Monday, September 13, 2010

My August Thyroid Labs

By Diana Hsieh

On August 24th, I had another round of thyroid labs. Here's the letter that I wrote my doctor about my status:

Here's another update on how I'm doing with respect to my hypothyroidism. As you recommended, I reduced my total thyroid medication by omitting .5 to 1 grains per week from my baseline of 1.5 grains per day. That didn't work out so well, and let me explain how.

Starting on May 12th, I took just 1 grain on Saturdays, but 1.5 grains every other day. In that very same week, I increased the intensity of my workouts substantially by starting CrossFit once or twice per week. (That's definitely ramped up my metabolism, as I was eating about 30% more each day, but my weight remained the same.) I felt great for a few weeks, but then slipped back into feeling a bit more lethargic and experiencing some more dry skin. I didn't worry about it too much, however, as I was also under lots of stress (and not working out much) because I was preparing a series of lectures for a conference in early July.

After returning from the conference, I decided to try omitting another .5 grains per week starting the week of July 12th. Actually, for ease of managing my medications, I would take 1.5 grains for two days, then 1 grain for one day. So I was omitting a bit more than 1 grain per week on average. That was a small disaster: various hypothyroid symptoms returned, and I felt like my body didn't know which way was up, I suppose due to the variation in T3 each day.

I stopped that variable dosing on July 25th. But instead of returning to 1.5 grains per day, I began taking just 1 grain per day. That seemed worth trying, given that I felt slightly better when I reduced down slightly from 1.5 grains per day. For the first few weeks, I felt fantastic again, but now I'm slightly lethargic and my skin is too dry again. Most tellingly, I've been gaining a pound of weight per week again, and I've experienced a return of some other GI problems that I had when seriously hypothyroid, e.g. diarrhea if I skip a meal. As for the weight gain, I know that I've gained some muscle due to CrossFit, but I'm clearly gaining fat too.

So... Yikes! These past three months have been a series of failed (albeit informative) experiments for me. I'm curious as to what the labs will say now, but I suspect that I need to be bumped up slightly, perhaps to 1.25 grains per day. (For now, I'd rather try doing that than adding T4, although I'd be amenable to trying that option next time, if I'm still not quite right.)
So what were my labs? Odd, yet again:
  • TSH = 1.650 (okay, was .115 in May)
  • Free T3 = 2.3 (normal range 2.0 to 4.4, was 2.8 in May)
  • Free T4 = .78 (normal range .82 to 1.77, was 1.14 in May)
So my TSH is back to normal, but my Free T3 is lower and my Free T4 has plummeted off the charts. Grrrr.

(I'm so glad that my doctor isn't one of those who only tests TSH. If she was, I'd seem totally normal!)

After consulting with my doctor, I began taking 1.25 grains of desiccated thyroid on August 26th, but that hasn't done much for my hypothyroid symptoms. The skin on my hands is terribly dry, my carpal tunnel pain has returned, my menstrual cycle has gone wonky, and I'm stalled on my strength gains. I've stopped gaining weight, but that might be due to cutting out dairy and nuts around the same time. I've only been on the 1.25 grains for just over two weeks, so I hope to see more improvement with time.

You know what I'm learning here? Hypothyroidism is a hell of a bitch to manage. Even though I'm so so so much better than I was this past winter, I want to be right... and that sweet spot seems tough to find.

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