Wednesday, January 5, 2011

Thyroiditis

I saw an endocrinologist last week who told me I'd been taking my pills the wrong way for YEARS. Oops. Then I spoke to several others who've been on thyroid medication for a long time, one of them a medical professional, and they didn't know all the things I learned either! So, I'm posting this in the hopes that maybe I can help someone out there.  Of course, you should always talk to your doctor about your unique situation and know that I am not a medical professional just sharing my story and the things I learned from my specialist last week.

Thyroid disease is extremely common. It can either be Hypothyroid (under active thyroid gland) or Hyperthyroid (over active thyroid gland rather unfortunately named Graves Disease which I know little about).  I have hypothyroid, Hashimoto's Thyroiditis to be specific.  WebMD (linked above) gives symptoms of Hypothyroidism as: 
  • Feeling tired, weak, or depressed; 
  • Dry skin and brittle nails; 
  • Not being able to stand the cold;  
  • Constipation;  
  • Memory problems or having trouble thinking clearly; and 
  • Heavy or irregular menstrual periods.  
I have also noticed my hair falls out, I have breakouts in unusual places (like behind my ear), and weight gain or the inability to lose weight even when dieting and exercising when my levels are off. 

Additionally, in pregnancy hypothyroid can cause birth defects and mental retardation in the fetus, as well as miscarriage. Although we will never know for sure, I have a feeling my recent miscarriage at 6.5 weeks was due, at least in part, to my thyroid levels being too low.  

After pregnancy the symptoms of hypothyroid can be very similar to those experienced by most women postpartum.  That was the case with me and my dropping thyroid levels weren't caught until several months after my daughter was born. One clear sign- lack of breast milk. If your hair is falling out and you're tired and your nails are breaking AND you're not able to fully feed your infant get your thyroid checked.

If your doctor wants to test your thyroid levels he/she will draw some blood and test your TSH. It's always been a little confusing for me to understand. A high TSH number means your thyroid is LOW whereas a low TSH means your thyroid is HIGH.  I believe the normal range is -5 to 5 with the goal of being 0.  When mine was most recently checked my TSH was over 7 so my thyroid function was low. 

An under active thyroid is extremely easy to treat. Pop a teeny tiny pill in the morning and you're good. Or so I thought. Here's where my doc set me straight last week.  Most everyone I spoke with knew you had to take your thyroid replacement pill (known as Synthroid or generically as levothyroxin) first thing in the morning on an empty stomach.  I had been doing that for years. BUT I didn't know that I was supposed to take it alone and that I needed to wait a full hour before consuming anything other than water.  I had been taking my daily vitamins at the same time as my synthroid.  My endocrinologist told me that was the exact WRONG thing to do. He said the synthroid bonded with the vitamins and prevented me from absorbing the medication. So even though I'm on a relatively high dose of hormone, my body is only receiving a fraction of it. He even went so far as to say that 95% of the time if people start taking their drugs correctly their dose can be lowered over time.

So, here are the guidelines he gave me: 

1. Take synthroid or levothyroxin in the morning after fasting all night.

2. Take it with water ONLY. (No coffee for an  hour! Bummer.)

3. Do not take any other pills at the same time.

4. Continue taking vitamins but move them to 12 hours after you take the thyroid meds.

5.  No eating or drinking anything but water for at least 45 minutes and preferably an hour after taking the thyroid medication.

I found all this waiting around for coffee to be a pain. So, I had to alter my routine.  My husband leaves for work at least an hour before I typically get up for the day. So, I started keeping my pills on my nightstand. When he comes in to kiss me goodbye I roll over and take my pills. Then I go back to sleep. When I actually get up I can go straight to the coffee pot and start my day the way I want. 

The other bonus is that moving my vitamins back to dinner time has allowed me to better remember my other prescription that must be taken with food. I have traditionally been HORRIBLE about taking it but have found that I have remembered most days so far. 

I hope that sharing this has helped someone somewhere. Maybe if I can help keep someone from experiencing the pain of a lost pregnancy my little angel's short 6.5 week existence may not have been in vain. 

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