the day I went in for testing, just hormone levels, but my endo moved my appointment up. She had me come in April 19th, my period of feeling better had gone. :(
First I stopped improving. That wasn't too bad. I thought perhaps I'd reached the best I could feel on the 50mg and was okay with that. I knew it might take awhile before I reached the correct maintenance dose. I contacted my endo and asked about increasing my dose. The reply: your body needs time at least six weeks to fully adjust to the hormone replacement, we'd evaluate the situation at my appointment.
Then I started to back slide. That bothered me. I explained it away, maybe the trip to see family wore me out, then maybe I'm just having a bad day, a bad week, then I ran out of barely believable excuses. I could understand not getting better but losing ground was unnerving. Endo moved up my appointment, earliest she could, six weeks from my last but she wasn't surprised by my tale of woe.
Nothing dire is going on. I'll be fine. That I felt better for a time is good, means replacing the thyroid hormone helps me, improves my life quality. Okay I then whined why am I starting to feel like crud again? Well basically my body is working against me.
In simple terms the pituitary and the thyroid work in a sort of feedback loop. The pituitary is supposed to sense when the thyroid hormone is too low and it increases TSH thyroid stimulating hormone. When the thyroid senses an increase in TSH it is supposed to increase thyroid hormone T4. The actually process is more complicated but that's the basic concept.
Since my T4 is low, causing all the nasty hypothyroid symptoms, endo put me on thyroid medicine which replaces/increases the T4. My T4 has been low for some time, years, but it was only after this last surgery when hormones worsened and I was blunt - I'm sick of being a spectator in my life- that I was put on thyroid medication. Well I may be sick to death of feeling like crap but my body thinks that's normal and wants to keep the status quo. The medication did it's job. My T4 increased, I felt good then the pituitary sensed the new level of T4, decreased it's TSH, which decreased the T4 which meant I felt crappy again. Despite the medication six weeks later my T4 now was the same as it was before. I was not happy.
Endo says that happens. Joy. The answer is to keep increasing the medication a little at a time every six weeks to three months. Too much medication could really depress my TSH and that would be bad. Too little and nothing changes. The goal is to reach the dose where I feel good, the medicine puts enough T4 in my system and my pituitary can't or stops lowering it. She increased me to 75mg. This could be the dose or I could be still working toward my needed level for the next year. I'm supposed to be patient.
It's almost been two weeks on the increase and this one hit me like a ton of bricks. Instead of slowly starting to feel better, I felt like I did following radiation. So lethargic I actually found myself considering if I really need to go to the bathroom that bad because getting off the bed and walking seemed like an extreme effort. Endo says that happens sometimes, give it time, weeks - be patient.
The last few days seem a little better. I'm doing some things but I'm resentful of my body's weakness. I go to the store, a couple bags of groceries because I'm too tired to get more then have to sit around for a while until I have enough umph to do anything else. I couldn't do my nightly walk with the boys for almost a week and am forcing myself to now but it wipes me out. Painfully slow progress in the house, in my writing, in the yard. Life moves on ten steps or more for every one I take. Endo wasn't surprised. Patience is difficult. I'm 44 I don't want to feel 84. Time is a precious commodity.
