that might be in the normal range would be TSH.  If your runner is hypothyroid, she would not be seeking to increase her TSH but rather decrease it.  I don't mean to give any offense, but does she really understand what the problem is and what is being done to correct it, and is she conveying that accurately to you?  It might be a great idea for both of you to do some reading, either online or from your local library--and again, not to give offense, but I think knowledge is your main weapon here.  Thyroid problems can be linked to a lot of different issues (google and see how many sites you come up with!)

       

      Anyway, I'm sure you'll get some advice from folks in the medical field here, but I just wanted to chime in w/what I have observed/learned in my dealings w/my own hypothyroidism.  Best wishes to both of you!


      Prince of Fatness

        I'm not a doctor, but my wife deals with this stuff.  Anyway, my first question would be .... what kind of doctor is this person seeing?  I'd make sure it was an endocrinologist.

        Semi-retired.


        The Crap Whisperer

          I'm also not a doc but have hypothyroidism...she needs to see a doc that understands the problem and will treat it. Levothyroxin made me feel human again.

          Being the best tiny spec that I can be!

            There's a doc a bit further south in McLean, VA that was recommended to my wife. It turns out the practice is non-traditional and, as such, is not specifically listed with any insurance carriers so we did not pursue. May be worth checking out...

             

            http://thyroid.about.com/od/practitionerinterviews/a/adrienneclamp.htm

            http://www.dradrienneclamp.com/

            khardrunner


              Part of the issue is in trying to keep the posting short and readable. We only found out that there was a problem at the beginning of this summer after an extremely poor showing in track. After significant pushing and fighting an edocrocinologist finally saw her and tested her. They first said graves then maybe hashimotos but said they would not do any more testing for at least 6-8 months. Her parents have worked and researched tirelessly to try to figure out what is going on since we are getting no help from the docs. We are trying to save her season. The only good doc we know in the area will not see patients under 18. She trained fairly well and stress free over the summer with the use of the supplements, but as soon as racing season and school started up (thus increasing stress levels) she began to run poorly again and exhibit the same signs as in track last year. After MUCH more fighting and pushing the endo took TSH level tests again and they came back at 3.5. There is obviously something not right but they will not do anything to try to really figure it out. They believe they caught it early since she is a runner so they are "waiting" to see what comes of it. None of us involved is happy with that idea, especially since this is her senior year. We need information for one and a doctor who will actually give her the time of day. This is VERY frustrating.


              Oh roo roooo!

                Since a TSH of 3.5 is going to be considered to be in the normal range by most labs, you might have a hard time convincing docs that there is an issue.  A lot of them don't look any further than that number.

                 

                I can suggest 2 sites that might be helpful, but if the runner's parents have done a ton of research already, this may be old news:

                 

                http://www.stopthethyroidmadness.com/  (this portion in particular http://www.stopthethyroidmadness.com/how-to-find-a-good-doc/)

                 

                http://drknews.com/ 

                 

                The second one is the site for Dr. Kharrazian, whose book may shed some light also.

                 

                I surely hope you can get the problem figured out!

                heather85


                  I have a decent runner who should be running around a 20 min 5k and is at least 2 minutes slower than that. She has been tested and found to have TSH levels that are off and likely has Hashimoto's. She has been taking supplements (OTC, not prescription) and her levels "seem" fine but she is still performing very poorly in races and still displays many of the symptoms.

                   

                  1) We are really struggling to find a doc who will work with her. They basically say that she should just not run if that's her problem. They will only test her levels every 6 months and even then they offer no real help. Anyone have any docs in southern pa or northern md?

                   

                  2) Is it possible that her bovine supplement is causing some unhelpful readings meaning her levels are up (3.5) but she really is not getting the benefit of the higher levels?

                   

                  3) Anythings else???

                   

                  I have Hashimotos.  Besides the thyroid issues, it can cause issues with absorbing vitamins and cause deficiencies.    These could cause big energy/performance.  Iron and B12 are a couple.  I have had tons of problems there and have to take injections no matter how good my diet is, and keeping up with those make a far bigger energy difference than taking the levo did. 

                  Some people feel better at different levels than others though - some endocrinologists just try to get you to normal range and some like to go until  symptoms are resolved which might be TSH 3 for one, TSH 1 for another.  (Normal range is .3 to 3 with newest research, some still use the old standards (.5 to 5) and might say you're okay when your level is 5 and you're still symptomatic.

                   

                  There could be other related things - I'm not sure how much of this is scientifically backed because it's not my situation, but I have heard there are other things that come in conjuction like celiac disease and others-  It might pay NOT to stop looking for the cause just because you found one potential cause of the symptoms.

                  khardrunner


                    Got some more blood work back. Her antibodies were about 1000x higher than they should be. She is also on the anemic side right now. Apparently the docs refuse to give her a replacement hormone until her thyroid quits functioning completely. Until then I don't know what to do.


                    Feeling the growl again

                      Got some more blood work back. Her antibodies were about 1000x higher than they should be. She is also on the anemic side right now. Apparently the docs refuse to give her a replacement hormone until her thyroid quits functioning completely. Until then I don't know what to do.

                       

                      I was going to mention checking anemia.  In a young female runner, that is very common.

                       

                      Pardon my French, but with a positive antibody test for Hashimoto's her doc is a complete ass for refusing to treat.  Your recourse is for her to fire her doctor and find another one.  I mean, with just the 3.5 TSH it's hard to argue....but with positive antibody test their plan seems unreasonable.

                       

                      My TSH was like 4.5 or something, had not had the antibody test, and I managed to talk an endo into low-dose hormone as a trial run based on symptomotology alone.  Antibody test came back negative, but after a few months on hormone I felt A LOT better and my TSH came back at like 1.05.

                       

                      Her parents just need to be advocates for her.  She now has the test results to get a rational physician to take action...but not all physicians are rational.   I mean, really?  Wait for her thyroid to completely stop?  So they will wait until she can barely function, the flip a switch to make her normal again?  This is not a binary situation.

                      "If you want to be a bad a$s, then do what a bad a$s does.  There's your pep talk for today.  Go Run." -- Slo_Hand

                       

                      heather85


                        Got some more blood work back. Her antibodies were about 1000x higher than they should be. She is also on the anemic side right now. Apparently the docs refuse to give her a replacement hormone until her thyroid quits functioning completely. Until then I don't know what to do.

                         

                        Was this the TPO test or the other one? (Tab?)  Or both...  Some doctors don't pay too much attention to the antibodies because some will have them and never develop full blown hypothyroidism.  (Mayo Clinic  "If you have normal thyroid function with TPO antibodies, your doctor may recommend periodic checkups to watch for future thyroid problems.")  I know mine even with medication are extremely high and the doctor just said he wants to keep a close eye on it; didn't change the treatment any.  

                         

                        What will they be treating the anemia?

                         

                        It does sound like she has mild hypothroidism and sometimes that takes looking for the right endocrinologist to avoid waiting.  But keeping ahead of any associated problems can help with symptoms in the meanwhile.


                        Oh roo roooo!

                          She now has the test results to get a rational physician to take action...but not all physicians are rational.   I mean, really?  Wait for her thyroid to completely stop?  So they will wait until she can barely function, the flip a switch to make her normal again?  This is not a binary situation.

                           

                          Absolutely--there is no reason to wait for her thyroid to "stop functioning completely."  In fact, I can't believe a doc would even say this.  Heather is right, ditch that doc.  I don't think ANYONE is denied treatment until their thyroid stops functioning completely.  Ridiculous.

                          khardrunner


                            Yes she currently is a "mild case" which is certainly enough to affect her racing in a significant way. It's disappointing but we are really struggling to find an endo doc who will even see her before next year. The waiting lists are at least 3-4 months. After that they test her and wait another 3 months to see her again to discuss treatment if the would even consider it. Basically the one endo doc they did see said that we caught her case early likely do the affect it was having on her running. They refuse to do any hormone replacement yet. Her parents are really working for her but they are getting no real response from the docs.

                             

                            Right now she is on a 3 a day iron pill. Her parents are messing with supplements to try to find something that helps until she can finally get some real help. They are doing a lot of research, but it seems the only real help is in prescription replacement meds.

                             

                            Sorry I don't know which test it was. I just know that both times she has been tested, her antibodies have been through the roof.

                              Coach, the one thing you haven't discussed here on this running forum is her training. Her volume/intensity this season and her training history are quite important.

                               

                              You also seem very concerned that she deliver a maximal performance before she graduates, which includes medicating her to bring about the fastest result. Do you think this model of training is maintainable? Do you suggest medicating her indefinitely to boost her performance? If you had to build a training plan that allowed her to run without medication, but perhaps at a cost to her to performance, what would that training schedule look like and how would it differ from her current training?


                              just a simple cat

                                Probably she should stop taking the OTC  bovine drugs before her next blood work is done also.

                                 

                                Running is stupid

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