mind & body
better and no longer shedding hair. But her exhaustion remains. “When I take my kids to the park, I have to come home and take a nap. I just want to feel normal,” Marshall says.
Proper Dosage Requires Patience Even when thyroid replacement does work, it can take a while to get the correct dosage. Doctors base their initial dosage on a woman’s weight and lab results, then monitor her blood. “It can take a few months and several adjustments to get it right,” says Tamara L. Wexler, MD, an endocrinologist at Massachusetts General Hospital in Boston. Rebar also notes that variations between drug manufacturers for the same drug can affect results, so once you find a drug and dosage that works, it’s important to stick with it. Eight years after her diagnosis
of the hyperthyroid condition of Graves’ disease, Robin Pels is still waiting for relief. Because her thyroid was overactive, Pels, 49, was first treated with radioactive iodine to stop the production of hormones. Ever since, she’s been on various doses of Synthroid® and, more recently, a controversial pig-derived hormone known as Armour® Thyroid. Yet her exhaustion, hair loss, and mood swings remain—and her lab results continue to be abnormal. Her problem is likely exacerbated by the fact that she runs a hotel in the high altitude of South Lake Tahoe, CA. “Whenever I travel to see friends or family at sea level, I feel so much better,” she says, noting her doctors agree that the changes in the blood brought on by altitude can affect medication.
20 pause FALL / WINTER 2011
“A sympathetic doctor will move the dose within a safe range to see if a symptom goes away. ”
More Is Not Better Although Pels has been heroically patient, doctors say some women who don’t get relief clamor for extra medication. But Nanette F. Santoro, MD, professor and E. Stewart Taylor chair of obstetrics and gynecology at the University of Colorado at Denver, cautions that too much thyroid hormone can cause heart palpitations and, over the long term, weakens bones. “A sympathetic doctor will move the dose within a safe range to see if a symptom goes away. But there is a lot of bogus literature out there that suggests that all things can be treated with more thyroid hormone, and that is just not true,” she says.
Or It Might Be Perimenopause Doctors say that some women without thyroid problems also beg their doctor for the drug. When women are struggling with a host of symptoms that make them feel miserable, it’s tempting to believe a little thyroid pill holds the answer, Glueck says. “A huge part of my practice is letting women know that I hear them: that I don’t doubt that their hair is falling out, that they’re not sleeping well, and that their mood is terrible,” Glueck says. But if the thyroid test comes back normal, she works equally hard to ensure that the women hear her as well: the problem may be the result of perimenopause, and not their thyroid at all.
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iStockphoto.com/GeorgePeters
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