It took over a year that included questioning my sanity, to finally prove I had an underactive thyroid gland. You would think that diagnosis would be a slam-dunk, but apparently it can be elusive.

That I did not exhibit symptoms in the usual manner could have been the problem. I did not feel general fatigue. I was not gaining weight, just maintaining my then overweight status. In fact I felt fine — until I hit “the wall.” I would be taking a walk and feel all my energy drain out of me, like a car’s transmission fluid suddenly pouring onto the pavement. One time, I had to sit on the ground until I gained enough strength to drag myself home. I learned to carry hard candy with me to generate quick energy when needed.

Long Road to Diagnosis

I described the sensation to my PCP this way. “Remember when you were an intern and on duty or on-call for 24 hours when you hit a wall of fatigue? Felt like you would fall down if you didn’t lay down? Well, that’s what it’s like.” He nodded, smiled, and ordered all the right tests.

If the Thyroid Stimulating Hormone is elevated, it means your pituitary gland is trying to stimulate your thyroid gland to do its work. He ordered TSH levels and other blood work, including a radioactive iodine uptake test. The endocrinologist said, “I don’t know what you have, but it’s not hypothyroidism.”

You don’t want to know my reply.

Could this be in my head? I thought I was more grounded than that. By then I was convinced I was either losing it or did have hypothyroidism no matter what the tests indicated. Could it be playing hide and seek with my blood levels? Is that possible?

Thankfully, another clue appeared. At the time, I was teaching two-hour long classes in medical terminology every week. I found I developed neck pain by the end of each class, as if I were straining something. I called my doctor and challenged him, “What are you going to do about it?”

He ordered another TSH and the result was off the wall. YAY!  I had all I could do not to say “Duh!” when he, with some amazement in his voice, told me I was hypothyroid. Once on medication, I was fine.

Hidden Players

In my last blog I wrote about problems with overusing salt in our diet. However, we do need iodine to prevent underactive, enlarged thyroid glands, or goiters. Adding iodine to salt (iodized salt) has greatly reduced the incidence of goiters from the 20th century on. Another dietary source of iodine is sea vegetables. Dr, Greger’s videos (see below) are informative and also warn about eating the wrong kind of kelp. I like to cut up part of a sheet of Nori to put in my Oriental soups. It softens immediately and adds more nutrition than taste, in case eating seaweed grosses you out.  (Until now, I never considered eating seaweed a good thing. After all, the only seaweed I had encountered was green, smelly, and washing ashore from Lake Ontario. Yuk!)

But iodine alone is not sufficient for thyroid health. Turns out, we also need zinc and selenium (found in beans, nuts, and seeds).  I eat two Brazil nuts a day because they have the most selenium. In fact you could overdose on Selenium if you ate too many Brazil nuts!

Here are two short but excellent takes on thyroid disease by Dr. Greger.