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Friday, May 13, 2011

Et tu, thyroid?

Sometimes I feel like I'm really getting old. Lately I feel like I've been falling apart, and I'm only 36 - not 76. I have dealt with bouts of Crohn's disease and colitis since the birth of my first child, and thought I had finally triumphed when I no longer had to depend on expensive pills every day to manage my symptoms.

For several years, there have been murky goings on that I just couldn't put my finger on, and recently they seem to have intensified. I have felt intensely unmotivated to do things, even the stuff I used to love doing, and looking back it's probably bothered me for at least a year. I thought it was the weather - the Great Lakes area is not known for an abundance of sunshine and warm weather, which probably accounts for why so many people are depressed around here, it seems. I didn't exactly feel depressed in the traditional sense, but I knew something definitely wasn't right. Great, now what?

Then about 18 months ago I developed swollen, painful glands. It was difficult to swallow and even turn my head, and a mono test came up negative. I decided it must have been something my body was trying to fight off, and that was that. It finally went away, but since I have noticed a strange throat pain - not exactly like a sore throat, but a presence - off and on, just not as bad. I had no clue what was going on.

For several years, my sex drive has been in the crapper, and if it weren't for the God-fearing patience of my husband, I'm sure we would be divorced by now. I developed that before we even had kids, and chalked it up to the old phrase, "The best way to ruin a good sex life is by getting married." Whatever. I wasn't sure what it was, but it was troubling. I asked my old OB's nurse practitioner about it, and she had little to say except ask me why I didn't enjoy sex. I thought, if I knew that answer I wouldn't have asked, would I? I felt stupid for asking and decided to leave that one alone: after all, what young married woman doesn't enjoy sex? I was sure I was in the minority on that one.

Last year I had a regular checkup with my OB, and decided to ask him to check my thyroid levels. I had had some minor suspicions, and my mom mentioned having thyroid problems herself. I knew my grandma had been taking Armour Thyroid for centuries, but for some reason it didn't register in my brain that it was a familial problem. The day I visited the doctor's, I remember being tired; it must have been obvious because even the OB commented on it and asked if I was okay. He even asked if I was depressed, and I said no - because I didn't consciously think it was "real" depression. He left it at that and said, "Well, I have to ask questions like that," and shrugged his shoulders. I thought, God forbid I really was seriously depressed, thinking of all those mothers who are totally overwhelmed and need help but are afraid to admit it.

He called me several days later to tell me that my thyroid antibodies were elevated, which meant nothing to me. When I asked him what that meant, he brushed it off and said, "Basically you'll have to go on medication in the future." End of conversation.

After several months and talks with my mom, I decided to do some reading up on it. I realized that as much as I know about pregnancy and childbirth, for example, I know virtually nothing about thyroid problems, what causes them and what to do about it. I looked at list after list of symptoms, some of which weren't the same, and realized that depending on the list you consulted, I had several of them. I felt a glimmer of hope,  like "This could be what's causing all this?!" I was starting to get to the end of my rope.

I have also heard that thyroid problems are common and very under- or misdiagnosed in people. Some go to several doctors before even getting a definitive answer, and not all lab work will reveal problems. My mom enlightened me that those normal TSH (thyroid stimulating hormone) test results I've had in the past are not very indicative, either, and that individual hormone levels need to be tested, too. I've heard from people who have no symptoms yet their levels are whacked off the charts, or have lots of symptoms with near-normal levels. I've also heard that the reaction my OB gave me about it is typical - that many will only begin treatment once those symptoms start, instead of treating it before serious damage is done. I'm afraid that's been happening for a long time already.

I have an appointment scheduled with my family doctor this afternoon; I'm almost nervous and afraid of what he's going to say (or not say). I fear that he, like many other care providers apparently do, will contribute it all to being an overweight, overwhelmed housewife who is struggling with the joys and trials of three children. Here, here's an antidepressant, it'll make you feel better, is what our culture seems to say a lot of the time. It seems that we can draw lines among two groups: those who will willingly take a pill to solve every problem and symptom in the book, and those who are reluctant to rely on medication even though it's clear they need it. My mom herself takes iodine drops instead of medication, and I'm sure part of her advice to "Take Armour! It's natural! Don't take Synthroid!" is her skepticism of all things Big Pharma. I also wonder if the many people I know who suffer from depression are really being treated for a symptom rather than the actual problem? If it's so under-diagnosed, then who knows? How can we really know for sure?

As far as doctors, I've researched just a little online about area endocrinologists who are more understanding when it comes to treatment. This aspect makes me more fearful, especially because one who gets somewhat high reviews has the bedside manner of a goat and an office staff that, unfortunately, is about as notoriously rude as it gets. How they manage to stay in business, I don't know; but I don't want to be dealing with that in addition to everything else. Seven months' wait for an office visit? Are you kidding me? That's like almost another additional year of dealing with crap and I am not in the mood for that. And then to be berated and chastised by an apparently very rude care provider on top of it? No thanks.

I sort of feel like as far as medication, I'm in the middle. I'm not sure what I want to do about it, or what I can do. I am just learning about how this might be a piece of the big puzzle or the key that magically fits in the lock that explains why I've felt this way for so long. It's like a giant piece of black paper is in front of my face and someone is gradually piercing holes through it, letting light through one chunk at a time.

More reading:
Top thyroid doctors directory - The doctor I researched gets pretty good reviews here, but mostly terrible ones from sites like RateMD's and Health Grades. Scary.
Hypothyroidism Signs and Symptoms -
Stop the Thyroid Madness - A conspiracy theory club, of sorts, that just might be on to something


TracyKM said...

Wow! Much of what you wrote, is my story too! (some of which I wrote on your FB page). For years I thought things were "off", but got brushed off by doctors. Then, summer of 2009, I started putting on some weight (some explanable) and had several sinus infections and felt like I was one day away from a cold. Just after Labour Day, 2009, a tooth suddenly swelled up hugely. I had just moved so went to a walk in clinic. The dr. thought it was dental, but sent me for ultrasound and bloodwork. My glands were also swollen, and they found nodules in the thryoid. We redid the ultrasound in a month and it was the same. Waited 6 months for another one, it was pretty much the same, but he referred me to an endo. Yes, a 6 month wait here. Got another ultrasound, still under the 10mm threshold, by 1mm.
I also have that strange throat feeling...lump in the throat, feel like I'm getting a sore throat all the time, esp. if I yell, can't wear necklaces/turtlenecks...I'm going back on Monday to my new family Dr. who also has Hashimoto's disease, so hopefully she'll be more understanding than the endo!
I know others who are in the same boat, keep pushing, they all tell me, so now I'll tell you....keep pushing :)

MB said...

No idea about thyroid. I really don't. But you know me, and I rely on meds daily to live a healthy life. It isn't fun. I hope they figure out whats going on and you start to feel better soon. I know the thyroid can mess heavily with mood and hormones which in turn mess heavily with your and your life. (((HUGS)))

The Deranged Housewife said...

So much of what I'm hearing is that people who are depressed and bipolar also have hypothyroidism - so perhaps that's just one more avenue to check out. As far as meds, I'm willing to take them if it will help, even though I know my mom is the sort who sees it as some sort of "dependence" or whatever. (Although I'm sure she doesn't think that way about psychotropics and mood stabilizers) She prefers to take her drops or whatever they are, which is fine - but I'm like, Mom, you're taking them every day like you would a prescription med - what's the difference? LOL

The fatigue and tiredness is one thing I think is sometimes covered up or 'self medicated' with caffeine. LOL Although I'm not drinking it all day long, some days are better/worse than others for feeling tired. I just know that for as much sleep as I get, I should feel better. I rarely feel rested.

Had a decent visit with the doctor, so we'll see what happens. Labwork is scheduled for Monday.

Ethel said...

Armour is not available anymore. FYI, it is interesting to read what is written about hypothyroidism and pregnancy - like those with Hashimoto's (as you appear to have, which means you should be tested for celiac disease as having one autoimmune disorder create more) should have increased doses of Synthroid during early pregnancy - normally the placenta not only revs up your corpus luteum but your thyroid gland and the embryo is dependent on mom's. Have fun, it isn't but you can do just fine.

sara r said...

I had postpartum thyroiditis and did a lot of research on thyroid issues. I also think that I had subclinical hypothyroism before my daughter was conceived. I have totally cut out soy after learning that it is goitergenic and have switched to a "traditional foods" diet with no processed foods (mostly ) and have lost the weight that I had gained despite years of exercise. Check out the Weston a price website for more info!

The Deranged Housewife said...

Ethel, as far as I know Armour has not been taken off the market. However, it is harder to get, I believe, because there is a shortage due to it only being made by one company. My grandmother continues to take this, and as far as I know she still can get her Rx's filled. I may try contacting a compounding pharmacy, depending on what my lab results say.

Swimming-duck said...

I'm on Armour thyroid. It's still on the market. Be very careful as some doctors who don't work specifically in the field of endocrinology are using outdated #s to diagnose hypothyroidism. As for me, my #s were borderline but I had a competent practitioner who I was working with at the time regarding fertility issues (ended up being caused by the hypothyroidism) who had me take my BBT every morning and she used that in conjunction with my labs in order to properly diagnose me. I have a feeling if I had been going to my family doctor I would not have been diagnosed. Just a thought in case your labs come back "normal".

The Deranged Housewife said...

I am not expecting them to at this point, since I already knew a year ago that they were off. HOw much, I'm not sure - since I was never shown the results, and they were never faxed/cc'ed to my family doctor! I was irate when I found out he never even sent the blood work results to my regular doctor. Ugh. They act like they don't bother telling you the results, because they expect you to not even understand what they mean. So annoying!

I'm learning as much as I can - I feel so confused about all of it! Should I see an endocrinologist? Should I take Synthroid first and see what happens and then switch to Armour if there is no change? I have no idea, and what scares me most is that he might not really know, either. I don't think he minds if I consider a second opinion (as if LOL) but then what - it's terrible. :(

NM said...

I was diagnosed with hypothyroidism last 3 months. I struggled with fatigue, depression, aches, and swollen legs. Ever since I took porcine thyroid , I felt better.

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