The thyroid hormone is one of the bigger mysteries in the functional medicine performance world. In large part, due to the general public's perception that the reason you have more body fat than you would like is due to some type of thyroid dysregulation. It is "assumed" that all your thyroid does is make you feel cold and gain weight.
Often times athletes will break themselves dieting and training while not realizing that how they train, or how little they eat, is either creating or increasing thyroid dysregulation.
At the same time, most thyroid conditions are misdiagnosed while common symptoms are ignored until the wheels fall off the wagon and you’re broke, metabolically.
Typical thyroid symptoms in athletes include
difficulty losing weight and body fat
difficultly handling stress
dry skin and hair
inability to handle cold temperatures in comparison to people around you
muscle cramps and frequent muscle aches
constipation or bloating
memory loss, especially short term
abnormal menstrual cycles
decreased libido and sex drive.
Blood testing facts
I want to repost some facts about blood testing that I've listed before that most practitioners will never communicate with you. Oddly, these factors also happen to impact your blood values and determine if you’re “healthy” during this visit or “unhealthy” during this visit, black and white blood testing is not.
Sample Type-The reference ranges that you see on your blood work to determine what is considered “normal” is designed by sick people who go to the doctor when they don’t feel good.These reference ranges are broad and don’t factor in the athlete who has muscle mass, exercises intensely and regularly monitors and manipulates their diet.
Different labs provide different results-Reference ranges differ from lab to lab and even from the same lab but in a different state. You could get your blood taken in two different states, one hour apart and be considered healthy in one state and unhealthy in another.
No standardized testing-Getting tested is a random process. To truly evaluate changes from one test to the next, every variable needs to be accounted for from the quality of sleep the night before, to the type and date of the last exercise session before the blood draw to the food eaten the day before both tests to the time of day. Sounds over the top? Well so is determining that someone needs to be on a statin drug for the rest of their life without asking the patient if they were out all night drinking the night before a test.
Insurance companies-One of the main reasons that I recommend Life Extension blood testing is because the athlete or individual can specifically test for whatever issue that they are having. Medical doctors only run tests that are listed as medically necessary by the insurance companies. No doctor is going to run a testosterone test on a 30 year old male or a full thyroid panel on a female every year just because she’s concerned about her own health. Odd right?
Thyroid Biochemistry For Athletes 101
Your pituitary gland releases thyroid stimulating hormones (TSH) which signals the thyroid to release the hormone. The actual thyroid gland produces multiple thyroid hormones with the majority being thyroxine (T4). Triiodothyronine (T3) only accounts for about seven percent of the hormone produced by the gland but it is the active component. For the rest of the hormone to be produced, it must be converted to T4.
T4 is unbound from protein and converted to T3 in the kidney and liver and free T3 then accounts for all of the metabolic effects on the body, which is where the thyroid-metabolism connection comes from.
It’s important to note that roughly twenty percent of thyroid hormone is converted to active T3 by your gut bacteria. Ahhh, there it is again, the gut microbe impacts your health and body composition again.
Thyroid Hormone And Nutrition
Every single cell in the body has receptors for thyroid hormone so please understand how vitally important it is for our overall health.
High Cholesterol While Eating Paleo or Keto style diets.
If you’re eating a diet that a conventional doctor would find “bad” including a keto or paleo diet high in good fats and low in carbohydrates, you may be at increased risk for elevated cholesterol. Especially if you do eat a lot of coconut products since they are high in medium chain triglycerides.
The key being TRIGLYCERIDES which will be elevated on your blood test.
If your thyroid output is suboptimal then your cholesterol and triglycerides will likely be elevated and your doctor will tell you to “eat less fat” even though your diet likely isn’t a issue at all.
Now I'm not telling you to eat less fat or anything like that especially if you are eating pretty close to perfect on paleo. Just watch it.
Bloating, gas, constipation & flatulence.
Yep, they are all linked to low thyroid hormone output. Sometimes the fix is good systemic and digestive enzymes to rebuild gut health and stomach acid. Sometimes it takes longer but don’t think your thyroid isn’t involved, it is. Fixing your digestion by eliminating food sensitivities or rebuilding stomach acid may fix your bloating and gas while improving your thyroid or maybe it's your thyroid. Only further testing can validate things.
Dysregulated hormone production
Low testosterone? High cortisol? Blood sugar and glucose problems on a low carb diet? Yep, due to the tight connections between thyroid and other hormones, your seemingly mysterious low testosterone numbers could have nothing to do with testosterone itself or your diet or sleep or training in the first place. If you improve your thyroid you may very well improve your total hormone values.
Look outside of the issue.
Low thyroid conditions can impact key brain neurotransmitters including seortonin and dopamine which leads to will power, drive and overall feeling of happiness. That speaks to the weight loss aspect of hypothyroid issues. Sometimes it's not a will power issue, it might legit be a brain neurotransmitter combined with a "fat loss diet" where you're starving yourself.
What Is Causing Your Low Thyroid Results?
So what are a few common problems that intensely training athletes often run into?
Heavy Metals And Stress
Due to the extreme sensitivity of the thyroid gland, chlorine, fluoride, chemicals like BPA, fertilizers and even stress can disturb thyroid health. Can this happen acutely? I'm not sure but I do know that chronically daily exposure isn't a smart choice.
Autoimmune conditions (Leaky gut, Intestinal Permeability, Gut Dybosis.)
Call it what you want, inflammationary gut conditions likely cause thyroid problems. Remember, twenty percent of thyroid hormone is converted to T3 in the gut so it goes to reason that if there is a gut bacteria issue, low thyroid symptoms aren’t far behind.
HPA axis (adrenal fatigue) is a very real and common problem in stressed, high intensity athletes. When cortisol is high from over training, there seems to be, according to research, a natural suppression of thyroid hormone. It can be that your TSH is high but your receptors aren't "receiving" the message. Think of it this way, if you're constantly stressed and gaining weight, why would you be surprised if your thyroid numbers were low?
Increased estrogen production has been shown in research to increase thyroid binding globulin so less active thyroid is available to get into your cells. In this case it's not a thyroid problem at all. Why is your estrogen abnormally high? Is it the chemicals in your diet? Do you work in an area that produces a lot of toxic chemicals? A good doctor will do additional blood and urine testing to check enzymes and detoxification pathways but you can certainly help yourself today by getting on a good elimination diet.
Other times individuals can make too much free thyroid hormone which will cause receptor sites to downgrade their ability to handle thyroid hormone. Your free thyroid can show as “good” and high on a blood test but you can still have symptoms of a slow or hypothyroid. While high testosterone for men is less likely of an issue, women with PCOS or high testosterone can see this issues.
Vitamin And Mineral Deficiencies
High cortisol, oxidative stress and vitamin/mineral deficiencies can all lead to issues with the conversion of T4 to the active T3. Again, the thyroid gland can be perfectly fine but there can be a block preventing the proper physiology. Start eating a high quality food diet and consider taking a good men's multi vitamin or women's multi vitamin. That's the start.
The thyroid gland is complex. The purpose of this article was to show individuals with thyroid symptoms or a history of thyroid problems, hard charging athletes or even health professionals that there often needs to be other areas looked into before addressing the thyroid gland itself. It isn't always a thyroid problem and almost always deserves further testing.
1) Get on a elimination diet focusing on the QUALITY of the food over QUANTITY. Just eat good stuff.
2) Supplement with a good multi vitamin
3) Assess your training, sleep and stress levels.