ksingh123

I am a dedicated road cyclist. Recently I noticed that my resting heart rate started climbing up and up, from 70s to 80s to 90s and then into the 100s in a matter of days, which is then I decided to visit the doctor in the emergency. They found that my thyroid levels were three times high. After spending 3 nights in the hospital, they have prescribed me 50mg Atenolol to lower the heart rate and Methimazole. Has anyone experienced this and how can one come out of this ****. It is probably graves disease or thrioditis. This has thrown a wrench in my training. Any advice appreciated.

Climb14er

I was diagnosed with Graves Disease after dropping twenty seven pounds from one hundred and seventy two, that's a huge drop! My TSH baselined at zero. According to the docs, my normally very healthy system was overcharged and running out of control metabolically. Rather than have the thyroid irradiated, I reluctantly chose methimazole. 30mg to start then raised to 40mg. My body did not like this and my stamina was compromised, big time. I was 55 at the time, 12 years ago. Being that I always ate well, naturally, organically... I kept to a regime of exercise, fresh air, eating well and after two years, my TSH began to climb and after five years, stabilized at the mid normal range, all the while Reducing the dosage of Methimazole. The protocol for the drug is one year. I've been on it for almost thirteen, the last five years, one half of the lowest dose 2.5mg 1X a day. The thyroid is the least understood of the glands/organs. My energy is fine but has decreased a bit with the years, due to age. At least I still have the thyroid. Find yourself a good Endocrinologist who listens and experiment. Good luck.

datlas 

The beta blocker (atenolol) is going to lower your maximum HR so you will feel your top-end is lower than before. Just ride your best and once the dust settles and your thyroid levels are normal, you will be fine on the bike. Just accept this and do your best to enjoy riding at a moderate pace/effort. It may suck but it’s temporary and necessary.

ksingh123

Thanks for the detailed reply. Last year I was in the top shape. 64kg, good physique, good diet, no junk no processed foods. I am a celiac and was stable. However, this year I gave into snacking a bit of junk food here and there and eating gluten and then suddenly this happened to me. Luckily I was wearing a heart rate monitor and I became aware of my rising heart rate.

This graves disease has a thrown a wrench in my training. I feel miserable in this body now and it makes me feel more miserable that I cannot exercise, because my resting heart rate which is already in the 80s now will rise even higher.

I am on Methimzole

1)Will this cause joint issues?
2)Will this cause liver issues?
3)When the heck can I get off this drug as soon as possible.

Is it better to go with Radiation iodine or surgery? Just be done with it?

Just feel terrible at this moment. I have seen people eat garbage food all the time and they have just balloon shaped stomachs, yet not a single disease !

ksingh123

I am aware of that and I will come out of it as soon as possible.

Climb14er

I studied a lot about Graves and the thyroid and being a very active athlete, long distance cycling, high altitude mountaineering, etc my whole adult life, I too wanted answers. My body was rocked by the Graves and the Methimazole and I had to relax and slow down. This was imperative. My suggestion as mentioned is to find a top Endocrinologist... WHO LISTENS... and allow the Methimazole to get your system under some type of control. I had no damage to any organs and my body had to adjust to the side effects of the drug, severe itching, skin sensitivity. If your doc and you think its better to have your thyroid irradiated, so be it, but you will need to be on synthroid for the rest of your life. This is a subject that is near and dear to me as it came on to me suddenly and almost took me out of the picture. My heart and system were in overdrive, even in good condition, I was warned that I could have had a heart attack if I didn't get on the Methimazole and get the Graves under control. It took a lot of patience to get my TSH up and back to normal. For me, it was a Longshot. I get my TSH checked every six months and take it in stride.

ksingh123

Thanks for the reply. Are you still taking methimazole? are you still fit the way you use to be or has it made you sedentary? Is your resting heart rate back to normal to what it was prior to the graves. I am not going to stay on any drugs. I hope to get off methimazole once my thyroid is normal.

Is there any side effect of synthroid or its just a supplement like any other?

Climb14er

As mentioned, I'm feeling fine, the ability to do things athletically has slightly changed due to age and a broken back while riding in 2012, not due to the low dose Methimazole and Graves. Overall, for my age, I'm told I look very healthy and in excellent health. I cannot comment on synthroid as I've never taken it. Perhaps others can chime in. All that I shared with you, I have experienced. My recommendation is what I did regarding the Endocrinologist and Methimazole. The best I can say is be easy on yourself, relax, let the med try to do its thing and consult with your Endocrinologist. You got to approach this slowly and with patience and care.

RGMN

I was first diagnosed with Graves shortly after I had a triple bypass after a MI on a bike ride. It impeded the cardiac therapy due to my resting heart rate not settling down into a range they wanted to see. Fortunately I responded very well to Methimazole and had it under control within 6 months of diagnosis. I remained on it for ~8 months.

The Graves remained in remission with no additional Methimazole for almost 7 years. Late last year I started to notice my resting heart rate increasing, was losing weight, and started to get tremors. A blood test confirmed the Graves was back, and I was back on the Methimazole, 10mg daily. My TSH is now back in the normal range, and my endocrinologist has dropped the dosage to 2.5mg 4 times a week. Right now I'm in a maintenance mode with the Methimazole, and should be off it by the end of the year. Note that due to the MI & bypass I'm already on a beta blocker, and will continue to stay on it.

At no time did my endocrinologist recommend me to stop exercising. In fact, she wanted me to keep exercising as long as I felt okay. Neither her or my cardiologist were concerned about the elevated resting heartrate. They knew the cause and expected it to drop back to my normal 55 bpm once the Graves was under control. It did just that. They were more concerned that the heart would race out of control, but felt that exercising would help control that as. The primary thing I noticed is after a workout I don't recover as well as I usually do. I would normally ride both Saturday and Sunday, and would barely notice the Saturday ride on Sunday. Now I can feel it, and I don't feel recovered from it. This weekend is the first time I felt like I could ride 2 days without issue. My dosage of the Methimazole was reduced at the beginning of July, and it has taken almost a month for it to start working out of my system.

Talk to your endocrinologist. One thing I learned is that my endocrinologist really likes to discuss something other than diabetes, so she has given me a whole lot of information on Graves, what to expect, what complications to expect.

canklecat

Best wishes with this. It's frustrating. About 20 years ago I was diagnosed with Hashimoto's syndrome and over the years veered wildly between symptoms of hypo and hyperthyroidism, with odd spikes in HR and BP. I eventually developed thyroid cancer and had the left lobe removed in 2018. The doctors wanted to preserve the right lobe if possible to retain some parathyroid activity since I have early onset osteopenia and osteoporosis runs in the family.

I've been on levothyroxine for a couple of years, gradually increasing from 25 mcg to 112 mcg. Yeah,oddly specific, but my endocrinologist is very conservative in treatment, doing tests every 3 months. And they do an ultrasound a couple of times a year to monitor the remaining right lobe for recurrence of cancer.

My resting heart rate varies wildly over time. Sometimes it's around 60 bpm or a little lower, pretty much what you'd expect for a reasonably fit person who does long distance cycling or running. Other times it's been 90-100 bpm. Even now it can take hours after I finish a ride for it to drop below 100. It seems to respond appropriately to effort during a ride, but afterward doesn't seem to settle down for a long time.

Occasionally I take a beta blocker (usually propranolol, sometimes inderal), mostly to relieve migraines/cluster headaches, which pretty much wipe me out for the next day or so. I'll still ride but I have to recalculate my heart rate about 20 bpm lower. I set my bike computer to sound an audible alarm when I reach 160 bpm, which on a good day is where I can sustain an effort for about one minute before redlining (I'm 62 and my max HR is around 173). But when I take a beta blocker I have to remind myself my new red zone is 140 bpm.

Besides a heart rate monitor I also use the Elite HRV app most days. The results pretty well correspond with how I feel and what I can do that day.

I've had to adjust my training to fewer interval sessions (one a week at most, usually one every two weeks), more endurance type sessions. But it's getting difficult to use my heart rate as a reliable gauge for training because it doesn't always correspond with how I feel. So I use HR and the HRV app as guides and mostly go by how I feel. Usually works out.

Due to the pandemic I've quit all group rides this year, which were mostly tempo effort. I did a lot of that last year and felt like I was getting stale. So I'm trying different methods this year. It's mostly guesswork though. I did a 70 mile ride Saturday, including an hour of hill repeats, and felt great. Sunday I could hardly get out of bed to do an easy 13 mph recovery ride for an hour. Should have taken a walk and recovery nap instead.

aclinjury

Not according to many medical statistics on metabolic disease and endless observations from cardiologists!
Diseases can hit even the healthiest vegans eating organic plant. But statistically, people eating healthy, especially plant based, tend to have the lowest diseased life out there (but doesn't mean they are immune to Nature's will).

ksingh123

Thanks everyone for the reply. An update. The doctor has said it could be either Hashimoto's or Graves disease. They dont know yet and I am currently on Methimazole. I am wondering which of the two diseases is less severe?

If the doctor decide to RAI the thyroid gland, then I will be on synthroid or levithyroxine. I have heard people gain a lot of weight and become extremely fat. This is highly unacceptable to me and I dont want to become fat. I am currently 64kg with 14% body fat. I wish to keep it that way. Please let me know if it is possible to keep low body fat percentages while being on Synthroid or Levothyroxine.

If I choose to stay on methimazole will my Graves go into remission? (but i m not even sure if it is hashimotos or graves).

canklecat

While rare, this auto immune disorder does occasionally flip-flop symptoms, between hypo and hyper thyroidism, and symptoms of Hashimoto's and Graves. My symptoms flip-flopped about 20 years ago, then gradually deteriorated to just hypo-thyroidism and eventually cancer (no metastasis, the calcified lobe was removed). My mom had symptoms of Graves but her doctor didn't seem to think it was serious enough to add another medication.

Regarding prognosis, I'd say stick with your doctor if you've found a good endocrinologist. There's plenty to read on the internet, some of it credible, some not so much. I'm wary of pop culture health and wellness websites that don't cite credible sources. I don't mind changing my diet or trying reasonable suggestions, as long as there's some evidence for it. The biggest complaint I see online from folks suffering from thyroid disease is they feel neglected by their doctors, which may be exacerbated by the anxiety and depression that often accompanies thyroid disorders.

However once I found a good, attentive endocrinologist I mostly had to learn to be patient because, as I've mentioned, she's very conservative in treatment approach and has to weigh my bone density risk alongside my thyroid. So while she's sympathetic when I've said I seem to lack energy some days, despite being active (I ride bikes about 500 miles a month), she's not willing to authorize increased levothyroxine without considering the effect on my entire system. That includes the various steroid and non-steroidal inhalers I take for allergies and asthma, which complicates things.

ksingh123

When they turned you hypo, did you become fat? Were you able to reach your normal desired weight?

skier

Take a look at the Graves Disease and Thyroid Foundation forum (GDATF . Org). They have a lot of good info from reasonable people. I’ll pm you when I hit 10 posts.

canklecat

Oh, yeah, my weight got up to 205 lbs at my heaviest in the early 2000s. But that wasn't solely due to the thyroid problem. The thyroid problem drained my energy, sure. And serious back and neck injuries from a 2001 wreck made it even harder to do any exercise other than walking with a cane, slowly.

But the main problem was I ate too much junk. Too much beer, too much sugary junk food.

As soon as I changed my diet I lost weight, even without doing much exercise -- just walking, mostly with a cane for walks longer than a mile. When I resumed cycling in 2015, more weight came off. And when I cut way back on the beer (I'd already eliminated most sugary junk), I dropped another 10 lbs. At the moment I weigh 147. As long as I stay under 160 lbs I'm satisfied.

And that's despite the low thyroid function. I'll admit there are days when I can hardly crawl out of bed and stumble to the bathroom. But I still get a little exercise almost every day, no matter how I feel. At a minimum I'll try to walk a mile, usually for errands. Or do an easy spin on the indoor trainer. Some stretches and range of motion exercises. Often just moving and getting the blood circulating is better than a cup of coffee for invigorating me.

There may be some people who's "slow metabolism" really does thwart their efforts at maintaining a healthy weight. But all of the overweight people I know in my extended family are obese because of their diets and lack of exercise. They feel bad, sluggish, sick and depressed all the time because of a poor lifestyle. Diabetes and heart disease are common among the older obese relatives. But they get into a cycle of using the "illness" as a self-created trap to keep eating junk and packing on the pounds.

63rickert

A longtime riding partner and dear friend died of Graves. She was also a professor, taught endocrinology, was a leading authority on the disease. She was a PhD and a researcher. MDs frequently brought her in for clinical consultations. She never attempted to treat her condition herself, even though she invariably knew more about the disease and more about her own case than any MD.

Thyroid cases are notoriously difficult to work with. The doctor needs to be a psychiatrist as much as a physician.
Sounds like the OP is in the stage of bargaining. You can bargain with yourself and you can bargain with your doctor. You can’t bargain with the disease. It is going to follow its own chemical logic.

Way too early to make any guess for prognosis. My friend had many good years and was a monster on the bike until about age 60. GHW Bush (my friend consulted on his case) lived an unusually long life even though his Graves was quite severe. And his doctors never did understand why he did so well.

The first job job of the doctors is to keep the patient alive. Wishlists about weight and training and performance come much later. Try to work with the doctors. If there is a personality that you just can’t work with, fine, they have seen this before. It is important to have a good match between doctor and patient.

blacknbluebikes 

Dr. Google is not your friend. She's a temptress howling with advice from all corners of the globe, but knows nothing about you and your situation. I understand the need to see what the future may hold, but you're not going to get a good forecast from anyone, unless they're saying, "get your affairs in order." If you don't hear that, then carry on and face what you get. You will adapt, and don't doubt it for a second. I've been on levo for 13 years, it doesn't affect my weight whatsoever. I exercise regularly and pay very little attention to structuring a diet, I like pretty much everything and don't hesitate to eat anything. I just don't overeat - my meal size is based on how much I think belongs in my stomach, not how much someone put on the plate. If riding a bike is important to you, you will find a way to do that - just don't lose sight of that goal. Make sure you settle in with a doctor that "feels right" to you, because that peace of mind is part of your adaptation. I've had good ones, bad ones and truly exceptional ones. When things get really serious, only exceptional will do.