Since I miscarried in February, the last few months have been like a health scavenger hunt that eventually led to my diagnosis of hypothyroid.  It’s a long story, which I will share, but before I do I think it would be a good idea to have a crash course on hypothyroidism, or “Thyroid 101.”

What is the Thyroid For?

The thyroid is the small bowtie or butterfly-shaped gland, located in your neck, wrapped around the windpipe, behind and below the Adam’s Apple area.

Here is a picture:

The main action of the thyroid is to create energy and produce heat. All the cells in the body need energy to do their job. For that they need to receive small amounts of thyroid hormone every day. The thyroid produces several hormones, but two are key to our health: triiodothyronine (T3) and thyroxine (T4). T3 and T4 help oxygen get into cells, and make the thyroid the master gland of metabolism. A thyroid gland that functions normally produces T4 and T3. 20% of the T3 circulating in the body comes directly from the thyroid gland, and the remaining 80% comes from conversion of T4. When the thyroid produces more hormones and it gets to the cells of the body, it is similar to pressing the accelerator and revving up the engine of a car.

Without enough thyroid hormone metabolism decreases and weight will go up.  Energy will be low and you will get tired easily. Your immune system will not work properly, making your more likely to have infections and even cancer. Your brain will not be as sharp, causing decreased memory and concentration. In short, every function and every process within your body will slow down, from circulation to bowel movements. It’s like taking your foot off the gas pedal; the body’s functioning will slow down.

How do you know something is wrong?

There is a huge list of possible symptoms of hypothyroid and many of them are confused as other issues and so hypothyroid is often misdiagnosed.  You can find a long list of symptoms from Stop The Thyroid Madness or on my “Symptoms” page.

In my case, my hypothyroid symptoms went unrecognized, and quite possibly existed for years.  I am still figuring all of this out, but when I look back over the years several of the symptoms jump off the page at me as I read the list: miscarriages, anxiety, fatigue, hair loss, difficulty losing weight, easily and quickly gain weight, acne (acne in your 30’s is worse than as a teenager), forgetfulness, air hunger (feeling like you can’t get enough air), aching bones/joints, often feeling cold (sleep with socks on in the summer), low body temperature.  Only in the last few years would I agree that I have been dealing with low grade depression and I always equated it to grieving the loss of my pregnancies.

It wasn’t until my third miscarriage in February 2012 that I began to ask questions and feel dissatisfied when my Doctor rattled off the same statistics of women with multiple miscarriages going on to carry full term. I’d heard them twice before and at the time I just accepted that, for whatever reason, my babies died and I needed to work on moving forward.

After my second miscarriage in December 2009, it was my Doctor’s plan to start me on progesterone as soon as I learned I was pregnant, which we did. The hormone progesterone is often called “the pregnancy hormone” because it plays 2 important roles in pregnancy:

• Progesterone thickens and prepares the lining of the uterus, called the endometrium, for implantation of a fertilized egg.
• After implantation, progesterone is important during the first trimester to maintain pregnancy.

During a normal pregnancy, around 8 weeks after implantation, the placenta takes over the production of progesterone from the ovaries. The placenta produces a significant level of progesterone to maintain a healthy pregnancy.

The thought was that perhaps my body wasn’t creating enough of the progresterone hormone and that by taking progesterone my pregnancy would be supported until the placenta took over.  Sadly and once again, I discovered I had miscarried at 9 weeks, just like I had twice before. We also learned that we were expecting twins. Genetic tests confirmed they were boys and there were no chromosomal abnormalities. I hate that it has taken this long to research for myself, but in the midst of my grief I just believed what the medical professionals were telling me. Miscarriage happens.

A few weeks after losing the last pregnancy, I started to research online the terms “multiple miscarriages” and “unexplained miscarriages”.  I found several websites mentioned thyroid dysfunction had a link to infertility and multiple miscarriages. I started to dig deeper and learned a lot about hypothyroid symptoms, body temperature and blood tests. 

I learned that many doctors only test for the “TSH” which only shows what the level of thyroid hormone is present in the body.  For many people, their body is able to create the hormone, but it does not utilize the hormone as it is supposed to. The best illustration for this that I have read is to think of a room with 4 white walls. On the floor next to you is a bucket of red paint.  You have all the paint you need to finish the room, but you do not have a paintbrush or a roller to apply the paint to the walls. This is what happens when you thyroid creates the hormone but can’t get it to the cells.

There is a test to determine if your body is converting the T4 hormone to T3 which “gets the paint on the wall,” so to speak, but according to my research, doctors are taught in medical school that T4 is the only thyroid medication that patients with hypothyroidism need and so the most common test is the TSH blood test which shows the amount of the hormone present (T4) before it is converted to T3 which gets to the cells.

Are you still with me?  It’s a lot of information I am still getting my head around. Here is a funny picture of a cat and dog.  Take a break. I’ll wait for you.

Better? Okay.

Of course I learned all of this the hard way when I asked my OBGYN to check my thyroid my results for TSH were 1.93 which is “within normal limits.” The most important first step is to get a full thyroid panel to determine whether you are lacking sufficient amount of thyroid hormones (T4), or if, like me, your body is not utilizing the hormone properly (converting T4 to T3).

What Causes Hypothyroid?

Here is a list of the many possible causes of hypothyroidism, also from Stop The Thyroid Madness (STTM).  You can read more detailed definitions for each of them at STTM.

• Heredity
• Iodine Insufficiency
• Hashimoto’s Disease (also called “Hashi’s”)
• Overtreatment for Graves Hyperthyroid or Hashi’s with Radioactive Iodine
• Thyroid Removal Surgery
• Radiation of the face/neck/chest
• Tumor on the Pituitary Gland
• Trauma from Accidents or Surgery
• Pharmaceutical Drug Induced
• Supplements
• Over consumption of Goitrogenic Foods
• Over consumption of Soy Products
• Cigarette Smoking
• Pregnancy/Childbirth
• Menopause
• Aging
• Environmental Exposures
• Perchlorate and Other Toxic Chemicals Exposure

 That’s probably plenty for today. 

I’ll continue with how I randomly came to the discovery that I do in fact have a thyroid condition among other things next time.

References:
Stop the Thyroid Madness
Thyroid Manager
Alt.Support.Thyroid
Thyroid (About.com)
Endocrine web