Coaching and Thyroid issues (Read 1251 times)

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!

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.

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.

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.

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.

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?