Okay before I dive into the rest of the fascinating mystery of my health I want to back up a little with a mini human biology lesson.
This is your thyroid gland.
Pretty cute little guy, right? This is where he lives:
Your thyroid gland needs nutrients to do its job. Its primary nutrient is iodide which it converts to iodine. Selenium, zinc, and iron are really important too.
Your pituitary gland (located at the base of your brain) senses when your body needs more thyroid hormones and releases TSH (short for Thyroid Stimulating Hormone). TSH knocks on the thyroid gland’s door to, you guessed it, stimulate the production of more thyroid hormones. Traps for iodide are increased to ‘catch’ the nutrients the gland needs, and the thyroid cells then gets busy converting iodide to iodine and producing H202 (Hydrogen Peroxide). To super, super simplify things, this results in the production of those needed thyroid hormones, commonly referred to as T1, T2, T3, T4 and Free T3.
These are all super important, and when all is well, you feel really great with all those thyroid hormones zooming about doing their job (regulating your metabolism, helping you feel happy, and aiding in proper sexual function.)
Psst: You can make too much of these hormones, and that’s called Hyperthyroidism, but we’re talking about Hypothyroidism today, where your thyroid gland is not making enough (and you therefore feel like crap cake garbage in a poo can).
(You also feel like crap cake garbage in a poo can when you’re “hyper” but that’s another story for another day.)
Okay, there’s a lot more going on in those cells, but that is the basic picture. So when your thyroid is feeling under the weather (or rather, is nutrient deprived) and isn’t producing enough thyroid hormones, the pituitary gland increases the amount of TSH in your system – it’s basically screaming at your thyroid gland to produce MORE STUFF.
Therefore, a high TSH blood test is supposed to alert your doctors to the problem, and they are then supposed to give your pooped thyroid (and pituitary) a break by giving you some kind of thyroid medication to replace those hormones your body isn’t producing. Thyroid medication, in theory, should alert your pituitary gland that all is well, and it should then shut the crap up.
The problem is (and this is what my previous cartoon was poking fun of), that you can present with all the classic hypothyroid symptoms, yet still have a “normal” TSH blood test. If a physician is only going by TSH (and not symptoms or other more revealing blood tests), you can find yourself in a really frustrating position.
Further complicating the matter, the readily available thyroid medications (Synthroid, Levothyroxine) ONLY give your body a synthetic form of T4, which isn’t all that your body needs. Some doctors are willing (or can be coerced) to run the right blood tests (Free T4, Free T3, Reverse T3) and will (with arm twisting) prescribe dessicated thyroid, made from porcine thyroid glands. Dessicated thyroid includes the entire range of hormones your body would normally produce: T1, T2, T3, and T4. Many people do a lot better on dessicated thyroid for this reason. It mimics what your body should be making, and therefore does a much better job of calming your pituitary gland and that TSH production down.
Okay, are you with me so far? A lack of nutrients (remember? iodide, zinc, selenium, iron) leads to a decrease in thyroid hormone production, which leads to an increase of TSH from the pituitary gland hammering on the thyroid to increase production of hydrogen peroxide. An increase of hydrogen peroxide results in the inflammation of the poor little thyroid cells who don’t have the nutrients they need to finish the job.
(There can be a myriad of reasons you aren’t getting enough of the nutrients your thyroid needs. It might be your diet, or you might be eating great but not absorbing well.)
TAKING IT TO THE NEXT LEVEL
When thyroid cells get inflamed damage can actually occur, the cells can actually burst open and leak their contents into your blood stream in the wrong forms. What happens when you’ve got stuff that belongs INSIDE a cell coursing through your veins? Your white blood cells — the army guys, as my 5 year old likes to call them — start fighting.
These warriors, normally responsible for fighting crime like viruses, contaminants, bacteria, and disease, are now forming antibodies against stuff your body not only needs, but needs to be making. This, my friends, is an autoimmune situation. In blunt terms, your body is now incorrectly fighting itself. When you have antibodies in your blood stream called antithyroglobulin antibodies, or thyroid peroxidase (TPO) antibodies, you get a whole new diagnosis: Hashimoto’s. Or “Quasimodo’s Disease” as my father in law likes to call it.
NOW THAT WE ARE ALL ON THE SAME PAGE HOPEFULLY
After letting myself get a bit walked over back in June with my family doctor, I ponied up the dough and ordered a big ol’ pile of labs through My Med Lab including the 24 hour saliva cortisol test which I could not arm wrestle any local doctors into ordering for me. Since I left you on a stupid cliffhanger, I’ll wrap this mile-long post up with a quick run down of my blood work and saliva (ew) tests:
Low iron, anemic. Crazy high B12, “normal” TSH (high if you ask me), super low Free T4 (Thyroxine), high Antithyroglobulin / Thyroglobulin Antibodies, a super low Free T3, and a low reverse T3 / Free T3 ratio (more on that here). The cortisol test results showed a low-normal in the morning, normal during mid-day and too high at night.
In short (ha ha ha ha, never believe me when I say I’m giving you a ‘mini’ biology lesson or a ‘quick’ update. I think I am physically incapable of brevity.) I have Hashimoto’s Hypothyroidism with overactive adrenals (little triangular shaped glands that sit on top of your kidneys and secrete the stress hormone cortisol, more on them later this week). Mine are currently a little messed up, not as messed up as they were last time I had this huge rash, but still hyperactive enough to trigger my histamine freak out.
My low iron and hyperactive adrenals are complicating matters quite a bit (stressing out my thyroid gland). There’s a lot that can be fixed by first getting these in line, so that’s what I’m focusing on right now, and I’ll go into that in detail tomorrow. Or the next day. You know the drill, I’m sorry I’m so unreliable. This is why I don’t make the big pennies blogging. Also, lame cartoons and super long explanations of odd ailments. (And market saturation and serial domain hopping, and a serious over-use of parenthetical asides, I’m sure.)
OH MY WORD, THE CLIFFHANGER
Like I said I’m so bad at this blogging thing. I almost forgot. Our bodies are usually quite adept at getting rid of excess B12, and a high result in the bloodstream is pretty rare. To give you an idea of how high mine is, a normal range is 211-946 pg/mL. My result: 2000. TWO THOUSAND, HOLY CROW.
High levels of B12 can indicate cancer! Isn’t that super fantastic? The list includes: chronic myelogeneous leukemia, promyelocytic leukemia, polycythemia vera and hypereosinophilic syndrome. HIGH FIVES ALL AROUND. Or, if that’s not scary enough, it could also indicate several liver diseases like acute hepatitis, cirrhosis, hepatocellular carcinoma and metastatic liver disease (here is the source for all that terror).
I did find a mention online that a build up of B12 can occur if one has been taking too much B-12 supplement. That is a possibility for sure (and probably a very likely explanation), as whenever I was fatigued (all the time!), I’d double up on my B12 supplement. I have stopped supplementing and we’ll have to retest. If levels are still high I will need further screening to rule out any of those more serious issues. My ‘gut’ tells me there isn’t anything to worry about here, though I will absolutely be responsible and follow up, but I don’t have that panic alarm bell going off telling me that I have a terminal disease. So there’s that.
I’M FINALLY DONE, THERE ISN’T ANY MORE
Finally, good grief.