Wall St Journal looks at Houston Doc who treats Rupp, other thyroid users

I think a lot of people are still failing to understand hypothyroidism.

When your levels are off, you don't feel better by backing off training, eating better, sleeping more. If anything, I only got more sluggish and tired while sleeping more and backing off training.

However, I find it highly unlikely that any of these elite athletes has true hypothyroidism to that extent.

I don't want to change the topic but it goes with the discussion. Do a google for Beet Juice and Salazar's group and that us the new "legal EPO"

They have been using it as a performance enhancer before races and without much talk about it on the boards.

The research that I have seen even stares it as the legal version of EPO. How soon until every athlete in America is sucking down beer juice before racing like cyclists already do.

Lets face it. Salazar's group is going to do every thing possible they can get away with. The thyroid is a small portion of it. As stated on the boards previously Rupp has over 40 medical exemptions. This is just the tip of the iceberg.

Enduring Endurance wrote:

Armstrong was using low levels of banned substances...

Hysterical! Holy cow, we've found the one Lance fanboy remaining. Have you tried stand-up comedy?! This is priceless.

Recent research shows beet juice has no effect on elite athletes.

Beet juice is the same as Lasse Viren's reindeer meat or Paula Radcliffe's ostrich steak.

The possible performance enhancing effects of beet juice are entirely unrelated to EPO. Beet juice would be more accurately categorized as the "new" NOx

Zero tolerance? wrote:

I don't want to change the topic but it goes with the discussion. Do a google for Beet Juice and Salazar's group and that us the new "legal EPO"

They have been using it as a performance enhancer before races and without much talk about it on the boards.

The research that I have seen even stares it as the legal version of EPO. How soon until every athlete in America is sucking down beer juice before racing like cyclists already do.

Lets face it. Salazar's group is going to do every thing possible they can get away with. The thyroid is a small portion of it. As stated on the boards previously Rupp has over 40 medical exemptions. This is just the tip of the iceberg.

i certainly have questions wrote:

Does anyone think Bob Kennedy needed treatment for an underactive thyroid after he retired?

Yes. If he was clinically diagnosed hypothyroid then he would still be taking it. If your T3 is too low, your lipids go through the roof in addition to other symptoms.

I pushed my training beyond its natural capabilities back in 1995 (age 24). I was a 1500m runner and doing about 80 miles a week at a very high quality (3 hard workouts, a couple of tempo runs, a long run and the rest pretty steady running)

I was working a minimum wage job at a running store and was eating pretty poorly which likely contributed. One day I woke up after a hard workout and was completely levelled. Not normal fatigue that every serious runner would know but a completely dead leg accompanied by nausea. I rested a week and the fatigue dissipated but every run I did no matter how long or hard would immediately bring me back to that point and it would take a week before the fatigue would subside enough to try running agin..

I eventually had to spend a year and a half recovering with very little exercise and many mornings throwing up from nausea. I saw a few specialists that had me try B12 shots and eventually Prozac. It didn't really help. The diagnosis was some sort of pituitary gland/hypothalamus hormonal imbalance.

There was not really an internet to research at that point and the only reference I had to runners with this same issue was coincidentally - Alberto Salazar. I actually ran into him at a Nike sponsored race that he was endorsing and asked him what his experiences were and how he had turned it around but he didn't even give me the time of day.

Eventually my system re-balanced and I had a couple of years of decent running but was never really the same.

So reading this, my opinion is that if one creates a medical condition through overtraining, then medication to allow the athlete to sustain that level seems problematic. That to me is the essence of cheating, to use potential harmful drugs to get a competitive advantage beyond what good training and nutrition and healthy habits can get you.

I can justify taking medication to get you back to ‘normal’ but not to extend your capabilities.

In my case I had hit my training limit.

But honestly, if someone had given me a prescription back in 1995 for synthetic thyroid medication and it allowed me to train as hard as I was doing, would I have taken it? Probably. That was my world back then and it is only through wisdom of age and hindsight that I can better judge it.

Unfortunately, I wonder if this is not a chicken and egg issue. Did Salazar learn through overtraining that thyroid medication helped him get back on track and with a bit of research determine that prescribing the thyroid medication before symptoms of overtraining developed would allow increased training capacity for his athletes? Probably.

Shall we ban compression socks, altitude tents, training at altitude for that matter, protein recovery shakes, eating in general, surgery to fix a broken bone or torn achilles?

This is a good old fashioned witch hunt. I see the arguments but there is no proof of benefit. Why are we not talking about banning sildenafil which does enhance performance? Also, on a separate note, people who have undergone thyroid ablation or thyroidectomy, would you not allow them to compete?

I have 4 years of medical education and recently spent 4 weeks on an endocrinology rotation. Although benefits may be hypothesized, there are also consequences. I do agree it is wrong to treat subclinic hypothyroidism, as there is no evidence behind it as Dr. Brown has done. I also believe cytomel should be banned due to increased risk of adverse effects.

I have 4 years of medical education and recently spent 4 weeks on an endocrinology rotation.

Thank you for your expert analysis.

grunewald wrote:

This is a good old fashioned witch hunt.

Sounds familiar... ah yes, the Lance followers used this defense until the bitter end.

I hope there isn't anything to this, but comparing medication to compression socks, really?

yuiop wrote:

Enduring Endurance wrote:

Armstrong was using low levels of banned substances...

Hysterical! Holy cow, we've found the one Lance fanboy remaining. Have you tried stand-up comedy?! This is priceless.

You are a Dork. No fanboy, here. You on the other hand: troll.

LA did not fail a test. His levels of his drugs could not be tested for until recently using new tests and new equipment. He thought he was safe forever more. Oops!

Even years later, the Armstrong case proves: You might think you are safe today, but several years from now the intent is to caught you.

P.S. Don't troll from you mom's basement.

Enduring Endurance wrote:

LA did not fail a test.

P.S. Don't troll from you mom's basement.

Is this you best you've got?! How about a 1999 positive for corticosteriods? How about reports that Lance bragged to teammates about a positive at the Tour of Switzerland was covered up?

This isn't difficult. You claimed that Lance was doping at low levels, the USADA's report seems to indicate otherwise. His teammates testimony contradicts your ridiculous claim as well.

Haven't lived at home in 30 years, but I do have fond memories of mom and dad. I wish they were still alive.

That's interesting so apparently this drug allows you to keep training hard when you've overdone it. I must be super duper hypo-thyroided, as I get tired not even coming close to 100 mile weeks and intensities like these professionals.

I read something wrote:

Thyroid hormone induces erythropoietin gene expression through augmented accumulation of hypoxia-inducible factor-1

http://ajpregu.physiology.org/content/287/3/R600.full

^ Such an informative study. The evidence in Radcliffe's work is quite illuminating.

The science behind endurance training has constantly sought to re-engineer human physiology to push beyond all definable natural limits. What once was track-based lactic threshold / VO2max workouts is now lab-based hormone regulation and manipulation, including hypoxic living/training.

"When hypoxia occurs, a sensor in the kidneys is triggered which causes increased production of the hormone erythropoietin, or EPO. The EPO then causes more erythrocytes to be produced in the body's bone marrow. Accordingly, the additional erythrocytes result in the presence of additional hemoglobin molecules, which aid in the delivery of oxygen to the body's tissues. As this extra oxygen reaches the hypoxic tissues and alleviates the deficiency, the sensor in the kidneys that triggered erythropoiesis shuts off, and the production of additional EPO above normal levels is halted.

Erythropoiesis can be induced in two ways: by the administration of synthetic erythropoietin and by the inducement of hypoxic conditions."

Sildenafil and bosentan improve arterial oxygenation during acute hypoxic exercise: a controlled laboratory trial.

Olfert IM, Loeckinger A, Treml B, Faulhaber M, Flatz M, Burtscher M, Truebsbach S, Kleinsasser A.

Source

Center for Cardiovascular and Respiratory Sciences, Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, WV 26506, USA.

molfert@hsc.wvu.edu

Abstract

OBJECTIVES:

Sildenafil and, recently, bosentan have been reported to increase arterial saturation and exercise capacity at altitude. The mechanisms behind this are still poorly defined but may be related to attenuation of hypoxic pulmonary vasoconstriction (HPV) and improved gas exchange. This study was designed to examine and compare the effect of sildenafil and bosentan on pulmonary gas exchange during acute hypoxic exercise in a controlled laboratory setting.

METHODS:

Sixteen athletic university students (8 males, 8 females) were examined during exercise in a hypoxic chamber (11% oxygen) before and after the administration of either sildenafil (n=10) or bosentan (n=6). Respiratory and metabolic measurements were taken at rest and during increasing exercise intensity (up to 90% of their individual maximal oxygen uptake [VO(2)max]) in concert with arterial blood gas sampling.

RESULTS:

Both drugs resulted in small, but significant increases in arterial PO(2) (2-3 Torr) and O(2) saturation (3-4%) at rest and during hypoxic exercise, in both men and women. No significant changes in arterial PCO(2) or ventilation were seen at rest or during exercise in hypoxia; however, heart rate (both at rest and during exercise) was increased with both sildenafil and bosentan in both men and women.

CONCLUSIONS:

These data demonstrate that sildenafil and bosentan equally improve arterial oxygenation in acute hypoxia in both men and women, which could account for improved physical performance at altitude.

There is at least some concern that Dr Brown IS treating "subclinical hypothyroidism"-- See the section on Patrick Smyth: "When a physician near his California home found no evidence of thyroid dysfunction, Smyth flew to Houston to see Brown, who conducted some blood tests and diagnosed him with the condition." I've been a physician long enough to know that labs can fluctuate from lab to lab, and over time, so perhaps he truly was hypothyroid when he saw Dr Brown. But it does raise the concern that he is treating people as hypothyroid without them having the disease-- especially since he thinks a TSH of 2 could be consistent with hypothyroidism-- which few reputable internists or endocrinologists would agree with. Treating a person as hypothyroid who doesn't actually have the condition is far far different from repairing a broken bone, repairing a torn achilles, etc. Those all involve real pathology. This may not. Only a look in the medical records could answer that.

yuiop wrote:

Enduring Endurance wrote:

Armstrong was using low levels of banned substances...

Hysterical! Holy cow, we've found the one Lance fanboy remaining. Have you tried stand-up comedy?! This is priceless.

No, you have someone who probably actually read the USADA decision and its appendices summarizing the testimony of the various witnesses. I know that it's a crazy concept to actually read source material and look for underlying evidence, but some people do it, as opposed to getting all your information from Facebook rants.

Testosterone and thyroid hormone supplementation works synergistically to increase expression of certain proteins (MCT-1 and 4) that have a direct effect on your ability to run at fast speeds.

Also, remember when WADA was saying that steroids don't improve strength? That wasn't so long ago.

coach d wrote:

Hypothyroidism is a side effect of HGH use. I don't think I want to imply anything about Bob Kennedy, but it seems that we have a epidemic of hypothyroidism among professional distance runners and only professional distance runners. You don't hear much about sprinters who also push themselves very hard, and you don't hear about an epidemic of hypothyroidism in the NCAA (one of the above excepted).

Now if you think this is on the level, I'd like to sell you some property in Manhattan that I don't own.

Complete half backed opinion and hyperbole. "Epidemic"? What an idiotic contention.