Health: Hypothyroidism and Hormonal Imbalances

In 2014 at a routine OB appointment, my doctor felt my neck and asked if I’d ever had my thyroid looked at before. I told her I had not and she scheduled an ultrasound for that afternoon.

What the ultrasound showed was that half of the left side of my thyroid was a nodule and I had smaller nodules in the right side. We don’t know when it showed up or how quickly it grew. Even after multiple biopsies returned benign, my doctor still was not comfortable leaving it in due to the size and my young age.

In December 2014, the left side of my thyroid was removed. Doctors hoped that by leaving the right side of my thyroid that I would not have to be on synthetic thyroid. We tested thyroid function before the surgery and that became the baseline to test against after surgery.

For three months following the surgery, levels looked good and I was released from care without being prescribed Synthroid. A few months later, I developed a burning sensation in my mouth. At first it could be managed by avoiding certain things, but eventually even basic seasonings on food would burn. My dentist gave a diagnosis of “burning mouth syndrome,” which basically means your mouth burns and they do not know why. Eventually I evolved from burning to scarring and ulcers. Through searching online I found something called Oral Lichen Planis (OLP). I brought this up to my ENT and told her I believed it was related to my thyroid levels dropping (at this time we had just done follow-up testing and saw a drop, but still within the “normal” range). She did not believe that the two were related. I found a specialist in the dental world for OLP and he agreed with me that he has seen correlation between the two. I left my ENT and started managing my thyroid with an endocrinologist. When I was closer to my pre-surgery levels the OLP almost disappeared. To this day, a mild OLP flair up is often the first noticeable sign that something isn’t going right with my thyroid levels.

The typical treatment for OLP is steroids, but it was not very promising and because of the side effects I never opted to try that solution. I’m grateful that treating my thyroid resolved the painful symptoms of my OLP. If you find yourself dealing with OLP, the biggest tip I found that literally saved me from so much agony was to use Peppermint tea to soothe the burning and ulcers. I use Traditional Medicinals, but read that any straight peppermint (no mixes, spearmint, etc.) will work. You can hold the warm tea in your mouth and save the steeped tea bags in the fridge to use as compresses. Peppermint tea also has other benefits. It is my go-to evening tea even when not dealing with OLP.

Working with my endocrinologist, I got my thyroid levels under control and was able to put my OLP symptoms to rest and have more energy. I worked with her 2016 – 2020 and it became very cyclical: increase meds, everything improves for a while, symptoms come back, increase meds again, everything improves for a while…

During this time I was also going through my pregnancies and losses. Throughout all of my pregnancies I had low progesterone. I was told by my OB that this was only a problem when I was pregnant and that we would continue to supplement during any subsequent pregnancies. I had short luteal cycles (which can cause problems in getting pregnant, but I didn’t have problems actually getting pregnant so my doctor did not think it was an issue). When I tried to address cycle issues with my endocrinologist she did a hormone panel and diagnosed me PCOS. Without even discussing it with me she called in metformin to my pharmacy and left me a voicemail saying I had PCOS and to start taking it. I did not feel comfortable with the diagnosis, or the potential side effects so I did not take the medication. My OB was certain I did not have PCOS, but again told me not to be concerned with my imbalances so long as I was not pregnant or having trouble conceiving. Like many girls, when my periods were irregular as a teen I was put on birth control to “fix” it.

In 2020 during a CrossFit workout I felt like my body was failing me. I was not able to do a class that I knew I was in physical condition to handle. I had been doing CrossFit almost daily with my sister for a month and knew I should not have been struggling the way that I was. In the weeks that followed I had fatigue, muscle pain, joint pain, and was not able to work out like I had become accustomed to working out. A couple months prior I had asked for recommendations for supplements to improve energy and focus in preparation for starting my new job. I had been feeling depleted and having brain fog and I thought it may have been from being on a weight loss diet. In hindsight, my thyroid levels had started the decline phase in the cycle I had been on for years. One of the supplements I started taking was echinacea. I was unaware that echinacea can be harmful to some people with thyroid function disorders.

After talking to a friend, I stopped taking all supplements and started seeing a doctor at the Modern Thyroid Clinic. In my first session I learned that low T3 can cause muscle fatigue and joint paint similar to arthritis. Traditional doctors treat hypothyroid with T4, but not everyone converts it to T3 reliably. This results in levels being okay, then decreasing, then being okay after T4 is increased, only to tank again (as I had experienced). I learned that many people with hormone imbalances are incorrectly diagnosed with PCOS. The doctor listened to my timeline and symptoms and told me her suspicions. My October 2020 labs confirmed her thoughts – that T3 was way below optimal, along with low progesterone and iron. As we increased thyroid function and metabolism, other things started being depleted faster. In January 2021 we started supplementing iron, copper, and zinc. Because of cortisol imbalances supplementing progesterone resulted in my body converting it into cortisol and caused panic attacks. After two cycles, we quit progesterone and started trying to balance cortisol.

I discussed bodybuilding with my doctor and continued to be monitored during prep. At the beginning of prep I still had low progesterone and testosterone had also dropped too low, but supplementing either makes you bloated so we postponed treatment for post-show. The restricted diet of prep impacts the adrenal system (even though I adjusted to her recommended carb intake) and when you get below a certain body fat you stop having menstrual cycles. Between April – August I did not have cycles. I knew this would happen in theory, but actually experiencing it for such an extended period of time was a surprise. The impact of those missing hormones was definitely noticeable more than just missing periods. You’re kind of going through temporary menopause. Entering prep with already low progesterone and testosterone likely made this worse for me.

I went yesterday for my first set of labs post-show and will know more in two weeks how I’m recovering there. I have been dealing with muscle pain and injuries for months that are still lingering despite months of physical therapy. The going theory (between me and my PT) is that the low testosterone and impact of prep on my thyroid function could be the culprit: causing me not to recover after workouts while continuing to push throughout prep. I’ve taken the last two weeks off from the gym at the advice of my physical therapist, done some Pilates and Yoga, and have found a wonderful massage therapist to work with in addition to starting hormone therapies now that cycles have resumed. I plan to be back in the gym a few days next week at reduced weight and movement to maintain the active lifestyle that I’ve come to love so much.

As my body begins to regulate again I know I will want to be in better adrenal and hormonal health before entering into another show. I would also go for more frequent labs in future preps. And to be honest, because I know some of you might be wondering after all of this, I do question if I will do Bodybuilding again or if I might pursue a different type of fitness competition that won’t impact this aspect of my health. We shall see.