Sunday, August 31, 2014

Hashi's and Me: my experience with a thyroid disease (part 2)

I have Hashimoto's Thyroiditis, an incurable autoimmune disease that involves the thyroid gland. In a series of 3 posts, I am going to detail my experience with this disease to date. It is my hope to raise awareness and understanding of the disease, as well as provide a bit of support to fellow sufferers. I am not an expert or a medical practitioner; I am simply a person who is trying to live with this disease.

Part 1 covers the When: the timeline of my diagnosis.
Part 2 covers the What: definitions, descriptions, and symptoms.
Part 3 will cover the How: resources I have used and methods of maintenance I have attempted.

What is Hashimoto's Thyroiditis?

According to WebMD, this is the definition of this disease:

"Hashimoto's thyroiditis is an inherited thyroid disorder in which the body's immune cells mistakenly attack the thyroid gland. This attack damages thyroid cells and interferes with the gland's ability to produce thyroid hormone. Thyroid hormone plays a crucial role in the health of nearly every cell in your body. Hashimoto's thyroiditis is the most common cause of an underactive thyroid gland (hypothyroidism) in the United States. It is also the most common type of thyroid disease diagnosed. Women are seven times more likely to develop Hashimoto's thyroiditis than men."

This definition seems so simple, however the more I read about Hashi's I realized that there is still a lot to learn about the disease. There are differing viewpoints and on the symptoms and treatments, and the disease affects everyone differently. When I expand the definition to "Autoimmune Thyroiditis," I get a slightly different definition:

""Autoimmune thyroiditis (AT), also known as Hashimoto's disease, is a chronic inflammatory disorder of the thyroid gland that is caused by abnormal blood antibodies and white blood cells that mistakenly attack and damage healthy thyroid cells. It is a progressive disease that may destroy the thyroid gland, causing thyroid hormone deficiency (hypothyroidism). Autoimmune thyroiditis presents with various combinations of symptoms, making diagnosis difficult. This disease can occur at any age, but is most often seen in middle-aged women. In rare cases, it may be associated with other autoimmune endocrine disorders."

Either way, I interpret this to mean that my white blood cells have included my thyroid on the list of "known enemies" and perhaps at the top of their "Most Wanted" list. As my white blood cells attach my thyroid, my thyroid does not fight back; instead it attempts to continue to do it's job, however the war prevents it from doing the job well. Remember that line in the first definition about "nearly every cell in your body?" That is the key to why the list of symptoms is long and confusing, and why a diagnosis of Hashi's may take years.

Here is a long list of symptoms:
  • Anemia (both iron-deficient and pernicious)
  • Brain fog (forgetfulness, sluggish thinking, loss of energy for life) - check!
  • Chest pains
  • Cold intolerance; cold hands and feet - check!
  • Constipation - check! (TMI?)
  • Depression - check!
  • Dry, coarse skin - check!
  • Early graying of hair - check!
  • Exhaustion after exercise
  • Frequent colds and flu and difficulty recovering from infection - check!
  • Headaches, including migraines - check!
  • High cholesterol, especially LDL
  • Infertility; miscarriage
  • Joint ache/pain - check!
  • Low basal temperature
  • Low libido - check! (again, TMI?)
  • Muscle cramps/tenderness
  • Hair loss - check!
  • Restless leg syndrome - check!
  • Seasonal (cold weather) exacerbation of symptoms
  • Severe PMS
  • Sleep disturbances - check!
  • Slowed speech and ankle reflexes
  • Tired, aching muscles - check!
  • Weak, brittle nails - check!
  • Weight gain - check!
Can you see why the diagnosis is difficult? If this disease is common to middle-aged women, many of whom are working mothers, these symptoms are a part of every day life! When my doc would ask me if I was feeling tired, I would usually just give her "the look:" I have 2 small children and work full-time... of course I'm tired! Problems controlling my weight... don't we all? Brittle hair? It has been brittle and falling out for years; I thought that was due to hormonal changes related to pregnancy. Do I always feel cold? Uh, yeah, but don't most women feel cold all the time? That pain in my hip? I probably am not walking/sitting/standing correctly and my chiropractor is working on it.

Oh, these are all interrelated and mean my thyroid is not working properly?!? Huh. Who knew?

And then on top of these symptoms, which are primarily hypothyroid symptoms, I have discovered I would often have the symptoms on the hyperthyroid & Graves Disease list:
  • feel nervous, moody, weak, or tired. - check!
  • hands may shake, heart may beat fast, or have problems breathing. - check!
  • be hot and sweaty or have warm, red, itchy skin.
  • have more bowel movements than usual. - check! (TMI?)
  • have fine, soft hair that is falling out. - check!
  • lose weight even though you eat the same or more than usual. - check! (You would think this symptom would be awesome... except I have no control on when the weight loss stops!)

These are the opposite from the hypo list, which makes sense: hypo = too little hormone and hyper = too much hormone.

So it seems my thyroid likes to switch back and forth between hypo and hyper. Fun. I rarely come across an article that discusses this switching, but these articles do exist in the literature. There are many doctors and those diagnosed with Hashi's that will state the disease is completely related to hypothyroidism. So either the fact that my symptoms switching between hypo and hyper is rare, or that I should really categorize myself as "Autoimmune Thyroiditis" which swings between Hashi's and Graves diseases.

In part 3, I will cover How I support my thyroid as it is attacked my my immune system.

Since every case of thyroiditis is different, I would love to hear your story. Leave a comment about your symptoms below.

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