I was all set to write a little semi-inspirational post about health and fitness as part of my whole inquiry into a beautifully reasonable #goodenough life. I was going to write about how perfectionism is rampant in health, and how true wellness is about listening to and honoring your body’s signals, respecting your innate physical nature and shape, having compassion for your pulchritude in a world often hostile to women’s bodies, blah blah blah. All good and necessary stuff, complete with oft-repeated “no duh” advice to find movement you like, do as much of it as you can, find fun in physical activity, occasionally challenge yourself, get some fresh air and sleep and rest, and eat fresh and colorful and whole and clean when you can.
The problem was: I was following my own good advice…but it wasn’t working.
I’ve written earlier about post-partum depression, but even after emerging from that dark fog, I still didn’t feel quite myself. I got tired easily, whereas before I had always had a hardy sense of endurance. (I think this is just me being stubborn, actually.) I felt vaguely “low” at times, even after a few days of solid sleep, decent cardio exercise (endorphins!) and good nutrition. And no matter how much I exercised and ate well, controlled my meal portions, and counted calories, I just couldn’t shed any weight. I had a weird brain fog, like my mind was still sleepy. My cycle was Wackville central. And I lacked ‘sexy va-va-voom.’ (And not to get graphic, but I’ve never suffered from a lack of va-va-voom before, ever. I am usually all about the va-va-voom.)
Nothing could quite nudge me out of this weird haze. Exercise, meditation, clean eating…nothing. I was doing my best to be a health nerd but it wasn’t working.
The problem had been bedeviling me since I gave birth. At first I — and my ob-gyn — thought it was from the inevitable adjustments to raising a baby, though I saw other women around me raising babies who seemed to have way more energy and general ‘vitality’ compared to me. My gyno also thought it was because of nursing hormones — I nursed for a little over a year, and the prolactin your body produces to make milk has been known to suppress estrogen, which can keep weight on and reduce sex drive.
But then I stopped nursing after about a year, hoping for a shift…but nothing changed. It was frustrating, because I just knew I wasn’t right. People kept telling me, ‘Oh, this is what motherhood is like’ or ‘Don’t worry, you’ll get used to it.’ But who wants to get used to strange jags of sadness, a lack of interest in all the joyful, juicy parts of life and a constant level of fatigue? It just didn’t seem right.
Luckily I went to see a new, kick-ass, gorgeous Iraqi family doctor recently — a required appointment when I switched health insurance plans and needed a primary care physician. I explained to her that I had stopped nursing about a few months ago and was hoping that my hormones would’ve balanced out now. But I was still dogged with that vague sense of ‘not being quite right.’
My beautiful Iraqi doctor furrowed her immaculately groomed eyebrows. (She seriously has the most beautiful eyebrows I’ve ever seen on a human — they’re like wondrous architecture.) She asked about the last time my iron and thyroid levels had been tested.
Not since before early pregnancy, I answered. I had tested normal then.
You know, maybe we should check them again, she said.
A couple of needle pokes, a tube of blood and then, lo and behold! I finally discovered that while my iron was perfectly fine, my thyroid gland wasn’t producing enough hormone. I had mild hypothyroidism.
I read up on hypothyroidism and it didn’t sound like fun — but it sounded almost exactly like how I was feeling. I was a little apprehensive by what I was researching — no one likes to hear that an organ of their body isn’t working properly or they might need to take long-term medication — but I also felt relieved to know that this was a huge influence in why I haven’t felt fully ‘recovered’ from pregnancy and birth. My underperforming thyroid was a big missing piece of the puzzle in my rather rocky post-partum journey. And now I finally feel like I have a fuller picture of why my sense of vitality and zest hasn’t quite kicked back in — and feel better equipped to make decisions about it.
Chances are, you or someone you know might have a wonky thyroid, too. It’s shockingly common — and shockingly and commonly undiagnosed, especially with women. Apparently 10 million people in the U.S. have hypothyroidism, and some estimate that one-of-eight women have some kind of thyroid hormone deficiency, according to the American Thyroid Association. So here’s just a tiny bit of info on it, as well as some of my experiences and learnings so far.
Your thyroid is a butterfly-shaped gland that sits low on the front of your neck, wrapping around like a weird little bowtie. This little organ secretes several hormones that have a huge influence over your body and life. These thyroid hormones helps your body convert calories and oxygen into energy, influences the growth and development of many of your body’s tissues and basically sets the tempo of your metabolism, determining if you’re burning energy efficiently and effectively. It’s almost as if your thyroid is your body’s thermostat, helping your metabolism and general ‘motor’ hum and burn along efficiently. And when it’s not working, it can really throw your system out of wack.
But sometimes your thyroid doesn’t put out enough hormones. Often this is because your thyroid itself is inflamed, either through some kind of damage (for example, via chemo) or through autoimmune inflammation. (This is called Hashimoto’s thyroiditis, where inflammation is the result of your own immune system reacting against it.)
The result? Hypothyroidism! Its symptoms include:
+ Feeling ‘low’
+ Fatigue and weakness, or feeling ‘rundown’ in general
+ Dry skin and hair, and brittle nails
+ Loss of hair
+ Feeling cold and chilly all the time
+ Muscle cramps
+ Mental ‘brain fog’ and a less than sharp memory
+ Swelling in the face
+ Gaining weight or inability to lose it
+ Crazy menstrual cycles
+ Lack of sex drive
Your thyroid can also go haywire and overproduce hormones, leading to hyperthyroidism. Those symptoms are:
+ Unexplained weight loss
+ Rapid heartbeat and heart palpitations
+ Frequent bowel movements
+ Less frequent and light periods
+ Shaky hands
+ Bulging eyes
(I’m not going to write much more about hyperthyroidism because I have no experience of it. But either way you cut it, a wonky thyroid is absolutely no fun.)
A Special Note About Post-Partum Hypothyroidism
Of course, I had to read a bit more about the connection between pregnancy, birth and hypothyroidism. I learned A LOT that my (hombre-oriented) ob-gyn didn’t tell me.
Apparently many post-partum women first exhibit signs of hyperthyroidism, such as anxiety, irritability, rapid heartbeat and palpitations, fatigue and insomnia, in the immediate period after giving birth. Then, as thyroid cells become damaged or impaired from this abnormal activity, signs of hypothyroidism begin to develop. (Some women do develop only post-partum hyperthyroidism or only hypothyroidism, but not both.)
Post-partum thyroiditis is considered uncommon, but it does happen. It’s not well-understood, but many theorize that the hormonal fluctuations of pregnancy and post-partum can set off underlying autoimmune issues that make your system attack its own thyroid. However, it’s hard to diagnose because its symptons are often attributed to the stress of having a newborn baby as well as post-partum mood disorders like PPD and PPA.
Post-partum thyroiditis can last several weeks, or even several months. For most women with the condition — about 80% — their thyroid will go back to normal within 12-18 months of the start of symptoms — often with the help of medication — but some women develop permanent complications.
(You can read more at the Mayo Clinic website.)
This was all sooooo familiar to me when I read this! I don’t really think that my post-partum depression was misdiagnosed hypothyroidism — I definitely had outsized anger, rage attacks, ferocious crying jabs and crazy dysfunctional thoughts that I’ve never had before. But I do think it was a larger piece of the puzzle I’d been missing. I do now believe, though, that if you think you’re suffering from a mood disorder related to pregnancy and birth, you should get your thyroid levels checked.
The conventional treatment for hypothyroidism is taking medication — essentially, replacing the missing hormones that your poor ailing thyroid isn’t producing. Usually a doctor will start you on a low dose of synthetic hormones Synthroid or Armour and monitor your levels via blood tests to make sure it’s the right dosage. (Sometimes you get too much, and then you get hyperthyroidism!) Most people take the medication over a course of a few months, but some also take the medication for the rest of their lives.
Now, I’ll be honest — the idea of taking a medication for the rest of my life isn’t appealing to me. So I looked into things I could do myself to help my poor battered body along a little.
Some Small Measures I’ve Taken To Heal My Thyroid
First of all, I should issue a proviso: I’m not a doctor and you shouldn’t read this post as official medical advice. This is just my personal experience! If you AT ALL suspect your thyroid is wonky, you REALLY REALLY REALLY should go to your physician and get a proper blood test. This isn’t something you should self-diagnose, nor is it something you can just self-help and half-ass along. A wonky thyroid is a medical condition that is potentially serious. If you really think it’s an issue and your doctor doesn’t, get a second opinion. You’re entitled to one when it comes to your health, wellness and body!
Still, I’m all about being proactive as possible — but in communication with your doctor or naturopath. I have a good start: I try to live a healthy lifestyle in general. I’m no Olympic athlete, but I’m generally fit, try to eat well and move mindfully. I’m also no clean eating fanatic — I do enjoy wine and fries and never met a BBQ chip I didn’t like — but I’m at about 80/20 in terms of healthy vs. less healthy food. But I did some reading and have been taking small, fairly conservative measures I haven’t done before to address my thyroid issue. Some of them were actually counterintuitive to today’s health fads and wisdom, so I thought I’d share them here:
Switching to cooked, not raw, cruciferous veggies. I’d been a smoothie advocate for some time — it’s such a great way to get veggies and fruits in. But one thing I learned while researching hypothyroidism is that cruciferous veggies like kale and spinach in their raw form are NOT good for thyroid issues. You have to watch out for “goitrogenics,” which can contribute to enlarged or inflamed thyroids. Other goitrogenics include broccoli, cauliflower, cabbage, Brussel sprouts, collard greens and flax. Also: kohlrabi, bok choy, Chinese cabbage, arugula, and turnips. (Other foods that some say are problematic for hypothyroidism are almonds, strawberries, soy, peaches, peanuts, corn, radishes, rutabaga.) In other words, sooooo many of the healthy foods I love aren’t good for me! Wah!
Of course, figuring out what to do is a bit more difficult. While eating goitrogenics in reasonable amounts is fine for people with healthy thyroids, those with issues should check with their doctors. Some say cooking goitrogenics helps; others say avoid them entirely. Right now I’m figuring out my approach — I’m due for some follow-up tests — so I’m avoiding raw goitrogenics, switching up my veggies and basically cooking everything.
Really safeguarding against stress and prioritizing rest. Workout fiends often get the advice to ‘push through’ tiredness and fatigue and squeeze a workout in instead of getting rest. But hypothyroid types really need rest and rejuvenation from stress — the thyroid is acutely sensitive to exhaustion, especially from lack of sleep. This is hard for me, because I really do like a cathartic run! But I’ve had to make a new rule for myself — no crazy-hard intervals or long, draining workouts on less than six hours of sleep. I’ll do something gentler instead — swim, perhaps, or bike, for just about 30 minutes. I do find that it makes a difference. And of course, I try my best to get sleep. Being a mama to a toddler, though, that isn’t always easy or feasible, but I’m working on it.
Keeping an eye on my selenium. Many people already know there’s a connection to iodine in terms of the thyroid. Iodine is generally added to table salt, but even if you’re all about the low-sodium diet, you still get it in fish, dairy, eggs and some grains. But less known is the connection that selenium has to thyroid health. Selenium is one of those minerals that help support normal iodine levels — which supports a healthy thyroid. I’m taking a multivitamin for this, and am looking into adding Brazil nuts — which contains lotsa selenium — into my diet.
Really taking efforts to cut refined flour and wheat out of my diet. I’m not a fad dieter in any way. I really try to advocate sensible, clean, whole-foods seasonal eating, but I also recognize that food is pleasure, too, and it’s never good to deprive yourself. However, there is lot of good, solid scientific research that ties thyroid issues with autoimmune conditions linked to gluten sensitivity. My problem, though, is that whole wheats and other carbs are what fills me up. I don’t need a ton of carbs to feel satiated, especially in concert with some good healthy protein — but I need SOME. So, for now, I’ve cut down or out a lot of refined flour products, like bagels and pizza. I never ate too many before, but now I’m looking for gluten-free versions of these. I may go gluten-free for awhile to see if it helps, but that’s a big step for me. (I’ll keep you updated…it certainly doesn’t seem like fun.)
I’m trying a few other things, like taking some herbs and doing certain yoga poses on the regular and other such measures. I might start posting these experiences here, just because this is such an unexplored health issue — and it’s hard to find unbiased info about natural treatments on the Internet. (Everyone has some kind of supplement to sell!)
The Big Lesson In All This
I do a lot of yoga and am exposed to a lot via ‘Eastern medicine,’ and one of the underlying beliefs is that your body is a microcosm of your larger life and spirit — and certain ailments correspond to certain issues.
Now, I’m not at all rigid or whole-hog about this, but it’s not a bad idea to inquire over what larger emotional and psychological experiences might be correlated to your physical experience. One of the things I find fascinating to ponder is how thyroid issues perhaps reflect ways in which we’ve literally stifled our voices — either we don’t speak up for ourselves, don’t communicate authentically or don’t speak our truths or peace or whatever.
Introspection aside, the other big lesson is: really, really trust in yourself. If you just know something about your health isn’t right, TRUST YOURSELF. I can’t emphasize that enough, but maybe I’ll put it in bigger font size:
If you know you’re not feeling at your best, you know it. People — even experts and loved ones — might tell you “This is just the way it is” or “This is your new normal.” But you’re not delusional. You’re not stupid. You’re the one who occupies your body and mind, not anyone else.
I suspect hypothyroidism is often un- or misdiagnosed because women — who suffer predominantly from it — are told precisely that this is the ‘new normal’ and often tell themselves (or are strongly encouraged by others) to ‘tough it out’ or ‘pull yourself out of it.’ But the more you ‘tough it out’ when it comes to your thyroid, the worse it often gets. This is why I really think health conditions like these are also often a feminist issue as much as they are personal and medical ones. It’s ALL connected.
The other problem is that you’re still SOMEWHAT functional on a wonky thyroid — even though you’re functioning far from optimally. And as long as you’re somewhat functional, you have to keep going — at least in the eyes of the companies you might work for, the family or friends that want you do things, or even the loved ones that support you in life. Sadly, it often takes a more drastic condition to get the companies and people to take this seriously. And that’s a problem, too. We have lots of information that empowers us to take care of themselves — but it takes humane policies and cultural norms to put this amazing knowledge into palpable action.
Until that utopia happens, though, it’s important to care for ourselves as much as we can. I see health and wellness now as a work in progress. Subconsciously I used to think that if I found the perfect diet or exercise routine, I could just achieve a state of general well-being and then move onto other things.
But real health isn’t like that. It isn’t static, it isn’t something you ‘reach’ and then coast on. Maybe it’s more an act of improvisation: you learn to listen to yourself and then figure out what you need, day by day. That’s the hard thing these days with my wonky thyroid: some days I need more yin, other days more yang, and it isn’t entirely predictable. The good thing is that I have a more complete picture of the factors that affect my sense of vitality, zest and happiness — and I can adjust smarter, wiser and more compassionately.
Ironically, having to deal with hypothyroidism was actually the impetus I needed to realize what #goodenough wellness truly is: the practice of health rooted in being responsive, respectful and realistic of your physical self. You can’t be dogmatic or rigid — you have to take it day by day, and little by little. That’s one of the gifts I’m learning to embrace: to see this as an opportunity to really slow down and listen, and to take the time to make the connections between what I do in life and how I feel within my body afterwards. I’d rather have a good thyroid that I can blithely take for granted, of course — but I’ll take whatever lessons I can get!