The Challenges of Hypo-thyroidism

A friend of mine recently was diagnosed with hypo-thyroidism and I sent her some information.  I figured I would share some of this information on my blog as it likely pertains to many of my friends, especially since the incidence of this disorder has markedly increased in the last decade or so. 


I was diagnosed with Hypo-thyroidism (or an under-active thyroid) in 2000.  Additionally, I have several nodules (now) on both sides as well as on the isthmus (the part that connects both sides) of my thyroid.  They have been biopsied twice and are non-cancerous.  The doctors tell me that more is better in this case, as a single "lump" would be more indicative of a cancer.  I also have Hashimoto's Disease, which is a separate disorder from hypo-thyroidism but often the cause of it.


Most likely I had an under-active thyroid for many years before I was diagnosed, which seems fairly common.  It seems alot of doctors delay in testing for this.....maybe thinking it is an old hold-over from the days when every woman that was complaining of weight gain claimed they had a thyroid problem....But the problem is---today...woman do have this in increasing numbers....  Is it from food additives, pesticide use, preservatives?  Who knows...but the numbers are clear...this has been increasing every year, and more and more people are being diagnosed with hypo-thyroidism.

It can run in the family.  After I was diagnosed with it, my sister- mother- and father-were also diagnosed in the following years.  Of course, my father's case likely was related to the cancers he fought and his treatment.  I suspect that my maternal grandmother had the disease.  Pictures of her show that she had the same blocky figure that I had before I was diagnosed.

This blocky weight structure is something that always frustrated me before my diagnosis.  It seemed my weight was stacked on my body in a particular way...... kind of all over- and I looked like a thick block... no matter what type of clothes I wore.  And despite the fact that I was very physically active, it was difficult for me to maintain a desired weight.  After my diagnosis, and when I was started on replacement therapy, I didn't necessarily lose weight... but it was distributed differently on my body.  I lost that blocky look.  Its the same look I see on my grandmother in her photographs.  She and I were alike in more than just this way.  Like me, she suffered from migraines all her life.  Not just the annoying occasional headache, but the debilitating, head clenching, want to hide in the dark, oh-my-god-will-it-ever-end kind of headaches.  For me, those started when I was quite young and continued until I fully entered menopause.  My grandmother's ended when she died of a cerebral hemorrhage - a fate I feared would come to me as well.

Hypo-thyroidism is a metabolic disorder.  When your thyroid isn't producing enough thyroid hormone - it affects many parts of your body.   Beside regulating metabolism, the thyroid helps maintain healthy connective type tissue... That includes hair, skin, cartilage, etc.  Common symptoms of a lack of sufficient thyroid hormone includes low body temperature (and sometimes low blood pressure) thinning and loss of hair, including eyebrows and eyelashes; dry and cracked skin; and joint pain due to loss of good quality cartilage.  Many of these symptoms are reduced once thyroid hormone replacement therapy is started.  Some will not go away completely, due to loss that cannot be replaced.  For instance, I lost most of my eyebrow hair, and eyelashes.  Any damage to the cartridge cartilage that resulted from injury...due to reduced elasticity of the cartilage or tendons can't be fixed by restoring thyroid levels.  But your hair quality will return; your joints will feel much better, some of the muscle pain will go away (exercise will help this process) and most of all...you will feel a return of energy and a reduction in what you may be experiencing---what we call brain fog.

There are simple tests that your doctor can order to determine if you have an under-active thyroid.  The difficulty is in convincing your doctor that you need these tests.  As noted above, many are reluctant to do so, dismissing your symptoms as something else.

This diagram shows how the thyroid system works and the inter-connectedness of the various hormones.  When your thyroid levels T3 and T4 are low, the pituitary gland releases more TSH, calling for an increase in production of thyroid hormones.  Hence it is important to monitor TSH levels as well as T3 and T4.

 

If you are comfortable with your doctor, stay with him.  But if he is the type of doctor that refuses to test you, then I recommend that you seek a better partner.  The doctor you use must be a "partner" in this process, so he is an important component in your treatment.  If you are changing doctors, then I highly recommend that you seek out a good endocrinologist.  You will want to see him every 6 months.  You should be tested for thyroid levels every 6 months and then see him after this testing to review your levels and keep an eye on your thyroid's condition.  He should test you regularly for T3, T4 and TSH levels. By monitoring your hormones levels, you will know if your dosage is correct, effective and working for you.  I also suggest you be tested for thyroid antibodies, at least at the beginning.   This will determine if you also have the auto-immune disorder known as Hashimoto's Disease.  I have this disease and it is caused by the immune system attacking the thyroid hormone producing parts of the thyroid, eventually resulting in a complete shutdown of the thyroid.  Hashimotos's also affects other areas of the body, especially any connective tissue and can result in a higher incidence of bronchitis, arthritis and other disease factors.  Unfortunately, there is no treatment for Hashimoto's but there are some dietary changes that can help. For instance, you should reduce the amount of carbohydrates in your diet and increase fiber consumption.  You don't have to go hard core with an Atkins type diet (though less is better in this case) but even cutting out some of the sugars and "white" carbohydrates in your diet can be beneficial.

I highly recommend you buy and read, from cover-to-cover, the book Living Well with Hypothyroidism: What Your Doctor Doesn't Tell You...That You Need to Know by Mary J Shomon.  She is a patient advocate for people suffering from thyroid problems and a patient herself.  Her book is VERY informative. You can also follow her on several websites.  Her main website can be found here.  She runs a Facebook page for Thyroid Support, called Mary Shomon: Thyroid Patient Advocate, Author at  https://www.facebook.com/thyroidsupport.    She also has a Facebook page for Thyroid Diet issues at https://www.facebook.com/thyroiddiet.