Fun with Supplemental Thyroid Hormone (Synthroid or Levothyroxine)

It's been almost 8 months now since I was "officially" diagnosed as hypothyroid.  I say officially because it turns out that according to the normal TSH scale, which has changed over the last 10 years or so, I've been this way for at least 15 years.  The reason I know is that 15 years ago I'd had a complete thyroid panel done on me in preparation for dosing me with a god-awful drug called Depakote, which I ended up never taking.  I was quite depressed at the time, and thought I could use some chemical assistance, so I went to see a psychiatrist, who in the space of 15 minutes, pronounced me bipolar, ordered blood work, and then wrote the prescription for Depakote.

I did fill the prescription, but looked up the drug on the Internet, and was like there is no fucking way I am taking this shit I will get through this.  And I threw it away and was fine, at least fine for me. Turns out one of the symptoms of hypothyroidism is depression.  Go figure!

Anyway, I'd saved the test results from 1997, so when I was tested last December, I could compare TSH levels.  Of course I did a bunch of research on hypothyroidism and how they medicate it.  Turns out my 1997 level was already high (high TSH = hypothyroidism; low TSH = hyperthyroidism) according to today's scale.  And today's scale is variable, too.

My TSH wasn't sky high like some people, but it was enough to (coupled with a boatload of stress last year and for many years before) do a number on me--depression, brain fog, bouts of extreme fatigue.  I was to the point of seeing a shrink or my medical doctor, and when I was able to muster up the focus to summarize my symptoms, decided I'd go to medical doctor first, and if nothing wrong there, then off to shrink.  I didn't even consider hypothyroidism, because I always associated it with extreme weight gain, but turns out that's not the case unless your TSH goes sky high.  I thought I might have been anemic and maybe be experiencing adrenal fatigue.

So imagine my surprise to find out my thyroid is fucked up!  Or my pituitary, or both.  When they first begin dosing you with synthroid, they have to start you at a small dosage, because it takes your body something like 6-8 weeks to adjust to the extra boost.  And then you do another blood test, adjust dose as necessary, and so on, until you level out. 

The first 8 weeks I noticed that much of the brain fog disappeared, and the depression seemed to lift somewhat. But when I next got tested, my TSH had actually gone UP, and my doctor said this is because my thyroid gland is pooping out, so we caught it at a good time.  Oh, by the way, hypothyroidism is very common in post-menopausal women.  Another fucking bonus!

After the next 10 weeks and an increase in dosage, I started feeling better.  The bouts of fatigue seemed to be gone, and I naturally felt like working out more, but at next test, my TSH wasn't budging much.  But at least it wasn't getting any worse.

Round 3 of blood tests, it gets tiresome.  I laugh every time the nurse draws blood and tells me not to lift weights that day.  Um...OK.  I typically swim first and then wait until afternoon to hit the weights if that's on the menu.

After the 2nd dosage increase, though, I was still paranoid about pushing my body too much, and wondered if I actually had adrenal fatigue.  Turns out it's very difficult to test for, and my doctor said that if I continued not feeling right, then at some point we'd do that test.  Meanwhile, I totally get that I'd basically pummeled my body into submission over the prior 13 years, so needing an extended break was probably to be expected, even if I didn't like it.

I even took an entire rest week (except for weights I had to do SOMETHING) off from swim/bike/run and another super light week to see if that made an impact on how I felt.  Nope.  So onward with some semblance of workouts.  I couldn't call it "training" at the time because there were no races.  Although in February I did do a stair climb "event" where you get to go up and down a 17-story building as many times as you want.  Guess who did the most floors?  MOI, of course.  I blew everyone else away.  I went up and down 13 times, eclipsing my previous effort in 2012 of 11 times. It wasn't timed, and there were no medals (I did get a T-shirt, though), but I was pleased that I was able to do that.  I really expected some youngster to do more than me, but it just never happened.

But I digress.  So I took the 2 rest weeks the last week of March and first week of April, and I didn't feel more rested or anything, so onward I went, and right about then my synthroid was increased to 50 mcg. About this time I also began running outdoors.  You see, I was purposely staying on the treadmill to hold back my pace in case I was continuing to tax my body too much. Believe it or not, I did not go for an outdoor ride until April 27!  I didn't feel like I had "earned" the right to ride outdoors, and so I only rode my MTB until June 11!  Obviously, it was around then I was really beginning to feel better, but still not 100%.

I believe it was June 26 when I woke up and immediately thought to myself, "I feel NORMAL!"  It was such a wonderful feeling, subtle really, but I knew I was close to being right.  The week prior I'd noticed that I was beginning to experience real hunger again, which is good since I'd been watching my caloric intake like a hawk to avoid gaining weight while not working out much and knowing my thyroid was crapping out.

So either that day or the next, I decided I wanted to do a century ride to see if I still wanted to go long, and also increase my running to the point where I could do a 1/2 NothingMan.  I put pen to paper and sketched out a training plan that began July 1.

On July 3, I had another blood test, and it showed my TSH not budging too much, but at least still maintaining, so doctor ordered another dosage increase to 75 mcg.  I monitored how I was feeling while attempting so-called "training," and things went well, considering I'd just been on road bikes for 3 weeks!

And then we know what happened...I began feeling so good that when a friend suggested Leadman for next year (far off enough to give that idea a thumbs up) and then another friend suggested Ironman Cozumel in December, well, we know how that turned out.

Thing is, it's impossible to say whether how I'm feeling now is due to the synthroid, the extended break I had from focused training, or the elimination of major stress over my house (financial and physical).  Probably all of those things. I feel pretty damn good, even Crackheaded, so it will be interesting to see what my TSH level is when I get tested again August 20.  All I can say is that I am hungry and eating all the time, and my metabolism is pretty revved.  But I am not hyPERthyroid, as when I make a point to monitor my heart rate, it's still pretty much in the dumpster like it's been for years.  But I have started sleeping less.  I am still wondering what my brave new world is going to be like.  Has my Cracktacular spell (siege?) of the last 13 years been due to a wacky thyroid?  Have my periodic depressions been due to that, too? Unknown at this time.  All I can tell you is that last fall/winter, I was in a deep, dark hole that drew me inwards more than I've ever experienced.  I felt alone, abandoned by my tri "friends," (although a few did check in with me regularly and I appreciated it very much), old, weak, unattractive and out of shape.  Quite the antithesis of Crackhead!  Believe it or not, I am still working on getting out of that hole, as it gave me time to think on where I am in life in general, not just from a triathlon perspective. So as much as I or anyone else suffers while being depressed, at least I've learned to learn from it, even if it doesn't prevent a recurrence.

By the way, my doctor initially wanted to dose me according to this. But there is a cutoff at age 50, and I am not sure why.  Is the assumption that anyone over 50 doesn't give a rat's ass whether their thyroid is functioning optimally?  At any rate, I had a chat with my doctor about this, explaining that I'd interviewed other athletes about their own experience, and that since I intend to remain active, that I deserve to have my TSH in line with the youngsters.  Luckily, she agreed with me, otherwise I would not be medicated much at all right now!

While I have made a typically aggressive training plan for Ironman Cozumel,

I intend to do my best to continue listening to my body.  After all (thanks, Maz, for reminding me often the last few months), if I HAD TO do an Ironman right now, I could.  I do want to have a decent race time, but we shall see.

Stay tuned, and if anyone wants to chat with me regarding my experience with hypothyroidism, feel free to contact me via Facebook.