Where I'm At - December 2007

Take a pill and you'll be all better. That's what I thought once I was diagnosed with Hashimotos back in May. Unfortunately, that's not been the case.

I started on 2 grains (120mg) of Armour, didn't feel well and self-dosed to 3 grains. I still felt awful, so I raised it to 4. At that time I was feeling more hypo than ever. My doctor added in a small dose of Cytomel..which made me even worse. Blood tests at that time looked like I had gone Hyper...but I was having Hypo symptoms.

When I went on the Synthroid the more recent symptoms such as the itching, heel pain, depression and anxiety went away quickly. Because I was still having fatigue and still had a lot of other symptoms, I added in a bit of Cytomel. For a couple weeks I felt more energetic...but it didn't last. The itching and heel pain returned.

A few days ago I dug out an old bottle of Isocort (over-the-counter adrenal gland support) and took a few. I've continued to take up to about 6 each day since. I'm feeling a bit more energetic and less depressed. I've taken these before - years before I was diagnosed with Hypothyroidism- and they made me irritable and not much else. IF my adrenal glands are sluggish, adding the Isocort (or Cortef prescribed by a doctor) can help the thyroid hormone that is pooling up in the blood (like my last blood tests showed) to actually get into the cells where they belong.

I've thought I had adrenal fatigue for years. I have dizzy spells, hypoglycemia, hyperpigmentation and other adrenal symptoms. The doctor did run some blood and a urine tests, but all the levels seemed fine. I did however fail the pupil test here at home. For the pupil test you need to be in a dark room with a mirror, hold a flashlight to the side of your head and shine it into your eye. Your pupil should constrict and become small AND stay that way as long as the light shines on it. With adrenal fatigue your pupil will constrict and become small, but within seconds will become larger, then smaller...fluctuating.

If the Isocort seems to help I will stay on it for a few months and then wean off it. The adrenals can heal themselves with the Isocort or a stronger steroid such as doctor-prescribed Cortef or oral hydrocortisone.

A good adrenal questionaire can be found here.

Granuloma Annulare

Never heard of Granuloma Annulare? That's okay. It's a rare skin disease, looks a lot like ringworm. I'm making a post about it because I've had it since I was about 13 years old (so over 30 years). Is it in any way connected to the thyroid? Probably not, but I do know at least a couple people who have both thyroid disease and GA.

Children often get GA, but it usually clears up within a year with no treatment. Adults who get it often have it for years. It doesn't usually itch or hurt. There are several variants to the disease, some are associated with Diabetes. People with compromised immune systems sometimes get it too.

My Granuloma Annulare showed up on my foot about the time I hit puberty. It later spread to my stomach and elbows. I didn't treat it (there is no cure) at that time as it was easy to hide. When I got pregnant with my daughter in 1988, the GA went away. It does in the majority of pregnant women which probably means it is an autoimmune disease. Once my daughter was born, the GA returned with a vengeance. I started using the steroid creams which did help but also thinned my skin. Once the steroid creams are stopped, the GA comes back anyhow. I also tried some "home" cures like drinking cider vinegar. Ick! I even went on a anti-malarial drug which some folks had had good results with. Today I pretty much ignore the GA, it looks like burns to most people. It is on both hands, my elbows, neck, stomach, feet and a tiny spot near my eye.

I have a rarely-posted-to-anymore message board at Delphi. Feel free to take a look if you'd like to know more about this skin disease.


Click here to go to my Granuloma Annulare Forum

Celebs with Thyroid Disease

Here are just a few celebrities with thyroid disease:
Barbara Bush and George Bush Sr.
Linda Ronstadt
Marie Osmond
Rod Stewart
Kelly Osborne
Roger Ebert (film critic)

Recently talk show host Oprah Winfrey came out with the announcement that she had "Blew out her thyroid". She had a much anticipated show on Hypothyroidism which unfortunately left many Hypothyroid sufferers very disappointed. Oprah claims a 30 day vacation in Hawaii had 'cured' her Hypothyroidism. Her guest speaker, Christine Northrup claims thyroid problems are caused by "bottling up your words". From Dr. Northrup's own web site (www.drnorthrup.com): "In many women thyroid dysfunction develops because of an energy blockage in the throat region, the result of a lifetime of 'swallowing' words one is aching to say." Huh??? I imagine we have not heard the last from Oprah. I believe she has Hashimotos and will teeter back and forth between hypo and hyper until her thyroid gives out completely forcing her to go on thyroid hormones (if she isn't already).

A celeb that was never formally diagnosed with Hashimoto's was Anna Nicole Smith. It was found during her autopsy. Anna Nicole's weight fluctuated wildly, she was depressed, had trouble sleeping, suffered from anxiety and most likely had other hypo symptoms as well. I wonder if she might still be alive today had the Hashimotos been discovered and treated. Your thyroid really does affect your body in so many ways.

Doctors

We've all heard the old joke What do you call the guy who graduated last in his class from medical school? The answer is of course Doctor. The thyroid patient may feel this is too true as he goes from doctor to doctor first trying to get diagnosed, then trying to find treatment that makes him feel better.

I went from several GPs, a endocrinologist, a rheumatologist, a neurologist, a couple gynecologists...and not one did anything more than the standard tsh test. A test that didn't exist many years ago - doctors then relied on patient symptoms and treated them as they felt necessary. Today the tsh test is the gold standard. In the past five years the normal tsh range has changed - before it was .3 - 5.85, today it has been lowered to .2 -3.0 (depending on the laboratory). More and more people are being diagnosed today, but not all doctors are up to date on this new information.

The most common type of Hypothyroidism is Hashimoto's Thyroiditis. Often the tsh is normal with this autoimmune disease, so if additional testing (thyroid antibodies tests) aren't ran, the Hashimotos can be missed. Hashimoto's also brings with it another problem. Some doctors don't believe in treating it. Less than 6 months ago I was seeing 2 doctors and feeling at my worst. The one doctor had looked at my test results...gasped at my high antibody level...then proceeded to tell me she doesn't treat Hashimotos as long as the TSH is normal. She offered me a sample of the anti-depressant Lexapro. Had I not already had another doctor that I knew would treat me, I'd have waited outside in the parking lot and ran her over! At that time I was suffering from panic attacks that were starting to keep me from doing things I normally enjoyed...I'm sure after some time it would have progressed into full blown agoraphobia (fear of leaving one's home), I was also very depressed, not suicidal, but not really caring if I lived or died. Add to that the usual Hypo symptoms and I was a mess. Within about 10 days of getting on Synthroid (from my other doctor) - the panic, anxiety, depression were gone! No anti-depressants needed!

If you have that gut feeling that something is wrong with you - keep changing doctors until you find one that will listen, one that will look at that long list of symptoms and think maybe they are connected and not try to treat each individually. Insist on a full thyroid panel (INCLUDING antibodies).


Here is a good link about tsh and getting diagnosed

You can find a link there too for the Top Doc website. Check it out!

Symptoms

The symptoms of Hypothyroidism vary from person to person. The symptoms are also often confused with other diseases, often being attributed to aging or even depression.

Here are the symptoms I had:

Symptoms:
Severe cramping (pms) especially at ovulation
fibroids (1 is size of 3 month pregnancy)
periods becoming more irregular past 2 years
1 miscarriage (1981)

chronic daily headaches (fall and winter mostly)
irritability
fatigue
anxiety/nervousness
blurry vision occasionally
difficulty concentrating
poor memory
light headedness/often dizzy upon standing
claustrophobic

hyperpigmentation of face and forearms
acne
rough dry skin on face (recent)

decreased sex drive
need extra sleep (10+ hours)
weakness
shoulder pain (occasional problem)
seasonal allergies (spring)
low body temp/ most always cold (wear socks to bed, need hot shower before bed)
fluctuating blood pressure (usually low)
cold hands and feet
Easily overheated/sweaty/night sweats (recent)
stiff neck
hoarseness (recent)

Frequent urination (12 times a day?)
Thirsty (drink 1 1/2 gallons+ fluids daily)
Morning constipation (despite psyllium use)

Intolerant to exercise (tire very easily)
Easy weight gain, cannot lose weight on diets during past 2 years
Swollen abdomen (recent - have always had fairly flat stomach)

Also Have:
Granuloma Annulare (have had 30 years)
stubborn toenail fungus (not actual fungus according to clippings, but improved after 6 to 9 months of oral Lamisil)
venous insufficiency
ankle and foot swelling/edema
hypoglycemia (bg 42 once)
Intolerant of caffeine (get nervous/nauseous) and pseudo ephedrine (get VERY dizzy)
Loss of hair on inner lower legs
High cholesterol
Positive ANA (speckled 1:160; last year)
Quit smoking 8 years ago (seemed to make symptoms worse)

(After being diagnosed and before being properly treated, I also suffered from very painful heels (Plantar Fascitis), anxiety attacks, itching and severe depression.)

Other lists of Hypo symptoms can be found at the following websites:

http://www.emedicine.com/MED/topic1145.htm

http://www.elliotthealthcare.com/low_thyroid.htm

Armour VS. Synthroid

If you've done any research on the web regarding thyroid medications, you've probably come to the conclusion that Armour Thyroid (natural thyroid containing both T3 and T4 - taken from pigs) is what the Hypothyroid patient needs. That was part of my reasoning behind going to one of the doctors listed at Mary Shomon's Top Doc Directory, I wanted Armour.
http://thyroid.about.com/cs/doctors/a/topdocs.htm

Once the 'Top Doc' had diagnosed my Hashimotos, she put me on 2 grains of Armour Thyroid. I can't tell you how happy I was thinking that this was the answer. Unfortunately I was very wrong. Within 10 days I was feeling more fatigued than usual and I began to have severe itching - first on my neck, later behind both knees, the inside of my elbows, even my hips. After a month, I raised my dose to 3 grains (180 mg)...I started to need afternoon naps. Thinking I wasn't on a big enough dose I raised my Armour to 4 grains with the addition of 5 mcg Cytomel (a T3 med). Now my feet hurt, my ankles are swollen, my weight has increased by about 10 lbs, I am severely constipated and extremely tired.

Within a week of starting the Cytomel I am starting to have anxiety attacks. I have attacks while getting stuck in traffic and when driving on a tree- lined narrow street. I am taking .25 mg of Xanax to deal with the severe anxiety during the day and sometimes another dose again at night to help me sleep. I start to avoid leaving the house in fear of having another panic attack. I started to think that maybe I had adrenal issues as well as thyroid problems and asked my doctor to run some more tests. At this time I quit taking both the Armour and the Cytomel. I had a 24 hour urine test for Ketosteroids as well as blood tests for Renin, Testosterone, cortisol, DHEA and ACTH which all came back within the normal limits. I am having symptoms of depression now as well as all the Hypothyroid symptoms.

I was off both Armour and Cytomel for over a month and was at my worst at this time. I was having anxiety issues, depression, fatigue, itching, heel pain, edema as well as the usual hypo symptoms. I asked the doctor to give me a trial of Synthroid. She started me out on 100 mg. - within 10 days the anxiety and depression were gone!! The next month she raised my dose to 125 mg. although I felt better I wanted to experiment with the Cytomel that I had left, so I added 5 mcg. to the Synthroid. I had more energy within days than I had had for months. I raised the dose to 10 mcg. and felt even better. The itching subsided, the heel pain was happening less often, the edema in my lower legs vanished and the brain fog began to lift. Within the month and with no dietary changes, I had lost 5 lbs. My doctor is letting me continue this regiment for the time being.

For me the Synthroid/Cytomel combination seems to be what will work. I'm not sure why the Armour caused me so many problems. I still do think I could have slight adrenal or cortisol problems that weren't picked up by the test I had. A better test would be the 24 hour saliva test which I have not yet had done. Insurance won't pay for it. Maybe I'll go ahead and order it one day.

I would suggest trying Armour first since most hypothyroid sufferers seem to feel better on it than the synthetics. If Armour doesn't work for you and you still don't feel well - I'd suggest adding some T3 (Cytomel) to your T4. People taking Cytomel report feeling more energetic, have an easier time losing weight and have an overall increased sense of well-being. If your doctor won't prescribe it - find another doctor!

My Hashimoto Story

I'm not really sure when my Hashimotos began. I've always been more tired and less energetic than my friends. I became even more fatigued after the birth of my daughter 18 years ago...then came the adult acne and terrible monthly cramps, there was also the gain of about 10 stubborn pounds that refused to come off. I went to my doctor who ran the standard tsh test and told me I was fine. He suggested an anti-depressant which I declined.

10 years later I quit a 20 year smoking addiction. I had a very rough time of it, this time I did end up on an antidepressant. For about 6 months I took Paxil.....gained an additional 20 lbs. The Paxil did help me through the roughest time, but I was glad to get off of it. I was fat, tired, had acne, fibroids, cramps, brain fog...so I trudged back to the doctor for another tsh test. My levels were normal again.

My HMO changed some rules a few years after that and I was able to go to any specialty doctor without a referral. I took the opportunity to see a Endocrinologist. I was convinced I had Hypothyroidism and thought a doctor who specialized in hormones would be the one to find it. No such luck. I went to him with my growing list of symptoms, he glanced at it and ran the standard tsh test. When that came back normal, he decided to focus on my headaches. Headaches that I have had for the past few years - daily throbbing headaches from Fall through Spring. For a year I saw the endocrinologist and got absolutely nowhere. None of the symptoms, not even the headaches subsided.

Through the years I had dieted, lost weight...20 lbs, 30 lbs, even 40 pounds.....only to regain it quickly. The last diet I was on was "The Fat Flush" diet by Ann Louise Gittleman. It is a strict lower carb diet which I managed to stick to for about 6 months and lost 40 lbs. When I started to slip from the diet, the weight came back on quickly.....even going back on the diet didn't help. That next year..I tried about 8 different diet plans..glycemic diets, hibernation diet, low calorie diet...nothing budged the weight. I was back at the doctor and this time asked that she run not only the tsh test, but also a thyroid antibody test. Unfortunately she cannot hear. She did run a antibody test, but a ANA (anti-nuclear antibodies test) instead of the thyroid ones I had asked for. When the ANA test came back positive, I thought I would finally get diagnosed. My doctor sent me right away to a Rheumatologist who decided it was a false positive (5% of people do have a false reading) since I didn't have Lupus. He didn't run any additional tests...I'm sure he would have found the Hashimoto's then had he did so.

I started seeing a neurologist right after that for the never ending seasonal headaches that I was suffering with. I ended up with a lot of heavy duty drugs (Topamax, Stadol, among others) and no relief from the headaches.

Last spring I had about given up...I was feeling more and more tired, the weight wasn't budging, I had more and more symptoms of Hypothyroidism. As a last resort I made an appointment with a doctor listed in Mary Shomon's Top Doc directory. This doctor checked my neck (like all the others have done) and found a goiter. She ran a full thyroid panel on me including the thyroid antibodies test that I had asked for from the other doctor over a year ago. A few days later, their office calls.....all my numbers are normal....except for my thyroid antibodies. Normal is under 60., mine were 1515. FINALLY!

First Things First

First of all I'd like to say I am not a doctor, not a nurse and not presently working in any health field - I am just a newly diagnosed Hashimoto sufferer who wants to share my story. I hope this blog will be helpful to others with thyroid disease who are working towards feeling better or maybe just trying to get that initial diagnosis. I will be listing little tidbits I've gleaned from the worldwide web over the past few years - much of it from message boards, some from websites. I'll share the best links that I've found as well. Please do your own homework too, find a good doctor and ask questions as I cannot verify the accuracy of all my sources.

Feel free to comment on my posts and share your own experiences. Looking forward to hearing your thoughts!