Tuesday, April 12, 2011


Last post I wrote about my plan to follow a gestational diabetes eating plan. That is still true, though I haven't made much progress. However, I now know why that is true, and a whole lot more.

Years ago, when I worked for a medical center and had access to all kinds of specialists, I saw a neuropsych about my foggy brain. For years I had experienced nearly daily brain fog and trouble initiating, especially noticeable at work. Though I rarely talked about it, I described it to a few people as akin to writing with a really dull pencil, or even closer, being asked complex questions after waking from a dead sleep. Bottomline, I struggled to maintain focus on my work, reading, and sometimes had trouble figuring out what I was "suppose" to be doing in the given moment. I was also tired, even groggy, more than I thought was normal. The neuropsych listened to my (brief) description and said, "Oh, you have dysthymia. You'll probably need to be on anti-depressants for the rest of your life." (Dysthymia is chronic, low-grade depression.) It kind of made sense. What I had been experiencing were symptoms of depression, except I didn't actually feel depressed. Anyway, she wrote me a prescription and sent me on my way. Oh well -- better living through chemistry, right?

I took a low-dose of anti-depressants for a while, maybe 6 months to a year. They did seem to help my mental agility and fatigue, but I also felt a little too amped sometimes...a little like being over-caffeinated. I eventually decided that the brain fog was better than agitated productivity.

Since then, whenever I'm seeing a new clinician and am asked about my medical history, I always have included "dysthymia." And as a grad student, it felt almost comical to devise ways to trick my brain into doing what every grad student does most, read, think and write. I felt really slow at these fundamental activities about 80% of the time. Once in a while (maybe once a month), I would have a whole day of clarity. Otherwise, my strategy: suck it up, persevere, drink coffee.

Flash forward to a few months ago. I saw the endocrinologist about my gestational diabetes, and he mentioned the 'slight hypothyroid' note in my chart. I told him I had been borderline hypothyroid, as discovered by my naturopath after August was born. He wrote out a lab slip and said with some gravity, "Make an appointment with me 6 weeks post-partum. We need to talk about this." Okay Doc, whatever.

At six week post-partum, I showed up in his office, complete with my latest thyroid labs. I figured he would give me the low dose thyroid med my regular doctor had prescribed a couple years ago and I'd be on my way. Instead, he looked at me and took out a blank sheet of paper and a pen.

"You see, most people use this range to diagnose hypothyroid. See how broad it is? Well the American Academy of Endocrinologists have recommended a narrower range. See how your numbers are at the outside of that range? Now, even more recently we have research to show that the range should actually be even smaller. Given this, see how you are way outside the range. And the way your labs look, you probably have some trouble with mental function, like concentration and fatigue. Your previous thyroid meds wouldn't have addressed this at all. So I'm writing you the following script..."

I don't know what my face was doing through this description, but I finally managed to say "Doctor, you have just described my entire adult life."

I am now about a week and a half into my new prescription, and I think it's making a difference. Unfortunately, my infant-related sleep deprivation surely confounds the effects, not to mention I'm not doing much heavy mental lifting since I'm on maternity leave from school. But I think I feel better. I'll really be able to tell when I get a few more weeks out. Also, as it relates to my eating plans, it will also impact my metabolism. And I believe it will make a dent in the intense sweet cravings that have surfaced in the last month (intense enough that I am blaming my post-partum down-drifting thyroid function).

I'm excited to see what happens next -- though I wish I would've figured this out before my general exam.