Belgian paralympian Marieke Vervoort, who won gold and silver medals in wheelchair racing at the 2012 London Paralympics and silver at the 2016 Rio Paralympics, died by euthanasia Tuesday, officials said.

Vervoort, 40, suffered from incurable, degenerative spinal pain. She said in an interview in Rio de Janeiro three years ago that she only got about 10 minutes of sleep some nights and described the pain that caused others to pass out from just watching her. She said sports kept her alive.

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“It's too hard for my body,” Vervoort said in 2016. “Each training I'm suffering because of pain. Every race I train hard. Training and riding and doing competition are medicine for me. I push so hard — to push literally all my fear and everything away.”

Vervoort, a strong advocate for the right to choose euthanasia, spent her final evening with close friends and family. Before she died, she said signing the euthanasia papers gave her control and allowed her to put “my own life in my hands.”

“I'm really scared, but those [euthanasia] papers give me a lot of peace of mind because I know when it's enough for me, I have those papers," she told the Associated Press in 2016.

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“If I didn't have those papers, I think I'd have done suicide already. I think there will be fewer suicides when every country has the law of euthanasia. ... I hope everybody sees that this is not murder, but it makes people live longer.”

Condolences poured in for Vervoort, even from the Belgian royal family.

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“Marieke ‘Wielemie’ Vervoort was an athlete tough as nails and a great lady. Her death touches us deeply,” the family said.

The Associated Press contributed to this report.