A number of Tamoxifen’s possible side effects:

Excessive tiredness

Depression or anxiety

Weight gain or loss

Increased bone or tumor pain

Thinning of hair

Hot flashes

Some symptoms of stress can include:

• Fatigue
• Depression
• Excess eating or smoking
• Poor memory
• Increased alcohol consumption
• Anger/hostility
• Difficulty making decisions
• Frequent mood swings
• Negative thinking
• Distractibility
• Feeling overwhelmed or helpless
• Muscle tension or pain
• Change in sex drive
• Stomach upset
• Sleep problems

Signs of Menopause

Sleep problems

Mood changes

Weight gain and slowed metabolism

Hot flashes

Chills

Thinning hair and dry skin

Change in sex drive

In late July, I visited my rock star gynecologist, Dr. C., and we were discussing how I was feeling. Considering the stress I was under thanks to being let go from my position in late June–as well as understanding the side effects of Tamoxifen (on top of recognizing the impact of menopause) it didn’t seem that far fetched that I would be moody, have rapidly gained back much of the weight I had lost in the spring, have issues with sleep, have muscle aches, and feel EXTREMELY tired, exhausted frankly, finding it hard to concentrate. Life can wipe a girl out, right? Dr. C was sympathetic and we compared our stressors, but she also ran my blood work–and made sure it included looking at my thyroid numbers.

The numbers came back concerning, but considering my age and none of the usual risk factors showing up in my history, she was more concerned about doing an ultrasound and uterine biopsy to see what was going on after a couple of post-menopausal menstrual periods, than delve into possible thyroid issues.

Thanks to end of summer scheduling conflicts for her and a new job with a waiting period for insurance and sick days to kick in for me, I didn’t get in to see Dr. C again until early October. The extreme fatigue continued, as did the weight gain and moodiness bordering on depression. But, come on! There was an extreme amount of stress going on in all areas of my personal and professional life, not the least of it being that my new job starts at 7:15AM…

Hypothyroidism signs and symptoms may include:

• Fatigue and sluggishness √
• Weight gain√
• Depression√
• Increased sensitivity to cold√
• Constipation
• Dry skin√
• Brittle nails√
• Impaired memory√
• Puffy face√
• Muscle aches, tenderness and stiffness√
• Pain, stiffness or swelling in your joints√
• Thinning hair√

The test results came back in early October: hypothyroidism. And it really didn’t hit home right away what this meant. In early November, I wrote in the post, Comfort in the Overlap:

Oh, yeah, and the blood work that Dr. C had done in late July and again in October showed that I have hypothyroidism so when I went to the new primary care physician about my pre-surgical clearance, I was given a prescription for Levothyroxine. Trying to wrap my head around the idea of needing to take this medication the rest of my life is kind of a trip, but first things first.

I began taking this synthetic drug Levothyroxine after the appointment, but truthfully, I was more obsessed about the other stuff–ie. the really weird stress test to the outpatient D & C–than dealing with the diagnosis related to my thyroid. Eventually, when all of the other hoopla calmed down, I started to want some clarity and understanding, so I started to do my research on hypothyroidism.

Simply put, hypothyroidism (underactive thyroid) is a condition in which your thyroid gland doesn’t produce enough of certain crucial hormones. Ok, so? As Carolyn L. Todd wrote in her Self article last year:

Having an underactive thyroid proves that even your smaller organs can have a mighty effect on your health. As you read this, a tiny butterfly-shaped gland at the front of your neck is commanding a slew of your body’s most important functions. This powerful organ is called your thyroid gland, and it influences things like your heart rate, digestion, mood, menstrual cycle, and energy levels—essentially various factors of your metabolism, which is a fancy way of saying the way your body uses energy. As you can imagine, if you have an underactive thyroid, things can feel pretty out of whack.

Hmmm…maybe my life being out of whack isn’t all about how the world is impacting me, but how my body is interacting with my world? Has the lens that I view my world fogged over and I didn’t know that it had even happened?

I was fried, but trying to press on anyway.

That’s how I felt going into a 5-day Thanksgiving break and again a month later going into a 2-week Christmas break. A couple of the symptoms of hypothyroidism really were noticeable for me, but the extensive and intense fatigue has been the most significant–and the one hardest to get people to understand…including myself. I slept a lot over Thanksgiving break and also over Christmas break.  I continued to row as Recovery on Water transitioned inside, but I had to basically hit a pause button on my ‘training’ to race and take a detour into rowing for the exercise, where rather than celebrating improvements in my times or distance, I had to focus on feeling good about showing up and getting a workout in. Not the same kind of adrenaline rush there, folks.

I started to notice some improvements with the help of the medicine, but I really wasn’t feeling like ‘me’ going into the holidays. The whole situation was so subtle! We always struggle to get the tree up and decorated, but this year the process took 3 weeks!!!!! I traditionally put off holiday cards until the last minute, but always rally. Until this year. Nope. No New Year’s cards either and I couldn’t even send last ditch Valentine’s cards. I went to our ROW holiday party in mid-December and while in an environment where I am usually really happy and move around from friend to friend and socialize, I was feeling isolated and monopolized Coach Sheena’s time discussing her father’s progress since he was diagnosed with thyroid cancer–trying to find understanding and hope in regards to my own condition. I’ve found that if I push too hard in an erg workout–because I am feeling closer to my old self–it can lead to feeling wiped out if I don’t give myself time to recharge with a nap. Imagine needing to pull your car over so you can take a quick nap while running errands mid-day on a Sunday, because you pushed it a little too hard during your feel good Sunday morning row? Not fun.

A two-week Christmas vacation definitely helped balance things out, but it didn’t take long to start feeling tired and moody and ‘not quite right’ when I headed back to work. I had a discussion with Coach Lily early in January at a practice about being frustrated that after more than 2 months on Levothyroxine, I was still feeling fatigued and out of sorts so consistently–and worried that my symptoms were all in my head rather than the dosage not being quite right. Her story of having mono–but not knowing she did–while rowing competitively in college helped me feel hopeful.

When I returned to my doctor mid-January, with new blood test results in hand, I had lots of questions and because of our prior interaction, I wasn’t feeling all that confident about finding any answers. However, the appointment ended up being extremely beneficial and Dr. K and I were able to bond. We were able to have a really good conversation–with plenty of give and take–and come to an understanding of one another. This understanding was definitely lacking in our prior visit. Anyway, mainly, I wanted to know what in the world had caused my hypothyroidism and if the dosage of my Levothyroxine was correct. Turns out my hypothyroidism is because of Hashimoto’s disease. And

What is Hashimoto’s disease you might ask?

According to Cleveland Clinic:

Hashimoto’s disease is a disease that affects the thyroid gland. It is also called Hashimoto’s thyroiditis, chronic lymphocytic thyroiditis, or autoimmune thyroiditis.

What causes Hashimoto’s disease?

Hashimoto’s disease is an autoimmune disease, which means the body’s immune system is attacking its own cells and organs. Normally, the immune system protects the body against infections caused by bacteria, viruses, and other harmful substances. In Hashimoto’s disease, the immune system makes antibodies that attack and damage the thyroid. As a result, the thyroid gland becomes inflamed and hypothyroidism can develop.

Great. My body has been attacking itself. Wonderful.

The good news is that the synthetic drug Levothyroxine is effective in the majority of users, but it does take time for most people to adjust to its use. I started with a 50 microgram dose for my first 3 months and now we have raised it to 75 micrograms. The literature–from the American Thyroid Association to the Mayo Clinic to the Cleveland Clinic give pretty cookie cutter, one size fits all advice, which is good for the basics, but this becomes an issue if your body doesn’t snap itself into shape. Should I freak out and feel that everything is failing when after 4 weeks on the new dosage, where I’ve been feeling gradually better and catching glimpses of an energetic me (including having a really positive weekend), I woke up on this Presidents’ Day Monday feeling tired and unmotivated, wanting to just snuggle back under the covers? If I leaned solely into the above sources, I would start to think there is something wrong. But then I find the American College of Endocrinology’s site–that has been given a ‘Best Blogs of 2017–Thyroid Disorders’ by Healthline and I feel better when they say, “thyroid hormone acts very slowly in some parts of the body, so it may take several months after treatment for some people to see an improvement.”

Things are improving–it is just taking time and I can be an impatient person.

Speaking of time, I have commitment issues when it comes to certain ‘lifetime’ commitments. I was 36 before I got married, I have never had a tattoo because they are too permanent and let’s not talk about my work history. I am the responsible sort so I can take on things for extended periods of time, but I sure have a hard time making those ’til death do us part’ kinds of commitments. Embracing the idea of a lifetime commitment to hypothyroid medication is going to take some getting used to. However, I don’t have much of a choice since