Saturday, November 21, 2009

Hypothyroidism: Lethargic, Fat, Pained, and Cold

By Diana Hsieh

The past few weeks have been a drag for me. I've just not been feeling right. I've been lethargic, even somewhat depressed. Based on those and other symptoms, I suspected thyroid problems. I was right. I've been diagnosed with mild hypothyroidism, plus a two-centimeter thyroid nodule.

My symptoms seem to have started in a clear way in early September, then accelerated hugely in early November. In short...

  • I've been generally lethargic, with far less energy than usual. I used to have tons of energy, since my change in diet last July. I would run up hills during six-hour hikes for fun. I would do jumping squats while waiting for meat to grill. I needed my daily workouts to burn off steam. That changed this fall. I didn't want to work out or exert myself. In late September, I was very easily worn out by the hiking that Paul and I did with my father. I didn't want to run around outside with Conrad.

  • I've gained weight. Much to my dismay, I've gained about eight pounds in eight weeks, despite eating in a way that should have kept my weight steady. (I feel enormous: it's awful.) Also, I found myself unable to fast: I've needed regular inputs of food to keep myself going or I would crash. The last time I tried fasting, I crashed hard around 23 hours. I was shaky and ill, with a blood sugar of only 54. My attempts to raise it by exercise were totally fruitless. Also, my digestive system hasn't been working right: it protests if I do so much as skip a single meal. (I won't inflict the specifics on you.)

  • I've lost muscle power. At OCON in early July, I was able to leg press 320 pounds. In mid-September, I was down to 210. By late October, I was down to 150. Given the slow-burn-type workouts I was doing this fall, my power should have been increasing, not declining rapidly.

  • I've been cold, cold, cold. Last winter, I was remarkably warm and toasty, thanks to my change in diet. This fall, I was freezing. My temperatures -- tested with a good basal thermometer -- have been in the 96s. Only rarely have I gotten into the 97s, and then only in the bottom half. (I have been in the upper half of the 95s, much to my astonishment.)

  • I suddenly developed severe carpal tunnel problems in early October, even though my desk is set up the same as ever. I've also had mysterious aches in my left elbow and neck for the past two months that never seemed to go away.

  • I've been depressed on occasion without cause. In general, I've felt deeply unmotivated and emotionally flat. I just don't care: I've lost my too-hot passions. I've also had some bizarre bouts of utterly inexplicable and pathetic misery -- like crying because the interior of my car stank like solvent for about two minutes after the mechanic returned it to me. Seriously, that's just dumb.

  • I've had difficulty concentrating. My productivity has declined hugely over the past few weeks, to the point where I'm barely able to do my one Atlas Shrugged podcast per week.
Strangely, apart from the depression and the carpal tunnel, these symptoms made me feel like I was back to eating loads of carbs and other junk. In fact, I've been eating as paleo-ish as ever. For many weeks, I just assumed that I was being lazy, gluttonous, and weak-willed. Despite all that I know, I found it remarkably easy to blame and flog myself.

However, as I became more depressed and flat, I realized that something was seriously amiss. Thanks to some excellent hints and prodding from Monica Hughes, I realized that so much of what I was feeling matched the standard symptoms of hypothyroidism. Oh, and I should mention that I've had problems sleeping (very unusual for me), my cholesterol has been rising (despite no change in diet), and I could feel a lump on my neck where my thyroid is. Also, I've got a solid family history of thyroid problems.

My doctor agreed to do a thyroid blood panel before I saw her on November 10th. (That was good; I hate doing results over the phone.) That bloodwork showed an elevated (and rising) TSH of 3.23, as well as somewhat low free T3 and T4. That, in addition to my symptoms, suggested early hypothyroidism.

So I'm now on a fairly low dose of Synthroid, i.e. synthetic T4. That medication takes a few weeks to take full effect, so we'll likely need to gradually adjust my dose based on my symptoms and lab values over the next year. (The aim is to get my TSH down to about 1.) I would have preferred desiccated thyroid over T4, as many people report far better results, due to getting the full range of thyroid hormones. However, thanks to the regulatory overlords at the FDA, that's been nearly impossible to obtain in the US for the past few months. If I'm not happy with the Synthroid, then I'll make the effort to obtain desiccated thyroid from overseas.

On the 17th, I had an ultrasound of my thyroid. The lump I felt on my neck turned out to be a two centimeter nodule. Frustratingly, it's not clear whether -- and in what way -- the hypothyroidism and the nodule are related. I wonder whether the underlying cause might be iodine deficiency, particularly given that I don't consume much iodized salt. (Dr. Davis, the Heart Scan Doc, has written quite a bit on this problem.) However, I'm pretty thoroughly confused by all that I've read on iodine and thyroid. I think I ought to supplement, but I fear doing more damage to my thyroid. (I'm now eating a bit of sea vegetable every day for its iodine content, but I'm not sure that's the right thing to do.)

I'm scheduled for an aspiration of my thyroid nodule on Monday. That should be an easy procedure. The nodule is not likely composed of evil mutant cancer cells, but it's worth checking. Plus, I figure that I ought to get whatever medical care I can before Obama can ration everything based on collective cost savings.

For the moment, I'm feeling somewhat better. Granted, I'm still lethargic, fat, pained, and cold. Life still sucks. However, life sucks less than it did a few weeks ago. Right now, I count that as a win.

My plan is to keep myself relatively quiet through this Thanksgiving week, then try to get back to work in earnest in the first week of December. November feels like a lost month for me, and I hate that. Hopefully, December will be a month of happy frolicking for me.

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