Nutrition strategy for Performance

Endurance athletes require a unique approach to nutrition to sustain their performance, support recovery, and maintain overall health. Here are the top 10 nutrition tips that can help endurance athletes fuel their bodies effectively:

1. Prioritize Carbohydrates

Carbohydrates are essential for endurance athletes, providing both complex and simple carbs for sustained and immediate energy.

Complex Carbs: These include whole grains, fruits, vegetables, and legumes. They provide a steady release of energy and should form the base of your diet.

Simple Carbs: These are found in foods like fruits, honey, and sports drinks. They provide quick energy and are ideal during and immediately after exercise.

Daily Intake:

• Aim for 6-10 grams of carbohydrates per kilogram of body weight daily, depending on your training intensity.

Pre-Training:

• Consume a meal with 1-4 grams of carbs per kilogram of body weight 3-4 hours before training.
• Examples: oatmeal with fruit, a turkey sandwich on whole grain bread.

Intra-Training:

• For sessions lasting more than an hour, consume 30-60 grams of simple carbs per hour.
• Examples: sports drinks, gels, bananas.

Post-Training:

• Within 30 minutes of finishing, consume 1-1.2 grams of carbs per kilogram of body weight.
• Examples: a recovery shake with fruit, a sweet potato with chicken.

By combining complex and simple carbs effectively, you can ensure sustained energy levels and optimal recovery for your endurance activities.

2. Balance Macronutrients

While carbs are essential, it’s important to balance your intake with adequate protein and fats. Proteins aid in muscle repair and recovery, while healthy fats provide a sustained energy source. Include lean proteins like chicken, fish, beans, and healthy fats from avocados, nuts, and seeds.

Daily Intake:

• Protein: 1.2-2.0g/kg of body weight per day.
• Healthy fats: 0.8-1.2g/kg of body weight per day.

3. Stay Hydrated

Hydration is key for endurance athletes. Dehydration can significantly impair performance. Ensure you’re drinking water consistently throughout the day and during training sessions. For longer events, consider electrolyte solutions to replace lost minerals.

Daily Hydration:

• Aim for at least 3 liters (about 13 cups) of fluid per day for men and 2.2 liters (about 9 cups) for women. These amounts can vary depending on your body size, activity level, and environmental conditions.

During Exercise:

• Drink 500-750 ml (about 17-25 ounces) of fluid 2-3 hours before exercise.
• Consume 200-300 ml (7-10 ounces) every 20 minutes during exercise.

Post-Exercise:

• Rehydrate with 1.5 liters (about 50 ounces) of fluid for every kilogram of body weight lost during exercise.

Electrolyte Needs:

• For activities longer than an hour, replenish electrolytes, especially sodium, potassium, and magnesium, to prevent cramps and maintain performance. Sports drinks, electrolyte tablets, and foods like bananas and salted pretzels can help.

Combining these hydration strategies with electrolyte replenishment will help maintain performance and prevent dehydration-related issues during endurance activities.

4. Timing Your Nutrition

When you eat is just as important as what you eat. Aim for a balanced meal 2-3 hours before training, including carbs, protein, and fats. During exercise, consume easily digestible carbs like sports drinks or gels to maintain energy levels. Post-exercise, prioritize protein and carbs to replenish glycogen stores and support muscle recovery.

5. Incorporate Recovery Foods

Post-workout nutrition is crucial for endurance athletes to replenish glycogen stores, repair muscles, and reduce muscle soreness. Here are some key considerations and recommendations:

Carbohydrates:

• Consuming carbs within 30 minutes post-exercise helps replenish glycogen stores. Aim for 1-1.2 grams of carbs per kilogram of body weight.
• Examples: recovery shake with a banana, a bowl of oatmeal with berries, or a sweet potato with a small amount of honey.

Protein:

• Protein is vital for muscle repair and growth. Combine protein with carbs for optimal recovery.
• Aim for 20-30 grams of high-quality protein post-workout.
• Examples: Greek yogurt with fruit, a turkey sandwich on whole grain bread, or a protein shake.

Fats:

• While fats are not as critical immediately post-workout, including some healthy fats can support overall recovery.
• Examples: a handful of nuts, avocado slices, or a drizzle of olive oil on a salad.

Hydration and Electrolytes:

• Rehydrate with water or an electrolyte drink, especially after intense or long-duration exercise.
• Examples: coconut water, sports drinks, or water with a pinch of salt and a squeeze of lemon.

Sample Post-Workout Recovery Meals:

1. Greek Yogurt Parfait:
   • Greek yogurt, mixed berries, a drizzle of honey, and a sprinkle of granola.
   • Provides a balance of carbs, protein, and some fats.
2. Protein Smoothie:
   • Blend protein powder, a banana, a handful of spinach, and almond milk.
   • Quick and easy to digest, offering a good mix of carbs and protein.
3. Chicken and Sweet Potato:
   • Grilled chicken breast, roasted sweet potato, and a side of steamed vegetables.
   • A hearty meal for more substantial recovery needs.
4. Hummus and Whole Grain Pita:
   • Hummus with whole grain pita slices and a side of carrot sticks.
   • Offers a mix of protein, carbs, and healthy fats.
5. Turkey and Avocado Sandwich:
   • Whole grain bread, sliced turkey breast, avocado, and spinach leaves.
   • Balanced with carbs, protein, and healthy fats.

6. Monitor Micronutrients

Endurance athletes often need higher levels of certain vitamins and minerals, such as iron, calcium, vitamin D, and magnesium. Include a variety of fruits, vegetables, nuts, and seeds in your diet to ensure you’re meeting these needs. Consider a multivitamin if necessary.

Getting regular blood work can be beneficial, especially if you are a seasoned endurance athlete. Key biomarkers for performance include iron levels, vitamin D, and magnesium.

7. Experiment with Fueling Strategies

Every athlete is different, so it’s essential to find what works best for you. Experiment with different foods, drinks, and timing strategies during training to determine what fuels you best without causing gastrointestinal distress.

Experimenting with fueling strategies could mean trying different gels or determining if you benefit from caffeine before training. While there are general guidelines for endurance athletes, it’s important to consider your individual needs and responses.

8. Plan Your Meals and Snacks

Having a nutrition plan can help you stay on track. Plan your meals and snacks ahead of time to ensure you’re getting the right balance of nutrients. This can help prevent last-minute unhealthy choices and ensure you have the energy needed for training.

With your increased calorie needs, it is important to stay fueled or keep snacks on hand if you are in a pinch.

9. Listen to Your Body

Pay attention to how your body responds to different foods and adjust accordingly. If you’re feeling fatigued, it might be a sign that you need more carbs. If you’re not recovering well, you might need more protein. Learning to listen to your body’s signals is crucial for optimizing your nutrition.

Your body will tell you what you need during your training. Ignoring these signs can increase the risk of injury or low energy availability.

10. Seek Professional Guidance

Consider consulting with a sports dietitian or nutritionist who specializes in working with endurance athletes. They can provide personalized advice and help you develop a nutrition plan tailored to your specific needs and goals. Seek guidance if you are experiencing issues such as:

• Feeling chronically tired
• Poor performance
• Stomach issues
• Poor recovery

Takeaways

Optimal nutrition is a game-changer for endurance athletes. By prioritizing carbohydrates, balancing macronutrients, staying hydrated, and timing your nutrition correctly, you can enhance your performance and recovery. Remember to listen to your body and seek professional guidance when needed. With these tips, you’ll be well on your way to achieving your endurance goals.

If you think you may need to speak with a sports dietitian, check out our services at Stephanie Small Coaching.

Boosting Performance with Sports Nutrition

Welcome to the Ultimate Guide to Endurance Supplements for Runners, a comprehensive resource designed to enhance your performance through the power of sports nutrition. Whether you’re a seasoned marathoner or a beginner eager to improve your stamina, understanding the synergy between running and nutrition is key. This guide dives into essential supplements that can boost your endurance, ensuring that every step takes you closer to your goals. Discover how to fuel your body effectively, optimize recovery, and elevate your running experience with targeted nutritional support.

Understanding the Basics of Sports Nutrition for Runners

In the realm of endurance running, grasping the basics of sports nutrition is not just beneficial—it’s essential(1). The foundation of a runner’s diet rests on macronutrients: carbohydrates, proteins, and fats, each playing a unique role in fueling the body. Carbohydrates are the primary source of energy, crucial for sustaining long-distance efforts. They stockpile as glycogen in muscles and the liver, ready to be tapped into when your body demands that extra burst of energy. Proteins, on the other hand, are the building blocks of muscle repair and growth. After miles of pavement pounding, it’s protein that helps repair the micro-tears in muscle fibers, fostering recovery and strengthening endurance. Fats, often underrated in the athlete’s diet, serve as a vital energy source for longer, moderate-to-low intensity runs and support the absorption of essential vitamins.

But the role of micronutrients—vitamins and minerals—cannot be overstated. Iron, for instance, is pivotal for oxygen transport in the blood, directly impacting endurance performance. Magnesium plays a key role in muscle function and energy production, while calcium supports bone health, crucial for runners pounding the pavement day in and day out. Equally important is hydration; water and electrolytes work in tandem to maintain fluid balance, nerve function, and muscle contractions. Electrolytes like sodium, potassium, and magnesium become even more critical during long runs or in hot weather when sweat losses increase.

Understanding sports nutrition for runners means more than just knowing what to eat; it’s about mastering the timing and balance of these nutrients to optimize performance and recovery. This holistic approach ensures that every meal, snack, or supplement not only fuels the immediate needs of running but also contributes to the long-term health and success of the runner. As we dive deeper into the world of endurance supplements, remember that these are the bricks and mortar of the formidable edifice that is a runner’s body, providing the energy, strength, and resilience needed to tackle every mile ahead.

Top Endurance Supplements for Runners

Electrolyte Replenishers

With the long miles, especially as you head into warmer weather electrolytes become critical to maintain hydration and muscle function. As little as 2% dehdyration results in reduce performance and cognitive function (2). Electrolytes – sodium, chloride, and potassium – play a large in maintain hydrations status. You can consume all the water you want, but in order for that water to stay in the body and within specific tissues, it has to be around electrolytes. For every 1 L you sweat, you are losing about 1000mg of sodium – the most abundant electrolyte (3).

Depending on if you are a heavy or salty sweater can dictate how many electrolytes you may need, but here are some standard electrolytes based on sweat rate:

Moderate sweaters- Products to replenish electrolytes for moderate training/average sweat rates:

• Nuun Sport
• Drip Drop
• Thorne Catalyte
• Vegasport Hydrator

Heavy sweaters – Products with high amounts of sodium:

• The Right Stuff
• Gatorlytes
• LMNT
• Liquid IV

Carbohydrate Gels and Supplements

As an endurance athlete, you ultimate form of fuel is going to be carbohydrates (4). While you don’t have to use carbohydrate supplements and opt for whole foods, sometimes supplements can come in handy due to convenience and for those with sensitive stomachs.

When you are on a run or bike that lasts 90 minutes to 4 hrs, you need to aim for 30-60g of carbohydrates per hour to sustain muscle glycogen stores. However, when your training starts to exceed 4 hrs, you need to aim for 60-90g (if not more) of multiple transportable carbohydrates (4). 

Some of my carbohydrate recommendations include:

• Gu (classic)
• Huma (good for sensitive stomachs)
• Maurten (high cost, but they have a high quality product)
• Endurance Tap (simple and locally made)
• Precision Nutrition and Hydration
• Science in Sport (prefer the thinner texture)

Protein Powders

Protein powders are not required but due to the high demand of endurance athletes, sometimes they might help. Adding protein powders to yogurts, oatmeal, smoothies, pancakes, and more, can really help with boosting protein intake. Endurance athletes are now recommended to have between 1.7-2.2g/kg of body weight of protein (5). The use of a supplement should not be relied upon, but rather help athletes meet high demands. 

Creatine Monohydrate

Creatine is an amino acid that is vital for producing adenosine triphosphate (ATP, aka the body’s energy currency), the primary energy source for muscle contractions (6). It’s a naturally occurring compound found in small amounts within meat and fish. We would need to consume 12 lbs of red meat to saturate stores in the muscle, which makes supplementation a preferred option for most.

The main reason for supplementing with creatine is to saturate your muscle stores and free-creatine levels. This saturation is not possible through diet alone or is extremely unlikely (6). By supplementing with creatine, endurance athletes can enhance ATP production and improve exercise performance.

Typically recommendation is to consume 3-5g per day to saturate stores within a 3-4 week period. Some minor side effects include water retention and gastrointestinal distress. As always, consult with a sports dietitian to see if a supplement with creatine is a benefit to you. 

Iron and Vitamin Supplements

Supplementing with vitamins and minerals such as iron and Vitamin D has become quite popular in recent years. However, I caution over supplementing. For example, iron and Vitamin D can have too much of causing more harm than good. 

It is only recommended to supplement micronutrients when there is a deficiency present. Most, not all, can be determined with a blood test. This is where working alongside a physician and dietitian can be beneficial to see if you are defiant. Then if supplementation is warranted or if it can be accomplished through food first. 

How to Choose the Right Supplements for Your Running Goals

Navigating the dietary supplement industry can be daunting due to its vast array of types, brands, and claims, coupled with a regulatory environment that does not always guarantee product integrity. While supplements are not essential for everyone, certain groups—like those with nutrient deficiencies, pregnant or breastfeeding women, and athletes—may benefit from targeted supplementation. However, caution is advised to avoid over-dosage and potential interactions with medications, highlighting the necessity of consulting healthcare professionals for personalized advice. By adhering to the steps for verifying supplement safety, efficacy, and quality, consumers can make informed choices, ensuring they invest in products that truly enhance their health without unnecessary risks. Refer to my previous blog post on how to choose safe supplements: How To Choose Supplements

Incorporating Supplements into Your Training Regimen

Successfully integrating supplements into your training regimen requires more than just selecting the right enhancers; it demands a thoughtful strategy that aligns with your dietary habits, training goals, and the unique demands of your body. Begin by understanding the synergistic relationship between your diet and supplements. Supplements are not meant to replace whole foods but to complement your nutrition plan, filling in gaps and providing targeted support where needed. For instance, electrolyte supplements can be crucial during long runs or in hot conditions, while protein powders can aid in recovery after intensive training sessions.

Timing is another critical aspect to consider. Certain supplements are more effective when taken at specific times. For example, consuming a carbohydrate-rich energy gel during a long run can provide a timely energy boost, while taking protein immediately after a workout can optimize muscle repair.

Moreover, it’s vital to pay attention to dosage. More is not always better when it comes to supplementation. Adhering to recommended dosages ensures that you reap the benefits without risking negative side effects or interactions. Consulting with a healthcare provider or a sports nutritionist can provide personalized advice and ensure that your supplement regimen is safe and effective.

Lastly, consider the quality and purity of the supplements you choose. The market is flooded with countless products, each promising to enhance performance and recovery. Opt for supplements that are third-party tested and certified by reputable organizations. This guarantees that they are free from banned substances and meet high standards of quality and safety.

Incorporating supplements into your training regimen is a dynamic process that requires ongoing evaluation and adjustment. As your training demands, goals, or body responses change, so too might your nutritional needs. Staying informed, listening to your body, and possibly consulting with nutrition experts are key steps in ensuring that your supplementation strategy remains aligned with your overall training goals, contributing to improved performance, recovery, and health.

Take-A-Ways

This guide is brief and not all-encompassing, so always consult with a professional. In the quest for enhanced running endurance, integrating the right supplements into your sports nutrition plan can make a significant difference. From electrolyte replenishers to energy gels and amino acids, the choices are plentiful but require thoughtful consideration. Remember, the ultimate goal is to support your body’s needs, improve performance, and achieve your running milestones safely. Embrace the journey of discovering what works best for you, and let your passion for running be fueled by informed nutritional choices. Run longer, stronger, and with the confidence that comes from powering your body with the best that sports nutrition has to offer.

If you are unsure what type of supplement routine you need, you can schedule 1-on-1 consultation to get your customized supplement protocol. Schedule a 1-on-1 consultation for a supplement protocol here ($175 for 60 min session).

Get 20% off supplements through Fullscripts: Click here for 20% off supplements

If you have any questions or concerns, please reach out. Contact Stephanie Here.

References

1. Vitale K, Getzin A. Nutrition and Supplement Update for the Endurance Athlete: Review and Recommendations. Nutrients. 2019 Jun 7;11(6):1289. doi: 10.3390/nu11061289. PMID: 31181616; PMCID: PMC6628334.
2. Armstrong LE. Rehydration during Endurance Exercise: Challenges, Research, Options, Methods. Nutrients. 2021 Mar 9;13(3):887. doi: 10.3390/nu13030887. PMID: 33803421; PMCID: PMC8001428.
3. Veniamakis E, Kaplanis G, Voulgaris P, Nikolaidis PT. Effects of Sodium Intake on Health and Performance in Endurance and Ultra-Endurance Sports. Int J Environ Res Public Health. 2022 Mar 19;19(6):3651. doi: 10.3390/ijerph19063651. PMID: 35329337; PMCID: PMC8955583.
4. Jeukendrup AE. Carbohydrate intake during exercise and performance. Nutrition. 2004 Jul-Aug;20(7-8):669-77. doi: 10.1016/j.nut.2004.04.017. PMID: 15212750.
5. Jäger R, Kerksick CM, Campbell BI, Cribb PJ, Wells SD, Skwiat TM, Purpura M, Ziegenfuss TN, Ferrando AA, Arent SM, Smith-Ryan AE, Stout JR, Arciero PJ, Ormsbee MJ, Taylor LW, Wilborn CD, Kalman DS, Kreider RB, Willoughby DS, Hoffman JR, Krzykowski JL, Antonio J. International Society of Sports Nutrition Position Stand: protein and exercise. J Int Soc Sports Nutr. 2017 Jun 20;14:20. doi: 10.1186/s12970-017-0177-8. PMID: 28642676; PMCID: PMC5477153.
6. Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017 Jun 13;14:18. doi: 10.1186/s12970-017-0173-z. PMID: 28615996; PMCID: PMC5469049.

Dietary supplements are products that are used to supplements nutrients that we may not get in our daily diet.

The industry is filled with hundreds of supplement types and brands with several potential claims and benefits.

However, the supplement industry is not tightly regulated in some regards, increasing the chances of having a product that is not true to the labels.

It is crucial that you, as a consumer, how to determine which supplements may or may not be safe.

This guide will show you how to choose the highest quality and safest supplement brands, from protein powders to vitamins!

Who Needs Supplements?

Supplements are not inherently necessary or required to be live a healthy lifestyle. As all the required nutrients can be obtained through consuming a balanced and varied diet.

However, in some cases, supplements may be indicated due to increased nutritional needs or increased risk of nutrient deficiency such as (1):

• Those adults or children currently diagnosed with a nutrient deficiency
• Pregnant or breastfeeding women
• Individuals with diagnoses that cause malabsorption
• Disruption of the GI tract
• Inability to meet needs through diet
• Increased dietary needs such as athletes
• Dietary patterns or lifestyles that remove food groups

If you have concerns about consuming adequate nutrients, you must speak with a health care provider to ensure that supplementations are the best option for you.

Regulation of Supplements

Federal law does not require dietary supplements to be deemed safe or checked for quality by the Food and Drug Administration (FDA) (2).

The FDA instead monitors supplement companies’ advertisements and safety monitoring after the supplement enters the market. The FDA ensures that the claims of a dietary supplement are not branded as a cure, mitigation, treatment, or prevention of disease. Additionally, if any harmful side-effects occur, they are to be reported to the FDA (2).

However, companies can opt-in for third-party testing to ensure the quality of the product is what is intended on the label and contains no other harmful chemicals such as lead. Which can occur unknowingly by a company if ingredients are not purchased within the U.S. or are made with bad manufacturing processes.

Third-Party Testing

Third-party testing is not required by federal law before a supplement is sold.

Third-party testing is a voluntary commitment that a company chooses and pays to have their products undergo testing to ensure the ingredients of their products are of quality and are safe.

Third-party testing companies include

• NSF
• USP
• Informed choice
• Banned Substance control group
• Consumer Lab

Additionally, if you are an athlete, products that are NSF Certified for Sport or Informed Choice-Sport ensure that the products are free of the banned substances prohibited by sports organizations.

Third-party testing by these companies includes testing for one or more of the following (3,4):

1. Low-risk manufacturing (i.e. cross-contamination preventions, raw material assessments)
2. Contamination of the manufactured product
3. Supplements contain the ingredients presented on the label
4. All of the ingredients are presented on the label.

To obtain the third-party testing label on the supplement, each batch must be tested with additional regular blind testing. If a batch is not tested, then the third-party testing company label will not be presented on the individual label.

Ingredient Efficacy and Safety

Most supplements contain ingredients that are commonly found in foods, but this does not mean that there are additional concerns.

Over-Dosing

There is such thing as too much of a good thing. Your fat-soluble vitamins A, D, and E are stored within the fat cell, which can allow for excessive storage that results in a toxicity risk (5).

On the other hand, water-soluble vitamins are excreted when stores are full, but overdosing has the potential to result in digestive upset or liver damage (6).

This does not even include dietary supplement ingredients that have not been tested for such over-dosing effects.

If you choose to take a supplement, check what the recommended dosage is, if you are deficient, and if there is any toxicity risk related to the ingredients.

Side-Effects

Most minerals and vitamins won’t cause direct side effects. However, it is important to identify if there are any potential interactions with current medications. A common example of this is that Vit E can increase the risk of bleeding (7), so if an individual is on blood thinners this could thin the blood excessively causing harm.  

Additionally, other supplements such as caffeine can have negative side effects. Some supplements contain extremely high dosages of caffeine that can result in anxiety, elevated heart rate, or even heart palpitations (8).

Brain-boosting herbs and super-foods are increasing in popularity. Some herbs such as lion’s mane can cause headaches, dizziness, and other negative side effects (9).

Everyone responds to supplements differently. Be cautious of the potential side effects of the ingredients in a new dietary supplement.

Efficacy

Ensure that the efficacy of a dietary supplement is beneficial. If not, then the supplement could be a waste of money.

For example, creatine is recommended to be taken at 5g per day to see beneficial effects, so consuming a creatine supplement that only provides 1g may not be worth the money (10).

Additionally, a company cannot claim that a product cures, treats, or reduced the risk of a disease or condition UNLESS the claims are backed by research (2).

How To Choose A Supplement Brand?

Millions of consumers purchase supplements, it is a multi-billion-dollar industry. Most people are left unharmed. However, companies have been found to have harmful substances in their products, undeclared ingredients that could cause harm, and bogus supplements from unethical companies.

Before you purchase your next supplements, follow these steps to ensure you are staying safe, choosing high-quality products, and not wasting your money.

1. Check the ingredients for safety and efficacy – utilize credible sources, research articles, and try to avoid biased information.
2. Check the supplement company for third-party testing – check the label or website for the logos of third-party testing companies.
3. Check the supplement company for any current lawsuits or notices by the FDA – this can be done by a quick google search.
4. Check with a credible health professional to determine if the supplement would benefit you (i.e. a population in need or deficiency is present).

At the end of the day, when shopping for dietary supplements, do your due diligence to protect yourself from harmful substances.

If you want to stay up to date on the most recent research, check out Examine.com where experts provide detailed summaries on the most up-to-date literature.

References:

1. Ward, Elizabeth. “Addressing nutritional gaps with multivitamin and mineral supplements.” Nutrition journal vol. 13 72. 15 Jul. 2014, doi:10.1186/1475-2891-13-72
2. Food and Drug Administration Web site. https://www.fda.gov/consumers/consumer-updates/fda-101-dietary-supplements. Accessed Jan 2022.
3. NSF Web site. “What is Third-Party Certification?”. https://www.nsf.org/knowledge-library/what-is-third-party-certification. Accessed Jan 2022.
4. Informed Sports Supplement Certification Web site. “Informed-Sport Certification Process.” https://sport.wetestyoutrust.com/about/certification-process. Accessed Jan 2022.
5. Capone K, Sentongo T. The ABCs of Nutrient Deficiencies and Toxicities. Pediatr Ann. 2019 Nov 1;48(11):e434-e440. doi: 10.3928/19382359-20191015-01. PMID: 31710362.
6. Hamishehkar, Hadi et al. “Vitamins, Are They Safe?.” Advanced pharmaceutical bulletin vol. 6,4 (2016): 467-477. doi:10.15171/apb.2016.061
7. Owen KN, Dewald O. Vitamin E Toxicity. 2021 Nov 14. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 33232043.
8. Guest NS, VanDusseldorp TA, Nelson MT, Grgic J, Schoenfeld BJ, Jenkins NDM, Arent SM, Antonio J, Stout JR, Trexler ET, Smith-Ryan AE, Goldstein ER, Kalman DS, Campbell BI. International society of sports nutrition position stand: caffeine and exercise performance. J Int Soc Sports Nutr. 2021 Jan 2;18(1):1. doi: 10.1186/s12970-020-00383-4. PMID: 33388079; PMCID: PMC7777221.
9. Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017 Jun 13;14:18. doi: 10.1186/s12970-017-0173-z. PMID: 28615996; PMCID: PMC5469049.
10. I-Chen Li, et al. Neurohealth Properties of Hericium erinaceus Mycelia Enriched with Erinacines. Neurol. 2018; 2018. doi:10.1155/2018/5802634

Your thyroid creates hormones that play a variety of different roles within the body. The thyroid can create too much or too little hormones  resulting in thyroid disease such as hyperthyroidism, hypothyroidism, thyroiditis, and Hashimoto’s disease.

What is the thyroid?

The thyroid is a small gland located at the front of the neck, right above the collar bone. It wraps around the windpipe (trachea) in the shape of a butterfly. You have glands throughout your body that talk to each other via hormones. The hormones that the thyroid is responsible for play a huge role in the metabolism. That is why most people with low thyroid hormone typically have less energy.

The thyroid produces two specific hormones – T4 (thyroxine) and T3 (triiodothyronine). These two hormones are regulated by the pituitary gland. The pituitary gland releases a hormone call thyroid stimulating hormone or TSH, like the name it does just that. When the pituitary gland senses low thyroid hormones, it will send an amount of TSH to tell the thyroid to make more. The glands work in tandem to ensure proper hormones are produced. But sometimes that process goes a little haywire.  

Thyroid Disease

Thyroid disease is an umbrella term for a medical condition that results in abnormal hormone levels. Two of the most common thyroid diseases are:

1. Hyperthyroidism – the thyroid makes too much hormone resulting in using energy too quickly. Symptoms are fatigue, muscle weakness, rapid heartbeat, weight loss, nervousness.
2. Hypothyroidism – the thyroid doesn’t make enough hormone. So you lack energy, feel tired, inability to tolerate the cold, and weight gain.

These disorders can be secondary to a primary disease such as Hashimoto’s or Grave’s disease or simply be genetic. Thyroid disease can affect anyone, sometimes it presents itself early on or later in life. It is important to know how it is diagnosed and what the symptoms are.

How is thyroid disease diagnosed?

Primary tests include blood test, imaging of the thyroid, and physical signs & palpation. Imaging can determine textures, lumps, or defects that can be indicative of a thyroid disease. Physical signs and symptoms can be generic but sometimes can be predicted by the way they present themselves. A physician may manually feel the thyroid to detect lumps or enlargement. The most definitive test is blood work to identify that there is something wrong and their needs to be additional testing.

Thyroid panel may include some or all the following.

• Thyroid stimulating hormone (TSH): If TSH level are abnormal, then there is a problem with the feedback loop that TSH has on the thyroid hormones. For example, in hypothyroidism, a person will have elevated TSH to encourage the thyroid to produce more hormones and vice versa for hyperthyroidism. Normal levels: 0.40-4.50 mIU/mL
• Thyroxine (T4): T4 is the inactive form of the thyroid hormone and most tested. T4 is directly triggered by TSH. Low T4 is related to hypothyroidism and high T4 is related to hyperthyroidism. Normal range: 5.0-11.0 ug/dL
• Free T4: a method of measuring unbound T4 which could prevent accurate measurements. Normal range: 0.9-1.7 ng/dL
• Triiodothyronine T3: This can further detect the severity of hyperthyroidism and hypothyroidism. T3 is the active form. Normal Range: 100-200ng/dL
• Free T3: a method of measuring unbound T4 which could prevent accurate measurements. Normal range: 2.3-4.1 pg/dL

Additional blood test:

• Thyroid antibodies: these are used to identify autoimmune disorders of the thyroid. High antibodies indicate the body is attaching the thyroid.
• Thyroglobulin: indicative of inflammation of the thyroid and used to determine thyroiditis and thyroid cancer.

Recommendations to Maintain Healthy Thyroid

There are no specific recommendations in order to maintain a healthy thyroid outside of general health recommendations. You still want to eat a variety of fruits, vegetables, nuts, and whole-grain food. Consume lean protein and healthy fats. The root cause of thyroid disorders are either genetic or there are some studies that suggest things like metal toxicity, poor diet, etc. Nothing is definitive.

But something I do recommend is getting a baseline of your thyroid levels when you are healthy. Even though there are normal ranges, there is the consideration that something may be high or low for you but still within normal range. It is important to have an understanding of your normal so that when start to feel off, you can potentially identify the problem despite values being in normal ranges.