Friday, October 21, 2011

An Experiment of One

Someone wrote me recently with questions about how their training might cause them to alter their medication dosages as they explore moving up to running ultra distances.

The question was: Will it change my medication dosage? Will I "use up" my medication?

That depends on how your pituitary gland/and or thyroid gland are working these days. For example, if you have Hashimoto's thyroiditis, you might experience fluctuations in your thyroid hormone levels frequently, necessitating dose changes. If your thyroid function (and pituitary function) are stable, you might not be needing to change doses.

I did an experiment myself, I kept close tabs on my thyroid function for the past 2 years with the help of my doctor. I was in the process of training for a double Badwater run, and I was wondering the same thing myself. Normally I'm a 50ish mile a week runner. For my Badwater double, I was running 120 mile weeks. I also ran two other long ultras in the 7 months leading up to Badwater, of 114 and 151 miles. In the year before that I ran several 100 milers and multiple long training runs up to 70 miles.

During the entire 19 month period of time my thyroid function and medication dose did not fluctuate at all, except when I intentionally played with the medication. Here's what I did: I knew that being hyperthyroid in the heat of Death Valley in the summer would not be good. I have always felt at my best with a TSH of around 1. At the beginning of my training my TSH was 0.6. I felt this might be too much on the hyperthyroid end of things for what I was expecting of my body.

I did an experiment, and I told my doctor what I was doing. I skipped my Levoxyl (also known as levothyroxine/Synthroid/T4) once a week for 3 months, then re-tested. My TSH went up to 2.4. I added the missing Levoxyl back twice a month, so that I was only skipping my Levoxyl every other week- I did it on alternating Tuesdays, the same days that we have our recyclables picked up, which helped me remember. After 3 months on this, I tested again, in May, two months before the race, which would give me time to make any necessary adjustments.

My TSH was exactly 1.0. Pretty good, huh?

I went to Badwater, got a PR in the race, successfully did my double crossing, with no problems at all.

And three months later, as of today, I have taken an 8 week break from running, cut my total exercise and workout time to about one-third of what I was doing over the past two years, and I still skip the every other week dose of Levoxyl. I can't tell that anything has changed, except so far I've lost 4 pounds. I have a feeling it has more to do with being less exhausted from training than it does with my thyroid. I'll follow up with more on this soon.I'm going for my annual physical exam in a few weeks and will get my labs drawn again, so I'll let you know.

That's my experiment. Don't try this at home without discussing it first with the same doctor who prescribes the medication.


  1. Hi Arlene,

    I'm a 40something triathlete with low thyroid. I'm getting quite aggravated with the Dr's I've seen. I've contacted one in AZ several states away. Wondering if it's the same one you have seen. He works with athletes so I am curious but yet a bit apprehensive because of all the running around I've gotten from others. Funny that I'm asking a complete stranger her opinion. LOL I'm pretty frustrated and have been just gutting through my training. Honestly can't remember the last time I've felt good. It's my mind set and stubbornness that keeps me going. The Doctor I contacted was Dr. Alan Christianson. Glad I happen to stumble on to your blog. It has helped me realize that I'm not alone and I'm not crazy. :) Thank you for stepping out and sharing your story! Dawn

  2. Hi Dawn,

    Good for you for being persistent. I hope this doctor is able to help you, it's not the same doctor I saw (she went into research and no longer has her practice). It takes a while to feel like yourself again even after you get treated properly, so continue to hang in there. It does get better. If this doctor works with athletes, then that's a good thing, he should understand your frustration and will work on trying to help you get better. Good luck, and let me know how things work out with this doctor.

  3. Hi Alene!

    I am a mid-40's avid trail runner who was diagnosed with Graves Disease this past March. Although Graves differs from Hashimotos, there are still similarities. I am so glad to have found your blog. As you know, there isn't much info 'out there' for those of us who are endurance athletes with serious thyroid disorders. Like you, it has been a rather frustrating journey in trying to regain a semblance of my old self and good health. There have been good weeks and not so good weeks. I have chosen, for now, to try the anti-thyroid med, Methimazole. The blood levels continue to fluctuate up and down. Since mid Feb, I have had blood drawn and tested every 6 - 7 weeks. That's a lot of poking! :-) Thankfully, I have an endo doc who seems to be committed to helping get me back to my full, active, athletic health.
    If the Methimazole continues to be a challenge in managing my thyroid levels, I may have to consider one of the other management options - either surgical removal or radioactive ablation. I'm just not ready to commit to one of those treatments yet.

    Great job on completing Badwater - very impressive! Although I am not an ultra runner, we have LOTS of friends who are - we know the commitment it takes, physically and mentally, to cross those finish lines! And I can relate to you in the extra challenge it requires for you, with the thyroid issue, to do the training and get to the start line in the first place!

    Thanks for sharing your story and I look forward to reading continuing progress reports. Perhaps I should do the same just so we can get more info, support, and encouragement out there for those who have our same thyroid challenges!

  4. Kathleen, Thank you for writing! There are other ultrarunners with Graves Disease, who are doing quite well. I can try to get you in touch with one of them if you'd be interested.

    I see you live in Colorado Springs. I'm curious to know who your doctor is, because it's always good to know about physicians who are dedicated to helping people restore their quality of life and resume their athletic endeavors.

    I hope the methimazole works for you, I am not as familiar with the anti-thyroid medications and how people respond to them. I understand your hesitation at doing something more drastic. There is always the possibility that Graves can go into remission- but you can't count on that either.

    I would like to know more about what you've experienced with Graves and how you've responded to the treatment- how you're feeling, how it's affected your everyday life, participating in the things you love to do outdoors, etc. You can write me directly at buffmomatgmaildotcom.

  5. Thank you so much for your blog. I have recently found it as I have been similar up and down struggle with Hashimotos. Trying to find a way to keep running but go through periods of feeling really bad. I recently started Armour Thyroid to help with low T3. I am also waiting 3 months to see a Thyroid Specialist as all the other Drs have not been helpful at all. If Armour does not go well than I maybe going down the synthetic T4/T3 route.

    1. It's so hard. I am sorry. Right now, as your thyroid is still undergoing the ups and downs of Hashimoto's it's going to be a crapshoot- things are not predictable and you have no guarantee that what works this week is going to work next week. The only consolation I can offer is this: once your thyroid completely poops out from the Hashimoto's, it will be much easier to stay consistent. I wish I had more to offer than that right now. You have a great blog, keep on writing! And good luck to you with your running.


Please feel free to leave a comment. Sharing your experience can help someone else who feels they are alone! (Note: I do not endorse anyone's product. ALL attempts to sell a product WILL BE DELETED- don't waste your time!)