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Thyroid testing in these patients typically reveals elevated TSH (above 2.5-3.0 mIU/L even if within laboratory reference range), low or low-normal free T4, low free T3 (often most telling finding), and possibly elevated reverse T3

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For endurance athletes, this can be distinctly disadvantageous: accelerated glycogen depletion may precipitate earlier fatigue and reduce sustained performance within a single session, particularly before any long-term adaptations can occur