by: Weldon Johnson, LetsRun.com
April 10, 2013
The Wall Street Journal today has a full backpage article titled “US Track’s Unconvential Physician” on Dr. Jeffrey Brown who has diagnosed many track and field athletes, including Galen Rupp, Ryan Hall and Carl Lewis with hypothyroidism.
The article indicated Dr. Brown is unconventional because “several endocrinology leaders have never heard of hypothyroidism striking young athletes.”*
The articles delicately discusses the issue noting that the hypothyroid athletes are usually prescribed levothyroxine. The article says “that drug is not a banned substance by the World Anti-Doping Agency and by all accounts has never been shown to enhance performance. Taking it required no disclosure, and no permission from anti-doping authorities.”
Then the article says, “But in the wake of doping scandals all across the sporting world, athletic websites are rife with speculation about hypothyroid medication being used as a performance-enhancing drug. After all proving that a drug improves performance is often difficult.”
Now usually when you see the word “athletic websites” that means letsrun.com. And there have been quite a few threads on hypothroidism and whether its diagnosis is legitimate or abused for performance enhancing benefits.
There are two broad reasons athletes might get on thyroid medication.
1) Their thyroid levels are legitimately out of whack and they want to run and feel better. Just because a bunch of endocrinologists haven’t heard of elite athletes being hypothyroid, doesn’t mean it doesn’t happen. Elite sports science and general population science are very different things.
2) The thyroid drug has other performance enhancing benefits even with a normal thyroid level, so the athletes get a prescription for it when they don’t really need it.
I wish the article had discussed what the possible performance enhancing benefits are, and why athletes might want to abuse this drug. The article hints at two performance enhancing possibilities:
1) It’s a stimulant and that somehow helps performance (how?)
2) “anorexic effects” (Behind the scenes, I’ve heard rumors an athlete might stockpile their prescription and then take extra doses before competition to help lose weight which would presumably help performance)
What are other possible benefits?
It doesn’t take much Internet searching to find people claiming:
4) The thyroid hormone might be able to boost EPO production somehow.
5) It can help recovery and VO2 max.
6) People doping on HGH will have their hormones out of wack, so they need to get on thyroid medication to try and stabilize things.
If you’re more scientifically inclined than me, and have any insight on why athletes might want to abuse thyroid medication, let me know (you can remain anonymous).
Jos Hermens Speaks Out on Thyroid, Is It Harmful?
One thing the article does not discuss, is it harmful for an athlete to take thyroid medication if they do not need it?
That brings me to comments made at the Olympics last year that did not receive much attention outside of the Dutch press.
After the 10,000m where the Alberto Salazar coached Mo Farah and Galen Rupp got gold and silver, there were rumblings from some in the Dutch camp (Kenenisa Bekele’s agent Jos Hermens is Dutch) that Mo Farah and Galen Rupp were using thyroid medication for performance enhancing reasons.
All the quotes below were from Dutch journalist Marco Knippen who translated them and emailed them to me after the Games. Many of them were in Dutch or Belgian articles during the Games (here, here, here).
Jos Hermens said, “Science has triumphed over nature. Formally Farah and Rupp are doing nothing illegal. I rather just questioning if Farah during a doping control hands a laundry list of products specified, for which he apparently has a certificate. Within the environment knows almost everyone that it is used. Thyroid hormone affects all. I do not understand why it is not on the banned list.”
Herman Ram the Director of the Dutch Doping authority said, “We know the agent from bodybuilding. Thyroid is very harmful and dangerous to health. There is no discussion. ”
Knippen indicated that Ram tried to get thyroid medication on the banned list in 2010 but was unsuccessful.
Pieter Langerhorst, agent and husband of pro runner Lornah Kiplagat, said, “Athletes who use thyroid put their health at risk, even put their lives in jeopardy. This is Russian roulette. The exact risks are indeed not exposed, but I spoke to doctors who said that if you stop using the stuff everything runs away. Therefore it is very frightening.”
All of this begs the question, is thyroid medication dangerous if abused?
And then there is the question of who actually takes the substance. Athletes do not have to publicly disclose their Therapeutic Use Exemptions.
I’ve have never seen conclusive evidence that Mo Farah even takes the stuff. At the Olympics the Dutch journalists did ask Galen Rupp about his TUEs and he replied according to Knippen, “About my personal medical record I do not talk.”
A lot more needs to be known about hypothyroidism and runners. I guarantee Dr. Jeffrey Brown’s phone is ringing off the hook today.
More: MB Discussion: Wall St Journal looks at Houston Doc who treats Rupp, other thyroid users
Comments or insight? Email Weldon.
*This sentence doesn’t seem to be that well written as I personally know of a runner friend diagnosed with hypothyroidism and he didn’t go see Dr. Brown. Hard to believe endocrinologists have “NEVER” heard of it happening.