Tuesday, May 13, 2008

What's Up With My Thyroid?

I got diagnosed with hypothyroidism back in 1999 or 2000 during a routine exam when my then-internist noticed that my thyroid seemed enlarged. Sure enough, the tests came back showing hypothyroidism.

I didn't start taking medication for it for another year or so after monitoring suggested it wouldn't rebound on its own. But I never had noticeable symptoms from it.

When I was first trying to get pregnant in 2003, we discovered that my prolactin levels were elevated and that's when I first started seeing an endocrinologist. Turns out that even though my thyroid levels were within the normal range, increasing my dosage until I was at the high end of normal fixed my prolactin levels and allowed me to get pregnant in 2004.

Anyway, fast forward to my getting sick last summer and my hospitalization last July. One of my internist's partners was the weekend on-call doc and visited me to check my condition. He announced that my whole illness was probably caused by my thyroid dosage being too high and lowered me from 137 mcg to 88 mcg. I remember telling him that I wanted my endocrinologist to be consulted -- or any endocrinologist consulted -- because my levels were tested a week before I was hospitalized and were normal then.

But like a lot of doctors, he didn't listen to me and drastically changed my medication level. And as we've seen, it didn't make me all better.

I finally got in to see my endocrinologist last September or October, and he said that acute illness can cause thyroid levels to change but that's not necessarily a reason to change dosage levels. Also, he said, the sudden drastic decrease in my thyroid medication could have been very dangerous to me, although he very carefully noted that he would not call what the on-call doc did malpractice. :)

So he has very slowly been raising my medication dosage until I reached my original 137 mcg per day. I went for my 8-week blood test a couple weeks ago and expected him to say I was now where I should stay since I'd been at that level since 2003 except during the later part of my pregnancy.

But I got a note on Friday from him, with a new prescription enclosed, telling me my levels were still low and raising my dose up to 150 mcg.

I wonder sometimes what role, if any, my thyroid is playing in my illness. I do find it odd after being so steady for so many years that it's fluctuating so much now.

And of course, I'd just refilled my prescription on my last dosage so once again I'll have a bottle of pills in a drawer waiting to see if I get told to go back to that dosage again!


Good news -- I think I'm finally over that nasty bug. I took my last antiobiotic dose last night. I still have a little pressure in my sinuses, but I think it can wait until I see my ENT again in a few weeks.

Also, I go for a 90-minute MRI today, essentially back-to-back MRIs of my lumbar and cervical region. I'm very happy they gave me some Valium to help me through it. I'm mildly claustrophobic and while I can usually get myself through a regular/single MRI, I'm a bit frazzled by the time they pull me out. The thought of back-to-back ones just made me shudder.

Anyway, I won't see the neurosurgeon until mid-June to discuss his interpretation of the results of the MRIs, so we'll see if he still thinks fixing my tethered cord could really resolve the rest of my symptoms. (And if he thinks so, I'll then be seeing someone else for a second opinion!)

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