When I was an undergraduate student at the University of South Dakota, I worked out. I actually liked it. Over spring break of my junior year, I hiked the Grand Canyon (all the way down and up in one day) for which I trained, in part by running up and down the steps of the Dakota Dome for months beforehand.
I also did cardio and took long walks in town and longer bike rides out in the country. Shortly after the amazing spring break trip, I injured my leg on faulty gym equipment, bruising the bone. (There’s still a dent in my shin). This put my workout regimen on hiatus. Around this time, I noticed my hair and fingernails had become very brittle and were breaking easily. Frequent necessary trims brought my once long hair above my shoulders over the course of a couple months. I was feeling down and anxious, too; I assumed it was from a drop in seratonin since I wasn’t exercising much anymore.
My skin got very dry and my cuticles were a mess (and since I have a history of picking/trichotillomania, anxiety exacerbated these symptoms). I was sure that it was the hard water at my apartment, and I began treating buckets of water with Calgon before rinsing my hair. I spent oodles of money on expensive lotions and conditioners, none of which helped my skin or hair. I was always cold and people kept asking me if I was sick because I looked pale.
I also began to put on weight and had a hard time concentrating. If I didn’t accomplish enough, I felt even worse about myself and even more stressed out.
When I went home to the Twin Cities that summer, a family member facetiously told me that maybe my problem was “glandular,” playing on a common excuse people make for being fat. [Har.] I worked out for the first part of the summer, but I got depressed and didn’t bother much for the rest of it, mainly just hitting the bike trail when it wasn’t super hot. I also worked at a hotel as the front desk clerk, the 3 p.m. to 11 p.m. shift (on my butt), and shortly before I left each night, the donut delivery arrived for the next morning’s continental breakfast. I have always had a thing for old fashioned donuts (you know, the ones with the deep crease all the way around. I’d rip off the outer pieces in sections and eat them very slowly, and then pretend that the remaining circle was a-whole-nother donut). I was angry at my body for betraying me, and I was getting fatter and fatter anyway, so I wondered what the point was in watching what I ate. Every time I ate one of those donuts, I wanted to smack myself. A vicious cycle. That summer, I also drank mochas from Caribou Coffee whenever I felt like it and ate at my favorite restaurants in the Twin Cities (especially when someone else was buying) like Figlio and Café Latte.
Frustrated, anxious, and very blue, I considered that it might actually be “glandular” (or something that a doctor could diagnose, anyway), so I made an appointment with my old family practice doctor who I hadn’t seen in a few years. He ordered a TSH (thyroid stimulating hormone) test and some other blood work, but I was bummed to learn all of it came back normal. (For the TSH, bad is when it’s high). He prescribed an antidepressant because I reported depression. I took it for a while but felt no difference, so I never filled it again.
When I returned to Vermillion, South Dakota for my senior year of college, I realized I had gained almost 60 lbs in about six months. I needed new clothes, even a new coat and shoes. (Yes, my feet even got bigger. What the heck‽)
I knew something wasn’t right. That fall, I saw a doctor at the university health center who suggested birth control pills were causing my weight gain. He recommended I quit taking the pill and he prescribed a different anti-depressant. I gave this one even longer, six or eight weeks, before I gave up on it
Not surprisingly, my neck and back were bothering me that winter, so I made an appointment with a chiropractor I’d seen the previous school year. He was stunned at the change he saw in me–it wasn’t just the extra weight, but my skin and hair were dull and he said that I looked completely different. He told me to have my thyroid checked. I told him that a TSH test had come out normal a few months before, but he told me that I should do it again, and also get the T3 and T4 checked, and then if those three were normal (and compared to each other) to have my adrenal function checked. He wrote all this down for me.
To get the tests ordered, I had to be more aggressive than I usually am with physicians, but my chiro was right–when all three of those tests were compared, it was clear to the physician that I had an under-functioning thyroid even though my TSH was on the high side of normal, and he prescribed Synthroid. I felt better within a few weeks of taking the medicine, which surprised me because I didn’t expect results from a pill, especially one that tiny (probably because taking huge antidepressants hadn’t done squat). Unfortunately, while being on a proper dosage of Synthroid can help prevent thyroid-related weight gain, it doesn’t do anything to help one lose the weight gained while it was left untreated. Drat.
It’s now years later, and as far as medical problems go, I’ve found that hypothyroid is no big deal–when it’s treated. A couple of times over the years, I’ve known that I needed to up my dose because I didn’t feel quite right. There are some medical issues to be on the lookout for, especially if hypothyroidism has gone untreated for some time, like heart problems, mental health issues, and infertility. I have also since learned that hypothyroidism can cause anxiety–though many body functions are slowed down by a sluggish thyroid, anxiety is common and can cause insomnia and nervousness. (So while I was depressed and tired from my undiagnosed hypothyroid, I was ironically kept awake and nervous because of it for who knows how long. My concentration problems and math anxiety weren’t my fault!)
Most internist or family practice docs will handle treatment of hypothyroid, so high-priced specialist copays aren’t usually required. I just need blood tests every so often, but the prescription is reasonably priced (even the name brand, which is what I stick with after having a generic that didn’t work a few years ago). I had an ultrasound on my thyroid once (my doc thought it should be checked after she examined me, but it was A-OK).
Hypothyroidism is common, but why it happened was somewhat of a mystery to me. I was the only person in my family I knew of with any thyroid problem. I was pretty much a vegetarian when the symptoms began, a naughty vegetarian who ate a lot of carbs didn’t take vitamins. I occasionally ate seafood, but not enough, living on the Great Plains as I did, to get measurable iodine in my diet (and I certainly never ate sushi!) I also avoided salt as an attempt at healthfulness, so it’s possible that an iodine deficiency had something to do with it. But maybe not. My older sister was diagnosed shortly after I was, too, and she’s never been a vegetarian. That I know of.
If I knew then what I know now, I would have sought medical advice sooner–and then a second opinion immediately when the first doc said my TSH test was normal. The TSH has a large normal range and some physicians might disregard a result on the high side of normal, which is why they should test the T3 and T4 with the TSH when a patient has symptoms like I did at the time, symptoms like depression, anxiety, concentration problems, weight gain, lethargy, sallow skin tone, constipation, and dry skin, hair, & nails.
An estimated eleven million Americans have hypothyroidism, more commonly women and most commonly older women. Chances are you know someone with hypothyroidism, possibly someone who isn’t even aware of it. Luckily, there is a vast amount of information online (like at Mayo Clinic) and the tests and medications are reasonable and easy to get, so there’s no reason to suffer like I did. I still miss my hair and my old ass, but I hold out hope that I’ll get them back one day. I know that the weird little gland in the throat is responsible for these physical and mental symptoms, but I have the tools to manage it. Now I just need to remember to take my pills (and getting back in the gym would be good, too).