Hypo to Autoimmune to Hyper and Back
In March 2021, I wrote the first Body Battle installment. In this first part, I discuss my first time meeting with an endocrinologist, history of thyroid conditions, and symptoms. In this next part, I will go into what has happened in the last six months regarding life with Hashimoto’s Thyroiditis, changing medicine, and finding the right dosage.
Appointments and Labs
Since March, I have seen the endocrinologist twice more, once in May and once in September. In May, they increased my dosage from 112 mcg to 125 mcg. At the time, I was working my way through about a month’s worth supply of 112 mcg of levothyroxine and so the endocrinologist worked out a way for me to continue taking this medicine at a higher dosage.
At the May appointment, they also recommended I take a brand version of Synthroid as they had seen in patients of theirs as well as studies that the results were better. So when my 112 mcg supply of levothyroxine was up I had the endocrinologist send in an order for 125 mcg of Tirosint. Towards the end of June, I began a 30-day supply of the 125 mcg of Tirosint, then in July the pharmacy provided a 90-day supply.
With these appointments, I am supposed to get my blood tested within 5–7 days preceding my endocrinologist appointment. The May labs were not conclusive as the endocrinologist had realized that I take supplements with Biotin in them. Biotin interferes with test results. Before my September appointment, I made sure to abstain from taking my supplements the week of the lab. Because I have a health app for this doctor and the laboratory I got the lab results the same day but had no idea what the levels and abbreviations I read meant. Looking them up online and via information on thyroid.org I found that the lab results appeared hyperthyroid or “overactive” thyroid. Deciding to put it out of my mind until the appointment seemed like the best decision.
At the September appointment, the endocrinologist never used “overactive” or “hyperthyroid” to describe my blood levels but did describe the one measurement as very low and the other as very high. Then, they began to question me on symptoms I may have had that could be linked to this change in my labs.
Have you felt jittery?
How has your sleep been?
Have you been warm, suffered hot flashes, had problems with sweating?
My answers all centered around a theme of “it’s different.” When asked about feeling jittery I talked about reducing my caffeine intake. That I didn’t feel jittery but I definitely felt different. When asked about my sleep I told them I had been sleeping but again it was different. When asked about being warm, I said yes. Not sweating or having a problem of profuse sweating but a difference in feeling warm-ish always.
Also, of note I had lost five pounds. Was it the increased dosage? Not entirely but it definitely had something to do with it. This news excited me — maybe a little too much because I was tempted to go against what came next…
Temptation to Lose
Because I had around a two month supply left of the 125 mcg dosage, again they devised a way/worked out the math so that I could finish these pills and have it come out close to what an 112 mcg dose/day in a week would be. Their answer was to skip one day a week on the 125 mcg/day. Okay, I can do that. This was my initial internal response. The temptation was to keep taking the 125 mcg every day to see if I could drop another five pounds. Then, I would be back to the weight I was at the end of 2017 before all of the surgeries and lack of exercise. Telling my mom about this rebellious tempting thought her response was do what the doctor said ultimately you are still taking pills at the dose so there will still be some effect.
“Other Symptoms as Unassigned”
Living with an autoimmune thyroid there’s never an uninterrupted moment. In the May appointment, the endocrinologist told me to pay extra attention to any and all symptoms. Anxiety, for one can be something that increases and/or gets aggravated with autoimmunity. It’s not that the autoimmune status of the thyroid causes extra symptoms but that because there is autoimmunity — a thyroid composed of antibodies — those with this condition are more likely to see an increase in other symptoms. Kind of like a job post that reads “other duties as assigned,” except those living with this condition do not know the assigned symptoms ahead of time.
To help manage anxiety and “other symptoms as unassigned,” I have been seeing a therapist since June. This therapist is one I researched and sought out. Having two previous therapists, I knew what I needed and wanted in this one. We do teletherapy once a week. In these sessions, the therapist helps me talk through thoughts, ideas, feelings, and behaviors. From her, I have been learning how to mitigate anxieties, confront and sit with uncomfortable feelings, recognize biases, be compassionate; kind; and gentle with myself and others, boundary setting, and de-escalating intense emotions.
In addition to therapy, I have been attempting to do yoga in the mornings before work. I was trying strength training but I had severe knee pain and right now, yoga seems to be a catch all for stretching; meditation; breath work; a little cardio; and light strength training. Also, I have a goal of writing and publishing one thing a week. It helps keep me accountable, receptive to opportunity and inspiration, and feeling accomplished.
With these three things: therapy, yoga, and writing, I have noticed a difference in the way I feel overall. I still wear the FitBit and make a point while at work to make myself get up and walk. I focus on steps and movement instead of efficiency. For example, if my mug needs to be washed and my water bottle needs to be filled I will make two round trips to and fro across the room instead of one trip with both items in my hands. I may get up and talk to my co-workers to keep it moving but also socializing is something I enjoy.
Conclusion: And Back or *OTW
All this to say…this is what I know for now. Give me a day, week, or my next appointment and things will have most likely changed…again. Remembering compassion, kindness, and being gentle with myself and others helps me tolerate the uncertainties.
*On the way
To read the first installment of Body Battle, read here —