Thyroid update

On Tuesday I visited my endocrinologist to follow up on treatment for Grave's Disease after seven weeks on an aggressive dose of thyroid-blocking medication. The results were encouraging. I'm responding well to the medication. My T4 levels have reached the normal range, T3 is close, and while my TSH is still very low, it's normal for that to take several months to return. The doctor is keeping me on the high dose of methimazole for now, but seems confident that medication will be an effective treatment against my hyperthyroidism.

One of my main issues is the presence of Hashimoto's antibodies, which means I've probably been hypothyroid in the past, and likely will be in the future. Controlling thyroid disease will be a matter of managing this rollercoaster, and its unpredictability. That will likely be a lifelong battle regardless of which treatments I eventually choose.

"Lucky you," my doctor said.

Still, it's good news. And I have been feeling notably better. This post is a quick (boring, I know, but helpful to me and hopefully others) update on my health progress.

• Breathing — I haven't experienced any significant breathing difficulties since February. I have been much more conservative with my activity levels. But the last major episode happened while I was walking up my staircase at home, perhaps too fast, and felt my airways tighten in the way that tends to induce panic. That was two months ago. Whether these episodes are "asthma attacks" or something else, I still don't know. There's evidence of Grave's Disease exacerbating already-existing asthma, and there's also evidence of "air hunger" as a symptom of an overworked heart. I am reasonably certain that bronchodilators improve my breathing when I'm having an "attack," so I probably do have asthma in addition to thyroiditis. Lucky me.

• Allergies — I do (did?) have a severe allergy to grass that has become worse over the years, and seemed to ramp up exponentially when I moved to Colorado. I've been treated for this allergy with immunotherapy shots since October. In the past two weeks I've been receiving catch-up shots to which I have not responded well — swelling, itchiness, fatigue directly afterward. Spring is coming, which I'm not looking forward to. Hopefully the treatment will curb some of my hay fever symptoms, and I won't go through the allergic asthma that I was dealing with last summer.

• Exercise — I've felt noticeably stronger during the past two weeks, although I still have fluctuations in energy levels, sluggishness while running, and mid-day sleepiness. Overall, though, I am much *much* happier while exercising. My breathing is better, my head is clearer, I'm more relaxed, and there haven't been any major bouts of dizziness or anxiety. I also have yet to "push myself" into a hard effort — similar to my efforts during the winter, when I was desperately trying to improve fitness for the Iditarod. Staying conservative is still my plan. All of my workouts since Alaska have been hikes and runs — mainly because I'm scared of riding bikes. It's harder to control my effort level on the steep climbs around Boulder. Since diagnosis, fear of provoking a thyroid storm has made me obsessive about maintaining control of my heart rate and breathing. In Alaska this proved necessary, as I had particularly poor reactions to situations where I failed to control my efforts, as well as stressful situations. But as my levels drop, thyroid storm, asthma attacks, and other poor reactions become less of a threat. It may be time to start testing the waters again — slowly and carefully, of course.

• Muscle building — My thyroxine levels are currently in the normal range, which means I'm less likely to experience the "thyrotoxic myopathy" that causes muscle weakness and breakdown. People with hyperthyroid conditions tend to lose weight, but a fair percentage of that is usually muscle tissue. One of the reasons I'm likely beginning to feel stronger is this slowing of muscle loss. I renewed my gym membership and am excited to work on building endurance in the weight room.

• Weight loss — I didn't experience weight loss with Grave's Disease, and I have yet to see a gain outside my normal fluctuations. This is possibly because years of endurance racing taught me expert-level calorie replacement, so as I was burning up muscle, I consumed enough food to replace it with fat (just a theory.) Now that I'm approaching normal, I'm trying to be more cognizant about my calorie intake — fewer snacks, fewer dairy products, more fruits and vegetables. There's still a lot I can do to improve my diet.

• The hand tremors that I believed were a mild neuropathy (I had carpal tunnel syndrome last year) have almost entirely disappeared.

• The swelling in my thyroid gland appears somewhat reduced (although still noticeable.)

• My resting heart rate is down — I tend to see numbers in the high 60s and 70s rather than 80s and 90s.

• The frequent skin rashes that I believed were related to allergies haven't returned in a couple of months.

• I still have what I consider to be a higher-than-normal heat sensitivity, but I can't really expect that to go away since I've always been adverse to hot weather.

• Mentally I feel so much better. The dull, gray fogginess that I had been experiencing is becoming more apparent now that I'm beginning to come out of it. My mood has overall improved. I hope these clearer thought patterns will improve my writing efforts this spring and summer.

I think that's about it for now. Now I'm heading out for my first bike ride of the spring. Wish me luck!