Jo Pavey slams the Nike Oregon Project for thyroid Use

While I am not an endocrinologist, I am a physician. There is argument among endocrinologists that TSH should be below 3, not 5, as is currently accepted. If these athletes have TSH values above 3 ( and certainly above 5) regardless of T4 values ( sub clinical hypothyroidism) they have legitimate reasons to go on thyroid medication to correct there TSH to appropriate levels.

Taking thyroid medication in the face of a TSH below 2-3 would certainly hinder an individual by placing them in a hyper metabolic state which would lead to overheating, excessive sweating, diarrhea, increased BP, excessive anxiety, etc.

Think of this like iron. Iron will help one if iron deficient, but would make ill if taken in excess or, at least, not help if one is not iron deficient. While someone with sub clinical hypothyroidism ( high TSH, normal T4) appears to have normal free t4 by lab value ( it is the definition) there is evidence that there is less t4 overall. Like iron deficiency without anemia.

It would be great if an endocrinologist could weigh in on this thread

Once you start taking the meds you can't stop, you are on them for life.

Imagine you are an elite athlete, and you just cronicAlly overtrain. Your training would be effective if you could recover but instead your body is breaking down. Instead of dialing back the training because it is not natural for your body to handle that internist and instead you buy thyroid medication. That is not fair.

If thyroid medication is a masking agent, why don't they just ban it?

Why is this any more unfair than taking iron for running induced iron deficiency from foot strike hemolysis.

clerk wrote:

If the drug, by itself, was as powerful as people though it was, it would be banned. By itself, it is not a performance enhancer. Think about it like break fluid: it doesn't make your car go faster, but you certainly need it if you want to drive for a while. Dopers don't take thyroid because of a performance enhancing effect (there is none) they do it to sustain the other pieces of their doping program.

Nailed it.

As you said, it puts one in a higher metabolic state. Meaning, it's easier to stay lean and reduce any unneeded muscle mass. Up the dosage when intensity is lower, back it off when the intensity is higher.

If you can sustain a weight that is 2% lighter than you otherwise could, you'll typically run about 1.25% faster.

The difference between 27:00 for 10K and 26:40 is significant.

Physician runner, please help us clarify if maybe you could have missed the point. We aren't arguing that these guys have levels below 3 or 5. We're arguing that elite endurance athletes training at a ridiculously high level may cause, through their training, for their levels to decrease below 3 or 5. By taking thyroid medication they are artificially recovering better than other athletes training at that same level who aren't medicating to boost their recovery and ability to continue training at a high level.

Shoebacca wrote:

Physician runner, please help us clarify if maybe you could have missed the point. We aren't arguing that these guys have levels below 3 or 5. We're arguing that elite endurance athletes training at a ridiculously high level may cause, through their training, for their levels to decrease below 3 or 5. By taking thyroid medication they are artificially recovering better than other athletes training at that same level who aren't medicating to boost their recovery and ability to continue training at a high level.

How is this any different from taking iron? Training leads to low iron -- taking iron supplements then increases performance (over what it would be without supplements). If this is the case then the supplements allow to train at a higher level than you otherwise would be able to.

Physician runner wrote:

It would be great if an endocrinologist could weigh in on this thread

It would indeed. No one posting on here, or Jo Pavey, has a clue about the effects of thyroxine as a PED.

Listen fools- I had to have half of my thyroid taken out due to a large nodule. My dr said the remaining half would likely take over for the missing half and I wouldn't need meds. I went without them for 2 months and I couldn't take it anymore. I was exhausted all the time, I could barely run 30 minutes, I was falling asleep at work, dizzy, cranky, miserable. Found out my TSH was 5.9 and my dr put me on levothyroxine. I have been taking it since and I feel like a million bucks. The dose he started me on was too high and I felt even worse than without them...heart racing, nervous, jittery, couldn't sleep at all, just felt like I was going to explode. Taking more of it wont make you run faster or get better recovery. I am on the right dose now and I feel like I should have felt for a long time.

If training excessively did cause elevation of TSH above 3-5 ( TSH is inverse to total free t4), I guess I don't see the harm in giving an athlete a small dosage of thyroid medication to correct TSH to below 3. I feel it would be either harmful or potentially cheating to gets TSH to below 1-2.

More of my point was that subclinical hypothyroidism is quite common- much more common than overt hypothyroidism. I have seen many more patients with this than overt hypothyroidism. Certainly it is still improbable, but not as improbable as one may think, that these athletes have subclinical hypothyroidism irrespective of exercise habits.

Wait a min is that Smythe the trail runner now? I've lost respect for him. I'm a trail runner and i figured the sport mostly clean but now I see guys like him connected to less than moral docs with less than ethical practices is spilling over into other sports..

Smythe and Hall, just retire or find another hobby please

Only clerk makes sense on this thread.

rest of the arguments are horse manure. one guy says it is for weight loss to run faster. other guy says it miraculously cures over-training. Which is it? And how exactly does it cure overtraining?

weight loss guy. why don't athletes just do liposuction to get the % faster? liposuction is not banned. seems like a no-brainer.

rojo wrote:

I certainly wouldn't say this thread is useless. Given their assocation with Dr. Brown, I think many fans of the sport think NOP when they hear the word thyroid.

Without a Wall St Journal article hyping their association with thyroid meds, most people wouldn't even know about the issue.

A serious question: what is the basis for associating NOP with thyroid medication? I've tried to research this, but all I can find is the 2006 public admission by Rupp and Salazar that he was diagnosed with a thyroid condition when he was still at Oregon.

This is the same 2006 disclosure use that the WSJ mentions in 2013.

In 2014, Ricky Simms told LetsRun that Rupp was did not have a TUE which he would need to take thyroid medication. He denied that Mo Farah ever took a thyroid medication.

So is the idea that some large percentage of the NOP takes thyroid medication based on the 2006 disclosure, that getting repeated in the WSJ seven year later and then the echo chamber of LetsRun?

ETA: I also see that Amy Yoder Begley has disclosed that she has been taking thyroid medication since 1998, when she was a sophomore at Arkansas. So two athletes.

Here is the story:

Too much or too little thyroid hormone is not really of benefit to long distance runner.

To get high doses if thyroid hormone you need to be on a high dose. Taking normal physiologic dose shuts down your own thyroid so being in 75 or 100mcg will not make anyone hyperthyroid in most cases.

When people are hyperthyroid or subclinical hyperthyroid (suppressed tsh, normal t4,t3) they tend to have exercise intolerance due to increased metabolism and mitochondrial dysfunction. They have lower anaerobic thresholds. Weight loss is not only fat, but muscle as well long term. All my patients who come in complain of fatigue and exercise intolerance. Also insomnia anxiety issues. Long term causes cardiomyopathy arrhythmias leading to strokes. Also for guys lowers free testosterone leading to gynecomastia.

Body builders abuse it to get excess fat off (what you burn first before muscle typically). Most endurance runners do not have trouble getting weight off. Once you stop being hyperthyroid your weight goes back up.

Al Sal and friends got taken by snake oil of Dr. Brown. Probably did zippo and if done too much esp for long periods of time would hinder training and performance. Not a good idea for PED is distance running community.

This is a good answer and is in line with what I have read and what our family internal medicine doctor said when a family member was diagnosed with Graves' disease.

So the alternative is that thyroid meds offers no benefit to distance runners, and the fact that the US top 10 all-time list is filled with athletes rumored to be taking the medication is just one big happy coincidence.