Competitive athletes seem unlikely candidates for hypothyroidism, a disease that frequently causes fatigue, depression, and malaise.
But some athletes are surprised to learn their dwindling performance and failure to build muscle stems from improperly managed hypothyroidism.
The fact that athletes are typically fit and slender makes it easy for doctors to overlook their symptoms. And like 90 percent of Americans with hypothyroidism, most athletes have Hashimoto’s, an autoimmune condition that thyroid hormone medications alone do not properly address. As a result, performance declines until the athlete may be forced to stop competing and participating in a lifestyle she loves.
Studies show hypothyroidism affects athletic performance in a number of ways. It creates more muscle weakness and cramping, impairs cardiac function and blood flow, and hampers the ability of muscles to use fatty acids for energy, thus limiting endurance.
Athletes should avoid over training
Athletes set themselves apart by their ability to push themselves physically and mentally when most people would give up. However repeatedly pushing the body too far can produce negative health consequences.
What I commonly see in athletes, particularly endurance athletes, is adrenal fatigue, excess inflammation, and sometimes a form of anemia caused by the breakdown of red blood cells, another consequence of over training. These factors could lend a hand in triggering an autoimmune thyroid condition in someone genetically predisposed, and they can certainly exacerbate and existing thyroid condition.
I have seen many athletes boost flagging performance by adapting changes that include:
- Lightening up their training schedules
- Managing adrenal imbalances
- Eliminating foods to which they are intolerant
- Repairing inflamed and permeable guts
- Managing any autoimmune conditions
What’s required to modulate adrenal function and tame inflammation will be different, but most see improved performance and more enjoyment from their sport after tending to these issues.
Taking more thyroid hormones is not the answer
It may be tempting to take very high doses of thyroid hormones to boost metabolism and hence performance, but this is a trap. Too much thyroid hormone can cause resistance to the thyroid and hypothyroid symptoms. Also, studies show taking excess thyroid hormone can overstimulate the production of dopamine, which could predispose one to a dopamine deficiency. In fact Muhammad Ali took very high doses of thyroid hormone during his fighting career and later developed Parkinson’s disease, a disease of dopamine deficiency. Although we don’t know the thyroid hormone overuse caused his Parkinson’s, it may have played a role.
It’s more important to address the underlying cause of the thyroid imbalance and address that. For most that will mean managing an autoimmune attack on the thyroid gland. For some athletes, due the high amount of stress they subject themselves to, it could mean lowering stress and supporting the body’s stress-handling mechanisms. It is best to work with a qualified practitioner and read Why Do I Still Have Thyroid Symptoms? to learn the best way to manage your thyroid condition.
Following are some stories from athletes with hypothyroidism, and what they have learned about working with their condition.
Hypothyroid health coach says key is to avoid over training
Marisol Aponte plays roller derby, is a kettle bell instructor, and competes in triathlons. Because she was diagnosed with hypothyroidism as a child, she has had many years to finesse a training regimen that allows her to stay active without worsening symptoms. She finds she cannot train as hard as someone with a healthy thyroid because of the adrenal fatigue it causes. To keep her endurance strong without taxing her adrenals, she gets her cardio workouts from sprint interval training, long-duration low-intensity activities such as swimming, and weight-bearing exercises such as kettle bell training.
She has found supporting her digestion with an enzyme supplement helps her assimilate protein better to ensure muscle building, and she eats a healthy diet that is strictly gluten-free. Since adapting a healthier diet and modifying her training regimen she has been able to halve the dosage of her thyroid medication.
Hypothyroid cyclist can’t keep up
Lorraine, 46, didn’t think there was such a thing as exercising too hard. She lifted weights, cycled regularly, and rode in the Triple Bypass, a 120-mile bike ride up and over three of Colorado’s 11,000-foot mountain passes. She routinely did training rides of 80 miles, however when her health began to fail she struggled to make it 10 miles. She also noticed she was unable to lift much weight at the gym, and that she couldn’t build muscle. A doctor diagnosed her with hypothyroidism and after about six months on thyroid hormones she felt better, until her performance began to decline again. Then the doctor increased her dose and the cycle repeated itself. All along her TSH was normal, leading her doctor to dismiss her symptoms.
“Basically my doctor called me a liar,” says Lorraine. “I wanted to commit hari kari because I kept being told nothing was wrong with me. It’s criminal.”
Fortunately Lorraine began working with Shane Steadman, DC, DACNB and read Why Do I Still Have Thyroid Symptoms? She follows an autoimmune protocol, has eliminated gluten, dairy, nuts, and nightshades from her diet, and uses nutritional compounds to support her fatigued adrenal glands. Dr. Steadman explained to her how over training can exhaust the adrenal glands, and Lorraine has cut back on the intensity of her workout schedule, a formerly foreign concept.
“I always pushed myself through exercise because I felt I should be able to do it,” she says.
As a result she shed some unwanted pounds and her performance has improved significantly. She is back to building muscle at the gym and has seen her endurance return. But because she suffered for so long with adrenal fatigue, she knows it will take time to fully rebuild her strength, and that she must be vigilant to temper the intensity of her workouts.
Long distance swimmer questions hypothyroidism
Linda, a reader living in England, believes her recently diagnosed autoimmune thyroid condition started in 2006, the same year her performance as a long-distance swimmer began to suffer. She managed her second swim across the English Channel that year, although it was “touch and go,” and since has met with dwindling success in other long-distance swims. Nevertheless, she is training to swim the Catalina Channel in California this summer, although the effects of her improperly managed thyroid condition distress her. It has prevented her from swimming the English Channel a third time thanks to severe cramping and crippling pain that caused her to fall short of her target by five miles. She also struggles with other thyroid symptoms, chronic anemia, and repeat respiratory infections.
It wasn’t until she read Why Do I Still Have Thyroid Symptoms? that she began to question whether her thyroid condition was sabotaging her success, even though she takes thyroid hormone medications. When she brought up intestinal permeability, the role of gluten, and other concepts in the book with her endocrinologist, he dismissed them as irrelevant and said thyroid hormone medications were the only way to manage an autoimmune thyroid condition.
Linda will begin working on her thyroid condition long-distance with a U.S.-based practitioner, which will hopefully boost her swimming performance to previous levels.
Hypothyroid runner must be careful not to overdo
Troy is a runner in his twenties who has Type I diabetes in addition to Hashimoto’s. Although he enjoys staying active, he says it can be a struggle to balance his desire to train regularly without triggering hypothyroid symptoms.
“I can’t train consistently because of my Hashimoto’s,” says Troy. “I also can’t train too hard or I can’t recover and I get hypothyroid symptoms. I’m still trying to find the right balance. When I was able to get into a good routine that’s when I got my best time for a 5K. I don’t compete a lot but I feel like some of my times are pretty good for having two autoimmune diseases.”
Finding the right balance
Hypothyroid athletes must train a little differently than their peers. Although they may not train as hard or as long, some find they can still be just as fit and competitive through prudent training, a careful diet, and by listening to their body instead of blindly pushing themselves too hard.
Learn to take care of the ligamentous instability in the neck with a proper cool down routine and get the thyroid to stabilize itself.
There is a focus on not to overtrain, and not to go as hard as normal athletes. My concern is how do professional U.S. runners suffer from hypo conditions and still train and compete with the best. Therefore I refuse to believe that these hypo athletes have to train not as hard. They only need to have a stronger recovery habits than normal athletes. They can compete and enjoy thier sport just as “normal” athletes.
I totally agree with you Bill, I have often had the same opinion. How do all these other great athletes do it and still do great in their competition? I have been a runner for 10 yrs and hypo for 13 and in the last 2 yrs diagnosed with hashimotos. I have never been so depressed in all my life, its been hard, because of the fatigue and longer recoveries. But I am convinced there is someone out there who can help, I just have not found him yet. Also, its hard to find a doc who is an athlete than can understand, at least in my state, it sucks. Best wishes to you.
I soo agree with you. I had my thyroid removed almost 3 years ago and have felt horrible since!! My TSH level is “too low” so they keep saying my synthroid dose is too high, however when they take it down, I cant move ater 2 weeks. I am an avid endurance mountain biker and did well for a weekend warrior in races. I think changing my training schedule changes who I am as a person. I think train hard for better rewards….like All athletes with or without thyroid issues. I told my endocrinologist at NorthWestern that having my thyroid removed was the worst thing I could have done and I would have rather of dealt with it being cancer……her reply was ” a lot of people feel that way”..OMG All these physicians want everyone to fit into a diagnostic box and I never have! If you find a physican that is hypothyroid and an athlete, LMK….I will travel.
Melanie, thyroidectomy is a different thing. I have hashimoto’s and my mother had her thyroid removed due to thyroid cancer. Those who have no gland need a different treatment. For start your TSH level MUST be zero, because there is no gland to stimulate to begin with. Second, you should dose T4 in a way you feel ok.. and wait. Hormone adaption takes from three to six months (it’s really slow). Monitoring your hormone levels every three months will be ok until you find a good dose. Keep in sight that while your in a sub optimal dose your body will be “inefficient” so try to have an ultra clean diet and respect the limitations of your body during this time (eat if you have to, sleep if you have to, etc.) Also pay attention to the seasons. Winter make you need more hormone than summer (yes, a normal body do this automaticly but when you provide your system with hormones throug a pill you hsould do the adjustments). Last but not least: change your doctor.
Any reason why a search on pubmed.org shows no hits for “hypothyroidism in endurance athletes?” Are you saying that you are the point in an undiscovered epidemic? If you are, are you organizing some research to bear out your anecdotal discoveries? There seems to be lots of unsubstantiated rumor about diet and health on the internet these days, and to my mind, much of it is conjecture without solid evidential based studies to back it up.
Not sure it’s an epidemic, just a number of patient stories.
From my own experience and experimenting I find that salt loading before exercise alleviates the over-training problems. (Plenty non-iodized salt in litres of water over a few hours.)
The electrolyte imbalance due to heavy sweating was, I think, the trigger for adrenal fatigue symptoms — known as the over-training syndrome (OS).
I’ve known of gluten-free diet and lifestyle changes for a while. So hard to factor them in sometimes!
It’s not time to get serious, my friends!
WHY are there no doctors out there that are endurance athletes and suffer from the ill effects of this condition??!!
I’m a distance runner. Had to axe three runs: the 30k Race Around the Bay, E Murray Todd Half, and NJ Marathon, to recover from a serious case of shin splints. I’m NOT an “elite” runner. The fact that I do with with this existing hypothyroidism is enough! WHY does it seem it’s taking longer than others for me to get over these shin splints no matter what i do??!!
Do this.. do that. I’m not looking for a “quick fix” but MY GOD!! People that think this condition is “no big deal” and pay it no mind have to reconsider! Walk but a day in my shoes. You will be miserable!!
So impossible to get the answers we need, we so badly desire.
Total thyroidectomy almost a year ago due to cancer. Since then my endurance is way down. Even had a stress test and the test was stopped as I started jogging (with steep incline) and heart rate hit 190. I crossfit 3-4x week. Lifts have gone down(slowly going back up), and endurance is just awful. Have had echo, EKG, holter monitoring. I eat clean. Decent bodyfat at 26% (working on lowering). I take two different meds synthroid and westhroid. It\\\\\’s frustrating. It\\\\\’s embarrasing to do so etching like crossfit and you finish several minutes behind everybody. No one understands as my scar is barely visible. And of course thyroid cancer is the good cancer. I\\\\\’m thankful I feel fine the rest if the time. I\\\\\’m going to look into adrenal stuff. Doctor wants me to do a stool test first. Also working on hormones since I\\\\\’m 42.
I am on reading overdrive. I am hypo I take synthryoid. I run and I\\’m trying to train for a 1/2 marathon. I started adding stationary bike to my workouts and I went whole 30. My first month on whole 30 I didn\\’t work out as much but I lost weight. This past month I have been working out like crazy and eating clean and I didnt lose any weight. I also noticed that after a big workout I was done for the day. I was very tired and cold. During the whole 30 I was eating some of the foods (cauliflower broccoli) that wasnt good for my thyroid. I started looking at all the foods we shouldn\\’t have and the list kept changing. I\\’m so lost when it comes to the right list of food to eat and vitamins to take. Right now all the veggies I like I can\\’t have :(. I have noticed that while eating whole 30 that my running has gotten better and my endurance got better. I just don\\’t like the crashes. I\\’m open to anything at this point.
I read your comment, I’m doing all the research I can. My 16 yr old daughter is a competative swimmer and sounds like you. Both throid antibodies are high but t3 and t4 are normal. Do you mind if I ask you how much synthroid worked for you. We tried armor, and it was horrible. She does not eat gluten at all.
I just read your email and I am right where you were with my 14 year old competitive swimmer. She is currently on Armour. Any advice 5 years later?
The thing to be aware of with Whole 30 and the autoimmune diet is your blood sugar and brain chemistry. People often end up not eating enough or frequently enough to compensate for the shift in energy production with the new diet. It might not be the types of veggies but whether you are getting enough calories and protein or whether your blood sugar is dropping too low. We are all individual with carbohydrate needs too, you may need more given your workouts. I personally cannot do a ketogenic or super low carb diet, it nukes my adrenals. I have to have a certain amount of carbs, though still lower than average.
this is a mess. i run half marathons, have hypothyroidism and type II diabetes. take eltroxin and metformin. run three days a week. weekly run 40-50 k. weight training twice a week.
good blood glucose control. thyroid numbers within normal limits.
performance is unpredictable.
am hypersensitive to heat. find it very hard going when the sun is up. exhaustion and sleepiness 24 hours after the long run, though not too much the same day.
most physicians don’t seem to find a answer.
am a microbiologist myself
can you help?
I am 46 years old ad a lady squash player. I started playing squash when I was 40 , the same time I was diagnosed with hypothyroidism. My game steadily went down and I couldnt sustain 10 full minutes on court. I ignored medication wanting to fight it with will power. Put on 20 kilos in 2 years and havent been able to lose it. My nutritionist insisted that I try NO forms of fasting or starving or diet and should have a balanced meal at all times. SHe also said -no form of sport and only walking, Advice which I completely ignored.
I train twice a week in squash now, more to get my bursts of energy and stay fit. I prefer it to the treadmill. Plus it keep sme happy. I have learnt to understand my body and rest it when it so demands. If I have more than 3 days of squash together, I will sleep atleast 10 hours at night and an hour in the afternoon.
My TSH is 2.5 but my body cant really handle more than 1.5.
Respect your body and train within limits, accepting the condition is of primary importance. The more you delay that, the depression can get very severe. Come to terms with your limitations and be proud of what you can achieve- which in most cases would be better than what most people without hypo can do. DO not listen to people who tell you you need to diet or lose weight etc. For a cardio workout you do require some form of carbs. So just go ahead, run, play, be happy!
I was once a professional boxer. In 2004, I tried to make a comeback after some time off. I was only 29 years old. No matter how hard I trained my cardiovascular conditioning would not improve. My doctor tried to do a stress test and my energy gave out before my heartrate got over 140. No energy, depression, decreasing performance and insomnia followed. This went on for 5 years until I was diagnosed with hashimoto’s. I started on synthroid and I’m now on Armour. I get through the day, but my struggles with the disease didn’t stop when I stopped boxing. Some days are good, others are a crying shame. I just wish that I had known this was basically an unwinnable fight before I spent 5 years physically and mentally punishing myself. I just thought that I needed to change my training, tweak my diet and be mentally tougher. In my case, I tried everything within my reach. Couldn’t be done with my doctors and support system. I’m here to tell you, it’s not failure to walk away and find a new hobby or passion. It takes strength. My only regret is that I can’t get those 5 years back.
Hi Rob. It’s been two years since you posted, but I wanted to mention something. Your history with boxing, and the subsequent symptoms – if you have exhausted all the avenues for vitality with Hashimoto’s (as in attending to an anti-inflammatory autoimmune diet, micronutrient deficiencies, genetic issues such as MTHFR, and such) you might also look into how the concussions you undoubtedly got, affected your overall health for the long term. There is some really interesting research going on right now into the long-term effects of untreated or under-treated TBI (traumatic brain injury) and it’s showing that the symptoms can come up years down the line – even decades. Depression, lack of energy, and many of the common symptoms that you might attribute strictly to the thyroid issue could instead or also be related to brain inflammation that has continued from the concussions. If you are curious, seek out a functional neurologist. A FN is trained differently than a regular neurologist. On Dr. K’s Practitioner Locator at http://thyroidbook.com/practitioner-locator/ is a list of doctors who might be able to help. Some of them are willing to practice remotely. Good luck!
I have a family member that I used to train with in the 80s. He recently discovered triathlons. I was a crosscountry runner in HS. Trying to explain Hiroshimoto and Hypo to someone that doesn’t have it is wasted time. They think that more training will help you. They are ignorant about the disease. I find that antiflamitory foods before and after training are a great help. I don’t understand why there more information isn’t available for the hypo athlete. Anyone in NJ that’s a hypo athlete and has more info please LMK. Thanks take care all.
Has anybody here tried iodine supplementation? I’ve been following Dr. Brownstein’s protocol and it has changed my life! Hypothyroid symptoms were so bad I struggled to get out of bed. Working out only made things worse. I began taking high dose iodine and my energy came back almost immediately. I am now taking spin classes, really working up a sweat, and feeling great mentally and physically. I hate to see this simple solution overlooked.
Thanks for your comment, and it’s good to hear it worked for you. Dr. Kharrazian generally recommends against iodine supplementation for those with Hashimoto’s because he sees it lead to increased TPO antibody activity. He has an article about it here: https://drknews.com/iodine-and-hashimotos/.
Indeed, while some people are truly deficient and need supplementation, as an across-the-board treatment for anyone with thyroid issues, he doesn’t recommend it. Please check out the article for the details.