Monthly Archives: September 2012

Hashimoto’s Thyroiditis and the Endocrinologist

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After receiving the news that I have an autoimmune disease called Hashimoto’s Thyroiditis I was in a bit of a daze, as I didn’t know anything about the condition. All the typical questions were going through my mind: Why did I get Hashimoto’s? What causes Hashimoto’s? How can I treat Hashimoto’s? Can Hashimoto’s be cured?

While I waited to see the endocrinologist I tried using my phone to google for information, but the phone reception at Mt. Elizabeth Hospital in Singapore is terrible and I could hardly load a page or two before I was called in to see the specialist. Now I was going to get some answers!

The doctor, who was pleasant enough, then started to tell me the bad news. They don’t really know what causes Hashimoto’s, but there seems to be a genetic disposition to it. Hashimoto’s tends to be more common in women, especially those over 50, so I was rare male case. All that he could offer is to monitor my thyroid stimulating hormone (TSH) and Free T4 levels to determine the correct dosage of T4 (Euthyrox in my case). There is no cure and I would have to take the pill every day, for the rest of my life.

Unfortunately, this is where I started to learn the hard lesson that for chronic diseases, such as diabetes, Hashimoto’s, and arthritis, western medicine doesn’t have a good answer, other than: “here, have a pill.” I’ll do a dedicated post on this problem at a later date, but suffice to say, I was quite frustrated after leaving the specialist.

I contacted my family to find out that my mum has hypothyroidism, but was never tested to see if the cause was Hashimoto’s. Given the genetic component, I’m guessing she probably has Hashimoto’s and I was predisposed to getting it from her wonderful genes. Thanks mum! 😉

I was determined to educate myself on this disease and find out if there were any different opinions on Hashimoto’s.

Anyone who has used the internet to research health conditions will have undoubtedly encountered the same problem that I then did. There is just so much information and plenty of it is written by people who make sweeping statements about a particular condition based on their own experience. Known in the scientific jargon as N=1 studies (a sample size of one), thus their opinion is hardly a great indication of validity. There is also the complication that Hashimoto’s and hypothyroidism tend to get lumped together which can cause confusion and poor recommendations. Finally, most of the information is more focused on women with Hashimoto’s than with men with Hashimoto’s.

After a  lot of reading articles and watching too many Youtube videos, the best cause of action seemed to be to fix my diet to remove all possible food related triggers that cause possible immune system responses. A paleo diet came up as one of the best options. Can you imagine how I felt when I read that? Here I was trying to make a positive lifestyle change and had already chosen a paleo based diet. Then I find out that it is the best diet for a condition that I didn’t even know I had when I made that choice!

Once the diet is started I needed to get the medication working to bring my TSH, T4 and T3 levels under control. After that there was not much that I could find on people who had actually managed to come off their medication and keep the disease at bay.

Given that sorting out the medication would take quite some time (months), I decided to dive into the paleo and primal world to learn as much as I could about my choice of lifestyle change. Then when I had my medication sorted I would return to focusing on how to possibly cure or at least control my Hashimoto’s.

For those that are interested here are my first test results for the Hashimoto’s indicators:

T4 Free    10.37  (10.00 - 23.00 pmol/L) 0.81 (0.78 - 1.79 ng/dL)
TSH        11.873 (0.450 - 4.500 mlU/L)
Tg Ab     122.40  (0.00 - 4.10 IU/mL)
TPO Ab   1300.32  (0.00 - 5.60 IU/mL)

There was no T3 test performed, as at the time of testing there was no known condition, thus it was unnecessary. The antibody tests were performed on the same blood sample to confirm Hashimoto’s, but only ordered after the doctor saw my TSH result.

In my next post I’ll go into more detail on the research I did during this time, including Youtube videos to watch, websites to visit and other, useful bits of information.

My Pre-Primal Health Status

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I’d made the decision to try to improve my overall health by adopting a new lifestyle. As I described in my previous post, I believed that a paleo diet made the most sense from a scientific perspective and that an overall lifestyle outlined in Mark Sisson’s “The Primal Blueprint” seemed practical and most importantly maintainable. However, before I started this new phase of my life I wanted to perform some tests to make sure I had a record of my health markers going forward.

I had a few existing health problems before starting on this journey, but nothing that I considered major. The most serious was related to Gastroesophageal reflux disease (GERD) or reflux as most people know it. I also had a large bump on my upper eyelid that was the result of a blocked oil gland. Other than that I felt a bit tired from lack of sleep after having our baby girl join our family at the start of Janurary, 2012.

GERD/Reflux

My GERD symptoms are not that typical. I would only feel some acid coming into my mouth once or twice a month and had no heart burn problem. However, I had one big symptom that would occur at random intervals; my sphincter would close and stop food from entering my stomach when I ate. Often It would just be a slight delay before I could feel the food or drink entering my stomach, but sometimes it could take minutes or even get to the stage where my saliva would build up in my oesophagus and I’d have to depart to the toilet for relief.

My gastroenterologist did an examination of my oesophagus and stomach by shoving a camera down my throat on a long tube. Thankfully I was not awake when this happened! The results confirmed the irritation of my oesophagus and that I have a hiatal hernia. Apparently the acid was coming up from my stomach and irritating my lower oesophageal sphincter. Then when food came down the hatch it would sometimes cause the irritated sphincter to spasm and close.

Treatment was to take a drug called Nexium daily to lower the acidity of my stomach, thus allowing things to calm down and the sphincter to heal. Then I could gradually come off the drug and hope that things would return to normal. However, that plan never worked! I was fine taking Nexium every other day, or even every couple of days, but as soon as I stopped the symptoms would return in 7-10 days.

At this stage I concluded that I would have to take Nexium for the rest of my life.

Eye Chalazion

Chalazion on my EyeI must admit, being male, I don’t spend as much time as my wife in front of the mirror cleaning my face and in particularly my eyes. This fact has obviously contributed to me getting an eye chalazion twice in as many years. This occurs when one of the many oil ducts on your eyelid becomes blocked, gets infected and inflamed. A sty is a bit different from a chalazion in that the sty is obviously infected and quite painful. My chalazion was just an annoying bump resulting from inflammation that would not go away after months and months.

I’d been my GP and to see two specialists about this problem. My wife wanted it removed as she had to look at it, but the specialists insisted on leaving it alone and let it go away naturally.

I went with the specialists, so it was still there before I started on my new lifestyle, much to my wife’s dismay.

Health Tests

My gastroenterologist ordered a barrage of blood tests. I honestly didn’t feel like standing up after the lady had finished taking out all the blood needed. I think it was around seven vials! I also had to do a urine test and stool test.

I’ve never had to do a stool test before. They gave me an appropriately coloured (brown) plastic container, similar in size and shape to the one for the urine test, but the lid included a built-in spoon/scraping device. Not being an expert in these matters I asked for advice on how best to take a sample. The women at the counter seemed as perplexed as me and said “just use the lid to scrape a sample.” Oh really? Wow, I would have never guessed. Thanks for the help! In the end I managed to do the deed without contaminating other body parts, a miracle!

Test Results

The following day I received a call from my doctor’s assistant that I needed to come in to discuss my test results and that I had to see another specialist! The assistant was not able to tell me why I needed to see another specialist, saying that that I needed to see my doctor to discuss the matter. I was then told to come to her office in a week’s time because the other specialist was only free then!

I was slightly nervous (to put it mildly). Was it cancer, an infectious disease, something that required surgery. My mind was a flurry of activity covering all the hideous possibilities, so I called back and asked to see my doctor as soon as possible.

I went the following day to find out that my cholesterol was quite high, but that was not the big problem. I was told that I have a chronic, autoimmune disease called Hashimoto’s thyroiditis, which is the result of my own body attacking my thyroid gland. With the thyroid under attack my levels of the thyroid hormones are often too low (hypothyroidism), but can spike to high levels (hyperthyroidism) when part of my thyroid breaks away because of the attack by my immune system.

I was relieved to hear that it is not life threatening and that the medication is quite cheap. Unfortunately, I was told I would have to take a pill every day for the rest of my life.

Luckily a free spot came up with the other specialist, so I was able to go and visit him later that day. In my next post I’ll talk about the visit to my endocrinologist, more about Hashimoto’s thyroiditis and the treatment options.

Changing my Lifestyle to Paleo/Primal

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I’ve been quiet lately, but I hope that is about to change as I share the information I’m learning about the new paleo/primal lifestyle I have chosen to adopt.

I made the decision that it was time to get healthier while contemplating if I would be able to keep up with my new born daughter as she grows up. I left things a bit late, being nearly 39 when she was born.

An email from my dad about the apparent benefits of coconut oil for Alzheimer’s kicked off the initial investigation into health. I thought it sounded like a bunch of bollocks, but some of the anecdotal evidence suggests otherwise. That led me to think more about how diet influences health and to a TEDx talk by Dr. Terry Wahls about her transformation from being in a zero gravity chair, suffering from multiple sclerosis, to enjoying a normal life again through her special diet.

I started thinking about the different types of diets/lifestyles out there and just couldn’t contemplate going vegetarian or vegan, so I had to find something that still allowed me to have the meat that I love. Quite frankly when you read about needing to take extra supplements when on a vegetarian or vegan diet (unless you are very careful with what you eat) it is a complete turn off. What kind of diet can be good for you if you NEED to take supplements?

Eventually I ended up reading about the paleo (short for paleolithic) diet. That took me to a video by Mark Sisson who made a lot of sense to me, so I went to his website and was hooked on the Primal Blueprint. It’s relatively easy to follow, includes foods that I like and just makes sense. What’s more there is plenty of proof on the website’s forum of people having huge success in not only losing weight, but in general health improvements.

There are 10 key “rules of living” to the Primal Blueprint:

  1. Eat lots of animals, insects and plants.
  2. Move around a lot at a slow pace.
  3. Lift heavy things.
  4. Run really fast once and a while.
  5. Get lots of sleep.
  6. Play.
  7. Get some sunlight everyday.
  8. Avoid trauma.
  9. Avoid poisonous things.
  10. Use your mind.

I’m not too sure on the eating insects part, but the rest of it makes a lot of sense. The reason it seems to work for a large percentage of people who try it is that it mimics the lifestyle of our ancestors and is thus designed around what we have evolved to thrive on. The last 10,000 years or so of human existence have altered the way we live so completely that it could very well explain a lot of our health problems. Thus, to resolve that we just need to change some basic behaviour and get rid of a most of the processed food and drinks that we all too easily consume today.

Changing to a lifestyle like this does take a bit of commitment and requires some sacrifices. No pain, no gain, right? Thankfully the sacrifices are mostly those that you know you should be doing anyway, like more exercise and eating less junk! I’m prepared to make those sacrifices.

Before making such a drastic lifestyle change and to ensure that it does have some positive and measurable impact on my health I talked to my gastroenterologist in April, 2012 and we decided to do a lot of tests before proceeding.

In my next post I’ll talk about the tests, the results and my trip to another specialist! It wasn’t the start I was looking for, but things are looking quite positive now on a paleo/primal lifestyle!