I sat stiffly on the exam table as the internal medicine doctor tapped my knee cap. "Your reflex looks slow," she remarked. Huh? I had come to see her because of chronic constipation. What did that have to do with my knees? I was a twenty three year old graduate student who had tried everything to become "more regular" including high fiber foods, drinking water, increasing exercise...even downing prune juice. Now it was something with my reflexes?
The Blood Test
The doctor ordered blood work to check my thyroid levels. The results came back. My thyroid was not responding correctly to TSH or thyroid stimulating hormone. Levels of T3 (triiodothyronine) and T4 (thyroxine) were low. According to the doctor, a trained eye could also see that my neck bulged slightly, a sign the thyroid had beefed up to try to compensate. I was stunned. My grandmother had thyroid problems. It was an old-person's problem, right?
The Risk Factors
As it turns out, while being over 50 is a risk factor for hypothyroidism, the disease also runs in families. After I was diagnosed, so were my mother and my sister. According to the Mayo Clinic, other risk factors for the disorder are already having an auto-immune disease, having recently been pregnant or given birth, and having received radiation to the chest or neck.
The Symptoms
Symptoms besides constipation and slowed reflexes include depression, dry skin, unexplained weight gain, puffy face, slowed heart rate, difficulties with memory, heavy menstrual periods, joint pain and sensitivity to the cold. I had several other symptoms, I just hadn't really thought they were significant enough to warrant a doctor's visit, or even noteworthy enough to mention. Everyone struggles with weight gain, and having a period isn't supposed to be fun. I thought it was normal to have dry hands and feel cold. My hands were thin and that explained how delicate and sensitive they seemed to be, or so I convinced myself.
The Treatment
While some of my symptoms persist today (over a quarter of a century later) the treatment that the doctor initially prescribed, a daily dose of levothyroxine, an artificial hormone in the form of a small pill, alleviated my constipation and tiredness.
Thyroids can over or under produce hormones. The opposite disorder, hyperthyroidism can also be diagnosed with a blood test. Symptoms of that disorder include sleeplessness and weight loss. If you think your thyroid may be out of whack, contact your doctor for a needle stick.
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