Tuesday, January 29, 2013
Miserable is the word of the week. I've got muscle aches and pains -- no fever (in fact, my temp is below normal), so it's apparently not the flu. Couple that with fairly extreme fatigue, and I have no desire to do much of anything that requires moving. Sitting here typing is about all the exercise I can handle.
I went to the endocrinologist last week to discuss my hypothyroidism. I saw a new endocrinologist, who listened intently and didn't speak much. I told him that the nutritionist referred me to an endocrinologist because I have an abnormally low RMR, which is usually indicative of undertreated hypothyroidism. My diet is adequate and should be supporting healthy weight loss if not for the low RMR. My personal trainer suggested I see someone because despite a regimen of 6-8 hours of exercise per week for 4 months (cycling classes, lots of swimming, core classes, regular weight lifting, running, and outdoor cycling when feasible), my body fat has increased from 29% to 34% in four months despite averaging 1400 calories per day and 375 calories burned per day per SP (475 if you believe my HRM; yes, it's a chest strap). I talked with my gynecologist two weeks ago, and she is the one that referred me to the endocrinologist based on my symptoms.
Side note on the gynecologist: when she came into the exam room, she was SO excited! "You've LOST FIVE POUNDS in the last year!! That's GREAT!!" I groaned, because I really should have lost a whole lot more than 5 pounds given my diet and exercise. "No, you don't understand. I almost NEVER see a patient who weighs less than they did last year. I'm so glad to see someone that DOES weigh less! Most people weigh at least 5 pounds more!" I made her day (and that information did help me feel a lot better) by weighing less, then we talked about it some more. I talked about the nutritionist visit, the low RMR, inability to lose weight, and the other symptoms. She agreed that I should have lost a lot more weight and something is not right with my hormones. She arranged for an endocrinologist visit.
Back to the endocrinologist. I shared with him my previous labs, the list of symptoms, the various meds and dosages over time, and a summary of my diet and exercise to show that I have made a more than concerted effort to lose weight. He listened intently. His advice? Eat less, exercise more, and stop taking one of the thyroid replacement meds. No advice on the other symptoms of being obviously freezing in his office, a measured pulse of 46 and a temperature of 97.6F.
I cried my way home.
Per his request, I stopped taking the hormone that is taken twice a day; it clears one's system fairly quickly. Overdose symptoms are jitters, palpitations, fast heart rate, sweating, diarrhea, and weight loss (among others). Per the patient education leaflet, "Symptoms of low thyroid levels include fatigue, muscle aches, constipation, dry skin, weight gain, slow heartbeat, sensitivity to cold, or dry brittle hair that tends to fall out easily. These symptoms should disappear as your body adjusts to the medication." I had gotten rid of the fatigue and muscle aches when I started the medicine, and now they are back with a vengeance. I almost wonder if I have the flu, except the gradual onset and progressive nature of the aches is exactly when I stopped the meds and I still have a body temperature below normal. (And the flu isn't gradual.) I haven't been able to work out in four days because of the fatigue and disinterest, something that is REALLY abnormal for me (at least in the last 4 months). And to add insult to injury, I've gained three pounds in the 6 days since I stopped the medicine despite cutting my calories (offset by four days of no exercise...).
I got an email from the doctor's office that my lab results are posted on the portal. My TSH is up even more. Yes, it's still in the "normal" range, but it's fairly well above where I have symptoms. "Should you have any questions about your reports, please contact your healthcare provider directly." Does this mean that everything's fine and I can expect to interpret my own reports and contact the doctor myself? Or can I expect him to contact me to interpret them? Because right now, I'm feeling AWFUL, MUCH worse than when I went in. Thanks for sending this after hours, too.
Miserable. It's the word of the week. Except for the weather -- despite the ice storm over the weekend, it was 70F outside today. And I was inside, unable to enjoy it.