My friends know I have been blogging (or blabbing) for a long time on this home-made Weebly website! When my kids were young (and I was too), I found writing was therapeutic to helping me organize my thoughts plus a measure to record important events for my family. In addition, it allowed a platform for me to combine my love of Pilates with my home business of teaching Pilates plus identifying some of the intersections that occur between Pilates, health, and life. I'm almost 53 years old and maintaining a watchful eye on my overall health has been a constant. I also don't hesitate to share some of my experiences with others as some find it helpful. Please however don't misconstrue my experiences with medical advice! My journey is my own, I am not a doctor, and you have your own journey to navigate with your healthcare provider.
I shared many years ago of my auto-immune illness of Hashimoto's thyroiditis which occurred as it does for many women around the time of pregnancy and post-partum, 2002. Hair-fall, anxiety, insomnia, low-mood were all general yet vague descriptors of my symptoms. My best understanding of the condition occurred when a dear friend introduced me to an internal medicine doctor who boldly proclaims, he too is not a fan of doctors. I say that in jest as there are many great doctors but ideally I am well enough to not need their emergent services. We were the perfect fit. Before I found my thyroid doctor I had been prescribed anti-anxiety meds, anti-depressants, and birth control pills from well-meaning physicians for nearly a decade. All along however I did not believe I was anxious, depressed, or in need of synthetic hormone control, those were symptoms of an underlying issue. Dr. Brown looked at my full lab panel and declared even though my thyroid ranges were "normal" they were far from optimal. Most importantly my T4 was not converting to T3 and T3 is the bodies natural anti-depressant! So whether a chronic low-level inflammation related to gluten, a processed diet or other lifestyle choices, or simply not the correct type of thyroid replacement and support(natural vs. synthetic) my thyroid was not functioning well. He set out to educate me and help improve the quality of my life through better thyroid function. That was at least 12 years ago and I shared that experience on the blog at that time.
I shared many years ago of my auto-immune illness of Hashimoto's thyroiditis which occurred as it does for many women around the time of pregnancy and post-partum, 2002. Hair-fall, anxiety, insomnia, low-mood were all general yet vague descriptors of my symptoms. My best understanding of the condition occurred when a dear friend introduced me to an internal medicine doctor who boldly proclaims, he too is not a fan of doctors. I say that in jest as there are many great doctors but ideally I am well enough to not need their emergent services. We were the perfect fit. Before I found my thyroid doctor I had been prescribed anti-anxiety meds, anti-depressants, and birth control pills from well-meaning physicians for nearly a decade. All along however I did not believe I was anxious, depressed, or in need of synthetic hormone control, those were symptoms of an underlying issue. Dr. Brown looked at my full lab panel and declared even though my thyroid ranges were "normal" they were far from optimal. Most importantly my T4 was not converting to T3 and T3 is the bodies natural anti-depressant! So whether a chronic low-level inflammation related to gluten, a processed diet or other lifestyle choices, or simply not the correct type of thyroid replacement and support(natural vs. synthetic) my thyroid was not functioning well. He set out to educate me and help improve the quality of my life through better thyroid function. That was at least 12 years ago and I shared that experience on the blog at that time.
Fast forward and obviously, I am in a new phase of life now, one commonly referred to as peri-menopause. Hormones such as estrogen, progesterone, and testosterone begin a roller coaster ride in which many say hormones fall off a precipitous cliff. In October of 2023 I decided to invest in the Everlywell Hormonal Panel. I don't visit doctors often except for Dr. Brown once a year and my family doctor recently retired so I wasn't sure from whom to request a hormone test. Fortunately, with all the options today between Quest Labs, LabCorp, and companies like Everywell you can basically, independently order your own lab panels. Of course, it would be better if insurance would cover these tests but in my case it seemed less expensive to simply pay for the test out of pocket. When I received the results in October 2023 we were on the road visiting college kids in Alabama and then traveling south to Florida. The results were interesting. My cortisol levels (stress hormone) were in a good range. This was a relief as elevated or low cortisol interfere with thyroid function. Personally, I credit mind/body exercise like Pilates for helping me maintain healthy stress levels. It wasn't always this way. In fact a number of years ago I did a similar saliva test and cortisol was elevated. I was also over-exercising at the time, training for half-marathons. Lesson-learned. Extreme exercise, particularly chronic cardio, does elevate cortisol levels. This is o.k. for some people and perhaps acceptable in different seasons of life, but it was contributing to my "wired but tired" affect. The podcast I listened to today, the impetus for this long post, was Dr. Sara Gottfried, a Harvard and MIT trained integrative medicine physician who ironically affirmed my own findings. In fact, she specifically recalled the time in her life when she was running 20 miles per week, caring for toddlers, and working at McMedicine, an HMO facility in which she would see up to 40 patients per day. When told by her own physician that she needed an antidepressant and to eat less and exercise more her natural intuition told her this was an ineffective solution. She focused at that point on investigating her cortisol levels and made simple lifestyle changes, particularly reducing her excessive cardio and adding "adaptive" exercise. In this podcast she cites Pilates and resistance training specifically as being advantageous to helping her balance her hormones, particularly cortisol. In addition, she did more yoga and added meditation.
My Everlywell test showed my DHEA-S was on empty. DHEA is made primarily in the adrenal glands and is an important precursor to other hormones like estradiol and testosterone. It decreases as we age but unusually low levels can indicate a problem with adrenal gland function or with other glands such as the pituitary. When I shared my Everlywell test with Dr. Brown at my annual lab visit, he immediately pointed out my despondent DHEA value saying it indicated my body was under stress, that it wasn't all in my head or even a natural part of aging. He agreed that a low-dose DHEA supplement may be helpful so I started on Pure Encapsulations of 5mg. Of course, one must be aware that increasing DHEA will likely increase testosterone. Testosterone is great for confidence, personal agency, and muscle growth; we all need that, but I would prefer to not grow a beard!
When I was on the road in October and reviewing my Everlywell lab panels I noted my TSH, my thyroid hormone was at .20. This was quite low for me as usually I function best around .5 -1.0. I was also feeling odd signs of agitation and anxiety, not crippling, but just palpable particularly because I am fairly dialed-in to my body's fluctuations. I know what it is like to feel amazing and I recognize when something is sub-par. When I saw that value, I decided to reduce my Levoxyl from .112 to .100 knowing I had an appointment with Dr. Brown in 6 weeks which would include another lab panel. When I got those December results back from Froedert Healthcare, my TSH had changed from .2 in October to 4.7 in December! A pretty dramatic shift and again far from optimal and balanced. Dr. Brown immediately however tuned in to my Free T3 levels which on my Everlywell test in October were 2.91 and when i saw him the values had decreased to lower than normal at 1.9. T3 is the stronger of the two hormones (T3 and T4) produced by your thyroid gland. While produced in smaller quantities it's more potent than T4 with the ability to produce energy and deliver oxygen to cells to help regulate your metabolism. T4 converts to T3 in various tissues and organs, primarily the liver and brain. It seems like a similar situation from years ago, the ratio of T3 to T4 in correlation with an optimal TSH level was unbalanced. We discussed how I had changed my Levoxyl dosage while on vacation because .2 was definitely creating uncomfortable symptoms but my TSH ricocheted to 4.7 within 2 months also creating uncomfortable side-effects. He explained that my T3 was in need of additional support and recommended compounding my meds to include Cytomel or Liothyronine. He prescribed the lowest dosage possible, this tiny 5MCG pill that I cut in half and take with my .100 Levoxyl. For such a small dosage, the improvement has been incredible. More energy, less brain fog, better sleep, better mood are just a few of the positive side-effects.
This is my anecdotal experience. Rather than simply say my values were off in October, worse in December, and now better in February, I got into the weeds in this post because hormones and health are not always simple and straight-forward. It's complicated, levels fluctuate, and lab values give only a brief snapshot in time. I certainly don't encourage anyone to change their dosage without conferring with their doctor; I merely did so since I was on the road and had the results from my Everlywell test and did not want my TSH values to sink even farther beneath .20. The Everlywell test was also able to provide additional info to Dr. Brown in consideration for adjusting my medications. More importantly, he called my attention to the T3 and T4 values and astutely recognized that although they were near a "normal" level there were trends and indications that my thyroid needed different support to generate enough production of T3. So now here in Florida I did a follow-up lab test at Quest Labs mid-January at Dr. Brown's behest to see if the Cytomel was having the desired response. Dr. Brown promptly called me with the results and Quest Labs also provided them to me. My T3 is increasing its production in relation to T4 values and my TSH, although low, will likely stabilize as it definitely needed to drop from its December high of 4.7.
dhrupurohit.com/dp-ep445/ This podcast was helpful, timely and informative. It is also lengthy! I still have an hour remaining. It might be of support to you whether in your 30's or 60's and beyond. Dr. Gottfried reminds us that food is the backbone to the manufacturing of your bodies' hormones. In addition, lifestyle factors like decreasing sugar will increase testosterone as well weight/resistance training. Women suffer from insomnia at twice the levels of men. Women's bodies are more complicated! Naturally I loved her identifying mind/body exercise, specifically Pilates, as instrumental in her overall well being.
February begins a new month of Zoom On-Line Pilates and I am increasing class options to 4 days/week. Join me Monday and Wednesday evenings at 5:15pm or Tuesday and Thursday mornings at 8:30a.m. It's been well-received and I am delighted women are finding it accessible in their homes. I share the recorded link as well which is available for 30 days for continued practice. Some women join me for the session live on-line and others simply follow up later and tune in to the video recording. Sometimes we have 8 or 10 in the Zoom gallery and other times women turn off their videos and do the exercises in their pajamas while drinking their coffee! Nobody has to know! However it works for you, I would love to have you join me this February. Thank you for reading!
February begins a new month of Zoom On-Line Pilates and I am increasing class options to 4 days/week. Join me Monday and Wednesday evenings at 5:15pm or Tuesday and Thursday mornings at 8:30a.m. It's been well-received and I am delighted women are finding it accessible in their homes. I share the recorded link as well which is available for 30 days for continued practice. Some women join me for the session live on-line and others simply follow up later and tune in to the video recording. Sometimes we have 8 or 10 in the Zoom gallery and other times women turn off their videos and do the exercises in their pajamas while drinking their coffee! Nobody has to know! However it works for you, I would love to have you join me this February. Thank you for reading!
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