Up the dosage!

Just got back from a checkup with my Endocrinologist. She's thrilled that I've responded so well to the medication so far, and was a bit surprised that I had such a dramatic change with such a low dose. They did a blood test on me, to see how my blood numbers are doing and we got a very strange result.

In July?, my TSH was 2.91. Not very high, but definitions of "high" vary. Some people say over 6 is high, some say over 2 is high. Under.5 is very low.

In October, my TSH was 2.3 or thereabouts.

This week, after 8 weeks of treatment, my TSH was 3. This is weird. It should have gone down.

TSH is the messenger hormone that is produced by the pituitary to stimulate the thyroid and is believed to be the hormone that indicates how the thyroid is doing. So, if your body feels a bit short on thyroid hormone your body sends out more TSH. The thyroid reacts to this and makes more hormone. If your body feels like you have plenty of thyroid hormone, your body sends out very little TSH, and the thyroid makes less hormone.

With me so far?

Well, of course things can go wrong. If your thyroid is sick, your body might have to send out a lot of TSH to really get it cranking so you can make enough of the good stuff. Do this enough and you can stimulate the thyroid to grow. Twice as much thyroid, working half as hard as healthy tissue, should maintain healthy blood levels. As time goes by, and the gland packs it in, even a high TSH can't rev things up enough, and you become deficient in hormone and hypothyroid.

Well, my thyroid has supposedly been keeping up pretty well considering its injury. By supplementing thyroid hormone, the thyroid should have been able to rest a bit. However, my TSH is higher. What the? This means my body is asking for more thyroid activity, not less. We expected my TSH to drop.

Now, I've stated before that TSH is important to know, but really truly doesn't tell us everything. This redoubles that assertion.

My doc was surprised my TSH was up, and when I asked why it was higher, she shrugged and said that she really didn't know. I was glad she said that, I don't mind a doctor saying "I don't know", I do mind a doctor saying "I'm not interested" but that's a rant for another day. She is interested, so I'm satisfied with that.

My theory is that the low dose I've been taking has revved up my body to the point where it wants even more. We gave it an inch, it wants a mile. We'll see...

So the upshot is that she's upping my dosage! We're rechecking my blood numbers in 8 weeks. Yay!

She said I don't need to avoid so-called "goitrogenic" foods (cabbages, sprouts, almonds, etc.). Yay! Turns out that I don't have that kind of goiter. She did say that I have to make absolutely sure that I get enough iodine in my diet, but that she wasn't concerned since I take a multivitamin and eat seafood and seaweed (I have a little scrap a few times a week). We mix iodized salt with our kosher salt for cooking at home too.

She said my chance of recovery is 0%. I've got this for life. My thyroid will slowly continue to fail over time, and my need for supplementary hormone will only increase with time. This doesn't mesh exactly with some other information I've seen, so I'll do some more reading.

She also said that my thyroid should shrink, and that eventually it will probably atrophy almost completely. Much as this makes me sad - I'd rather it heal, I'm pleased that the goiter will shrink away. I'm self-conscious. I don't mean that I'm embarrassed by it, heck, I whip it out at parties and show all my friends. I just mean that I'm continually aware of it - I notice it in mirrors, especially at the gym where the light above the treadmills makes it especially apparent. Husbeast and I see it too often to be able to judge if it is shrinking, but my Mum says it is. Thanks Mum!

Go go gadget goiter!