no mo' endo'

Big weekend last weekend. Celebrated Alexander's graduation (even though the thesis isn't finished) and had my final appointment with my endocrinologist. It was my final time seeing this doctor because I'm moving to Mississippi, but as it turns out, I don't need an endocrinologist anymore at all--I'm just going to get a GP to manage my synthroid when I move. It's kind of exciting somehow. Even though I'll deal with Graves' Disease for the rest of my life, it feels like not having to have a thyroid doctor anymore is some sort of symbol of putting this chapter of my life behind me, and that feels pretty darn good.

I haven't written about Graves' very much for a while, but I do deal with/think about/learn about it all the time, so on this occasion, I'll summarize some of my recent observations.

One of the important things to remember when taking synthroid (the thyroid replacement drug) is that you have to take it on an empty stomach (with water only) and wait about 45 minutes before you eat or drink anything else. Apparently, pretty much everything reacts with this drug, rendering it ineffective. I'm usually pretty careful about waiting my 45 minutes, but a few times I've forgotten to take my pill in time to wait before the appointed/convenient time to eat arrives, and what I've discovered is that failing to wait results in mild chest pain for the rest of the day, which is definitely not fun. I'm really not sure about this, but I do have a theory based on what I know about the thyroid. The thyroid has a lot of control over the heart (hence my once overactive thyroid resulting in really high pulse and blood pressure), so when there is no thyroid (synthroid, in my case) to tell the heart to beat, it has to work a lot harder to keep beating, making it a little bit painful. I'm no anatomy expert, so I could be totally wrong, but it makes sense. In any case, I'm always careful to wait 45 minutes now.

Speaking of synthroid, my doctor actually changed my dosage very slightly, such that I take only half a tablet one day a week (and a whole tablet six days a week.) I have long since given up on my quest to increase my dosage, but I was still a little annoyed that it's being decreased. It's so minute that I can't imagine it making any real difference in how I feel, and it'll be a little difficult to get in the habit of remembering which day only take half, but I guess I can handle it.

The other thing the doctor talked to me about was pregnancy stuff. I will probably forget everything he told me by the time I want to have kids, but maybe if I write it here I'll be more likely to remember. Two things: 1) I have a higher risk of miscarriage than other women, and 2) The moment (that's really what he said) that I find out I'm pregnant (which needs to be early), I must start taking a double dose of synthroid.

Another new thyroid thing I just learned is that there are some foods called "goitrogens" that suppress the function of the thyroid gland by interfering with iodine uptake. These foods include several things that I like to eat, such as strawberries and peanuts. I learned about goitrogens from a great beacon of scientific inquiry called O Magazine, so my knowledge is fairly limited. I'm wondering if this really has any effect on me since my thyroid function can't exactly be suppressed since I don't have a thyroid. Can foods interfere with the function of artificial thyroi d hormones (after the 45 minutes are up, of course)? This I don't know, and I should probably find out.

It's funny--the thyroid is such a tiny little gland, but I still don't think I'll ever know everything there is to know about it. Still, it's fun to keep learning.