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So little ol’ Kirsty1 is lying in A & E awaiting diagnosis from the “Big Cheese”. She’s been prodded by a houseman, and poked by a Junior doctor, not to mention having been prodded AND poked by the GP why had sent her to A & E in the first bally place. They have all said “It’s Appendicitis” with great aplomb so if the large Edam would just say the same we could all get a move on with cutting the offending organ out of Kirsty1.
So out she is stretched, reading Three Men in a Boat, when a nurse comes in to “generally hustle” in the background. Hustle she does indeed until she abruptly stops to say something that Kirsty1 found to be really quite extraordinary:
“You’ve got a goitre Kirsty1,” says she “When you get out of here go back to your GP and tell his exactly what I have said.” Kirsty1 had precisely no idea what hustley-nurse was talking about but briefly thought to herself “Right, I’ll do that when I’ve got over all this Appendiexcitement.”
The huge Brie did eventually wield his opinion and then his scalpel to great effect and three days later Kirsty1 was back home with her lovely Oxford English Dictionary. She asked him what a goitre is (he’s so good at that sort of thing…) and he said in a starched-collary kind of a way:
“Kirsty1, a goitre is, ahem: “A swelling of the neck due to enlargement of the thyroid gland, as caused by disease of the gland, iodine deficiency, etc.”
Hypothyroidism is simply a lack of Thyroxine production from your Thyroid gland which is an H-shaped gland in your neck (but why they stick out when enough Thyroxine is not being produced I have never had a satisfactory explanation…). Some people display a goitre, like I supposedly did, but there are a myriad of other indicators that the Thyroid may not be working hard enough.
It is a chronic condition in the literal medical sense that if it was not medicated you would eventually die of it. In this case your poor old heart would probably just get too weary to pump away any more. But rest assured that is now an incredibly rare event in the first world because it is so easy to medicate.
It tends to be thought of a female problem, this is something of a myth as men do get it too, albeit at a lower percentage. The other myth is that it is only a problem in older people. WRONG. It can strike at any time, but the quicker you get diagnosed the healthier it will be for you, as putting your body under the strain of not having enough Thyroxine for months or years can result in all sorts of other problems later on.
Most chronic conditions are listed by the NHS as being exempt from prescription charges, and as Thyroxine sufferers are listed you will quickly become exempt from all prescription charges if you are found to be in need of daily synthetic Thyroxine.
(A complete aside: the UK Govt should be completely ashamed of themselves that they have still done nothing to include MS on this list – it makes me truly embarrassed that a mere requirement for Thyroxine is available to me free whilst the complicated medical requirements of an MS-suffered must be paid for by the patients themselves. Kirsty1 to Tony Blair “I KNOW YOU’RE BUSY BUT SORT IT OUT!”)
The main difficulty is that Hypothyroidism doesn’t mean NO Thyroxine is produced, although it quite commonly does, but it also encompasses those patients who are still producing SOME Thyroxine naturally. This means that any and all ailments such a patient may have are likely to be exacerbated. Other indicators can all be indicative of many many other conditions and therefore can be over-looked. Common mistakes are to confuse the onset of middle or old age, and a feeling of being under-the-weather as just that and so not take your concerns to the medical profession.
There are so many possible symptoms of Hypothyroidism that if you are concerned that you may have it please do not take the list below as gospel, I write it just to give you an idea of some of the possible symptoms:
Dry skin and hair Hair prone to falling out Skin that bruises easily Poor blood circulation Slower heart-beat Pins and Needles Poor quality nails that are prone to brittleness Low (or lower) blood pressure Slow metabolism resulting in weight gain Lack of concentration Feeling of lack of sleep/inability to stay awake Inability to “get going” in the morning A goitre
…and as I say, I’m not an authority on this so I have possibly missed many other signs. Of course, that’s not to say that each patient will get ALL of these, no: far from it. you may only exhibit one or two of them.
In my case I think my metabolism did slow down marginally and my circulation which was already poor got much worse. On the plus side the only hair that fell out was under my arms – hoorah! Sadly now that I am taking synthetic Thyroxine this side-effect is almost cured – boo hoo!
Although I found it incredibly easy to get my diagnosis this is not the case for everyone. Two factors contribute to the doctor being loath to go down this road too quickly:
Firstly, as explained above the symptoms can be vague and not specific to Hypothyroidism
Secondly, you know all those desperate over-weight women who say “it’s a medical problem”, well when they say that what they probably mean is that they have Hypothyroidism. So if you are obsessed with your burgeoning weight problem you may fall into the trap of HOPING that you have this ailment and pestering your doctor to test you for it. Sad but true. This makes doctors unsurprisingly rather wary in some cases.
The way that you are tested is via blood test - I have given blood to be tested for both T4 (which is the thyroid hormone) and TSH (which stimulates the Thyroxine) every six months since my diagnosis about four years ago. I know that some patients who have settled into a pattern only give blood every year or even less than this. The blood tests are for your doctor to balance your prescription, as over time your natural production rate may reduce so that your requirement for synthetic product increases.
It is likely that your GP will be incredibly cautious because they are anxious to avoid giving you too much Thyroxine which will send your heart racing and your blood pumping faster than it should do. In many ways this is a far more serious problem than its alter-ego and your doctor will do their best to ensure that they don’t overdo things for you – in fact they may well start you off on 50mcg for the first six months, even though they know you will almost certainly need more, just to have the added security of a second blood test to see how your body responses to the addition of more Thyroxine.
Synthetic Thyroxine is a remarkably simple and successful solution to this problem. It is currently made in 25 mcg 50 mcg and 100 mcg tablets and according to your prescription and requirement you might need to take anything between 25 to 150 mcgs each day. There are very few recorded cases of people having problems with synthetic Thyroxine although I believe there is a tiny percentage chance that you will have some type of allergic reaction to it.
There seem to be a myriad of manufacturers of the generic product, which has been off-patent for years.
…couldn’t be easier. It is probably the best chronic condition you can possibly have because as long as you take the drugs it is impossible to know you have it. Yes there is a long list of possible side-effects from the tablets but I don’t propose listing them all out here as that is true with just about every drug available to man, and personally I have never suffered with any of them. There are also specific issues for people already suffering from Diabetes and Epilepsy, but I would be lying if I said I know what they were. I’m sure if a Diabetic Epileptic presented with symptoms of Hypothyroidism a doctor would notice that he’d better gen up pretty quickly. Then he’d probably write a paper for The Lancet just about them.
You do have to be careful with iodine consumption – it is found in seaweed (don’t worry about so-called seaweed in “English” Chinese restaurants – it is always cabbage!) and there are Kelp supplements available in Health food shops that would really bugger you up if you took them. Other than that there is nothing it is really necessary to avoid or go out of your way for once the synthetic Thyroxine has got you back up to speed with everyone else!
I was diagnosed with this about 4 months ago, 2 blood tests done already, another in a couple. Still very tired and not really seen any change to how I was before unfortunately. Hoping it'll change soon.
kismet 25.05.2005 11:57
This review is very helpful. My brother is a farmer and was feeling ill for months and was working himself into the ground as my father had a triple heart bypass and was unable to work for around 8 months. He went to the doctor as he had tunnel vision, breathlessness, pins and needles/numbness in his legs and the doctor diagnosed STRESS nad DEPRESSION due to working too hard. After repeated visits, the doctor reluctantly did some blood tests, only to reveal that my brother had an underactive thyroid gland!! Now he is on the thyroxine he is starting to feel better although he still needs to get the level right and still gets very tired. Stress and depression my arse! Wish the doctors wouldn't put everything down to that!!