Friday, June 19, 2009

Down time.

As I was shooing the world's sweetest cat away from the baby scorpion on my kitchen floor, it occured to me that sometimes, it's good to have someone in your life to keep your ass from getting stung when you're too stupid to use common sense.

There's no real life analogy to that.
I let it stand, just as it is, for anyone to reflect upon and apply to any area of their life that they find meaningful.

So. the thyroid thing. Well, it's been nearly 3 months. I'm still tired a lot, but it's not as bad as before. I tried a b complex, and it seems to give me a boost for a few hours in the morning after I take it.

I was visiting with a colleague who is an MD, on another matter, and she happened to ask after my hypothyroid condition. What's your TSH? She queried.

4.2, I responded. My endocrinologist seemed satisfied with that number.

She frowned. Someone as active as you should really be in the low end of normal, (between 1 and 2) she said.

I confessed to my doc friend I experimented by upping my dose one day and felt good all day but and slept normally that night. She nodded. No surprise. I mentioned that I was running 20+ miles a week and cycling 60+ miles a week, no weight loss yet. She snorted.

You need to ask your doctor to up your dose.

Okay, uh I will, I promised.


Except that I'm still intimidated by white-haired guys with MDs. Me, overeducated, Iron me. I'm intimidated by the white-haired guy in the lab coat. He's perfectly nice, and yes, I know that he poops just like everyone else, but I have a hard time asserting myself .

Maybe it's the whole dad thing. I have dad issues. Don't go there. Just know that I do. My dad's untimely death left the whole thing unresolved, too, so it just kinda floats in my mind, like a preserved specimen in formadehyde.


I'm guessing we're not going
swimming tonight, Baboo and I. Apparently, he fell asleep while doing some armshair research on "exhaustion" on the Internet.

That's fine. I can stand an evening of down time.

I'll stare at the baby scorpion in the jar and draw some more simple analogies.


  1. "baby scorpion in the jar" = 2 questions: How? WHY?

  2. Back to the endocrinologist with you, missy! Feeling better is good, but feeling good is better! You could just up your dose by yourself and tell the dr next time; he'll probably look all wise and say, good plan, just what I would have recommended. Or take Baboo along to speak to him

  3. 4.2 is too high. The normal range ends at 3 (0.3-3), and most folks do feel better closer to 1 (definitely below 2).

    If you're taking a T4 (like Synthroid) you may or may not have felt a difference from the meds in a day (if you're really sensitive, maybe) since it has a 6 week half life (why you change dose and go 6-8 weeks before a new blood draw) so in my experience, somewhere in the 2-4 weeks is when I start to feel differences from a dose change. If you're taking a T3 like Cytomel (though usually you take that in combination with a T4 rather than alone) you would feel it, since the half life on those is in hours.

    Know that, in my experience and in what I've read, many or most endos go by the number rather than how you feel, and for some if the number isn't bad (say, up to 10) they'll go with it even if it's out of range - treating problems instead of shooting for optimal health and wellness, especially hard for athletes.

    I would suggest asking for a dose change first (you can start by getting him to get you in the normal range) instead of just doing it yourself, even if you have to get an appt rather than just talk on the phone. If you do it yourself and get a blood draw, you'll just be explaining why you didn't follow instructions (noncompliant!) and arguing about things. Plus, depending on how you much more you take, you could be overdoing it - the doc can rx smaller incremental changes. If the doc refuses (possibly because of learning/belief, possibly just because you'd be challenging him - ask for his rationale), you may want to find a new doc. (it is quite common for thyroid patients to have to go through several docs to find a good fit) Depending on your comfort level, you probably don't need an endo - any doc can rx thyroid meds, and some GP/FamPrac docs, esp those that focus on wellness, will work more cooperatively with patients to achieve desired results. If you need some references to support a dose change, let me know and I'll hunt them down for you.

    I'm not good at challenging authority figures EXCEPT for docs - I've run into too many instances where a doc didn't know enough or was just acting without considering all the factors or wasn't up to date on research (or other issues). No one cares more about how I feel and my health than I do. I'm the one living in this shell every day, and I want the most I can get out of life.

    I strongly encourage you to take action even though it's hard - you CAN feel better than you do, and when you do, you'll be glad you pushed through the discomfort with the doc.

    Let me know if I can be of any help.

  4. Yep, like I said before: you have got to be VIGILANT about this. Sad as it is, I long ago figured out that my health and well-being is 100% my own responsibility and doctors are merely a small part of the means to that end. Ask for what you want--after all, who knows better what's right for you than YOU? :)

    p.s. I prefer my TSH below 1, as far below as possible. You can dooo eeet!

    p.p.s. I second the Cytomel recommendation...or even Armour if you are willing to try. Iodine may be helpful, as might Vitamin D, in addition to the B-complex. Good luck!

  5. This is such a great opportunity to assert yourself to a white haired man. This is your health. This is how you feel every single day. You need a lower dose.

    You could also just take less and then TELL him that's what you did. No need to ask Daddy for permission. You are all grown up now. Just do it.

  6. or is that take more? I guess you need more synthroid to excrete less T1 or Twhatever. Just do it and then tell him you need more stuff because you feel much better, thank you very much Dr. White Hair.

    That or change doctors. You are fighting for your health here - not permission to go on a date.

  7. MJ is on the right path, for sure... he/she is a smart cookie.

    Don't back down against the white-haired MD -- you're way tougher than that!! The one thing I have read in many different places is that with regard to your Thyroid and how you feel, you must that communicate strongly and not enough just to you to the "normal" range.

    I got super lucky in that my Endo also works with lots of higher level (higher than me) athletes -- so he won't be happy with being in the "normal" range if I'm not feeling good, and this is what your Endo needs to consider.

    If he can't wrap his head around what you are telling him, then you need to find another Endo who does listen.

    You, as a trained endurance athlete, are going to feel different than someone who doesn't routinely exercise and stimulate their thyroid naturally.

    Have you considered augmenting with acupuncture? I've heard great things about it, when being used as a compliment to medication (not a replacement).


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