Thyroid Hormone Abuse in Elite Sports: The Regulatory Challenge

[helvella]

Just a slightly different take on thyroid hormone use.

J Clin Endocrinol Metab

. 2022 Apr 19;dgac223.

doi: 10.1210/clinem/dgac223. Online ahead of print.

Thyroid Hormone Abuse in Elite Sports: The Regulatory Challenge

Matti L Gild 1 2 3 , Mark Stuart 4 5 , Roderick J Clifton-Bligh 1 2 3 , Audrey Kinahan 6 , David J Handelsman 1 6 7 8

PMID: 35438767 DOI: 10.1210/clinem/dgac223

Abstract

Abuse of androgens and erythropoietin make hormonal doping the most effective and frequent class of ergogenic substances prohibited in elite sports by the World Anti-Doping Agency (WADA). At present, thyroid hormone (TH) abuse is not prohibited but its prevalence among elite athletes and non-prohibited status remains controversial. A corollary of prohibiting hormones for elite sports is that endocrinologists must be aware of a professional athlete's risk of disqualification for using prohibited hormones and/or to certify Therapeutic Use Exemptions, which allow individual athletes to use prohibited substances for valid medical indications. This narrative review considers the status of TH within the framework of the WADA Code criteria for prohibiting substances which requires meeting two of three equally important criteria of potential performance enhancement, harmfulness to health and violating the spirit of sport. In considering the valid clinical uses of TH, the prevalence of TH use among young adults, the reason why some athletes seek to use TH, the pathophysiology of sought-after and adverse effects of TH abuse together with the challenges of detecting TH abuse, it is concluded that, on present data, prohibition of TH in elite sport is neither justified nor feasible.

Keywords: sports; thyroid hormone.

A pre-print (double-spaced) version was freely available on 20/04/2022. This might change.

pubmed.ncbi.nlm.nih.gov/354...

[nellie237]

I wish I benefitted enough from TH to be energetic enough to do elite sports, don't you?

[helvella in reply to nellie237]

So glad you came back with that. Incisive and, sadly, all too often true.

[Gcart in reply to helvella]

Is it saying that these sports people use thyroid hormones for enhanced performance?

And is it saying it can’t be detected?

Sorry for not understanding .

[helvella in reply to Gcart]

Yes.

But I think they are not too concerned because using them, effectively making the sportspeople hyperthyroid (whether in training or competition), does not appear to be performance enhancing and would actually have a negative effect in many sports.

They are sceptical even in the field of bodybuilding, where there is much evidence of the actual use of thyroid hormones.

And that, if T4 and T3 were banned, they would also need to test other substances (TRH and TSH and others). Making it much more difficult to check than for other substances where a single blood test suffices.

[McPammy]

I’ve always wondered if some sports people try to get away with using Liothyronine to enhance their performance. I’ve thought this as since I started combining T4 and T3 treatment I feel so energetic. Prior I could barely walk or sit up at my worst points. Now I feel some days I could literally fly. T3 makes me feel very energetic and youthful. Lost over 4st without trying just metabolic rate working well. My TSH is in range and is 95% of the time with my T4 and T3 always in range too. I get my bloods checked every 3 months and they’re always good, vitamins all good too. So, if an athlete decided to take liothyronine how would anyone be able to detect if their blood tests are in range.

[helvella in reply to McPammy]

Yes - that is one of the fundamental problems - identifying potential offenders.

But whether thyroid hormones would have the same effect if used by someone who has a working thyroid is more questionable. They might end up with some negative impacts - such as on absolute strength - which would not lead to an improved performance.

[Gcart in reply to helvella]

In a book my husband read some time ago it was alleged that the German soldiers were given T3 to keep them awake snd fighting in WW 2 , He had come across that in books regarding the wars where these are used commonly.

In the end it just exhausted them apparently .

Could be true whilst the France drank wine and had a snooze 🙃

[helvella in reply to Gcart]

I don't know how they would have done that. So far as I am aware, one of the first papers on T3 was this:

3:5:3'-Triiodothyronine

1. ISOLATION FROM THYROID GLAND AND SYNTHESIS

BY J. GROSS* AND ROSALIND PITT-RIVERS

National Institute for Medical Research, Mill Hill, London, N.W. 7

(Received 5 August 1952)

ncbi.nlm.nih.gov/pmc/articl...

It seems feasible that they at least tried desiccated thyroid in large doses?

Many documentary programs and books have established a huge use of methamphetamine and other drugs during WW2.

High Hitler: how Nazi drug abuse steered the course of history

Rachel Cooke

German writer Norman Ohler’s astonishing account of methamphetamine addiction in the Third Reich changes what we know about the second world war

theguardian.com/books/2016/...

[TSH110 in reply to helvella]

Pity we can’t get any doses of NDT let alone large ones, when we actually need it!

[TSH110 in reply to helvella]

Most interesting articles on T3 & Nazi drug abuse - thanks for posting

[TSH110 in reply to McPammy]

I don’t think it works like that if you’ve got a full quota of TH, which we haven’t, in fact I have zero quota - I can only think it’s downright injurious to health if you don’t actually need it.

[McPammy in reply to TSH110]

I agree. I only had 8% thyroxine. I’m a very poor converter of T4 Levothyroxine to active T3. I’ve got Hashimotos. I’m also DIO2 positive. I’m so so much better now finally being on combined Levothyroxine plus Liothyronine privately. What I was saying is that it must be hard to detect in an athlete. I can keep my TSH in range on it and so might they.

[TSH110 in reply to McPammy]

Yes quite, as everyone has their own individual ideal set point

[Purplesash in reply to McPammy]

This is wonderful to hear you and inspiring that you are doing so well on T3 and have managed to lose so much weight. How much T3 are you on? I have been on 40mcg T3 (with 100mcg T4) and not lost an ounce and still very fatigued. Endo has just put me on 60mcg T3 only so hopefully that will help🤞

[McPammy in reply to Purplesash]

Thank you. It’s been a time of trying things out and being in tune with my body. Prior to adding T3 I was on 75mcg liquid Levothyroxine a day. That brought my T4 level to the top in blood tests back then. I was prescribed to add 5mcg T3 twice a day 8hrs apart. I felt good from the off really. My T4 Levothyroxine wasn’t reduced.

I joined a gym and found I needed a third 5mcg dose in the being.

As the pandemic arrived I stopped the gym. I carried on with brisk walks each day. I found I needed to reduce my T3 back down to twice a day 5mcg 8hrs apart. I’ve stuck with this regimen now for about 3years. Except I’ve reduced my Levothyroxine recently to 64mcg a day. I’ve had 20 blood tests while on T3. Only 2 have been slightly suppressed TSH. I don’t know why it works for me and others can’t keep their TSH from suppressed. I feel really good. I lost my weight over the first year and it’s kept off since. I eat more now than when on Levothyroxine only. I believe it’s my metabolism now working right after decades of not. I keep a close eye on my vitamins also which are now optimal.

[Purplesash in reply to McPammy]

That’s really good and lovely hear, amazing what a small dose of T3 has done for you.

[McPammy in reply to Purplesash]

I know. I’m a little shocked that some people have to be on a much higher dose to get themselves to a good level. Has the brand anything to do with that? I’m on ThyBon Henning.

[Purplesash in reply to McPammy]

I have Mercury Pharma and it is the only brand I have tried, I have only been on T3 for 5 months (and gained 1/2 stone in that time 🙄). Still trying to find my correct dose, I seem to need a high dose.

[McPammy in reply to Purplesash]

I guess we are all so different trying to find our sweet spot. I try not to change anything now I’ve found mine. I do feel though that a lot of it is about your activity routine. If I have a period where I’m not doing much I start to feel over medicated. As soon as I start walking briskly again I’m fine again. This can happen during to winter months I’ve found. I have to balance my activity versus t3 intake.

[tattybogle]

it was an interesting read . They've identified that individual setpoints would have to be pre recorded before they could even contemplate accusing anyone of anything.

They've identified that Free T4 and Free T3 test standardisation is not regulated strongly enough to hold up in court as accurate .

They've bothered to read a lot of body builder forums to find out what people are actually doing and why they think it works for them .. and more to the point .. even though they are very sceptical about the scientific accuracy of the concepts being used by these people .. they warn against ignoring such amateur views/experiences .. and remind everyone that 'expert' views have been very wrong in the past.

It contained a lot of thought provoking detail about how T3 is used by the body , and it's response to intense exercise /calorie deficit etc

All in all ... i wish most endocrinologists were half as interested as this lot seem to be in the subject .

paper could be subtitled "This issue is far too complicated ,so we're not touching it with a bargepole"

[TSH110]

Pity they don’t at least do set point testing for those with a family history of thyroid disorder whilst they are unaffected. Interesting that they know what to do to catch TH drugs cheats but no one can’t be bothered to do it for those at risk of thyroid disease so that optimal treatment can be aimed for should one succumb to it later on. I haven’t read the article yet but it sounds very interesting. Having had long periods of being hyper I must admit I was always on the go - I had so much energy it was a job to dissipate it. I had no idea, I just thought it was normal to exercise to superhuman levels and only sleep a few hours a night and not eat for days in end because I never felt hungry…I know different now. It didn’t take me to international level that’s for sure 🤣🤣🤣

[TSH110]

They have missed out that thyroid hormones are also used in treatment of bipolar and schizophrenia, with some success and there’s nothing about T3 in cardiology, unless I missed them. No mention of NDT either. Combination therapy is deemed of no benefit to us 🙄

Thanks for posting.