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04-27-2013, 03:47 PM #1
Testing hypothyroid without symptoms? This may explain why. *STUDY*
Credit goes to hypRgonad for locating and posting this study on DBT. I thought it may be relevant and useful for some folks here.
Exercise Intensity and its effects on Thyroid Hormone Levels
Figen Ciloglu, Ismail Peker
1, Aysel Pehlivan2, Kursat Karacabey3, Nevin İlhan4,Ozcan Saygin5 & Recep Ozmerdivenli3
GENLAB Medical Diagnostics and Research Laboratory,
1
Marmara University, Engineering Faculty, Department of Chemical Engineering,
2
Marmara University, School of Physical Education and Sports – Istanbul,
3
University of Gaziantep, The School of Physical Education and Sports,
4
Firat University Medicine Faculty Biochemistry Department,
5
Muğla University The School of Physical Education and Sports, Mugla - Turkey
Correspondence to:
Yrd. Doc. Dr. Kursat Karacabey, PhDUniversity of Gaziantep, The School of Physical Educationand Sports (Beden Egitimi ve Spor Y.O)TR 27100, Gaziantep, TURKEY
FAX
: +90 342 3600751
TEL
:+90 342 3601616 Ext:1412 / 1417
EMAIL
: [email protected]@gantep.edu.tr
Submitted: May 1, 2005 Accepted: May 13, 2005Key words:
exercise; thyroid hormone; thyroxine
Neuroendocrinol Lett 2005;
26(6):830–834 PMID: 16380698 NEL260605A14 © Neuroendocrinology Letters Neuroendocrinology Letters - Psychoneuroimmunology, Chronobiology, Peer-reviewed journal
Abstract
BACKGROUND
: Physical activity influences energy metabolism in human subjectsby increasing activity-induced energy expenditure and resting metabolic rate forseveral hours after exercise. Effects of exercise on circulating thyroid hormonevalues remain controversial. We have investigated the effect of acute aerobicexercise on thyroid hormone values.
MATERIALS/METHODS
: The effect of different intensity levels of acute aerobicexercise on thyroid hormones was investigated in 60 male well-trained athletesby performing bicycle ergometer at 45% (low intensity), 70% (moderate intensity),and 90% (high intensity). These intensities were selected according to theirmaximum heart rate (MHR). At each intensity level, heart rate, blood lactic acid,serum total thyroxine (T4), free thyroxine (fT4), total triiodothyronine (T3),free triiodothyronine (fT3) and thyroid stimulating hormone (TSH) values weremeasured.
RESULTS
: The results of this study show that exercise performed at the anaerobicthreshold (70% of maximum heart rate, lactate level 4.59 ± 1.75 mmol/l) causedthe most prominent changes in the amount of any hormone values. While therate of T4, fT4, and TSH continued to rise at 90% of maximum heart rate, the rateof T3 and fT3 started to fall.
CONCLUSIONS
: Maximal aerobic exercise greatly affects the level of circulatingthyroid hormones.
Introduction
It is a well-known fact that exercise affects theactivity of many glands and the production of theirhormones. One of the glands affected is the thyroid.Thyroid gland secretes two separate aminoacid-iodine bound thyroid hormones known as 3-5-3’ triiodothyronine (T3) and 3-5-3’-5’ tetraiodothyronine(T4, thyroxine) both of which are alsofound in the free form (fT4, fT3), whose impor-
To cite this article:
Neuroendocrinol Lett 2005; 26(6):830–834
Neuroendocrinology Letters No.6 December Vol.26, 2005 Copyright © Neuroendocrinology Letters ISSN 0172–780X
Neuroendocrinology Letters - Psychoneuroimmunology, Chronobiology, Peer-reviewed journal
831
Exercise intensity and its effects on thyroid hormones
tance on the regulation of general metabolism, growth,and tissue differentiation as well as gene expression hasbeen known for a long time [7, 22]. It is also knownthat thyroid hormones act in fatty acid oxidation andthermoregulation [9]. Thyrotropin-releasing hormone(TRH) secreted from hypothalamus stimulates anteriorpituitary to release thyrotropin (TSH, thyroid stimulatinghormone) [9]. When exercise is repeated at certainintervals, there is a pituitary-thyroid reaction that isproperly coordinated by increasing turnover of thyroidhormones [3]. When thyroxine turnover and relatedhormonal action is increased, this would lead to hyperthyroidism[9, 10]. However, there is no evidence thatsuch a case occurs in trained athletes. For example, intrained athletes the difference between basal metabolicrate and body temperature is rarely abnormal [9]. Thus,it appears that an increase in thyroxine turnover, whichoccurs with physical training, may have a differentmechanism [10, 14].Training disturbs the athletes’ energy homeostasis inan attempt to invoke beneficial adaptations. At the sametime, body weight and food intake controlling systemssend the signal to save energy. Ignoring this processcan result in overtraining and a reduced sensitivity toanabolic hormones and other endocrine signaling [10,20, 21].Research on marathon training women brings outvery interesting results about thyroid turnover. When arelatively sedentary person starts to train and increasestraining to 48 km/week – a moderate thyroid disorderdevelops reflected by increasing T3 and T4 levels [21].The purpose of this study is to uncover the acuteeffect of increasing metabolic activity through exerciseon thyroid hormones, if an effect is observed – to seewhether it is related to the intensity of exercise andwhich of the thyroid hormones are more intenselyaffected.
Methods
The ethical consent to study on human subjectswas provided by The Ethical Committee of MarmaraUniversity according to The Declaration of Helsinki.
Subjects.
Sixty healthy and well-trained male athletes participatedin this study. Their ages were between 20–26(23 ± 3) years; average heights were 176 ± 7,7 cm, andweights were 72 ± 7,8 kg. All subjects were informedabout the purpose and procedures of the study.All subjects were volunteers and selected randomly.They had a medical examination and completed ahealth status questionnaire.
Study Design.
A total of 9 minutes of exercise was applied to thesubjects with a gradually increasing intensity every 3minutes. Each subject performed in different intensitiesusing bicycle ergometer at the 45%, 70%, and 90%.These rates were calculated of maximum heart rates(MHR). Carvonen method was used for selectingintensity of exercises [1].Capillary blood was taken from the ear lobe fordetermination of lactate at the ergometer tests and duringthe training cycle.
Laboratory analysis.
At the end of each three minutes, they wereinterrupted for 30 seconds and blood samples weretaken. From the blood samples, lactate (Boehringer
Table 1:
Values during low, moderate and high exercise intensities (at 45%, 70%, 90% of maximum heart rates)
Percentage of maximum heart rate
(Mean value ± standard deviation)
Euthyroid adultvalues*
45% 70% 90%
Lactate (mmol/l)
2.86 ± 0.658 4.59 ± 1.75 8.25 ± 2.74
TSH (
μIU/ml) 0.5–8.9 1.69 ± 0.55 1.78 ± 0.60 1.89 ± 0.74T3 (ng/ml) 0.8–2.1 1.47 ± 0.23 1.78 ± 0.42 1.48 ± 0.26Free T3 (pmol/l) 3.4–7.2 5.30 ± 1.20 6.46 ± 1.62 6.17 ± 1.29T4 (ng/ml) 42–120 71.10 ± 19.02 84.35 ± 24.86 86.35 ± 28.36Free T4 (pmol/l) 11–24 16.97 ± 3.86 19.49 ± 3.82 20.16 ± 4.80* Reference values of kits
Table 2
: P-values of thyroid hormones changes in different exercise intensities
45%–70%of max heart rate45%–90%of max heart rate70%–90%of max heart rateTSH (
μIU/ml) 0.200 0.045* 0.204T3 (ng/ml) 0.025* 0.086 0.021*Free T3 (pmol/l) 0.047* 0.063 0.038T4 (ng/ml) 0.012* 0.008* 0.049Free T4 (pmol/l) 0.023* 0.027* 0.311
832
Neuroendocrinology Letters No.6 December Vol.26, 2005 Copyright © Neuroendocrinology Letters ISSN 0172–780X Neuroendocrinology Letters - Psychoneuroimmunology, Chronobiology, Peer-reviewed journal
Figen Ciloglu, Ismail Peker, Aysel Pehlivan, Kursat Karacabey Nevin İlhan, Ozcan Saygin & Recep Ozmerdivenli
Mannheim lactate kit, Boehringer Mannheim 4010spectrophotometer), T4 (Diatech Diagnostic enzymeimmunoassay test kit), T3 (Diatech Diagnostic enzymeimmunoassay test kit), free T4 (Amerlex brand RIA kit),free T3 (Amerlex brand RIA kit), and TSH (BiodataDiagnostic brand RIA kit) values were measured.
Statistical analysis.
Differences between values at different time pointswere tested with one-way ANOVA and Tukey HSD.The assumed level of significance for differences wasequal to or less than 0.05 for all tests.
Results
In this study, hormone values at all heart ratecategories were compatible with the values of healthyand euthyroid adults (Table 1). In all hormones, withthe exception of TSH, the maximum rate of increasewas observed at the anaerobic threshold level (70% ofmaximum heart rate, lactate level 4.59 ± 1.75 mmol/l).The rate of increase of TSH was similar, going from45% to 70% and from 70% to 90% of MHR (Fig. 1). Theincrease in TSH level going from 45% to 90% of MHRwas statistically significant (Table 2). T4, fT4 continuedto increase, going from 70% to 90% of MHR and thisrise was statistically significant when compared to thevalues seen at 45% MHR, but T3 and fT3 began todecrease and for T3 almost to the same level as wasseen at the 45% of the MHR (Fig. 2, Fig. 3, Table 2).
Discussion
Some studies performed on animals show thatthyroid hormones regulate the transcription of severalgenes expressed in skeletal muscle, such as the genecoding for Type I myosin heavy-chain (MHC), actinand the sarcoplasmic reticulum (SR) Ca21 ATPasepump [ 7, 8,11, 18 ]. Therefore, hypothyroidism andhyperthyroidism states might respectively reduce andincrease Ca
+2 uptakes by the SR [4, 5, 8]. As a result ofthe effects of thyroid hormones on MHC expressionand Ca+2 uptake mechanisms, the shortening velocityof skeletal muscles increases with increasing thyroidlevels [11]. On the other hand, the slow fibers exhibita greater sensitivity to thyroid hormones than the fast
Fig. 2.
Change in T4 and T3 values with exercise intensity Fig. 3. Change in Free T4 and Free T3 values with exercise intensity
Fig. 1.
Change in TSH values with exercise intensity
Neuroendocrinology Letters No.6 December Vol.26, 2005 Copyright © Neuroendocrinology Letters ISSN 0172–780X
Neuroendocrinology Letters - Psychoneuroimmunology, Chronobiology, Peer-reviewed journal
833
Exercise intensity and its effects on thyroid hormones
ones. Within physiological limits, increased thyroidactivity might be associated with a higher efficiency ofthe mechanical work performed by exercising muscles[9, 16].Peripheral metabolism of thyroid hormones can bechanged significantly by a number of physiological andpathological conditions, which can alter the deiodinationpathway and lead to a change in the circulatinglevel of thyroid hormones. The biological effects ofshort-term changes in the thyroid hormone levels arenot currently completely understood but are potentiallyimportant in the body’s adjustment to stressful orcatabolic states [17]. Compelling evidence also suggeststhat, if exercise-related energy expenditure exceedscalories consumed, a low T3 syndrome may be induced.In female athletes, four days of low energy availabilityreduced T3, fT3, increased rT3, and slightly increasedT4. Since an adequate amount of the prohormone T4was available throughout the study, an alteration in theperipheral metabolism of T4 was likely. The increase inrT3 and decrease in T3 are consistent with a decreasedactivity of hepatic 5’-deiodinase activity, since thisenzyme is responsible for the production of T3 and theclearance of rT3. These alterations in thyroid hormonescould be prevented solely by increasing dietary caloricconsumption without any alteration in the quantity orintensity of exercise [2, 15].While the role of a hypo caloric diet in producingalterations in thyroid hormones has been demonstratedin several studies, the role of exercise in thyroid hormonemetabolism is not very clear. A connection isestablished between increasing training to 80 km/weekand elevated hormone levels [10, 16]. In another studylooking at men with six months of endurance training,while T4 and free T4 concentrations reduced a little,no change in thyrotropin was observed [16]. Koistinen
et al
.’s study on unacclimatized top class skiers showedthat training at moderate altitude for 12 days resultedin a significant decrease in serum total T3 levels and anincrease in fT3 levels with no significant change in TSH,T4, fT4 and reverse T3 (rT3) [14]. Another study doneby Deligiannis et. al. looking at the thyroid hormoneresponse to swimming for 30 minutes at varying watertemperatures showed that TSH and fT4 levels weresignificantly increased at 20°C as compared to 32°Cbut no significant effect was seen on T3 [ 6 ]. Pakerinen
et. al
. study on the effects of one week of very intensestrength training on the thyroid hormones of maleweight lifters showed a significant decrease in TSH, T3and T4 with unchanged fT4, rT3 and thyroid bindingglobulin (TBG) [19]. Baylor et al revealed that overtrained athletes show an impaired hormonal responseto insulin -induced hypoglycemia with recovery after4 weeks of rest indicating a hypothalamic dysfunction[2]. In a different study, untrained subjects experiencedreductions in cortisol and rT3 and an increase in T3after exercise. However, trained subjects had an increasein cortisol and rT3 and a decrease in T3 with exercise.Concentration of T4 was unchanged in both groups[6,19]. The confounding results of thyroid hormonelevels seen following exercise might be mediated byelevated cortisol levels however; additional research isrequired to establish this connection.José L. et al., examined the thyroid hormone levelsof professional cyclists during a 3-week stage competition,they concluded that serum T4, FT4 and FT3 levelsshowed a significant increase by the last week of competitionwhile concentrations of TSH and T3 remainedunchanged [13].Zarzeczny R, et al., studied effects of thyroid hormonedeficit, and triodothyronine (T3) treatment on exerciseperformance, blood lactate (LA) concentrations and LAthreshold (TLA) were studied in trained and untrainedrats. They found that T3 treatment markedly increasesmaximal and submaximal LA levels. This shows somesimilarities with our studies results [23].This current study shows that as compared to thethyroid hormone values during low-intensity exercise(45% max. heart rate), there is an increase in TSHvalues at moderate intensity (70% max. heart rate) andhigh intensity exercise levels (90% max. heart rate). Anincrease then a decrease is seen in T3 and fT3 levels atmoderate and high intensity exercise conditions respectivelyand an increase in fT4 and T4 values in moderateintensity with continued increase at high intensitylevels. These results partially agree with Schmid et al
findings of continuous TSH increase until 15 minutesafter the end of a sub maximal exercise period with anunchanged or slightly decreased T3, rT3 and fT4 [21].A possible cause for the increase of TSH levels maybe due to pituitary secretion and may serve to fulfillthe exercise induced increase in peripheral need forthyroid hormones [12]. But it should be kept in mindthat in the current study all the observed changes arewithin the euthyroid levels and could be realized as aminor physiological response within normal levels. Asa conclusion it can be said that a rise in cell metabolismand changes in the internal medium of the organismserves to change the thyroid hormone levels. Thyroidfunction depends to a certain degree on the exerciseintensity and perhaps to other factors such as specificcharacteristics of the athletes.
REFERENCES1 ACSM’s American College of Sports Medicine. The recommendedquantitiy and quality of exercise for developing and maintainingcardiorespiratory and muscular fitness in healthy adults. Med SciSports Exerc 1990;
22: 265–274.2 Baylor LS, Hackney AC. Resting thyroid and leptin hormonechanges in women following intense, prolonged exercise training.Eur J Appl Physiol 2003;884–5):480–4.3 Bogaard JM, Bush HFM, Sholte HR, Stam H, Versprille A. Exerciseresponses in patients with an enzyme deficiency in the mitochondrialrespiratory chain. J Eur Respir 1988; 1:445– 452.4 Caiozzo VJ, Herrick RE, and Baldwin KM. The influence of hyperthyroidismon the maximal shortening velocity and myosin isform distribution in slow and fast skeletal muscles. Am J Physiol1991; 261:285–C295.5 Caiozzo VJ, Swoap S, Tao M, Menzel D, and Baldwin KM. Single fiberanalyses of type IIA myosin heavy chain distribution in hyperand hypothyroid soleus. Am J Physiol 1993; 265: 842–C850.6 Deligiannis A, Karamouzis M, Koudidi E, Mougious V, Kallaras C.Plasma TSH, T3, T4 and cortisol responses to swimming at varyingwater temperatures. Br J Sports Med 1993; 27:247–50.
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Neuroendocrinology Letters No.6 December Vol.26, 2005 Copyright © Neuroendocrinology Letters ISSN 0172–780X Neuroendocrinology Letters - Psychoneuroimmunology, Chronobiology, Peer-reviewed journal
Figen Ciloglu, Ismail Peker, Aysel Pehlivan, Kursat Karacabey Nevin İlhan, Ozcan Saygin & Recep Ozmerdivenli
7 Edwards JG, Bahl JJ, Flink IL, Cheng YS, and Morkin E. Thyroidhormone influences beta myosin heavy chain (beta MHC) expression.Biochem Biophys Res Commun 1994;
199:1482–1488.8 Farnburg BL. Calcium transport by skeletal muscle sarcoplasmicreticulum in the hypothyroid rat. J Clin Invest 1968; 47:2499–2506.9 Gullu S, Altuntas F, Dincer I, Erol C, Kamel N. Effects of TSH-suppressivetherapy on cardiac morphology and function: beneficialeffects of the addition of beta-blockade on diastolic dysfunction.Eur J Endocrinol 2004; 150:655–61.10 Hackney AC, McMurray RG, Judelson DA, Harrell JS.. Relationshipbetween caloric intake, body composition, and physical activityto leptin, thyroid hormones, and cortisol in adolescents. Jpn. JPhysiol. 2003; 53:475–9.11 Hartong RN, Wang R, Kurokawa R, Lazare MA, Glass CK, AprilettiJW, and Dill WH. Delineation of three different thyroid hormoneresponseelements in promoter of rat sarcoplasmic reticulumCa21 ATPase gene. J Biol Chem 1994; 269:13021–13029.12 Huang WS, Yu MD, Lee MS, Cheng CY, Yang SP, Chin HM, Wu SY.
Effect of treadmill exercise on circulating thyroid hormone measurements.Med Princ Pract. 2004;
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14 Loucks AB, Heath EM. Induction of low-T3 syndrome in exercisingwomen occurs at a threshold of energy availability. Am JPhysiol 1994;
266: 817–R823.15 Lucia A, Hoyos J, Perez M, Chicharro JL.Thyroid Hormones mayinfluence the slow component of VO2 in professional cyclists.Japanese Journal of Physiology 2001; 51:239–242.16 Miller RG, Boska MD, Moussavi RS, Carson PJ, Weiner MW. Nuclearmagnetic resonance studies of high energy phosphates and pHin human muscle fatigue. Comparison of aerobic and anaerobicexercise. J Clin Invest 1988; 81:1190–1196.17 Muscat GE, Griggs R, Downes M, and Emery J. Characterizationof the thyroid hormone response element in the skeletal alphaactingene: negative regulation of T3 receptor binding of thethyroid hormone response element in the skeletal alpha-actingene: negative regulation of T3 receptor binding by the retinoidX receptor. Nucleic Acids Res 1994; 22: 583–591.18 Pakarinen A, Hakkinen K, Alen M. Serum thyroid hormones, thyrotropinand thyroxin binding globulin in elite athletes duringvery intense strength training in of one week. J Sports Med PhysFitness 1991 ;31:142–6.19 Rosolowska-Huszcz D. The effect of exercise training intensity onthyroid activity at rest. J Physiol Pharmacol. 1998; 49:457–66.20 Simsch C, Lormes W, Petersen KG, Baur S, Liu Y, Hackney AC,Lehmann M, Steinacker JM. Training intensity influences leptinand thyroid hormones in highly trained rowers. Int J Sports Med2002; 23:422–7.21 Sterling K, Lazzarus JH, Milck PO, Sakurada T, Brenner MA. Mitochondrialthyroid hormone receptor: localization and physiologicalsignificance. Science 1978; 201:1126–1129.22 Zarzeczny R, Pilis W, Langfort J, Kaciuba-Uscilko H, NazarK.Influence of thyroid hormones on exercise tolerance and lactate
threshold in rats. J Physiol Pharmacol 1996; 47:503–13.
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