Seeking endocrinologist/climber

I am looking for another climber or athlete who is an endocrinologist. I have Hashimoto's and would appreciate any advice or wisdom to get my health better. It’s very hard to top rope on hard 9’s. I really struggle to lead. Just got back from a trip and I struggled to climb 7’s and only clip a few bolts on a 6. I’ve suffered thyroid issues since 18, now 36. Not quite a year into Hashimoto's diagnosis. Working on nutrition, weight, and reducing stress. Once my heart has to work hard it’s like I got nothing. I’ve made lots of progress on my health the past 10 years and I would love to climb 10’s and lead up to 9. I have been researching more on athletic performance for my condition and would love to step up my game. Thank you!

Any other climber's out there with Hashimoto's? I would love to hear your story!

This year has been rough. I had a lot of stress and working through it has been tough. I am pretty sure I got covid and who knows how long that effects the body. 

I have been on a few trips this year and have struggled on just about all of them. Some I feel like I had good days and bad days. The thing I struggle with the most physically and it is just frustrating to me is my breathing. I will climb a route and get to a point that my breathing seems out of control, and I try to control/calm it and it won't until I am done with climb or come down. I feel fine physically and capable of the climb, but gosh it freaks people out and just frustrates me. My heart rate is spiked. 

I then struggle to recover that night or for a few days. When I climb at the gym, my Garmin watch says my sleep was too stressed. Sometimes I can't sleep. I also attempt at trail running meaning I can only do walk/run intervals because my body protests. I have been training as much as my body will tolerate for years and I have made significant progress. My levels are still elevated and my endo things my dose is too high. I want to lead climb and boulder, but my body drags me down, literally. 

Anyone have experience with the above or care to share their story? Any groups I can join? I am taking thyrosol by metagenetics and it has helped. I have started a powerful fish oil and glucosamine because my fingers burn and crunch on anything crimp but that is arthritis. A previous functional doc recommended magnesium glycinate, l-carnitine (which really helps). I also need to constantly eat energy gummies when trailing running longer distances or I pack a ton of carbs for climbing trips. 

I am working with someone already who is an Endocrinologist and my own endo as well. 

Typically people with hashi can't do high intensity. I am super thankful and feel like a bad ass that I am doing what I have been doing already. I have really pushed past the odds so hope that is an encouragement to others. 

Chelsea Lybargerwrote:

Any other climber's out there with Hashimoto's? I would love to hear your story!

My friend with somewhat unique medical disorder joined Facebook for the sole purpose of getting in touch with people who have same physical affliction.  I am quite sure 99.9% are not climbers, but challenges they face in daily life - functioning, being physically active, dealing with medical issues, are quite similar.

Best luck

Hesitate to respond, but your post sounds very similar to what my ex (and climbing partner) struggled with (thyroid issues, Hashimoto, etc).   Basically got nowhere for years and years.  Then she discovered this guy  

Personally, I think it’s 50% common sense and 50% poppycock, but it turned her life around and I can attest that something is definitely working for her after she went whole hog on this book and modified her diet.   She spun a 180 and swears by him.   More likely in my estimation it’s a combo of coincidence, time, and placebo effect, but couldn’t hurt if you’ve been struggling for 10 years like she was.  
A data point of one, so take it for what little it’s worth….like most internet medical advice from climbing forum randos.  

My fiance is a nutritional counselor specializing helping people though precise, evidence and lab test based nutrition.  She does not suffer from Hashimotos herself, but is a climber and adventure sport athlete and understands the energy demands of our sport. The first appointment is free, and many of her clients are totally tele-med based.

https://www.knappnutrition.com/about

Do you take meds to combat the thyroid dysfunction?  Until my wife got hers well regulated she had similar problems as you.

Mark Pilatewrote:

Hesitate to respond, but your post sounds very similar to what my ex (and climbing partner) struggled with (thyroid issues, Hashimoto, etc).   Basically got nowhere for years and years.  Then she discovered this guy  

Personally, I think it’s 50% common sense and 50% poppycock, but it turned her life around and I can attest that something is definitely working for her after she went whole hog on this book and modified her diet.   She spun a 180 and swears by him.   More likely in my estimation it’s a combo of coincidence, time, and placebo effect, but couldn’t hurt if you’ve been struggling for 10 years like she was.  
A data point of one, so take it for what little it’s worth….like most internet medical advice from climbing forum randos.  

Thank you! Yes this guy is interesting. he has several books and I have focused on the ones with adrenal and thyroid. Thank you for the recordation and feedback, I really appreciate it!

Andy Shoemakerwrote:

My fiance is a nutritional counselor specializing helping people though precise, evidence and lab test based nutrition.  She does not suffer from Hashimotos herself, but is a climber and adventure sport athlete and understands the energy demands of our sport. The first appointment is free, and many of her clients are totally tele-med based.

https://www.knappnutrition.com/about

Awesome! I will check her out. I have been to 2 functional doc's and my current one moved away. Thank you!

skik2000wrote:

Do you take meds to combat the thyroid dysfunction?  Until my wife got hers well regulated she had similar problems as you.

Yes I take meds, doc just lowered my dose again as my levels are still high. 

Chelsea,

I have Hashimotos and Type1 Diabetes. Not sure I can provide much advice as I’ve never had such noticeable symptoms from Hashi’s. I obviously have to pay much more attention to my diabetes, blood sugar levels, and the carbs I eat. My Endo tests my thyroid levels a couple times a year and they’ve generally been ok. I take Synthroid and have been on Levothyroxin (the generic). Both seemed fine for me, but from what my Endo has seen in anecdotal observations some of his patients react differently on Levo than on Synthroid. I also take some B Complex vitamins and a Glucosamine Chondroiton MSM & Hyaluronic Acid blend for arthritis in my feet. Hope you’re able to find the right course of treatment for yourself. Happy to chat more if you wanna direct message me. 

18 years and your treatment is still insufficient? I fear you are being treated by old school endocrinology guidelines that do not serve your medical need, or potentially there are other medical issues that are causative to your symptoms.

Thyroid issues can be complex, but a huge part of the status quo in endocrinology oversimplifies this to the detriment of many patients. Old school assessment and treatment guidelines do not take care of many patients' actual needs. There are many endocrinologists who focus only TSH or only TSH and T4 for assessment, and treat with only Synthetic T4 like Synthroid. This misses the boat for many patients. 

I am one of those patients. I don't have Hashi's but I am hypo. The treatments that work for me are NDT which has both T4 and T3, or a combination of Synthroid T4 plus Cytomel T3. I do not do well on just Synthroid T4. And my case can not be adequately managed by virtue of TSH and T4 labs alone. Apparently this is very common.

Here's what happens with me, and my understanding of the cause and effect of assessment and treatment approaches:

The rubber meets the road at the cell receptors that take thyroid hormone into the body's cells. The form of thyroid that acts at the receptors is Free T3. But the thyroid gland makes predominantly T4. The number indicates the number of iodine molecules attached to the thyroid hormone molecule. You normally have deiodinase enzymes which act on the T4 to remove one of the iodines which converts T4 into T3. So T4 is the pro-hormone, which has to be reduced to T3 in order to act at the cell. 

For me, if all I take is Synthroid (T4), I do not adequately convert enough of it to Free T3. The result is my T4 remains high, but my cells are not getting enough thyroid hormone. If you look only at TSH and T4 in that state, I appear hyperthyroid, but T4 does not work at the cell receptors, so I am functionally hypothyroid.

If you look at the entire picture with Free T and Reverse T3 labs, it is clear. Free T3 is inadequate, and there is a second effect which is my deiodinases convert too much of the T4 into Reverse T3 (RT3). Reverse T3 does bind to cell receptors, but it is not functional as thyroid hormone being delivered to the cell. It actually blocks the uptake of T3. So this is kind of a double whammy where the rubber meets the road.

The solution for me is to either take NDT which has some T3 in it, or take both Synthroid (T4) and Cytomel (T3). The ratio of these needs to be correct to keep T3 and 4 in correct range. 

I like NDT, but the problem is frequent supply problems. I have had to change brands multiple times due to shortages, and I've found that with every change of brand I have to re-adjust dose. This is a PITA, it takes an extra set or two of labs and adjustments. Synthroid and Cytomel are always consistent.

I understand my own case, but you are a different person and your case is different, but if you are not well on your current treatment, yeah, seeking a new doc is good! I encourage you to seek out a doctor who goes beyond the TSH/T4 modality and uses a wider range of options to optimize individual treatment.

There's a lot to unpack, try http://www.tiredthyroid.com/blog/tiredthyroid-main-site/  I think that understanding labs and how they relate to deciding treatment is also key: restartmed.com/?s=lab+tests