My follow-up visits with the Nurse Practitioner at endocrinology following my thyroid surgery were unremarkable, which is a good thing. She’d look at my lab work, palpate my neck, ask me about symptoms, and declare me good to go until the next follow-up.
My most recent visit was with the actual endocrinologist. My most recent lab work showed a significant spike in my Thyroid Stimulating Hormone (TSH), while my T4 levels remained on the low end of normal. Since I’d already gotten an education in how hormones work when I went through menopause, I suspected that the higher levels of TSH were a sure sign that I’d be put on thyroid medication — if not now, then eventually.
As suspected, he prescribed a low dose of levothyroxine. Now that I’m already on Hormone Replacement Therapy (HRT) for estrogen, adding another hormone to the regime doesn’t seem as daunting as it once did. In fact, I’m looking forward to seeing if it lessens any of the symptoms that could be attributable to my thyroid.
According to the Cleveland Clinic, some of the main symptoms of low thyroid function include:
Brain fog (forgetfulness or difficulty concentrating).
Well, that’s nigh on impossible to separate from symptoms of ADHD and menopause.
Depression and anxiety.
I’ve been living with diagnosed depression for years (and undiagnosed for decades prior). My T4 levels have been on the low end of normal since they were first tested in 2015, so I guess it would be cool if my depression can be at least partially managed by managing my thyroid hormones.
Dry, coarse skin and hair.
I never used to have issues with dry skin, but I’ve been experiencing this in weird ways lately. Mostly I notice it when I’m drying off after a shower and see tons of skin flakes coming off on the (dark brown) towel, or when I’m sitting on the mat at my martial arts class and my ankles leave white skid marks of dry skin behind them. (Which I immediately try to brush off of the mat and hope no one is looking, because that’s a little gross.)
Elevated blood cholesterol levels.
Last time it was checked, my total cholesterol was high, but it was mostly my “good” cholesterol that was high, and my ratio of total cholesterol to HDL was totally normal. My doc told me not to worry about it… then, again, he usually says not to worry about most things. (We’re on the hunt for a new primary care physician, BTW, and not just because he’s retiring soon.)
Feeling tired (fatigue).
This is the commonest of symptoms, and could be attributed to any number of things: poor sleep hygiene, depression, menopause, obesity…
Inability to tolerate cold temperatures.
Every winter I can remember involves me having cold toes from the first frost through the last. That said, menopause has really screwed up my internal thermostat. I’m no longer getting hot (or cold) flashes, thanks to HRT, but I still dress in layers because I’m never sure how my body will react in any given situation.
Numbness or tingling in your hands.
I get this sometimes, but it’s mostly on the left side. My chiropractor attributes this to a nerve in my left arm getting aggravated.
Physical changes in your face (drooping eyelids, puffiness around your eyes).
Sure, my upper eyelids are a little droopy, but I attribute that to being middle-aged, and it’s not enough to impact my vision or to be noticeable to anyone but me.
Unexplained weight gain.
Oh, I can explain it, all right. The initial weight gain some three years ago was peri-menopause, but I didn’t realize it at the time. Over the months and years, it’s slowly compounded with changing habits — working from home, ordering takeout, being generally more sedentary. I’m now holding steady at a weight that’s about five pounds higher than it was at the time of my thyroid surgery, 25 pounds higher than when I entered menopause, and 60 pounds higher than my lowest weight (last seen in 2019).
I guess the point is that all of these symptoms can be explained by other things, so I’m unclear whether replacement thyroid hormones will alleviate any of them. Even if it helps a little, though, that’ll be a win.
I suspect that it will.