My Hashimoto’s and Hypothyroidism Journey

Thank you for following my my research. On this post, you will find my Hashimoto’s journey. It is my sincere hope, if you have suffered from fatigue, hair loss, brain fog, weight management, dry skin, depression, muscle aches, and the countless other symptoms, that your life will be changed for the better after implementing the research I’ve uncovered. It can help you do what most doctors and most clinicians would consider impossible, to put Hashimoto’s into remission.

Why Focus On Hashimoto’s?

The easiest answer to this question is that I was diagnosed with Hashimoto’s thyroiditis during a routine physical at age 27. As a pharmacist, I was trained about the pathophysiology of diseases, as well therapeutic treatments. Our professors always stressed lifestyle interventions to reduce the need for medications and to prevent disease progression.

People with hypertension were told to eat a low-sodium diet, people with high cholesterol were supposed to reduce their fat intake, and Type 2 diabetics could essentially reverse their condition by eating foods with low glycemic indexes and losing weight.

In mild cases of most chronic conditions, we were always taught to recommend lifestyle interventions first, followed by medication therapy if the interventions were unsuccessful, or if the patient was not willing to change.

In advanced cases, and if the benefits of medications outweighed the risks, the patients would be started on medications in conjunction with lifestyle interventions.

We also learned that patients should be monitored as they made progress toward their goals to see if medication therapy was still warranted.

Thus, I was confused, as there were no mainstream lifestyle interventions for Hashimoto’s, or any autoimmune conditions, for that matter. The only intervention recommended by endocrinologists, was a pharmacological one, to start taking a supplemental thyroid hormone such as Synthroid®, the #1 prescribed medication in the United States in 2013.

While I was prepared to start taking Synthroid® after having a gradual decrease of thyroid hormone production as I aged well into my 30’s, I didn’t feel this medication was appropriate for use in an autoimmune condition. The supplemental hormone did not stop the destruction of the thyroid gland by thyroid antibodies. It simply added more hormone when the thyroid was too damaged to produce it on its own. It was like pouring water into a leaky bucket without plugging up the holes that were causing the leak.

Furthermore, I was only 27! I just got married, started my dream job, moved to a house by the beach … this was not right.

I am a firm believer in cause and effect, and it did not make sense to me that this disorder just happened out of nowhere. On top of it all, I had been suffering from severe digestive troubles for about one year, was chronically fatigued, and was experiencing profuse hair loss. It seemed unnatural to me to do nothing as a part of my body was being destroyed.It didn’t make sense. Those who know me will attest that I can be quite stubborn when I feel that I have been wronged.

One can think that the world is unfair and ponder the many reasons for the lack of lifestyle interventions, but focusing on the problem never seems to yield a solution.

But perhaps, I thought to myself, if I could make connections among all of my symptoms, then maybe I could find and treat the root cause of my condition, and hopefully my story will inspire others to do the same. Sometimes we have to be the change we want to happen, and hope that the medical establishment will take note and promote further research.

October 6, 2009

Me: a 27-year-old woman, passionate about my career, newly wed, proud owner of an adorable Pomeranian, frugal (yet trendy and stylish), amateur chef, aspiring cosmetic chemist, family oriented, ex-smoker, non-drinker, yoga enthusiast, scrapbook lover, healthcare professional … with Hashimoto’s thyroiditis.

What does Hashimoto’s mean to you? To me, it meant losing my hair, feeling exhausted, anxious, cold, and forgetful (a.k.a.the infamous “brain fog”), followed by pain and numbness (carpal tunnel) in both of my arms.

To some, Hashimoto’s may mean recurrent miscarriages, an inability to lose weight despite diet and exercise, depression, constipation, and years of frustration.

To others, it may mean pale skin, premature aging, feeling lethargic, unmotivated, sluggish …

I suspect that my journey with Hashimoto’s, like for many of you, began many years before diagnosis, which in my case was in 2009.

Without going into too much detail, the first of the crucial defining moments in my disease development may have started during my undergraduate studies at the University of Illinois. Due to the communal living setting of dormitories (and less than stellar hygiene habits of most college students) I had recurrent strep throat infections and even contracted mononucleosis (Mono), a viral infection caused by the Epstein-Barr Virus (EBV), which is implicated in triggering many autoimmune conditions. I received multiple courses of antibiotics as well as flu shots (which may be associated with EBV infections), and started birth control for menstrual cramps.

It is my belief that this combination had a profound impact on my gut flora, and thus my immune system.

Up until the middle half of my freshman year in college, I used to be an early riser who only needed six to eight hours of sleep. I woke up energetic and ready to face the day each morning.

However, after one particularly nasty sore throat, I just could not get enough sleep, no matter what time I went to bed! I once arrived thirty minutes late to an 8 a.m. exam, having just woken after sleeping for sixteen hours straight (I had lain down for a quick nap the day before at 4 p.m.).

A previously straight-A student, I barely passed my classes that semester. Discouraged, I spent the summer after my freshman year going to bed at 9 p.m. only to wake up exhausted around 1 or 2 p.m. the next day.

Within a few months, my need for sleep gradually decreased, however, I felt that I never fully recovered since that time, requiring much more sleep than I had prior to the mono infection.

Two years later, during the first year of my pharmacy studies, I required a series of immunizations in order to be allowed to start my clinical rotations, and developed irritable bowel syndrome (IBS) with diarrhea, which seemed to be triggered by soy lecithin. Upon cutting out soy lecithin-containing foods, my symptoms reduced from daily to once or twice per week. Further elimination of red meat eliminated the symptoms.

A bout of urinary tract, yeast, and throat infections, as well as acne the following year, led to the use of additional antibiotics. My lifestyle was filled with fast food, late-night study sessions, caffeine, stress, and virtually no time for myself.

Towards the end of my fourth year of pharmacy school, I started noticing an onset of anxiety symptoms. I attributed the anxiety to the changes I was undergoing at the time: graduating, taking board exams, getting engaged, moving to a new city, finding a new job … for you it might be your job, kids, or just life stress in general.

The following year, I came down with a terrible viral infection with the hacking, lungs-coming-out kind of cough. The lack of energy went away after a few days of missed work and lying around at home, but the cough lingered. I would wake up in the middle of the night choking. I often would have uncontrollable fits of coughing while counseling patients at the pharmacy where I worked. One day I was coughing so hard I vomited in a trash can in the bathroom.

“Are you pregnant?” one of the clerks asked with an assuming smile.

“No, I take pills for that,” I replied.

Being a pharmacist, I tried every over-the-counter cough syrup that was available at the drug store where I worked. The cough persisted. I tried Claritin®, Zyrtec®,Allegra®,Flonase®, Albuterol … none of those helped, either! I ended up seeing an allergy specialist after a primary care doctor ran a blood allergy test that showed that—yikes!—I was allergic to dogs!

The allergy specialist ran more detailed tests. First was the “itchy skin” test, also known as the scratch test, where a nurse scratches your back with a pin that contains small amounts of allergen and watches for a reaction. It turned out that I was allergic to—wait for it—everything! Horses (which might explain my irrational fear of them), dogs (although I’ve had dogs most of my life, while the cough had just started), trees (all of the ones native to California), and grass (strangely, I was more allergic to grass than I was to histamine). I was started on Singulair®, Xyxal®, and another steroid nasal spray, but they did not help the cough. The second test was called a barium swallow, where you swallow a whole bunch of chalky liquid so the doctor can image your esophagus. (Side effect: white poop!). I received a diagnosis of a small sliding hiatal hernia with spontaneous reflux, and thus gastroesophageal reflux disease (GERD), commonly known as acid reflux.

I was actually relived to have a diagnosis! Finally, an answer, although I was somewhat puzzled as I didn’t have any of the typical symptoms of GERD that we learned about in school. I started on Aciphex®, an acid-suppressing medication used for GERD, and followed up with a gastrointestinal specialist. He said “Take two a day for a few months and call me for refills”.

Well soon after taking the Aciphex®, Iactually developed symptoms of GERD. The cough continued. I decided to discontinue the Aciphex®, and implemented anti-reflux dietary changes and began to sleep pretty much upright. I also started taking Pepcid®, another medication for reflux, Mylanta®, and drinking ginger tea. I believe that these medications further contributed to a change in gut flora.

Later that summer, I traveled to Poland with my family and experienced almost daily food poisoning with severe diarrhea for two weeks—another strike against my gut flora. After my return to the U.S., I began to notice hair loss, but I dismissed it on the belief that it must have been all in my head (no pun intended). A few months later, it was that time of year again to get a full physical.

Diagnosis: Hashimoto’s Thyroiditis and Subclinical Hypothyroidism

September 2009 Thyroid antibodies = 2000; TSH =7.88; Normal T3 and T4.

I was also told I had a possible mitral valve prolapse or murmur that needed to be checked out by a cardiologist. I was in shock and disbelief.

I read up about the symptoms of hypothyroidism, or an underactive thyroid, and perhaps I had some of them, but the symptoms were so nonspecific that I rationalized all of them away to stress, work, getting older and everyday life worries. While it was true that I slept for more than twelve hours each night, I had just grown to live with it, and decided that it was the new normal for me. Additionally, I had been checked for anemia, thyroid disorders, and other common reasons for fatigue a few years back when living in Arizona, and was told everything was fine.

I’ve always had cold intolerance, but I attribute that to my low body fat. Weight gain? Not me. Depression? Not at all, this was the happiest I have been in my life. Slow, sluggish? Have you seen me running around at work??

Quite frankly, I was shocked that I had hypothyroidism and not hyperthyroidism (Did you know 90% to 95% of those that have hypothyroidism actually have Hashimoto’s?!). In the textbooks I had from pharmacy school, people who had underactive thyroids were overweight and sluggish. This clinical picture did not fit me.

While I did sleep for more than twelve hours every night, I was very anxious, thin, and tired but wired. If anything, I thought, an overactive thyroid (hyperthyroidism) seemed to fit me better.

What I came to later understand is that as the thyroid antibodies produced in autoimmune thyroiditis were attacking my thyroid,packets of hormone were released into my blood stream, causing symptoms of an overactive thyroid in addition to those of the underactive thyroid. The best of both worlds…

Once the shock settled, I found out that lifelong thyroid medications are recommended, and that untreated Hashimoto’s can lead to serious manifestations such as heart disease, severe weight gain, and infertility, which as a newlywed was very hard to swallow.

Endocrinologists were divided on whether to start thyroid hormones or wait in case of subclinical hypothyroidism. Additionally. most medical websites at the time stated that nothing could be done for the autoimmune destruction of the gland.

But I knew in my heart of hearts (or perhaps it was my gut), that waiting around while a part of my body destroyed itself just couldn’t be right. I decided to use the scientific literature review skills gained during courses in pharmacy school to look for any new research or studies about Hashimoto’s.

Within a couple of hours, I was able to find the following encouraging information:

• Selenium 200-300 mcg is shown to reduce anti-thyroid antibodies by 20%-50%, over one year. And yes it was a statistically significant study, for you statistics buffs! (p value)
• Thyroid supplementation may be used with subclinical hypothyroidism to improve outcomes.
• Strict adherence to a gluten-free diet normalized subclinical hypothyroidism in most cases.

I also decided to search information on medical boards where patients would share their experiences. In my work as a clinical consulting pharmacist, I often examined these types of sites to gain insight about patient perspectives on the effectiveness of various medications. Many times, these sites contained information that had not yet been described in the scientific and mainstream literature and was still experimental.

I was excited to read a testimonial that stated: “Acupuncture eliminated my need for levothyroid (I was up to 300mcg/day); and I no longer test positive for anti-thyroid antibodies.”

Unfortunately, my insurance did not cover acupuncture, but what did I have to lose? (Other than money, of course.) I decided to give it a shot. I also scheduled appointments with an endocrine specialist, cardiologist, and ob-gyn. I felt 27 going on 72.

Over the next three years, I have spent an enormous amount of time and money to heal myself. I have read various books, spent countless hours researching medical journals, health blogs, and making myself a human guinea pig.

I have researched, considered, and/or tried various interventions to heal my Hashimoto’s, including:

I became obsessed with finding the answer, and as those who know me can confirm, I am very stubborn and determined to get my way.

Protein indigestion/malabsorption

Protein: My A-Ha! Moment

When I first became chronically exhausted, I would sleep as long as possible. This was much easier as a college student. Unfortunately, it led to having a less than stellar GPA. But I soon learned to compensate. I would sleep all day, and then stay up to study all night to take my exams at 7:30 a.m., come home, and sleep more. Other times, when I had to wake up with less than ten hours of sleep, I would often be struck with diarrhea. With the help of a supervising pharmacist, I was able to connect the diarrhea to protein shakes that contained soy lecithin. Red meat was also a culprit in causing gastrointestinal distress, as was lack of adequate sleep. I remember saying to my mom, “It’s like I need to sleep so that my body can process everything I ate, when I wake up too early it’s still not processed.” She suspected lactose intolerance. “It can’t be,” I thought. Why would it just start all of a sudden? Fast forward to the future. I started taking Betaine with Pepsin on Friday, February 10, 2012, one capsule with each meal containing protein. I was surprised to wake up the following morning at 8 am without an alarm. I had been dragging myself out of bed after 10 most mornings when I did not have to work. Strangely, I continued to feel energetic all day. I even stayed awake when my usually much more energetic husband took a nap. With a friend’s wedding fast approaching and having barely exercised in the last year, I had also started doing P90X on that same Friday.

I wondered if my new energy was due to the exercise or to the enzymes. Happily, I continued both, and thought I should test my theory at some point. Meanwhile, things became easier, and all of a sudden, I felt that I had a surplus of time. I felt more at ease going to bed and even had time to meditate, something that I had been wanting to do for years!

As the week went on, I felt myself having more and more energy, and actually became more outgoing and talkative. Additionally, the mental fog was completely lifted, and I could come up with all sorts of clever words quickly. My co-workers commented on my good mood at work. My husband noticed that my sense of humor even improved. I felt like myself again, the self that I had not seen for almost ten years.

I woke up one day at 5:17 a.m. and decided to start writing the book: Hashimoto’s Root Cause. I had always loved writing, and even took a workshop about writing a novel in 2007. The instructor suggested that working people have the best chance of writing a book by waking up two hours prior to their usual rising time, and write. With a full-time job and responsibilities, I thought becoming an author would be impossible, and I gave up that dream. But now, here I was … doing the impossible. Certainly, if I could wake up energized after only six hours of sleep after feeling chronically exhausted for ten years I could easily overcome Hashimoto’s and then write a book about it!

But the journey did not stop there. The energetic feeling only lasted a few weeks, and unfortunately, I have had many setbacks before I found something that worked for me. But I never forgot how great it was to finally feel normal and kept pushing on and fighting. After much perseverance, time, and trial and error, I can finally say that I was successful and was able to put my Hashimoto’s is in remission.

Through my book, I share my rationale for the Root Cause and treatment of Hashimoto’s based on what finally worked for me, with the hope that it perhaps will also work for you. I am also going to share the process of how I came to find my Root Cause, so that hopefully, my readers will be inspired to find theirs using a similar methodology.