Medical Forum
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Question
Posted : February 6, 2009
I have Addison's and Hashimoto's (autoimmune hypothyroidism), and I have the PADI OWD certification.
Besides taking adequate doses of my medicines, of course, what else do I need to observe or to do in order to dive safely?
Does diving affect the dosages of thyroid hormones and cortisone (actually, I'm taking prednisolone), and if so, how (e.g., increase) and maybe even (roughly) by how much (e.g., percentage estimate)?
Does hypothyroidism or hypocortisolism affect the uptake and elimination rates of nitrogen in body tissues?
E.g., should greater safety distances be kept from no-decompression time limits in diving tables?
Is elimination of dissolved nitrogen or small nitrogen bubbles (if ever any, God forbid) (partially?) an active process that costs the cells energy, in other words, is dependent on thyroid hormones?
Thank you very much in advance for your kind advice!


Answer
Posted : February 16, 2009
Sorry for the delay in replying.

In general, diving with these conditions is safe as long as they are adequately controlled (by which I mean the replacement hormones are relieving your symptoms). The doses don't change with diving. Elimination of nitrogen is by passive diffusion of gases, so DCI is no more or less likely to occur with replacement hormone therapy.

Some patients with uncontrolled thyroid dysfunction can be prone to abnormal heart rhythms, or eye problems that could be worsened by diving. But if the thyroid function tests reveal a normally functioning gland, then the risk of these problems is remote.

You'll need a dive medical from a suitably qualified dive doc to check you over, but from what you've said you should be fine.

Regards

Dr O
Answer provided by Dr Oliver Firth
Dr Ollie Firth
Additional Comment

Posted : February 16, 2009 by - R. Lars
Dear Dr. Firth,

thanks a lot for your answer!

Maybe one should add that three factors can increase the risk of cramps: too little thyroid hormones, too little calcium and too little magnesium.

People with Hashimoto's tend to have malabsorption and/or increased demand for certain vitamins and minerals, therefore it may be helpful to keep a watch on those too.
Additional Comment

Posted : February 16, 2009 by - R. Lars
I wondered though whether diving would increase the need for thyroid hormones and/or cortisol, due to the greater loss of body heat and corresponding temperature stress, which might need more cortisol to counteract.
Disclaimer:
The views expressed by Dr Firth & Dr Jules are their own and the publishers accept no liability for the advice and views expressed by Dr Firth , Dr Jules, or other users, which are provided as a general service to divers. Users are warned that secondary posts are the views of other users and may not be medically correct.
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