Tired of being tired? My journey of hypothyroidism... the beginning

In the spring of 2006, I was diagnosed like millions of other Americans with low-thyroid disease. I had suspected a sluggish thyroid for years from dealing with some classic thyroid disease symptoms in articles I would read such as an inability to lose weight and an unmotivated spirit with fatigue. My doctor, however, never made mention of a thyroid issue at any of my annual physical exams until May 2006. In the next year, I learned a lot about thyroid disease as I took charge of my health.

What is thyroid disease?
We really don’t hear much about thyroid disease even though it could be a bigger health issue than diabetes! Thyroid disease usually develops slowly, and its symptoms tend to appear over time. Thyroid disease is a chronic, long-term disorder, but if managed well, it does not cause fatal symptoms. It’s also typically something that doesn’t affect children here in the United States, but rather it affects older adults. Some things that could trigger the disease are: genetic disposition, food choice, exposure of radiation (including dental x-ray), over consumption of soy and raw foods, especially broccoli and other curcerfious vegetables. My mother and all three of her siblings suffer from hypothyroid although I had a much earlier onset at age 42. My husband’s corporate career caused us to move quite often, and lifestyle stress is another factor in diminishing thyroid function.

The thyroid is a small gland, shaped like a butterfly, located in the lower part of your neck. The function of a gland is to secrete hormones. The main hormones released by the thyroid are triiodothyronine, abbreviated as T3, and thyroxine, abbreviated as T4. These thyroid hormones deliver energy to cells of the body and help get oxygen into the cells. They also work as messengers that tell the body what to do. When your body’s thyroid no longer produces enough T3 and T4 hormones, you have a thyroid disease called hypothyroid. Your thyroid makes 80% T4 and 20% T3, and yet, it is the T3 that is more powerful in regulating your metabolism. This is why many hypothyroid patients experience weight gain.

Other classic symptoms of low-thyroid include fatigue, constipation, fuzzy thinking, low blood pressure, fluid retention, depression, body pain, slow reflexes, but there is a list of many more. Plus, thyroid disease affects people quite differently. I once discussed my symptoms with two friends the same age as myself, and we all suffered from different symptoms.
Symptoms of hypothyroidism may include:
· Slowed metabolism and slowed heart rate
· Cold and heat intolerance - cold hands and feet
· Fatigue
· Fluid retention - face, legs, eyelids and abdomen
· Dry skin, eyes and/or hair
· Yellowed skin
· Loss of eyebrows
· Constipation
· Headaches, migraines
· Depression, apathy and anxiety
· Irritability - low self esteem
· Low sexual desire
· Infertility
· Memory and concentration impairment
· Enlarged tongue, deep voice and swollen neck
· PMS, Irregular menstrual periods
· Lack of exercise tolerance
· Weight gain (especially in the stomach)
· Hypoglycemia (low blood sugar)

How are thyroid disorders diagnosed?
Primarily, thyroid disease is diagnosed with a blood test called TSH (Thyroid Stimulating Hormone), which is a hormone produced by the pituitary gland. The TSH regulates the thyroid to release the T4 and T3 hormones. The TSH standards for a normal thyroid TSH had been .5 to 5.0: hyperthyroidism being below .5, and hypothyroidism above 5.0. In 2003, the American Association of Clinical Endocrinologists revamped the normal range of TSH to .3 to 3.0. With the new guidelines, many as 27 million people may have abnormal thyroid function. This would more than double the number of people thought to have abnormal thyroid function under the old guidelines, making thyroid disease more common in North America than diabetes. For some people, their TSH test comes out in “normal” range, yet they have symptoms. Doctors can then take more in-depth tests on the T4 and T3 hormones to get a better understanding of what their thyroids are producing.

A way to check for thyroid function at home test beyond the symptom picture is a basal metabolic test. If you test your basal metabolic temperature at rest, you can get an idea of an under active thyroid with a temperature lower than 97.8. When you first wake up, place a thermometer under your arm for 10 minutes and wait in bed to take your temperature. If you don’t have that kind of time, pee into a Styrofoam cup, and take temp of your urine. Urine is actually a mostly sterile byproduct of the body. The test is not the gold standard of a blood test, but it could help you decide if you want to pursue your symptoms with a medical professional.

My TSH was 4.09 when I was diagnosed in 2006 with hypothyroid. Looking through my medical records I found that my TSH was 4.02 in 2002, so I believe I had been dealing with hypothyroid for at least 4 years without a being diagnosed by the old standards. The reason I was diagnosed in 2006 with virtually the same TSH as 2002 is that the normal TSH range had been lowered from 5.0 to 3.0 for the highest normal range. Plus, some doctors like mine were slow to adopt the new TSH standards for a few years. I had many of the symptoms for years, but never put the whole puzzle together. I chalked up a lot of my symptoms due to the fact that we had moved three years in a row with major stress-inducing life changes. I really believe my hypothyroidism started with the birth of my third child in 1999. I was not myself after my last son was born. I was overwhelmed with 3 kids aged 6 and under, but I again after quizzing everyone I knew with a family of five or more, I decided it was the parenting vortex of 3 children everyone deals with. Plus, thyroid symptoms tend to develop over years, so it wasn’t as evident in 1999 like it was in 2006 that something was indeed off. It’s important to be treated for thyroid disease because if left untreated, it can lead to elevated cholesterol levels and heart disease, infertility, muscle weakness, osteoporosis and, in extreme cases, coma or death. For me, my biggest issue was inability to keep the inches off, even with consistent exercise and a good diet, and the debilitating lack of motivation, which I will describe as a sort of depression. My thinking was pretty fuzzy too, which would affect anyone functioning day to day.

Getting on thyroid medication
So my doctor did what most family physicians would do for a newly diagnosed thyroid patient. He prescribed the smallest dose of Synthyroid, which was 30mg. Having researched hypothyroid before my appointment, I was aware that there was a “natural” medicine out there called Armour thyroid. The Armour meat company has provided desiccated thyroid extract from the thyroid glands of animals (typically from pigs) since the late 19th century. Beginning in the 1970s, the use of desiccated thyroid for the treatment of hypothyroidism was gradually replaced by a synthetic form of T4 known as levothyroxine sodium (Synthroid, Levoxyl, Unithroid, Levothyroxine, etc). My doctor told me the synthetic was better because it could be accurately measured dose to dose and refused to let me try Armour. Researching this fact, I found it to be misinformation because there are no FDA reports on problems with Armour thyroid. In 1997, however, the FDA reported such about levothyroxine sodium being inconsistent dose to dose, and has also written that Synthyroid has a long history of quality control problems. My mother also tried to discuss Armour with her doctor, and her doctor argued with her, asking if she’d want to take something from a dead animal. When my mom told me this, I replied, “Mom, you eat bacon, don’t you?” I suspect that most doctors really don’t educate themselves about this complicated hormonal disorder and take whatever they are told by those working in the healthcare industry as truth. The healthcare industry seems to push the newer synthetics as better too.

What worked for me
I took the Synthroid prescription and vowed to find another doctor to treat me with Armour thyroid, just because I personally believed more in bio-identical hormones over synthetics. I didn’t have to look far because I found two friends with hypothyroid, and both friends were taking Armour. Another great online source for thyroid specialists is: http://www.thyroid-info.com/topdrs/

I had to wait three months to get into see this new doctor though, so I took my Synthroid prescription for those three months hoping it would help. The Synthroid did absolutely nothing to alleviate my symptoms. I didn’t lose any weight; still wasn’t coping with daily life very well, and my energy levels were still low. My new doctor tested my blood after being on Synthroid for 3 months, and she found a TSH of .5. She said that the Synthroid was actually suppressing my thyroid and that my T3 levels needed a boost. Most doctors hold the belief that patients do not need T3, because they assume their patients’ thyroids will convert T4 into the T3 the body needs. This does not allow for the possibility that some people, like myself, may lack the ability to efficiently convert T4 into T3. Synthroid, and the other levothyroxine sodium medicines only have the T4 hormone in the pill. So it’s fairly certain that my body wasn’t converting the T4 from the pill into the T3 because I saw no symptom relief and yet my TSH level was really low.

I started the Armour the following day, and it was like flipping a switch on my energy level. I felt like I got more done off my checklist in that first week than I had the entire previous three months! The Armour has the T3 and the T4 hormones in it, plus is the T3 that regulates the metabolism more powerfully of the two hormones. I also had motivation and energy again to do my T-Tapp exercise program more consistently without such fatigue. I attended a T-Tapp fitness event one month after starting the Armour and promptly lost 11 inches in three days. I completed just 11 workouts the rest of the month and lost another 12 inches for 23 inches total in 30 days. A month later, I realized the foggy thinking had lifted back to “normal”. I could once again concentrate.

Over the course of my first year on Amour, I lost about 33 inches total, which I find amazing. I’m still a size away from my goal size 8 according to my skeletal set point, but I just had my dosage upped to 90mg last month. My TSH was 1.53 which my doctor said was working, but it was not optimal. She believes also that most doctors under prescribe thyroid medication. Hormonal balance is so complicated, and some people need continual adjustment to the amount of thyroid medication they take. Some doctors try different dosages for 3 months and then test your hormone levels by blood tests. Other doctors, like mine are more interested in the symptoms being alleviated.

I still find I gain inches quite easily if I’m not working out with 60-90 minute T-Tapp exercise sessions 3-4 times a week (ttapp.com). Yet, I will have to see what this new dosage does within the next few months. The good news is that it is possible to manage your health with thyroid disease if you take charge of your health. Yes, you can!

~Kate (written in 2007)