A PSA of Sorts
Sunday, August 1st, 2010 10:41 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
rolanniThose who have been reading along at home will perhaps recall that I have an underachieving thyroid. It's no big deal; is, as I understand it, fairly common, or at least not uncommon; and perfectly treatable with a daily dose of a prescribed medication. You can read about it here, if you're interested.
Now, one of the interesting things about the hormones produced by your thyroid, my thyroid, and the thyroid of the woman at the coffee counter trying to decide if she wants a double-shot of espresso, is that "normal" is a range -- between X and Y is normal function.
With me so far?
Good.
The aim of medicating people with hypothyroidism is to supplement hormone levels to "normal," which makes perfect sense.
Except that -- and despite the fact that hypothyroidism is a pretty common problem for Women of a Certain Age -- apparently no one takes a baseline of "normal" thyroid function when you -- General You -- are young and healthy and presumably firing on all cylinders, so that there's an on-file "normal" to return you to, should your thyroid suddenly come up lazy.
This potentially leads to circular discussions with one's doctor about if one's supplemented hormone level is "normal" on the scale, but one is still experiencing symptoms, could it be that one had been used to a higher "normal" production level of hormone, back in the day?
So! If you're a young woman -- ask your doctor about a thyroid test the next time you get blood work, so you have a baseline on-file, should the day ever come when you need supplements. You might have to get a little chesty with him or her, but, hey, it's your blood and your future.
Now! Another cup of coffee, and to the couch!
Now, one of the interesting things about the hormones produced by your thyroid, my thyroid, and the thyroid of the woman at the coffee counter trying to decide if she wants a double-shot of espresso, is that "normal" is a range -- between X and Y is normal function.
With me so far?
Good.
The aim of medicating people with hypothyroidism is to supplement hormone levels to "normal," which makes perfect sense.
Except that -- and despite the fact that hypothyroidism is a pretty common problem for Women of a Certain Age -- apparently no one takes a baseline of "normal" thyroid function when you -- General You -- are young and healthy and presumably firing on all cylinders, so that there's an on-file "normal" to return you to, should your thyroid suddenly come up lazy.
This potentially leads to circular discussions with one's doctor about if one's supplemented hormone level is "normal" on the scale, but one is still experiencing symptoms, could it be that one had been used to a higher "normal" production level of hormone, back in the day?
So! If you're a young woman -- ask your doctor about a thyroid test the next time you get blood work, so you have a baseline on-file, should the day ever come when you need supplements. You might have to get a little chesty with him or her, but, hey, it's your blood and your future.
Now! Another cup of coffee, and to the couch!
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no subject
Date: 2010-08-01 03:50 pm (UTC)no subject
Date: 2010-08-01 04:03 pm (UTC)To which I explained (more politely than was perhaps warranted) that I'm a geek and therefore perfectly happy in jeans and t-shirts, and she could go get stuffed. I then found a new different doctor who actually tested my thyroid levels but decided that because I was right on the edge of the bottom line of that range, I was fine. Having an earlier value to compare that to would've been very helpful at that point.
Then I became pregnant with twins and my thyroid threw its hands up in the air and declared it was DONE with me once and for all, so now I've got meds and it's amazing how much more normal I feel.
no subject
Date: 2010-08-01 05:24 pm (UTC)This is an OB who refused all pre-hiring interviews, because her reputation was supposedly good enough.
Right.
no subject
Date: 2010-08-01 07:48 pm (UTC)Alas, I wish I could claim to have found a good doctor since; I can only say I've found one less demonstrably bad. Sounds like your own luck has run much the same as mine. )-:
no subject
Date: 2010-08-01 09:13 pm (UTC)For a while, it did. I was not happy with my PCP, my gyn, my dentist, my psychiatrist, my therapist...when I moved "over the hill" to Silicon Valley, I got a superb dentist who has enabled me to drop ALL my coping techniques (and my husband to go to the dentist at all, which had to start with an abcessed tooth which had to be pulled and replaced). When I was working up the Peninsula, it made sense to see a dr. in Menlo Park: now it's just another drive to make, but I had no recommendations for the San Jose area, so I stick with the travel. In 2001, the only psych who called to say there was space in the practice and she took my insurance, also thanked me for leaving the details she was going to have asked for and saving her the time. She's still 90 min. away, but what ain't broke ain't going to get fixed, and it's a pretty drive. I asked my son's therapist if she'd take me on, and boy was she a help! Son still sees her, and while in Santa Cruz, there are other things to justify the drive.
My second OB (the first had her own medical issues going on) said 2 really heartless stupid things afterwards in later visits that made me livid enough to leave.
I had 2 clueless psychs in SCruz before I started a clinical trial at Stanford where the 2 working on the study were such sweeties, I knew I could do better than what I'd had. Claire and I work well together, and the drive is worth it for the excellent attention I get.
no subject
Date: 2010-08-02 02:03 am (UTC)My mom was livid. ("Is she TRYING to get you pregnant?" she snapped.) I have no idea why she didn't fire the woman entirely; as it was, she found me a new doc and kept going to her same one.
Oh yeah, and then there was the small (*cough*) matter of the abnormal Pap smear that the stupid woman's office never called me about and I only learned of when the new doctor's office had the results faxed over, and you can bet that if a doctor EVER did that to me now I would be on the phone to the medical board and the insurance company before you could spit.
Rude names abound. Alas, I suspect that many of them, being quite misogynistic, would not fly in this space.
no subject
Date: 2010-08-02 03:08 am (UTC)My parents were of the "don't until marriage" school. I think the only contraceptives covered in "social health" were condoms and maybe the Pill. Don't know how I learned about other methods, unless it was by reading Our Bodies, Ourselves.
My son refused to take Social Health, or whatever they're euphemizing now, because "my parents already told me everything I need to know". We have talked to him about things sexual and reproductive since he was a small child, when he'd bring up the topic, or we'd hear something on the news I wanted to explain.
I was flattered, but I suggested we might have forgotten a few things, and to take it if it were offered later. I certainly didn't go over the stages of STDs--didn't think to--but I explained why he was to use condoms, although the AIDS talk came only last year.
no subject
Date: 2010-08-01 04:38 pm (UTC)no subject
Date: 2010-08-02 04:44 pm (UTC)no subject
Date: 2010-08-02 04:46 pm (UTC)no subject
Date: 2010-08-01 05:20 pm (UTC)I have a friend who has the same dosage. She has major depression, I have bipolar NOS. This is not the only thing that can cause the need for a closer titration of synthroid.
Perhaps you need a specialist on this, if insurance allows. I started out at 4ish, and 25mcg. During the worst of recent spells of depression & inability to get myself out of bed, my TSH was 4ish, again...quelle surprise. I always ask for the TSH number, not just "normal"--I have to.
no subject
Date: 2010-08-01 07:46 pm (UTC)no subject
Date: 2010-08-01 09:17 pm (UTC)Good luck. I did have to keep arguing until I got someone willing to give it a try. Indeed, normal for the general population is not normal for *everyone*.
no subject
Date: 2010-08-02 05:02 am (UTC)Another suggestion would be to have them check for the presence of thyroid autoantibodies (Anti-TPO and Anti-TG) since autoimmune thyroiditis or Hashimoto is the most common cause of hypothyroidism in the US.
Ask specifically for an endocrinologist referral if you have doubts.
no subject
Date: 2010-08-01 05:23 pm (UTC)no subject
Date: 2010-08-01 05:33 pm (UTC)no subject
Date: 2010-08-01 09:00 pm (UTC)...which you'd sort of expect.
no subject
Date: 2010-08-02 02:05 am (UTC)no subject
Date: 2010-08-02 04:47 pm (UTC)no subject
Date: 2010-08-02 06:50 pm (UTC)no subject
Date: 2010-08-01 09:18 pm (UTC)no subject
Date: 2010-08-01 08:16 pm (UTC)Since I changed doctors and they've been monitoring my vitamin D levels along with everything else, things seem to be better.
I do have a baseline measurement from when I was young, but unfortunately I had hyperthyroidism at that point and my heart rate was 132 bpm at rest, so they don't want me anywhere near that. The doctor does little eyebrow raised frownies when I suggest it :)
Synthyroid, vitamin D supplements, try to eat lots of seaweed (sushi, miso soup etc.) because it is a good source of iodine and the thyroid is the only thing in your body to use iodine, and some sort of exercise (yuck) and I feel somewhat human.
no subject
Date: 2010-08-01 09:24 pm (UTC)I was moved from Lamictal to its generic lamotragine. On 200mg Lamictal I was fine, but I needed 300 of lamotragine. Claire said that generics have to have a minimum of only 80% of the chemical of the brand name, and some of them ARE noticeably lower in activity.
I've been moved to a generic of Effexor XR, and we'll see how that goes.
For migraines, I take Fiorinal. A generic of Fioricet (acetominophen rather than aspirin in with the main med) is no use to me, as acetominophen has no effect on me, and at the time, there was no generic for Fiorinal, at least not in the states. Dr. had to write specifically, no generics, capsules only.
no subject
Date: 2010-08-02 02:21 am (UTC)Cats
Date: 2010-08-02 06:32 am (UTC)Still having symptoms?
Date: 2010-08-02 06:42 am (UTC)Watch out .....synthroid, a synthetic thyroid, is often prescribed BUT it doesn't work on all patients. So...if you are still having symptoms you might want to try Armour thyroid which is natural thyroid, unfortunately from cows. I say unfortunately because I am a vegan and don't like to take thyroid from cows. The synthroid is color coded. I am allergic to my dose which is bright red. I'm allergic to all food colorings. The Armour thyroid....I take a big dose, 90 mg is not colored. However...in addition just to make sure I also take 130 mg of thyroid from a very high quality supplement company called Nutripak. More thyroid won't hurt you. Too little will. Hope that's helpful.
Re: Still having symptoms?
Date: 2010-08-02 03:20 pm (UTC)Too much thyroid can be bad, too. Specifically, it can adversely affect bone density. They didn't use to have a test for too-high levels, but they do now. My mother's dose is way down since that was developed. She'd been taking too much for many, many years.
One problem with natural-thyroid supplements is that the concentration can vary quite a bit from one batch to the next.
(edited to fix editing mistake)
Thyroid joys
Date: 2010-08-02 10:13 pm (UTC)It took weeks to find a happy medium.
I give my sympathy to anyone who has to go through this process.