Almost one of the 20 million Americans with a thyroid problem

This woman is checking her own thyroid.  I did that too.

This woman is checking her own thyroid.  I did that too.

Now that we are out of the woods, I can tell you.  I don’t have an underactive thyroid.  But it was dicey there for a few days.  The days between my web self-diagnosis and an actual blood test. 

There are a lot of women who recognize that they are tired, but they are too busy to notice the symptoms.  I, on the other hand, have full days to listen to my body and notice my symptoms.  I do not recommend a full day that involves you (in pajamas) on a couch, with a browser open to Mayo Clinic.  If it were WebMD, you might as well save yourself some time and drive straight to the ER because you are dying.  

Low energy? Oh yes.  Couch, pajamas …

Weight gain? Uh-huh.

Fluid retention? So much fluid.

Dry skin and hair? Of the flaking variety.

Intolerance to cold?  Considering that our thermostat is a marital battleground, yes.

Depressed? Maybe.  (I should be deliriously happy, right?  Paris, Spain ….)

Constipated? Not that one.  But I do drink a lot of coffee.

Irritability?  Let’s just count that as a baseline personality flaw.

Do you cry about little things? Yes, yes. I had quite a cry about the hard boiled eggs that weren't peeling right.  I’ve tried everything…

Unusual loss of hair in the outer edge of the eyebrow? OMG.  I’m calling the doctor RIGHT NOW.

After a quick bathroom break (where the lack of constipation was confirmed), I dialed down the panic and dialed up my Mom for some medical history.  I knew she was on thyroid medication, and she confirmed that her hypothyroidism started in her mid 40s.   I also decided to look back at my blood work from six months prior, where BINGO - my TSH level was borderline for hypothyroidism and above the borderline according to European standards.  Mystery solved.  Note to self: change doctors when you move back to the US.

Of course, until that morning, I had no idea what TSH even was.  I rang my female British doctor here for the first available appointment.  Which conveniently in Luxembourg, is usually the next day or two.  I then send texts to my sister and BFF to let them know my diagnosis.  If they lived closer, they would have come running over with chocolate but instead they sent (multiple) texts of encouragement and affirmation of my smart sleuthing.

I then thought about Oprah.  Happy that I didn’t have the weight gain as bad as she did but then grateful that she brought visibility to this disorder that disproportionately affects women.  Some say that one in eight women will develop a thyroid disorder in her lifetime.  So here I was, ahead of the game – skipping past the prescribed skin creams and antidepressants and going straight for the thyroid medication.  Which of course was my next area of web research.  I was hesitant about synthetic thyroxine, but given that my options might be limited overseas – I was willing to take on some drug risk in return for some energy. 

In the next 48 hours, I did get off the couch and go for a run with my Thursday running group.   One of the women had also just had her thyroid tested.  One in eight, baby.  Who knew the power of this butterfly shaped gland.  She too has a family history, but it turned out that her TSH was fine. She tried to encourage me, “You know, Kate, a lot of trailing expat wives hit a slump at the 6-9 month mark.  Depression is pretty common.”  To which I replied: “I know, but look at my hair and skin.  It’s never been this dry.” Then there was some discussion about the Lux weather and water which could very well explain the flaking phenomenon. 

Bread belly was the next conversation topic.  I know it’s an American living in the land of European pastries cost of doing business, but my bread basket was very, very full.   It was also carrying some Belgian Beer, but come on -- I’ve been running up these hills!

At the doctor’s office, I told her about all my symptoms.  She seemed less focused on the missing eye brow hair and more focused on the crying about the hard boiled eggs and my son living 5,000 miles away in the US, but she agreed that we should definitely do the blood test.  When she saw my previous blood work and heard more about family history, I assumed she was putting the nail in the synthetic thyroxine coffin but demurred: “Why don’t you come back in for the results, in case we need to prescribe something for the thyroid  or you know, the depression.  Going through a rough patch is very common for expat wives –even if you don’t have a depressive history -- especially once the honeymoon period is over and you’ve settled in.”

Oh.  Does she think I'm overreacting?

I sent some more texts to get additional confirmation on my affliction.   My Mom and BFF were hoping that it was not a thyroid problem.  I was hoping it was.  I wanted a definitive answer to my malaise and a pill to make it all go away.  I didn’t care that I could be facing a lifetime of managing a gland with a synthetic drug.  I wanted a quick fix.  We’re having the time of our lives over here; I can’t afford to be sitting on the couch.  And I really hate putting on lotion.

The test results came back.  I braced myself for the news, anticipating how significant the spike in my TSH levels would be.  Well I kind of already told you at the beginning - they were fine.  My TSH level had returned to normal from being borderline six months earlier.  My iron was low and I needed a supplement for that.  My Vitamin D was also low – me and 98% of people living through the darkest, greyest Luxembourg winter and spring on record.  The other thyroid numbers (which I hadn’t researched and didn’t understand) were fine but signaled a potential thyroid issue in the future.  (Proving I’m not a total Idiot Sleuth). I then had to promise to come back if the depression got worse.

While I should have felt relief, I actually felt disappointed.  I wanted a reason.  A label to slap on my leaky love tank – a tank that was being filled with so many good things but leaking faster than it was being filled.  The doctor said that expat wives spend so much time on setting up things and then making sure the kids are OK that they eventually hit a wall.  It happened to her too. 

It took me a couple of weeks to start the iron supplement.   Some web research got my freaked out about accidental iron overdoses.  Also, you can’t take iron with caffeine which totally screws up your morning coffee – so the iron supplement sat there for a while I worked through my lesser diagnosis.  More sun, more exercise, wearing a jacket indoors, more hair conditioner/lotion/eyebrow pencil, less bread, patching up some holes in the tank.  That sounds like so much more work than a pill and it is, but the healthy way is always the long view. 

Over/under/normal thyroid, there’s never a short cut.  And the more I learned, the more I realized that a thyroid out of whack is a really hard thing.  No one wishes for that.   My issue was something that was real, but situational.  At the moment, I don’t have a medical problem or even a condition that has to be managed – I should be grateful for this thing that is only a passing shower. So I’m spending less time on the couch.  I’ve stopped making hard boiled eggs for the moment.  Most days I take my iron supplement when I go to bed.  Me and my belly are now planking daily to Macklemore -- soon they will be called Abs again.   And, my son is coming here – coming home to me -- for good in 2 weeks.

Take that synthetic thyroxine.