Saturday, July 29, 2006

Hashimoto’s Disease

While living in San Francisco a few years ago, I discovered the wonder of clinical trials.  Clinical trials not only meant free treatment for conditions a person might have, they often meant cash.  I got started in my first clinical trial when I answered a newspaper ad looking for people with symptoms of depression, and that’s how I ended up in an open-label study of Celexa.  I didn’t get paid, and only received free medication, but I was completely broke and would have otherwise not been able to seek treatment.  After Celexa, I participated in a trial of Gingko Biloba and Cordyceps mushrooms under the same psychiatrist, and this time I was given free medication as well as free bloodwork.  That bloodwork showed I had a low testosterone level, so I was given a testosterone cream to try.  I wouldn’t have ever thought to look for that problem if the bloodwork hadn’t found it.  Before we’d left San Francisco, Flippy and I had also been in paid trials for a new intra-nasal tetanus vaccine, and I think we were excluded from a trial regarding staph infections as the bacteria didn’t show up in our normal flora.  I thought it was pretty cool to get a free tetanus vaccine, free blood tests, and a check for $100.

(There were certain clinical trials I just couldn’t do, like one for Lasix which required a few days of staying in the hospital.  Even though it paid $600, I didn’t want to do anything so dangerous as to require hospitalization).

When we moved to Las Vegas, I again looked to clinical trials to meet some of my healthcare needs.  I found a trial which I think involved using zinc to treat breast cancer (it’s amazing what I can’t remember).  I didn’t have breast cancer, but they needed healthy volunteers to take a pill with a very low-level of radiation in it, which I was assured was completely safe.  Part of the screening was thyroid bloodwork, and I found out I didn’t qualify for the trial because I had Hashimoto’s disease.  I’d never heard of that before, but the doctor running the trial assured me it was nothing serious, but that my thyroid couldn’t risk being exposed to any radiation.  The short definition is that Hashimoto’s thyroiditis is an auto-immune disorder, wherein the body attacks its own thyroid and products thyroid antibodies.  Although my TSH and Free T3/T4 blood levels were normal, the presence of thyroid antibodies in my blood was not.

I liked the doctor running the trial (young, Canadian, and gay), and I asked if I could see him as my primary care physician—I could.  So, I started to see him for treatment for my depression, as well as for my aches and pains (which I would eventually learn were fibromyalgia).  He was good about giving me free Effexor from his sample cabinet, but never suggested that my aches and pains were anything other than “in my head”.  When I did some reading and found out that Hashimoto’s disease could cause symptoms of hypothyroidism, even with a normal TSH, I asked him if I could try taking T4 to see if it helped my overall discomfort, but he was very reticent to try that.  He discounted materials I brought him from Medline, saying he’d “read them later”, and basically just refused to try me on any thyroid replacement hormones.  That’s when I ceased to be his patient, and sought out an endocrinologist.  The endocrinologist felt my thyroid, said it was enlarged, and immediately put me on both T3 and T4 to stop the problem from getting worse.  He noticed I had quite a few symptoms of hypothyroidism, and he treated me based on how the symptoms resolved, not on what my bloodwork said.  I think I eventually got my TSH down to just slightly above zero before I noticed an improvement in some areas.

I currently take 10 mcg of Cytomel daily, and 75 mcg of Synthroid.  Without them, I’ve had severely dry, cracked skin, an abnormally low body temperature, and extreme sensitivity to cold.  Those are the things I’ve noticed which have resolved most dramatically, but I’m sure there have been other small changes as well.

Long story short, if you need medical treatment but have little money and no insurance, check out clinical trials.  They can be a way to get treatment and medication, especially for mental health issues like anxiety and depression.  Also, if you feel you have the symptoms of hypothyroidism, but your bloodwork turns up normal for your TSH/free T3/freeT4 range, you might want to have your blood checked for thyroid antibodies.  A “normal” TSH of 4, in the presence of antibodies, can be a sign that your thyroid is marching towards the shutdown mark, and replacement hormones can help prevent or slow that process down.

Posted by Leigh-Ann on 07/29 at 11:26 PM
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