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Tuesday, February 10, 2009

In Spite Of Everything....

....I have lost almost 45#. However, I have recently been diagnosed as having Hashimoto's hypothyroidism. For those that know anything about hypothyroidism, symptoms include fatigue and weight gain.

Uhmmm....yeah. I've lost almost 45# since June. And I have said on multiple occassions that this has been the fastest and easiest 45# I have ever lost.

So here's the story. I had a physical back in September. I had lost almost 30# at that time and I wanted to see what my numbers were ie lipid profile, comprehensive metabolic panel, and complete blood count. Given my extensive familial history of heart disease my PCP added a TSH (thyroid stimulating hormone) level to be drawn. TSH is produced by the pituitary gland. The TSH stimulates the thyroid to produce T3 and T4. Usual normal high of TSH is around 5.6. My TSH level came back as 12.5; more than double. This was quite a surprise for me as I'd been losing weight purposefully. My T3&4 levels were fine. This might have been a fluke reading or a snapshot of hypothyroidism where my T3&4 were normal but could be on their way up. My PCP wanted another level drawn in December. Pretty standard procedure.

So what all these numbers mean is that it was taking more TSH to keep my thyroid going. Eventually my thyroid would peter out and I'd be full-blow hypothyroid.

December rolled around and my TSH level was up to 13 while my T3&4 remained normal. Now my PCP was ready to hand things over to an endocrinologist as nothing had really changed.

Had an appointment with the endocrinologist in mid-January. She and her resident took a very detailed history. In looking over signs and symptoms of hypothyroidism I had a few and some that didn't even occur to me like brittle hair. I've noticed that while on my pillow will be hairs with roots on them there have also been shorter hairs with no roots, like they had broken off at night.

Chronic dry skin. It's winter with forced heat, why would I think of this? But I have dry skin all year round. It's nothing that bothers me, just slather up with lotion and I'm good until my next shower.

I had noticed starting sometime last summer that my cycles have changed. (Sorry, Tom! I know you don't want to know this!!) I've always been irregular, but how I start changes all the time. Normally I don't spot. Some months I'll spot for 2 days before anything happens. Some months I'll be really heavy for the first 2 days then POOF! All done. I mentioned this to my OB last fall and he had my September bloodwork. He put his hands up and said, "It's your thyroid."


The following morning after my appointment with the endocrinologist I had a thyroid ultrasound. I know, this is getting fairly intense! After the tech finished up I asked, "So, in your non-professional opinion, of which you're not supposed to tell me anything, what did you see?" She noted increased heterogenous vascularity ie more blood flow. She did not see any tumors or goiter.

The endocrinologist got back to me a bout a week later with the results and she told me I'm classic Hashimoto's. I did a little research and discovered it's an auto-immune disorder. Hashimoto's usually starts off as hyperthyroid within the first 12 months of having a baby. This would explain why the weight was pretty easy in coming off. Then the thyroid becomes "normal" as it's burning itself up at re-entry. Eventually the thyroid won't be able to keep up.

So even though my T3&4 levels are normal, they won't be for much longer. I still have a hard time wrapping my head around this as I've felt fine. This was the furthest thing from my mind that could happen.

On the flip-side, hypothryoidism is so easily treated with thyroid pills. Right now I'm on the lowest dose of 50 mikes (mcg). I'll go back in March for another level to make sure I'm on the right path, then I'll the endocrinologist again in May.

Prolonged untreated hypothyroidism will lead to a goiter which is where the thyroid is enlarged. It can also lead to infertility and mental retardation if the woman is pregnant. Pretty important stuff! And given that women of child-bearing potential are 10- to 20-times more likely to develop this instead of men suggests a strong hormonal component during pregnancies.

If I'm supposed to be fatigued, I shudder to think what I'll be like with full energy!!


Gina (Mannyed) said...

I've been battling my thyroid since I was 16. First it was hyper and medication was unable to regulate it so we did the whole radioactive iodine thingy and killed it. Now, surprise, surprise (not really) it's hypo. 50 mikes of the name brand stuff as generic just won't do. FUN STUFF. Losing weight for me is a struggle. Big time.

kilax said...

Wow. Thanks for sharing all of that! I knew nothing about hypothyroidism, but was rather curious. Let us know how you feel when you "get your energy back" ;)