Part Two: Thyroid, Adrenals, and Hormones – My Personal Battle
In Part One of this three part series, I talked about some of my symptoms that slowly crept on over the past few years. I knew something was wrong with me, and I suspected that it was my thyroid and/or hormones, but truthfully – I was scared shitless. I had heard horror stories of people with these types of problems and how once they were diagnosed it was a roller coaster ride trying to find the right dosage of this and that, and to be honest, I was in denial.
I kept telling myself, “I eat so healthy and try to take such good care of myself… how could anything be seriously wrong?”
I sought out a Naturopath (ND) in Salt Lake City during the summer of 2012 when my PMS got so out of control that I couldn’t handle it anymore – a woman that specialized in females and hormones – and I also got a second opinion from an ND in Maryland that is basically a genius when it comes to interpreting lab results.
We ran a full hormone panel using salivary tests, which required my filling up four tubes with saliva at four different times throughout the day. We tested my estradiol, testosterone, androstenedione, DHEA, cortisol, progesterone, and SIgA levels. We also ran a standard thyroid panel, which is TSH and T4.
** A quick note about cortisol testing: cortisol is a rhythm. It should start high in the morning and slowly taper off as the day goes on. Doctors that test cortisol using only one test don’t get the full picture. They are simply given a snapshot of where your cortisol is during that exact moment in which the test was ran. This isn’t thorough because lets say you run a test for cortisol in the morning and it shows high like it should, the doctor would never know if your cortisol doesn’t decline throughout the day like it needs to because they only ran one test. For this reason, multiple tests throughout the day are necessary in order to give a much more accurate depiction of what your cortisol rhythm is doing.
Are you taking notes? There will be a quiz at the end.
So what turned up?
August 2012 Thyroid and Hormone Results
My hormones were WHACKED OUT. Elevated estradiol, high testosterone, extremely low DHEA, and low cortisol across the board.
My basic thyroid test of just TSH showed that things were within range (which is admittedly quite skewed to begin with, but more on that in Part Three).
** Important note: We only ran a basic thyroid test at this point, which is just the typical TSH test.
My blood tests showed that some of my liver markers were abnormal, my blood glucose was in the tanker (I was borderline hypoglycemic), and my Vitamin D was low.
August 2012 Treatment
Both of my doctors are convinced that all of this mess was brought on by my extreme dieting and exercise from years ago. They believe that because I’ve taken such good care of myself with solid nutrition and staying active post-Figure show that I was able to cover up the symptoms to a certain degree over the last few years, however it eventually caught up with me.
I’m going to say it again for emphasis: This was brought on from extreme dieting and training like a wild banshee, with the mindset that days off are for the lazy. Learn from my mistakes!
The first thing my doctor did was advise me to cut back on my training, to the tune of 2 – 3 sessions per week, max. Initially I was devastated because I had always preferred to train 4 – 5 days per week, but I realized I felt so awful that I wasn’t physically able to train more than two or three times each week, even if I wanted to.
The thought behind backing my training down is fairly simple. Training at a high intensity stresses the body. The fact that my adrenals were suppressed and cortisol output was low showed that my body was extremely stressed out and we needed to eliminate as much of that as possible. I was also instructed to focus on relaxing. Meditation, leisurely walks, baths, being happy as much as possible, watching a ton of Grey’s Anatomy, and munching chocolate whenever the opportunity presented itself. Okay, fine. I made those last two up, but seriously, McDreamy = stress-free. Can I get a witness?
Another reason for decreasing my training is that strength training can slightly increase testosterone levels in a woman. Normally this is a good thing for fat loss and performance, however my testosterone was too high and we didn’t want to exacerbate it.
Also regarding testosterone, I was advised to back down my consumption of saturated fat due to the fact that it can elevate testosterone. This meant substituting some of my grass-fed beef and coconut oil with fish, turkey, and olive oil. Again, some saturated fat is healthy, but I was consuming too much and my testosterone was too high.
As for the elevated estrogen and severe PMS, my IUD (the Mirena) was the suspected culprit, and in conjunction with my abnormal liver markers, Dr.W suspected that my liver wasn’t detoxing excess hormones like it should. He advised that I remove my IUD immediately and start a heavy supplementation protocol for liver support. I took his advice, got my IUD taken out and started the supplements.
I was also advised to start getting some sunshine and supplementing with Vitamin D.
About 45 days went by and things improved dramatically. My skin cleared up, my brain was functioning better, and my PMS had vastly improved (woohoo!), however I still didn’t have much energy and continued to wake up each night at 2 or 3am.
Back to the doc I go…
My doc in Maryland requested that I redo my hormone tests and also run a more extensive thyroid panel (which is what we should have done from the get-go), which included TSH, Total T3, Free T3, Free T4, Total T4, reverse T3, and thyroid antibodies.
I was in Kentucky at the time and had to request that my doctor in KY order the additional thyroid labs. To say he fought me on this would be a vast understatement. He flat out refused, saying that additional labs weren’t going to change the fact that my thyroid “was just fine” according to my TSH results. I basically told him I wasn’t going to take no for an answer and he finally relented, if for no other reason than to get me out of his office. I had the labs ran and sent the results out to my doctors in Maryland and Salt Lake City.
October 2012 Test Results
Hormones were much better! Estradiol and testosterone were now well within range (!!!), which was great news and meant that removal of my IUD and the liver supplementation definitely helped. However, my DHEA remained quite low, cortisol was still slightly depressed, and now progesterone was a smidge low.
My thyroid was also pretty messed up. Borderline low Free T3 and Total T4, and extremely low Total T3, which is a biggie and explained 80% of my symptoms. The fact that my TSH and antibodies tested normal ruled out the chance of Hashimotos Disease, which was a relief.
** Important note: The same doc that initially refused to run the extensive thyroid panel got the results and called me the next day and said, “You need to be on medication immediately.” Go figure. Remember that I ran the basic thyroid test of TSH back in August, and it showed that it was within range, however we didn’t discover that I had serious thyroid problems until we ran much more extensive testing! When you go to your doctor to get your thyroid checked, it’s absolutely imperative that you ask them to run more than just the standard TSH and T4. Specifics on this in Part Three.
October 2012 Treatment
My doctors made the decision to start me on a thyroid medication which is dessicated pig thyroid (of course my best friend has mad jokes about this and refers to it as my “piggy meds”). I was instructed to run this medication for 30 days and retest my levels.
Mid-November 2012 – It’s All Worse
Retested my thyroid again, and this time all of my thyroid results were significantly worse. Every single thing had decreased across the board. My formerly borderline low Free T3 and Total T4 were now even lower, my Total T3 had, much to my dismay, dropped even lower, and now my TSH was borderline low, too, which is a common side effect of taking the thyroid medication.
Back to the drawing board
We backed down my dessicated thyroid medication and added another one to the arsenal, which is a very low dose of T3. The interesting thing about the thyroid is that a dosage can be just fine for a few days and then WHAM! it’s too high for the next few days. This is exactly what happened to me. I was taking it for about a week and felt fine and then all hell broke loose. My heart was pounding so hard that I could hear it in my ears and feel it in my eyeballs!
We immediately backed my dosage way down, and I also started taking a natural thyroid supplement along with it, which includes selenium, iodine, etc.
They also instructed me to bring my carbohydrate intake up. I am an innate low-carbbie. I love meats, fats, and veg and because of that my daily carb intake had been <25g/day for months and months. I was to shoot for at least 100g carbs/day, as it’s crucial for T4 to T3 conversion.
The also advised me to back down my intake of raw kale, cabbage, and other goitrogens, and when I did consume them they had to be cooked. I am a veggie junkie so this was a huge change for me as I was used to munching raw kale, cabbage, spinach, and other goitrogens multiple times per day.
I was instructed not to fast, and to make sure I was eating every few hours.
I was told to take my temperature every morning using an old school mercury thermometer, which, according to my docs, are the only ones worth a damn in regards to accuracy.
Over the next few weeks, I started feeling good. Then better than before. Then better than I had in the last year. My energy increased, my cognitive function had noticeably improved, my feet weren’t freezing anymore, my drain wasn’t always full of hair and I went 30 full days without desperately needing a mid-day nap. I think we are on to something!
January 2013 Thyroid Testing… Yes, Again!
After 40 days of running the most recent medicinal and supplementation protocol, and making the other dietary/lifestyle changes I mentioned above, we retested my thyroid once again, running another extensive panel: TSH, Total T3, Free T3, Total T4, Free T4, and reverse T3 and…
In part three of this blog series, I’ll share my most recent test results with you, along with a summary of my symptoms, the dietary & lifestyle changes that I believe caused it and then helped it, what I think you should be watching for, and anything else that I think of that might help you or somebody that you love!