A ‘Grave’ Situation

My new primary care doctor is thorough, for which I am glad.  At my annual workplace medical she examined my thyroid and asked me if she could run one other test that wasn’t on the list my work requires me to do.  I said ‘of course, whatever you think is necessary’.  But then my test results (TSH and Free T4) came back showing I had a hyperthyroid and she wanted me to see an endocrinologist to figure out why. Cue Dr google.  What is a hyperthyroid?  What does it mean?

Turns out I had all the symptoms I had put down to postpartum and getting older in general.

  • Tiredness – I was struggling to get up in the mornings, feeling exhausted having just slept;
  • Heart beating hard and occasionally very fast, I’m always on the verge of feeling like I’m catching some kind of cold;
  • Pain in my neck I’d put to sitting funny at my desk;
  • Chris had noticed I was always warmer than him (very unusual because I am constantly cold!!!), I was feeling warmer in the office despite it being very cold!
  • When I got sick it was taking me a lot longer to shake it off. I caught a summer cold and the sore throat persisted for over two weeks.
  • Random sore throats that would come and go quickly. I have a toddler who exposes me to all the germs in the world??!
  • Also hand and feet numbness which has been going on for two years, my old doctor ran tests back then, nothing conclusive, decided it was probably postpartum arthritis and I would get over it soon when I stopped breastfeeding. It never went away.  It just never got worse.
  • My new doctor told me off for being underweight, I told her that was not true the scales in the office must be off, my clothes hadn’t changed. Actually I had lost 5lbs and hadn’t noticed so I was close to being underweight on the BMI scale.
  • Finally, the last thing was that I was getting quite short tempered and easily irritable. At work one day recently I slammed the phone down.  I was really mad at someone who wasn’t listening to me.  Everyone came to ask me what was wrong!  It just wasn’t like me.

None of these things I felt worth mentioning to my doctor at my workplace medical because on their own are little thing, but in hindsight perhaps I should have.  I did mention being slightly tired but put it down to being a parent of a toddler.  When in reality, Aviana sleeps incredibly well and is not a little night terror, there is no reason really why I should be tired.

The endocrinologist I was referred to was not available until November (I was referred in July), I thought that was an insane amount of time to wait so I called around looking for a doctor who would take on a new patient sooner.  Eventually I found one who was available in September so I asked my doctor to send a referral to this one.  Like magic, she managed to get me an appointment with the specialist for the following week.

So the following week, the endocrinologist asked me a few questions and took an ultrasound of my thyroid.  He explained that there were a few things that can cause hyperthyroidism and we needed to investigate all of them.  He did an ultrasound and ruled out any masses – my thyroid was swollen on the left side – just where I’d felt the pain in my neck and ignored it.  I also was now able to see what my primary care doctor had felt – my thyroid was clearly swollen.  I just thought my neck was getting fatter!  I had some more blood tests taken and my TSH levels were getting lower and my T3 and T4 levels higher, only just slightly abnormal.  Another test, TSI, came back normal – this was the test that would have given me a clear diagnosis of Grave’s disease.  The endocrinologist told me my symptoms weren’t that bad because many people with advanced hyperthyroid would be sat shaking, anxious, heart racing with their eyes bulging out.  So whatever it was it was caught early, most likely its early onset of Grave’s disease, an autoimmune disease that attacks the thyroid.

The endocrinologist emailed me to say I had a choice (I have a choice?!): to wait and be monitored or to start taking a drug that would help control my thyroid.  Of course, given a choice I will always try the non-drug route.  But then in that time period I also found out my father had a stroke because his thyroid had stopped working and has been on thyroid medications since.  I mentioned it to the doctor and he changed his mind and told me given my family history, he would prefer I took the drugs.  OK so not much of a choice now.  So here I am on 5mg of methimazole every other day.  This is a very low dose given my blood test results.

Chris picked up my prescription and the pharmacist told him that these drugs take some time to get used to and can have some nasty side effects, they printed a detailed sheet for him to give to me.  That made me feel nervous.  I did some research online and many of the side effects included nausea, headaches, upset tummy, weight gain and pretty much all the other reactions someone may have to drugs in general.  I joined a support group on facebook and learned that it is best to take the medication with food before bed.  The first day I took it I was at a party, 20 minutes after taking the tiny pill I suddenly felt like the world slowed down, I couldn’t feel my heart beating as hard or fast that it felt really strange.  I felt like a weight had been lifted off my chest.  Chris told me I looked like I was stoned.  But that didn’t last too long.  Over the next few days I started to feel less tired, I had more energy and my heart was not pounding as hard.  I guess I was ill after all, I just hadn’t noticed it.

I bought a fitbit to help monitor my heart rate.  I’ve been taking the medication now for almost four weeks and my resting heart rate has come down a little bit….however I have started to do exercise again as I have felt like I’ve got my energy back, so maybe that’s related to the exercise or a combination of the drugs and the exercise.  In general, I haven’t any side effects – I put the weight back on immediately, but not excessively and I sometimes experience nausea a few hours after taking the pill, but it’s not terrible.

I spent a bit of time researching the thyroid and infertility.  It turns out that your thyroid can mess up your fertility.  I took a look back at my TSH levels that my primary doctor tested every year for my annual medical and there were high-normal.  My Reproductive Endocrinologist never tested my thyroid, but if she did or looked at my annual results from my primary care physician some RE’s would have considered my TSH levels for fertility too high and may have given me drugs.  Perhaps this all explains my unexplained infertility after all?  I found out that thyroid tests are now included in the standard workup at the clinic since I least went 4 years ago which I am glad about.  But that doesn’t really matter right now as we are not planning to TTC.  Our frozen embryo remains on ice.  Even if we did want to TTC, the drugs I am on currently are toxic in the first trimester so that would be problematic. Plus I would have to get my thyroid levels back to being normal before getting pregnant.

Oh did I also mention that thyroid problems are relate to IUGR?  May be another explanation for something so unexplained in my life?

My next monitoring appointment is Friday.  I’m hoping for positive news that the drugs are working and I don’t need a higher dosage.

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