Thyroid hormone use in athletes: Physiological insights and doping controversies

Hussam Hashim Mohammed; Noor Owaid Owada; Noor Jaasim Mohammed

doi:10.32593/jstmu/Vol7.Iss2.310

Hussam Hashim Mohammed Middle Technical University, Baqubah, Iraq
Noor Owaid Owada Middle Technical University, Baqubah, Iraq
Noor Jaasim Mohammed Middle Technical University, Baqubah, Iraq

DOI: https://doi.org/10.32593/jstmu/Vol7.Iss2.310

Keywords: Bodybuilding Athletes, Sport, Thyroid Hormones, T3, T4, TSH

Abstract

Among the human body's most vital organs is the thyroid gland. The hormones produced by the thyroid have anabolic properties, at least when present at physiological concentrations. This paper aims to provide an overview of the current understanding of thyroid hormone use in sports doping. The physiology of skeletal muscles is significantly influenced by thyroid hormones. Exposure to T3 and T4 may enhance muscle blood flow, myogenesis, and renewal. Over an extended period, such hormones could contribute to weight loss. These methods suggest that thyroid hormones might be a likely agent in sports doping. Nonetheless, T3 and T4 aren't listed as sports doping drugs in the World Anti-Doping Code (WADA) standards; the argument over the drug's inclusion is still ongoing, and doctors must be mindful of the impact of the thyroid hormones on the metabolism of people from the standpoint of sports management. The underlying causes of the desired and negative consequences of TH exploitation, the prevalence of TH use among young adults, the legitimate medical applications of TH, the reasons why certain athletes look to utilize TH, the difficulties with identifying TH abuse, and other factors all contribute to the conclusion that, based on the available information, banning TH in highly competitive sports is not possible nor appropriate.

Downloads

Download data is not yet available.

Author Biographies

Hussam Hashim Mohammed, Middle Technical University, Baqubah, Iraq

Assistant Lecturer, Department of Medical LaboratoryTechnology, Middle Technical University, Baqubah, Iraq

Noor Owaid Owada, Middle Technical University, Baqubah, Iraq

Assistant Lecturer, Department of Medical LaboratoryTechnology, Middle Technical University, Baqubah, Iraq

Noor Jaasim Mohammed, Middle Technical University, Baqubah, Iraq

Assistant Lecturer, Department of Medical LaboratoryTechnology, Middle Technical University, Baqubah, Iraq

References

Chen J, You H, Li K. A review of thyroid gland segmentation and thyroid nodule segmentation methods for medical ultrasound images. Comput Methods Programs Biomed. 2020; 185:105329.

DOI: https://doi.org/10.1016/j.cmpb.2020.105329.

Dilmurodovna TD. Morphological aspects of the thyroid gland in various forms of its pathology. Am J Ped Med Health Sci. 2023; 1(8):428-31.

Sharma S, Hashmi MF, Chakraborty RK. Treasure Island: StatPearls Publishing; 2021.

Babić Leko M, Gunjača I, Pleić N, Zemunik T. Environmental factors affecting thyroid-stimulating hormone and thyroid hormone levels. Int J Mol Sci. 2021; 22(12):6521.

DOI: https://doi.org/10.3390/ijms22126521.

Köhrle J. Selenium, iodine and iron–essential trace elements for thyroid hormone synthesis and metabolism. Int J Mol Sci. 2023; 24(4):3393.

DOI: https://doi.org/10.3390/ijms24043393.

Rajalakshmi AN, Begam F. Thyroid hormones in the human body: A review. J Drug Deliv Ther. 2021; 11(5):178-82.

DOI: https://doi.org/10.22270/jddt.v11i5.5039

Cioffi F, Giacco A, Goglia F, Silvestri E. Bioenergetic aspects of mitochondrial actions of thyroid hormones. Cells. 2022; 11(6):997.

DOI: https://doi.org/10.3390/cells11060997.

Liu YY, Milanesi A, Brent GA. Thyroid hormones. InHormonal Signaling in Biology and Medicine. Academic Press; 2020. 487-506.

Hershman JM, Beck-Peccoz P. Discoveries Around the Hypothalamic–Pituitary–Thyroid Axis. Thyroid. 2023; 33(7):785-90.

DOI: https://doi.org/10.1089/thy.2022.0258.

Nikanorova, AA., Barashkov, NA, Pshennikova, VG, Teryutin, FM, Nakhodkin, SS., Solovyev, AV, et al. A Systematic Review and Meta-Analysis of Free Triiodothyronine (FT3) Levels in Humans Depending on Seasonal Air Temperature Changes: Is the Variation in FT3 Levels Related to Nonshivering Thermogenesis? Int J Mol Sci, 24(18)14052.

DOI: https://doi.org/10.3390/ijms241814052.

Salvatore D, Davies TF, Schlumberger MJ, Hay ID, Larsen PR. Thyroid physiology and diagnostic evaluation of patients with thyroid disorders. InWilliams textbook of endocrinology. Elsevier; 2016; 333-368.

Liu J, Zhao K, Qian T, Li X, Yi W, Pan R, et al. Association between ambient air pollution and thyroid hormones levels: A systematic review and meta-analysis. Sci Total Environ. 2023; 166780.

DOI: https://doi.org/10.1016/j.scitotenv.2023.166780.

Toloza FJ, El Kawkgi OM, Spencer HJ, Mathews SE, Garcia A, Gamboa A, et al. Determinants for thyroid hormone replacement therapy in subclinical hypothyroidism: a multicenter electronic health records-based study. Thyroid. 2023; 33(9):1045-54.

DOI: https://doi.org/10.1089/thy.2023.0062.

Ettleson MD, Ibarra S, Wan W, Peterson S, Laiteerapong N, Bianco AC. Demographic, healthcare access, and dietary factors associated with thyroid hormone treatments for hypothyroidism. J Clin Endocrinol Metab. 2023; 108(12):e1614-23.

DOI: https://doi.org/10.1210/clinem/dgad331.

Jin J, Li J, Liu Y, Shi Q, Zhang B, Ji Y, et al. Thyroid hormone changes correlate to combined breast cancer with primary thyroid cancer. Breast Cancer: Targ Therap. 2024; 31:15-22.

DOI: https://doi.org/10.2147/BCTT.S442707.

Stedman M, Taylor P, Premawardhana L, Okosieme O, Dayan C, et al. Trends in costs and prescribing for liothyronine and levothyroxine in England and wales 2011–2020. Clin Endocrinol. 2021; 94(6):980-9.

DOI: https://doi.org/10.1111/cen.14414.

Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, et al. Serum TSH, T4, and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002; 87(2):489-99.

DOI: https://doi.org/10.1210/jcem.87.2.8182.

Handelsman DJ, Gild M, Clifton-Bligh R, Speers N, Kouzios D, McMartin MC, et al. Thyroid hormone abuse among elite athletes. J Endocr Soc. 2023; 7(5):bvad027.

DOI: https://doi.org/10.1210/jendso/bvad027.

Taylor PN, Albrecht D, Scholz A, Gutierrez-Buey G, Lazarus JH, Dayan CM, et al. Global epidemiology of hyperthyroidism and hypothyroidism. Nat Rev Endocrinol. 2018; 14(5):301-16.

DOI: https://doi.org/10.1038/nrendo.2018.18.

Bereda G. Definition, causes, pathophysiology, and management of hypothyroidism. Mathews J Pharma Sci. 2023; 7(1):1-5.

DOI: https://doi.org/10.30654/MJPS.10014

Bernet VJ. Thyroid hormone misuse and abuse. Endocrine. 2019; 66(1):79-86.

DOI: https://doi.org/10.1007/s12020-019-02045-1.

Gleaves J, Petróczi A, Folkerts D, De Hon O, Macedo E, Saugy M, et al. Doping prevalence in competitive sport: evidence synthesis with “best practice” recommendations and reporting guidelines from the WADA Working Group on Doping Prevalence. Sports Med. 2021; 51(9):1909-34.

DOI: https://doi.org/10.1007/s40279-021-01477-y.

Stangierski A, Ruchała M, Krauze T, Moczko J, Guzik P. Treatment of severe thyroid function disorders and changes in body composition. Endokrynol Pol. 2016; 67(4):359-66.

DOI: https://doi.org/10.5603/EP.a2016.0025.

Handelsman DJ, Hirschberg AL, Bermon S. Circulating testosterone as the hormonal basis of sex differences in athletic performance. Endoc Rev. 2018; 39(5):803-29.

DOI: https://doi.org/10.1210/er.2018-00020.

Gild ML, Stuart M, Clifton-Bligh RJ, Kinahan A, Handelsman DJ. Thyroid hormone abuse in elite sports: the regulatory challenge. J Clin Endocrinol Metab. 2022; 107(9):e3562-73.

DOI: https://doi.org/10.1210/clinem/dgac223.

Juiz-Valiña P, Cordido M, Outeiriño-Blanco E, Pértega S, Varela-Rodríguez BM, García-Brao MJ, et al. Central resistance to thyroid hormones in morbidly obese subjects is reversed after bariatric surgery-induced weight loss. J Clin Med. 2020; 9(2):359.

DOI: https://doi.org/10.3390/jcm9020359.

Volke L, Krause K. Effect of thyroid hormones on adipose tissue flexibility. Eur Thyroid J. 2021; 10(1):1-9.

DOI: https://doi.org/10.1159/000508483.

Sagoe D, McVeigh J, Bjørnebekk A, Essilfie MS, Andreassen CS, Pallesen S. Polypharmacy among anabolic-androgenic steroid users: a descriptive metasynthesis. Subst Abuse Treat Prev Policy. 2015; 10:1-9.

DOI: https://doi.org/10.1186/s13011-015-0006-5.

Brown ED, Obeng-Gyasi B, Hall JE, Shekhar S. The thyroid hormone axis and female reproduction. International J Mol Sci. 2023; 24(12):9815.

DOI: https://doi.org/10.3390/ijms24129815

Barbagallo F, Cannarella R, Condorelli RA, Cucinella L, La Vignera S, Nappi RE, et al. Thyroid diseases and female sexual dysfunctions. Sex Med Rev. 2024; 10:qeae021.

DOI:https://doi.org/10.1093/sxmrev/qeae021.

Kjaergaard AD, Marouli E, Papadopoulou A, Deloukas P, Kuś A, Sterenborg R, et al. Thyroid function, sex hormones and sexual function: a Mendelian randomization study. Eur J Epidemiol. 2021; 36:335-44.

DOI: https://doi.org/10.1007/s10654-021-00721-z.

Mountjoy M, Sundgot-Borgen J, Burke L, Ackerman KE, Blauwet C, Constantini N, et al. International Olympic Committee (IOC) consensus statement on relative energy deficiency in sport (RED-S): 2018 update. Int J Sport Nutr Exerc Metab. 2018; 28(4):316-31.

DOI: https://doi.org/10.1123/ijsnem.2018-0136.

Grossmann M, Wittert GA. Dysregulation of the hypothalamic–pituitary–testicular axis due to energy deficit. J Clin Endocrinol Metab. 2021; 106(12):e4861-71.

DOI: https://doi.org/10.1210/clinem/dgab517.

McCall LM, Ackerman KE. Endocrine and metabolic repercussions of relative energy deficiency in sport. Curr Opin Endocr Metab Res. 2019; 9:56-65.

DOI: https://doi.org/10.1016/j.coemr.2019.07.005

Bloise FF, Cordeiro A, Ortiga-Carvalho TM. Role of thyroid hormone in skeletal muscle physiology. J Endocrinol. 2018; 236(1):R57-68.

DOI: https://doi.org/10.1530/JOE-16-0611.

Maiden MJ, Torpy DJ. Thyroid hormones in critical illness. Crit Care Clin. 2019; 35(2):375-88.

DOI: https://doi.org/10.1016/j.ccc.2018.11.012.

Guerri G, Bressan S, Sartori M, Costantini A, Benedetti S, Agostini F, et al. Hypothyroidism and hyperthyroidism. Acta Bio Medica: Atenei Parmensis. 2019; 90(Suppl 10):83.

DOI: https://doi.org/10.23750/abm.v90i10-S.8765.

Yau WW, Yen PM. Thermogenesis in adipose tissue activated by thyroid hormone. Int J Mol Sci. 2020; 21(8):3020.

DOI: https://doi.org/10.3390/ijms21083020.

Johann K, Cremer AL, Fischer AW, Heine M, Pensado ER, Resch J, et al. Thyroid-hormone-induced browning of white adipose tissue does not contribute to thermogenesis and glucose consumption. Cell Rep. 2019; 27(11):3385-400.

DOI: https://doi.org/10.1016/j.celrep.2019.05.054.

Machado M, Bachini F, Itaborahy A. Thyroid Hormones and Skeletal Muscle Beyond Thermogenesis. J Sci Sport Exerc. 2023; 26:1-9.

DOI: https://doi.org/10.1007/s42978-023-00235-y

Negro R, Attanasio R, Nagy EV, Papini E, Perros P, Hegedüs L. Use of thyroid hormones in hypothyroid and euthyroid patients; the 2019 Italian survey. Eur Thyroid J. 2020; 9(1):25-31.

DOI: https://doi.org/10.1159/000502057.

Twitchell DK, Pastuszak AW, Khera M. Controversies in testosterone therapy. Sex Med Rev. 2021; 9(1):149-59.

DOI: https://doi.org/10.1016/j.sxmr.2020.09.004.

Chen DW, Lang BH, McLeod DS, Newbold K, Haymart MR. Thyroid cancer. The Lancet. 2023; 401(10387):1531-44.

DOI: https://doi.org/10.1016/S0140-6736(23)00020-X

Abbey EJ, McGready J, Oh E, Simonsick EM, Mammen JS. Thyroid hormone use and overuse in dementia: Results from the Health, Aging and Body Composition Study. J Am Geriatr Soc. 2022; 70(11):3308.

DOI: https://doi.org/m 10.1111/jgs.17961.

Kuś A, Chaker L, Teumer A, Peeters RP, Medici M. The genetic basis of thyroid function: novel findings and new approaches. J Clin Endocrinol Metab. 2020; 105(6):1707-21.

DOI: https://doi.org/10.1210/clinem/dgz225.

Virili C, Antonelli A, Santaguida MG, Benvenga S, Centanni M. Gastrointestinal malabsorption of thyroxine. Endoc Rev. 2019; 40(1):118-36.

DOI: https://doi.org/10.1210/er.2018-00168.

Palacios-Bayona KL. Optimizing TSH Testing: Minimizing Overdiagnosis and Unnecessary Interventions.2024.

DOI: https://doi.org/10.5772/intechopen.1005108