Monday, July 26

Differential Diagnosis – Slob or Slob with hormonal issues?

Three years ago I was in great shape cardiovascularly and weight wise. I was racing my bike, had a resting pulse in the low 50’s, and weighed less than 180 pounds with a body fat of around 8% (I know, sounds heavy, but at 6’2” with my frame, people were asking me if I had cancer – anything under 200 and people call me thin).

Then my daughter was born, we oversaw the building of a new house, and I started picking up more administrative duties at work. I stopped working out altogether, and my eating habits did not change much (you can chow on a lot of calories if you are riding your bike 12 hours a week). I am out of shape. By a LOT. I knew things had to change in February when I had to have a physical to take my EMT class. My labs came back less than stellar, and a 50 pound weight gain was right on the doctor’s computerized charts for all to see.

So I vowed to start working out again and eating better.

I didn’t.

In fact, since February I have gained weight and my labs have gotten WORSE (in total I have gained almost 80 pounds!) , as evidenced by my trip to the MD today. Between February and now I have been lethargic, needing a nap to get through most days, and generally down about things. I assumed the weird sleep patterns associated with my volunteer ambulance work, with perhaps some sub-clinical depression, was the cause. However, my labs this time pointed out another issue that is playing a partial role: My TSH level was over 18. TSH stands for Thyroid Stimulating Hormone, which is produced by the pituitary to get the thyroid to produce more of its hormones. For those of us with intact pituitary glands and crappy thyroids, TSH is used as a measure of how well the artificial thyroid hormone (Synthroid in my case) we are taking is fulfilling our bodies’ needs (with the pituitary being the judge). Any TSH value over 5 is a problem. I am clearly hypothyroid (AGAIN – I have been treated for this for a long time and we can’t seem to find one dose that continually works) to the extent that I am experiencing symptoms (which include most all of what you read above).

You’d think I’d have been though this enough times to know that if I feel depressed and want to eat carbs and fats all day between sleeping then I should get my TSH checked. Instead I assume I’m just being a slob and need to just “get over it”. I may be a slob, and I do need to “get over it”, but my newly increased dose of Synthroid should help.