All Things Thyroid: My Hypothyroidism Journey + Q&A with Physicians
I’ve noticed the topic of “thyroid” in general become increasing popular over the past few years. All over social media, I see phrases about “thyroid imbalance” or “healing your thyroid” but, is any of this actually legit? As someone who actually has a thyroid disorder – hypothyroidism – I thought it would be helpful to share my own journey and clear up the confusion by interviewing two physicians.
Despite sharing a lot of my life on my blog and social media, I’ve never talked much about my hypothyroidism. The reason is simple: it doesn’t really have an effect on my life. Now that it’s controlled – and has been for over 10 years – it’s something asymptomatic that’s just part of my medical history.
That, and I know that the thyroid is an easy scapegoat. Any time we feel anything is “off” it’s easy to assume a thyroid problem or seek non-credible advice online that blames the thyroid. But, the truth is, there are only a few actual thyroid disorders. And they can only be diagnosed by a medical doctor.
In an effort to clear up some of the confusion, I thought it would first be helpful to finally share some of my own story and journey with hypothyroidism.
My Journey with Hypothyroidism
I was diagnosed with hypothyroidism in 2007 – at the end of my freshman year of college. Hypothyroidism is an underactive thyroid. You’ll learn more about this and what the thyroid does from the physician Q&A below.
Pretty much at the start of my freshman year, my symptoms also started. The first one that I noticed was the weight gain. This is not to say that all weight gain equals hypothyroidism, by any means. For me, it was rapid weight gain and without explanation. I’d buy jeans in a size bigger, and by the next week, those jeans would no longer fit and I’d have to go up a size again. Granted, I do believe some of this was due to restricting my intake in high school and those patterns finally catching up with me in college. But still, gaining around 30 pounds in about 3 months was part of the various symptoms that led to my diagnosis.
In addition to the weight gain, there were a few other telltale signs. I was always tired. I remember that my first class of the day on Mondays, Wednesdays and Fridays was at 1pm. And I wouldn’t wake up until right before that class. I’m an early riser. In high school, I was the one who’d wake my whole family up in the mornings. So for me, sleeping past noon regularly was super unusual.
Finally, I was always cold. And it wasn’t just cold. I literally could not get warm. On top of that, my mood was just generally low. Looking back, I thought I just didn’t enjoy my first semester of college. I now realize that the hypothyroidism that led to depression-like symptoms and made it difficult for me to enjoy.
While there are many symptoms of hypothyroidism, the ones that I experienced are a few of the more common ones: weight gain, fatigue, intolerance to cold and low mood.
On top of this, hypothyroidism was suspected because it runs in my family. A family history of thyroid conditions is a big indicator of likelihood of there being a thyroid disorder.
At this point, my doctor decided to take blood work in order to test for a thyroid condition. As you’ll learn below, a blood test is the best way to officially diagnose a thyroid condition. Both my thyroid stimulating hormone (TSH) and T4 levels indicated hypothyroidism.
Once diagnosed, I started the medication Synthroid – a synthetic thyroid hormone. And, once on the correct dose, almost immediately, my symptoms began to resolve. I stopped gaining weight, I was no longer overly tired and cold, and my low mood improved markedly.
I’ve been taking Synthroid every day since 2007. And since 2007, I’ve also been asymptomatic and my hypothyroidism is truly a non-issue in my life.
I know the idea of taking medicine every day seems off putting to many. But, as I understand it, medication is needed in order to correct an underactive thyroid. But, don’t take my word for it! I’m not a doctor. I’ve consulted two physicians below who will explain more about all that medical nitty gritty.
Q&A with Physicians
I asked the below common questions to two doctors:
Dr. Corey Haber, DO is my dad :) Dr. Haber is a board certified family physician who’s been in practice for 33 years. He’s also an adjunct clinical professor of family medicine at Michigan State University. Dr. Haber has won numerous local awards as the best family physician in Oakland County, Michigan and is still actively practicing.
Dr. Amanda Goldstone, MD is a board certified physician. She practices Internal Medicine in Manhattan.
What does the thyroid do?
AG: The thyroid is a gland that is controlled by the brain to secrete hormones. These hormones help regulate metabolism, body temperature, the cardiovascular system, and other bodily functions.
What types of thyroid disorders are there? Besides these, is there a such thing as thyroid imbalance?
AG: There are a variety of thyroid diseases some of which can cause the thyroid to be overactive or underactive depending on the disease. This could be considered an “imbalance” because your thyroid function depends on 3 different hormones in a cascade to be made in the right amount. So, one hormone level could be high or low to try and compensate for another.
CH: There are 3 main types of thyroid disorders:
1) With hyperthyroidism, it can be due to something as simple as a virus or inflammation in thyroid, autoimmune (body makes antibodies against thyroid making it inflamed – Graves’ diseases) or thyroid cancer, where you have little nodules independently producing thyroid hormone.
2) There’s also goiter, which is an enlargement of the thyroid. With a goiter, someone can have a hyperthyroid, euthyroid (still producing correct amount of the hormone but have an enlargement) or hypothyroid.
3) Hypothyroidism can happen as a result of infection (and then infection resides), Hashimoto’s disease, or failure of the gland itself due to other reasons.
CH: Someone may have an imbalance when put on medication and first trying to figure out the correct dosage. Besides that, I don’t believe there’s such a thing as a thyroid imbalance.
What should someone do if they suspect a thyroid condition? How can it be diagnosed?
CH: If you suspect a thyroid condition, see your doctor. A thyroid condition will be diagnosed by a thorough history, physical exam and confirmed by a blood test. The most accurate and most sensitive is TSH. TSH will pick up signs of hypothyroid or hyperthyroid before the thyroid hormones will change.
AG: Talk to your doctor - blood tests can help diagnose if you have high or low thyroid hormone levels. Additionally, scans, physical exams, biopsies, and other tests are sometimes needed to help with the diagnosis.
What’s the best way to treat a thyroid disorder?
AG: There are a variety of ways to treat a thyroid condition. Talk to your doctor about what treatment is right for your thyroid condition.
CH: For hyperthyroidism, it depends on cause. Some causes are self-limiting, meaning they’ll go away on their own when you treat the symptoms and monitor the thyroid hormone. Other times, you may need to treat with medication to lower the thyroid function. More drastically, for Grave’s disease, you might need permanent destruction of thyroid through radioactive iodine and/or surgery.
Hypothyroidism is treated by thyroid hormone replacement (aka medication). That’s the only way to treat it. There are two types of thyroid hormones, T3 and T4. The standard treatment is Synthroid, which is synthetic T4. Even though Synthroid is commonly given as the #1 treatment, some people do better on other forms of thyroid replacement therapy (like Armour thyroid – which is desiccated T3 and T4).
Goiter can sometimes can be treated by thyroid medication. By giving thyroid medication, it tells the pituitary gland not to secrete TSH, so the thyroid gets less signals to produce and that can help shrink a goiter.
Do you think thyroid disorders can be treated with food/diet alone?
AG: Some thyroid disorders can be caused by an iodine deficiency, but this is uncommon in the United States - this can sometimes be treated with iodine repletion, but needs to be done under the supervision of a doctor.
CH: No.
Any downsides to being on medication for life?
CH: No. The downside would be not taking the medicine. People may assume other symptoms as a result of the medication, but most often, in reality it’s the thyroid condition that’s still not fully treated that causes those symptoms. Additionally, if you see any supplements called “thyroid support” or something similar, be mindful that it’s just a collection of vitamins, amino acids and herbs that doesn’t have a medically proven benefit. It can’t hurt, but don’t take it in place of medication.
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The point of this is definitely not to tell you that your symptoms aren’t real. Instead, it’s to help you navigate through all that – often inaccurate – noise online.
I wanted to interview two separate physicians so you could also get two separate opinions. Dr. Goldstone and Dr. Haber each practice in different states and have been in practice for different amounts of time. Interestingly though, their answers were pretty similar!
At the end of the day, like with anything, you know your body best. If you’re concerned you have any symptoms, reach out to your doctor to see what’s going on. No matter where you stand, there’s a time and place both for Eastern and Western medicine. I’ve found personally, with my own hypothyroidism, that when it comes to something as important as your thyroid, having input, diagnostics and treatment from Western medicine can be hugely beneficial.
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