When hypothyroidism begins, several things happen, usually gradually. The first is lack of energy and ambition. You just seem to lose desire for activities you've enjoyed in the past. You feel unusually tired and apathetic, but can't figure out why. You begin to crave carbs and begin to snack regularly. This is your body's way of trying to stay awake. You'll try not to give into it, and when you can't fight the cravings, you set yourself up for horrible eating habits and weight gain that are difficult to reverse. You might already be taking some thyroid supplements, but they're obviously not enough. Warning: if you are taking prescribed thyroid medication for underactive thyroid, do not add kelp as it will raise your blood pressure to frightening and dangerous levels. I learned this the hard way.
I have been a hypothyroid sufferer for 30 years. I was originally diagnosed by an old-fashioned European doctor. He was a gem. Then I had to switch to a modern, young South African doctor with a large and fragile ego, who knew nothing about thyroid glands but based everything on blood tests, which he didn't really understand. As a person with hypothyroidism, it is hard to get any respect from the medical community. General practitioners and endocrinologists alike seem to know and care little about people suffering from hypothyroidism. Their “gold standard” is the TSH test, and most of them use the old standards of readings between .6 and 6 instead of the new readings of .3 and 3 that the American Association of Clinical Endocrinologists adopted in 2003. These new readings allow more people (it's mostly women, particularly those who are middle-aged, who suffer from hypothyroidism) to be diagnosed and treated. Too bad the professionals that we trust to look after our health don't seem to know or care that the standards have changed. Endocrinologists, by and large, specialize in diabetes. This is where their primary interest seems to lie. The first endocrinologist I was referred to told me that she doubted I'd ever been hypothyroid and that my thyroid gland was habituated to being overstimulated. She was so wrong! Then I was referred to another endocrinologist who misdiagnosed my thyroid virus for Grave's Disease (overactive thyroid.) The medication she prescribed raised my TSH to about 22. When I stopped taking that medication, my TSH dropped to 4.7. She told me my 4.7 TSH reading was now normal. It clearly wasn't normal for me because I still had hypothyroid symptoms. Consider that normal or average clothing sizes could be between 6 and 14, and that you fall into this category. How many of these sizes will fit? If a size 10 fits you, why would you wear a size 14? TSH is much like that. You have to find the number that fits YOU. When you have been told for the nth time that your TSH is in the normal range, read these symptoms, most of which are commonly known, but some of which aren't.
1. Fatigue. This is not the same as tired. This refers to falling asleep at work, during conversations, as soon as you get into a vehicle. You can't stay awake. You need at least 10 hours sleep at night, but within a couple of hours of waking up, you begin to battle to stay awake. You nod off during conversations, which you can't focus on anyway. You avoid socializing in the evening because you can't stay awake.
2. Sluggishness. You move slowly physically, but even your brain is slow. Your thought processes don't work properly.
3. Increased sensitivity to cold. Summer's not too bad, but in the winter, there is no way to get warm or stay warm. You wear extra layers and surround yourself with space heaters. It helps, but you're still cold.
4. Constipation. You drink lots of water and eat next to nothing, but your body processes everything slowly. Constipation follows.
5. Pale, dry skin. Skin color is pasty-looking, and skin is always dry, no matter what kind of lotion you use. My heels were so rough that every day they chewed through my socks even though I filed the roughness away daily and used foot balm.
6. A puffy face.
7. Hoarse voice. Your voice takes on a gravel-like quality at times.
8. Elevated cholesterol level.
9. Weight gain that makes no sense. You're too tired to eat, but gain weight anyway.
10. Muscle aches, tenderness and stiffness. Flexibility and mobility are gone. You move like a lead weight. If you crouch or kneel, you can hardly get up again, and it hurts to crouch or kneel anyway. Even bending down is difficult and painful, for instance, trying to reach for something you dropped under a desk.
11. Pain, stiffness or swelling in your joints. Or all of them. Any sprain you've had begins to hurt again. Hips, fingers, ankles ache and don't bend properly and contribute to your moving like a lead weight.
12. Muscle weakness. You can barely walk. Walking is slow and tiring. When I brushed my teeth, I had to put my arm down and rest at least 2 to 3 times to finish brushing my teeth. You fall into chairs as opposed to sitting down, and it's a struggle to get back into a standing position from sitting. Getting out of a car is difficult, and getting into a pickup truck a little higher off the ground is equally difficult.
13. Heavier than normal menstrual periods. By now I don't have those any more, but when I did, I all but hemorrhaged for at least four days out of the seven or eight that my period lasted. I had to put plastic on my mattress because I would wake up during the night having bled through and past the tampon, and leave a blood trail down the hall to the bathroom. Wasn't fun.
14. Brittle fingernails and hair. Hair is dry, brittle and unhealthy looking. Nails can't be grown long without breaking.
15. Depression. No need to elaborate.
16. Muscle cramps. You develop cramps in muscles from head to foot. Fingers, forearms, back, abdomen, legs. These cramps happen numerous times during the day and for no logical reason. My arms, hands and fingers cramped up when I cut up meat to eat.
17. Hair loss. It's not just the hair on your head, although that thins out a lot. It also affects pubic hair and underarm hair. That can all but vanish. Eyebrows also fall out, particularly the outside corners.
18. Sinus infections. You have recurring sinus infections even though you have never had a history of sinus problems.
19. Snoring. You begin to snore even though you've never had a snoring problem in the past.
20. Craving for carbohydrates. You begin to crave chips, chocolate, candy, baked goods and anything with sugar. Your body is trying to stay awake and carbohydrates provide quick energy. Doesn't help with keeping the weight down either.
21. Irritability. Little things set you off and enrage you. Everything becomes personal and you get angry enough to want to physically harm the offender.
22. Edema. You retain water. You look puffy and blubbery, particularly in the abdominal area. Makes you short of breath when you exert yourself – even going for a walk can leave you breathless.
23. Forgetfulness. You become sharp as a bowling ball. You try to commit something to memory, but your brain is a sieve.
24. Slow heart rate. Your resting pulse can drop below 60 beats per minute.
25. Low body temperature. My temperature was consistently between 35.8 to 36.2 C, which also explains why you feel cold.
26. Painful intercourse. Having sex hurts, and add to that, you wind up with muscle cramps from the waist down.
27. Light sensitivity. Your eyes can become unusually sensitive to sunlight.
My advice? Shop around for a doctor who is willing to learn together with you about thyroid problems. General Practitioners are generally more reasonable to deal with because they have no learned bias where thyroid is concerned. My GP told me the 4.7 was too high and told me to take 50 mcg of thyroid supplement. I took 100 mcg. My TSH dropped to 1.9. She was happy with that but I wasn't. I still didn't feel right, and remember that only YOU know how you should feel. Remember what I said about the clothing sizes? I took another 25 mcg and the TSH dropped to .5. She used the standard of .4 to 4, so she was still happy and I was too. I finally felt normal again. Don't let doctors bully you into believing that diet, exercise and/or antidepressants will cure what ails you when you know that isn't the problem. Shop around for a doctor who will listen to you and work with you. Google “Mary Shomon”. She is a great source of good and useful information and advice on thyroid issues. There is hope and there is help. It's just a matter of finding them.