Life in the Slow Lane

I am rowing a boat along a river.  The river is flowing down a slope and I am headed uphill, against the current; it is very hard work.  This image came into my mind in the middle of a busy day selling real estate.  It returned to me later when an endocrinologist asked what it felt like to be hypothyroid.  That doctor was the one who finally got my thyroid situation under control after almost fifty years.

The thyroid is a butterfly-shaped gland at the base of the neck.  It releases hormones that control metabolism.  When it releases too little (hypo) symptoms like fatigue, weight gain, constipation, depression, and sensitivity to cold may appear; with too much (hyper) there may be sweating, weight loss, heart palpitations, and anxiety.  Thyroid conditions behave differently in different individuals so they can be frustrating to treat, both for doctor and patient.

When I was in high school I started noticing that it had become almost impossible for me to lose weight.  At a younger age I could take off ten pounds in a few weeks; now, even if I ate 1000 calories a day, the weight stayed on.  Something was wrong, I thought.  A neighbor of ours who was a surgeon did a blood test and discovered that I was hypothyroid.  Little white pills were prescribed and I took them every day.  I didn’t feel any different; I didn’t lose weight; and nobody followed through with further tests so eventually I quit taking them.

During an extremely stressful period in my early thirties I developed an eyelid retraction (stare) so that my left eye was wider open than the right.  Since this can be a symptom of hyperthyroidism, I was given a radioactive iodine uptake test to examine the functioning of my thyroid gland.  The results were inconclusive and, after several months, the eyelid retraction mostly went away.

After a few years my life settled down and I acquired a regular family doctor.  When blood tests again indicated hypothyroidism, she got to work trying to fix the problem.  I took pills of various colors; the levels went up and back down again, often up in summer and back down in winter.  Eventually she concluded either that I was not taking the pills as prescribed or that there was something else wrong and sent me to a specialist.

From the endocrinologist, Dr. Melissa Cavaghan, I learned a number of things.  One is that you shouldn’t take your thyroid medication at the same time of day when you take calcium because the supplement can affect the medication.  Another is that levels of thyroid medication need to be adjusted in tiny increments so you don’t get the kind of swinging back and forth that I experienced.  For some people, including me, it is important to use the same type of thyroid medication because generics don’t always work the same as the brand name product.  Also, in recent years medical science had changed its opinion about treating hypothyroidism, calling for intervention at levels that were previously considered normal.  Probably my hypothyroidism has been under-treated all my life.  In any case, I now take light blue and dark blue pills on alternate days, which produces an acceptable result on the blood test and makes everybody happy.