As doupt over Sir Mo Farah and his link with his banned former coach Alberto Salazar refused to go away, new evidence has now emerged from BBC panorama. In the said panorama, it depicts ‘wide spread of thyroid medication use especially among UK and US athletes’. Emails obtained by Panorama suggested UK athletes based in the US were asking UKA doctors about thyroid medication for “performance gains” because “the Americans” were taking it.
UK Athletics told the BBC: “Any concerns relating to Sir Mo Farah and medication oversight were addressed in July 2011 when Dr Barry Fudge took over liaison between Mo’s medical treatment at the NOP and UKA medical personnel.”UKA medic Dr Noel Pollock wrote that thyroid medication was “well used by Alberto’s group”.
The belief in the centre of all the scepticism is that when endurance athletes train hard this can induce an early onset of a thyroid hormonal imbalance called Hypothyroidism which involves a fatigue like condition that can prevent an athlete from performing at their peak. The medication for this is a synthetic thyroid hormone called Levothyroxine which helps to regulate the body’s metabolism. The diagnosis for Hypothyroidism is done using blood samples that measure another hormone, Thyroid Stimulating Hormone (TSH), which controls the production of the thyroid hormones. An increase in TSH means a decrease in thyroid hormone production and a large possibility that you have an underactive thyroid and need medication. Based on the American College of Endocrinology Literature, the normal range of TSH is very broad, ranging from a low 0.5 to 5, with a TSH level of greater than 4 along with reported fatigue being enough to warrant medication for underactive thyroid, similar to the guidelines stated in the UK. However, Dr. Brown, stated as the best endocrinologist in the world by Salazar, argues that an underactive thyroid can be defined by a TSH level as low as 2. What’s more worrying than this fact is that Nike Inc. pay Dr. Brown to evaluate Nike athlete’s medical test. Interestingly, an early study exploring performance and the effects of overtraining on a variety of hormones, including the thyroid hormones TSH, tri-iodothyronine (T3) and thyroxine (T4), showed no differences in the level of thyroid hormones through-out the study (Lehmann et al., 1992). 17 distance runners were physically over-trained as the main aim of this study in order to examine the impact of an exhaustively high volume and intensity training program on several hormones.
Unfortunately, some athletes do actually have an underactive thyroid and need the medication. However, there is potential for athletes to be abusing this and using the medication to enhance performance as the thyroid hormone thyroxine is a stimulant.