Note: this may get SUPER boring if you don't have anxiety and/or you're not interested in thyroid conditions.
Also: I'm not a medical professional or even close to an expert, so always consult your doctor and do your own research before starting or changing any medications, treatments, or supplements.
Late last year I decided I wanted to really tackle my growing agoraphobia, so before I got too serious with exposure therapy, I asked my doctor to run a bunch of tests. (It's always smart to get checked out before you start any new treatment - even non-drug ones.)
The tests revealed I had a "shocking" vitamin D deficiency - which I expected - and also Hashimoto's Thyroiditis, which I did not.
At the time I told you guys the good news, I was pretty dismissive of the Hashi's, calling it, "essentially sluggish thyroid, which is easily treatable" and claiming it had nothing to do with my anxiety. Several of you immediately cautioned me in the comments, explaining that it's far more than that, and has potential anxiety implications. So before I started any meds, I went looking for the best book I could find on the subject, and eventually decided on this one:
Hashimoto's Root Cause, by Izabella Wentz
I bought and read it in a matter of days, taking copious notes, and then took to the web to research more of what I'd just learned.
In a nutshell, Hashi's is an autoimmune disease in which your body begins attacking your own thyroid. As the thyroid is destroyed, it obviously can't produce all the thyroidy goodness your body needs, and a host of symptoms like fatigue, cold intolerance, weight gain, etc, can pop up. Apparently Hashi's can be hard to catch, so I'm lucky, in a way, that my test results were clearly positive. (The most conclusive test looks for Thyroid Peroxidase Antibodies, which is what your body produces to attack your thyroid. If you have any those, you probably have Hashi's. Easy-peasy.)
Most doctors consider Hashi's an easy fix: you just supplement the body with synthetic thyroid - Synthroid being the most common - and plan to increase that dose as the thyroid is slowly destroyed by the body's own immune system. Since no one really knows WHY your body suddenly has it in for the thyroid, all you can do is essentially treat the symptom, and of course you'll need to be on the synthetic thyroid for life.
That's not necessarily a bad thing, of course - these drugs save lives - but Wentz's book delves much deeper, searching for that "root cause" and positing that, if you find it, you can actually reverse thyroid damage and potentially avoid a lifetime of ever-increasing Synthroid doses.
I should stress that the author is NOT anti-drug, and heartily recommends Synthroid or other medications as a first step in any Hashi's treatment regiment. Wentz is a pharmacist, and frequently explains things from the molecular level, which can be both daunting and extremely technical, but I kind of love that.
I can tell you that Wentz's recommendations are flatly overwhelming, though, ranging from a dizzying array of both prescription and supplement options, to further test recommendations, to diet plans that made me die a little inside. (Or, ok, die a lot.) It's complete information overload, but coupled with her in-depth explanation of what exactly your body is experiencing with Hashi's - and the host of seemingly unrelated symptoms that go with it - it was also pretty encouraging. Suddenly my life-long history of GI issues is making sense! And hey, get this: anxiety and panic disorders can definitely be directly related to Hashimoto's.
Mind = blown.
(Here's a post on Wentz's blog about it.)
Armed with better information, I returned to my doctor and discussed treatment options. Given that my thyroid numbers weren't all that bad yet, he allowed me to hold off on Synthroid for 6 more weeks, and instead focus on fixing my severe vitamin D deficiency, which I'd learned can have a major effect on thyroid function. Based on my research I also began taking Selenium, and we decided to check my iodine levels for possible supplementation of that, too.
Quick note on iodine: Long considered the go-to thyroid supplement, I was surprised to learn there's quite a controversy among doctors regarding iodine, as some [like Wentz] believe excess iodine actually *causes* a lot of the Hashimoto's here in the U.S. (Whaaaa?) In other countries it's usually an iodine deficiency that causes Hashi's, so you can see how that'd get confusing.
All I can say is, do your homework, and talk to a knowledgeable doctor. If you do decide to supplement, definitely get your iodine levels checked first. It's a simple urine test, so no excuses! (Mine turned out to be on the low end of normal, so I supplemented briefly, but then stopped after 2 weeks.)
Ok, so! Ready for the good news?
After a little over 6 weeks on vitamin D and selenium, my D levels were back in the normal range, I felt more awake & energetic, and my TSH (Thyroid Stimulating Hormone) improved by half: coming down from 6.05 to 3. (Normal range is roughly from .3 to 5, so that puts me back in range.) My doctor was especially pleased to see my T3 come down almost a full point, since he tells me that's the more adrenaline-like of the Ts, and so more likely to cause panic issues.
I still have those pesky Thyroid Peroxidase Antibodies, which means my body is still attacking my thyroid (and I still have Hashi's), but even those reduced from 194 down to 148.
Encouraged, my doc and I agreed NOW we could start Synthroid. The lower T3 meant I was less likely to have a panic reaction, and the drug will help with my Hashi's symptoms and potentially even allow me to lose some extra pounds, which Doc is keen to see. [Insert grumbling here about responsible doctors and their persistent demands for better health. I mean, REALLY.]
It's been just over a month now, and I'm happy to report that the Synthroid hasn't caused any noticeable uptick in anxiety - though there's also no miraculous wellspring of energy or weight loss, either. Heh. I'm on the smallest dose possible, though, so we'll reassess my levels in another few months and see if I need more.
I'm posting all this because some of you asked, but also because I hope my story encourages you guys to ask more questions, do more research, and maybe even order some tests through your doctors. Hashi's is most common in women over 30, so if you have the symptoms, get the test. (And make sure it's the antibodies test, not just your TSH level!) This could be one more piece of the panic puzzle for some of you, and that alone makes it worth a dozen blog posts, in my book.
Closing thoughts (ie the slightly less boring stuff):
John told me last week that one of the things he's most admired in me the past 7 years has been my tenacious search for answers. I refused to accept that I started having severe panic attacks - literally over night - for no reason. I refused to accept the "No Diagnosis" on my hospital charts. I've never stopped looking for a root cause, never stopped seeing new doctors or trying new things.
Some of my efforts were a disaster, like my 2-year foray into bio-identical hormones, and some brought me blissful relief, like this new spine stretch that combats computer hunch, and lets me go up to 2 months between chiropractic visits. (I can literally halt minor free-floating panic with a simple shoulder stretch now - which took me years of needless suffering to learn.)
I've met so many people who've given up, saying they're just "the anxious type" and resigned to a lifetime of Xanax. Xanax is a godsend, don't get me wrong, but I'm convinced panic and anxiety should never be a life sentence. Maybe I'm wrong. Maybe I'll still be struggling to ride the Hogwarts Express in ten years, and maybe I'll never get on a plane again, because I'm just too scared. Maybe I'll never see Tokyo Disneyland.
But I'm tenacious, dangit, and I refuse to accept that.
So here's to all my fellow rebels out there, spitting in the face of panic and daring it to do its worst.
And then doing responsible research and talking to our doctors and therapists.
'Cuz we got this.