Why Muhammad Ali Couldn’t Sting Like A Bee

A patient of mine recently asked, “Why can’t you prescribe thyroid hormone to help me lose weight?” It wasn’t the first time I’d heard this question. In the past I always asked these patients whether they thought it was safer to drive at the normal 100 kilometers an hour (60 miles an hour) or faster. But now I’m going to ask them, “Why don’t you ask Muhammad Ali whether it’s a good idea?”

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The thyroid sits like a bow tie, just below the Adam’s apple in the neck. Its purpose is to extract iodine from the blood to produce the principle thyroid hormone, thyroxin. Thyroxin acts like the accelerator on a car. Normally it’s in cruise control going along at a constant speed, resulting in a normal metabolic rate. It’s like Muhammad Ali when he was in top form. He said he was, “Pretty like a butterfly and stinging like a bee”. But the thyroid can accelerate causing hyperthyroidism with a too-speedy metabolic rate. And if, on the other hand, too little thyroxin is manufactured (hypothyroidism) the body slows down. Patients who suffer from the “Hyper” type may complain of a rapid heart rate, palpitations, hand tremor, agitation and difficulty tolerating hot weather. This requires either medication, radioactive iodine or surgery to get the gland back into cruising mode. Today more patients suffer from the “Hypo” type. In this case, a lack of thyroxin causes a low metabolic rate with decreased rate of oxygen consumption and the result is less energy production. Hypothyroidism occurs at any age, but is more common after 50 and strikes women 5 to 10 times more often than men. Studies show that about 10 percent of the elderly suffer from the hypo type. And in some severe cases this deficiency can mimic senility. The majority of cases of underactive thyroid are due to what’s known as “Hashimoto’s thyroiditis”. It’s a disorder in which the body’s immune system attacks itself, like a plane dropping bombs on its own soldiers. The result is an inflammatory process that progressively destroys the thyroid. Other cases of hypothyroidism may occur after thyroid surgery when too much of the gland has been removed to treat hyperthyroidism. Or following treatment with radioactive iodine for the same purpose. A report from Harvard says that people who are left- handed and prematurely gray are also more likely to develop this problem. (That’s me!) The gold standard for diagnosing either an underactive or overactive gland is the TSH (thyroid stimulating hormone) test, a hormone secreted by the pituitary gland. A low TSH indicates you’re cruising too fast and high FSH means you’re in the slow lane. Patients suffering from hypothyroidism often complain of fatigue, depression, constipation, loss of hair, feeling cold and unexplained weight gain. Nor can they, “Sting like a bee”. No astute manager would ever send his boxer into the ring suffering from these problems. But according to the New York Times newspaper in 1980, Muhammad Ali was prescribed thyroid hormone while training for a fight with Larry Holmes. Doctors had allegedly misdiagnosed a thyroid problem. Then, to make matters worse, had increased the dose of thyroid. During the fight Muhammad Ali appeared to be disoriented, and he lost the next-to-last fight of his career. “Bad idea with thyroid pills”, Ali told the New York Times a year later. “Started training at 253, went down to 217 for the fight. Too much.. People were saying ‘Oooh, isn’t he pretty?’ But I was too weak, didn’t feel like dancing. I was dazed. I was in a dream.” The Times report doesn’t say if Ali was hypothyroid, but possibly he was prescribed thyroid medication to lose weight. Both Dr. Jeffrey R. Barger, Professor at The Harvard Medical School, and Muhammad Ali would warn about the use of thyroxin if the TSH test is normal. Too much thyroxin can cause heart problems, osteoporosis and if you lose weight much of the loss is protein. Moreover, perking up the metabolism can also perk up the appetite. So it’s much better to stay in cruising speed if everything is normal. After all, we may not be pretty like a butterfly, but we all like to sting like a bee.