In 1995, I was diagnosed with Hashimoto’s thyroiditis. This is an autoimmune form of hypothyroidism. It causes lymphocytic infiltration of one’s thyroid gland, eventually completely destroying it.
Prior to receiving this diagnosis, my primary care physician ordered thyroid function testing. My TSH was normal. Consequently, he concluded that I was not possibly experiencing any problems with my thyroid gland.
Nevertheless, I knew that something was seriously wrong. I was continuing to exhibit all of these symptoms: profound fatigue, decreased appetite, weight gain, hair loss, heavy menstrual periods, increased depression, decreased ability to concentrate, constipation, decreased reflexes, dry skin, and extreme cold tolerance.
Furthermore, I had a family history of hypothyroidism. I aggressively educated myself about hypothyroidism, including autoimmune forms of this condition.
I asked my primary care physician for a referral to an endocrinologist. He was extremely reluctant to do so, since my TSH test was, after all, normal. Eventually, I received that referral to an endocrinologist.
I mentioned having my antithyroid antibody titers tested, given that I questioned if I might have autoimmune form of hypothyroidism. He actually mocked me for making such a suggestion. After all, I was not a physician, but a mere graduate student studying behavioral medicine. Actually, my having a secondary autoimmune disorder was a quite likely possibility.
Once you have been diagnosed with an autoimmune disorder, you are much more likely to develop a secondary one. I had previously been diagnosed with relapsing-remitting MS, in 1993. (I now have been diagnosed with three different autoimmune diseases).
Well, as it turns out, my anti-thyroperoxidase and antithyroglobulin antibody titers were staggeringly elevated. As a result, I was diagnosed with Hashimoto’s thyroiditis. My endocrinologist didn’t want to initially place me on thyroid replacement medication, however. Again, this decision was based upon my still normal TSH test. I tried to stress that, nevertheless, I was continuing to experience debilitating symptoms.
Over my decades of living with Hashimoto’s thyroiditis, there have been multiple adjustments to my thyroid replacement medication dosage. I’ve had ultrasound scans of my thyroid, which have revealed nodules. Thankfully, they were determined to be benign. At one time, I was prescribed two different forms of thyroid replacement medication: T4 (Synthroid), and T3 (Cytomel). The addition of Cytomel drastically decreased my extreme cold intolerance.
Despite my thyroid function testing results being in normal range, I do continue to struggle with debilitating fatigue.