Follow-Up: An Experiment of One

If you read my October 2011 post, An Experiment of One, I said I would follow up with the post when I got my next thyroid labs drawn.

I got my results back two weeks ago. TSH 2.29, FT4 0.89, FT3 0.99. I've been symptomatic since around mid-November.

Afternoon fatigue that starts around 11 am. Feeling cold all the time. Difficulty concentrating and multitasking. Dry, dry skin, worse than usual for this time of year and our climate. Weight re-gain of 4 pounds, after I worked hard to lose it earlier this fall, despite no change in diet and increased running mileage. Total cholesterol 252, up from 199 last year at TSH of 1.0.

I'm adding back the skipped doses of Levoxyl and see where that takes me. I'll re-test in about 4 months if I do feel better, also recheck cholesterol. If I don't feel better within 12 weeks I won't wait, I will ask to re-check thyroid and see if a dose adjustment is necessary.

I did have another thyroid ultrasound and the nodule in question has shrunk further, which is good news. My thyroid appears shrunken too, without a lot of blood flow. It's not very functional, which is no surprise, this many years into Hashimoto's. I don't know if this means I am less likely to have flare-ups of thyroiditis now, but that would be a nice benefit of a non-functional thyroid.

I'd like to ask an endocrinologist these questions.

Another good source of information

Columbia University Medical Center has an excellent website with a variety of health resources.
http://www.cumc.columbia.edu/dept/thyroid/index.html

New Comprehensive Article on Hashimoto's Thyroiditis

An excellent updated (November 2011) article on what is known about Hashimoto's thyroiditis. Written by endocrinologists, there's a lot of material here, everything from diagnosing, to symptomology, to treating, to research, and lots of good stuff in between.

It's a good update on what is known now and recommendations for treatment. The only comment I would make, from personal experience, is that there is still an overreliance on lab values, and failure to listen to patient symptoms.

The authors state that only one of nine studies showed an advantage to adding T3 to levothyroxine. That is where I think endocrinologists need to be willing to open their minds and give it a try. If the patient is still reporting symptoms despite a "normal" TSH and Free T4, in the absence of cardiac problems, a little trial of T3 might be a good idea! They state that T3 is more popular with patients than with physicians.

Hmmm. I wonder why that is?

Addition of a little T3 can require cutting back on the amount of levothyroxine, but if it works for the patient and doesn't cause any abnormal labs or symptoms, hello...

I'm not saying T3 is for everyone, or the magic answer, but quality of life is a big issue with thyroid patients. Endocrinologists need to remember they are treating PEOPLE. People who have lives, and don't feel good when they are constantly plagued wth fatigue and brain fog.

If you're looking for an endocrinologist, do a little research. Find out if they have a genuine interest in thyroid disorders. Have they attended any conferences or participated in any research on thyroid diseases? How do they balance the patient's symptoms vs. lab values when treating?

If you're having problems getting back to feeling like your normal self, "come back in a year" is not the right answer.

Just food for thought.