Whether to Smile or Cry
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I know I want to smile, but I think I just want to cry a sigh of relief.
I got the results of my blood test today, and, praise the Lord! they confirm what I could only conclude after many false leads while searching for the cause of my chest pain: my t3 levels are too low. With the lab's normal range between 87 and 178, my active thyroid hormone scored an 80.
It sounds like a simple enough matter to question and test. But t3 tests aren't typically among the tests performed to determine hypothyroidism. The pituitary gland's thyroid stimulating hormone level is the primary test, but occasionally the t4 level is tested since almost all synthetic replacements prescribed today consist exclusively of the t4 thyroid hormone.
Conventional wisdom in the endocrinology specialty is that t4-only is a sufficient replacement, as the body, under normal circumstances, converts what it needs from t4 into t3. However, there is a slight problem with this, which you'll see when I explain the difference between t4 and t3.
Having t4 is like having food in the freezer. It's there, but you need to thaw it out before you can use it. Having t3 is like having food in the refrigerator. When you need it, it's right there. But if you haven't moved anything from the freezer into the refrigerator to thaw out, and the refrigerator is mostly empty, it doesn't matter how much meat you have in the freezer; you could even have more than you can handle stuffed in there: you'll have to settle for scrounging up whatever food is available.
The problem with relying solely on t4 replacement is that a person has to assume that the body is moving stuff from the freezer and into the refrigerator. All too often that's what exactly what endocrinologists assume.
Up until last year I had been plodding on with the same thyroid replacement dose, when my old prescription ran out and complacency allowed me to accept a resident's radically reduced dose.
It didn't take long before I started to feel the old symptoms of hypothyroidism. My arms began to ache. I lost the ability to maintain my composure in the face of adversity. A burning sensation returned to my chest that I hadn't had since I was completely off meds for the radiation therapy 5 years earlier.
(Interestingly enough, the endocrinologist later read my blood test and saw that I had too much food stuffed in the freezer. He never looked in my refrigerator; he didn't see any reason to. In fact, he told me that I never was hypo, and that he would eventually start to cut my grocery budget again.)
At my insisting, however, I was returned to my previous dose, but the burning persisted. It got to the point where it felt like pressure from within, as if something were physically present there. And because it is not uncommon for the tall cell variant of papillary carcinoma to metastasize to the lungs, I earnestly researched and pursued that angle as far as my HMO would allow.
Then a woman on a forum for advanced thyroid cancer recognized my symptoms which she had always associated with metastases to her lymph nodes. I pursued that angle as far as I could within my physicians group without receiving any satisfactory answers.
I can't tell you how difficult it is to have pain that nobody understands and some suspect is exaggerated. One explanation for the symptoms seems promising in its plausibility, and even though it carries serious consequences, there is no joy in eliminating it as a possibility when there are no other candidates in sight.
Well, completely separate from this wearying battle, I was inwardly inspired and motivated to fortify the structure of our home[school] schedule. This included getting up early and working out, and it was great: I felt energetic and was amazingly productive.
For about a week.
After that it became increasingly difficult to recover from the exercise to get moving on with the day. One day I went back to bed and slept for another hour. Old symptoms of hypothyroidism had returned, and I was fatigued and weepy.
Some old, unanswered questions from the early post-thyroidectomy days began to gnaw at me: how can a static dose sufficiently replace a dynamic organ? Is it possible for a body's demand to exceed the synthetic replacement available? What happens if it does?
Growing more convinced that being on thyroid replacement is like being on a fixed income, I decided that I had been overdrafting, and I stopped working out. Not surprisingly, I began to recover.
In the meantime I was searching the internet for some answers when I discovered what I'd been looking for: a fibromyalgia clinic.
It turns out that this doctor has had an 85% success rate in treating patients with fibromyalgia by addressing their previously undiagnosed thyroid condition. The solution: ignore the level of thyroid stimulating hormone produced by the pituitary (which appears to be overly sensitive to t4 compared with other key organs) and get the t3 levels up where they ought to be. Then you can reduce the t4.
This was a big revelation for me. If it's true that fibromyalgia is actually chronic hypothyroidism manifested over many years, then my pain, if it's at all similar to that which is typical of fibromyalgia, just might be due to being undertreated.
All I needed was the bloodwork to confirm or confuse the issue for me, and since I had my blood drawn, I'd been holding my breath: it could be either a glorious dιnouement or another terrible plot twist.
But today we're tearfully relieved, and the curtains seem to be opening on the final scene of this drama: my family doctor has now e-mailed me the name of an area doctor who might be able to work with me on adjusting my medication. I look forward to when the curtain falls on the whole thing.
Thank you for your prayers. I hope that what I've been learning the hard way might make its way to others who are also having a difficult time with their thyroid.
It's just so nice to smile, isn't it?
from Psalm 145:
14 The LORD upholds all who fall,
And raises up all who are bowed down.
15 The eyes of all look expectantly to You,
And You give them their food in due season.
posted on Thursday, March 30
Comments
Friday, March 31
Great news, Pam
Posted by PreschoolersandPeace
Praise God for His faithfulness!
-Kendra
Friday, March 31
Untitled Comment
Posted by Dana
I think I held my breath through the whole 'story'. Your research and unsettled spirit lead by the Lord brought you answers in His time. Smiling with you!
Dana
