So I have this autoimmune disorder. I've had the disorder for at least ten  years...and for the majority of those years, I guess I've done pretty well without medication. When a doctor wrote across a blood panel back when I was  twenty "monitor every year" I guess it got lost on my "invincible not even twenty-one yet mindset." Though looking back now there were certainly times
where I probably should have had some drugs.

 As with any other autoimmune disorder, my own body attacks one of my own body parts. Last year, when I was having all sorts of medical troubles, most notably ovarian cysts (which were preventing me from getting pregnant), one of my doctors decided to run a test. A very specific test.

It was the thyroglobulin AB test. The test came back positive for Hashimotos.

Hashimotos is (according to webmd) an autoimmune disease, a disorder in which the immune system turns against the body's own tissues. In people with Hashimoto's, the immune system attacks the thyroid. This can lead to hypothyroidism, a condition
in which the thyroid does not make enough hormones for the body's needs.

During the last year (and throughout pregnancy) my thyroid levels have been closely monitored. And since pregnancy, it's been a struggle to "get it back in check."

I want to stop right now, and say, if you stumbled across my blog, and are a woman who is pregnant, and suspects hypothyroid, go get your TSH checked tomorrow.

I was fortunate to have a progressive doctor (and to have been in grad school learning about thyroid related psychology problems) and personally requested frequent testing, even then my TSH levels were just under two. Recent studies
shows pregnant women should increase their dosage immediately upon pregnancy confirmation and should maintain TSH levels under one for proper cognitive development of the fetus. Additionally, undertreated or undiagnosed hypothyroidism during pregnancy can cause: miscarriage, preterm delivery, and breech presentation at birth. (Alexander 2004; Behrooz 2011; Milanesi 2011)

This last blood draw, I was 19 times the maximum for "normal" range. And since the thyroid is the key ingredient to the endocrine system, means I am chugging through a slough of symptoms, the more blog worthy and light hearted ones being dry skin, hair falling out, bruises not healing, ridged and broken nails.

While I'm a very open book, I'm not usually so open about things like this. However, during the course of the last year and a half, I've come across an enormous amount of people - mostly women- who either say, "Oh, I've been on thyroid medication for a few years." Or, conversly, people who say, "Oh my God. I have those same symptoms, I wonder if I should get checked?"

The one that hit the closest to home, was just this past month, when my own father was telling me about some of his latest medical troubles. I encouraged him to research Hashimotos, as it is typically genetic, and get tested.

Sure enough, my Dad has it too. My Dad's sister is now being tested, and we can't help but wonder if my grandmother who died "healthy" in her sleep of Conjestive Heart Failure, didn't actually have untreated final stage Hashimotos. I did some medical research and learned that, "Cardiac autonomic dysfunction may develop in patients with clinical or subclinical thyroid hormone deficiency."  (Celik 2011). Even our Golden Retreiver was diagnosed with hypothyroid, and takes daily medication.

 I began to seriously investigate more and more about thyroid, and while I am not planning to get my PHD until 2020, I assure you, my thesis will be on the rise and health impact of thyroid problems in America. Hashimotos is the more rare, auto-immune version of the standard  "hypothyroid" or underactive thyroid gland, which many people are diagnosed with (and Graves, the auto-immune version of "hyperthryoid" or overactive thyroid gland). It's important for me to clarify, there are distinct differences between  the autoimmune version of hypothyroid and general hypothyroidism. But every day I find myself coming across more and more people who are hypothyroid. 

And while the cause of my disorder is unknown - and very different than some of the more known causes to hypothyroid, I cannot help but beg to ask the question, what the heck are we eating?

If you stop reading my blog, in this moment, and ask ten people (preferrably women) what they know about hypo (or hyper) thyroid, I bet you 80% of them would say, "I'm currently taking medication" or "I know someone who is."

I've come across diet enthusiasts who swear by Gluten-Free; I've come across Usana colleagues that swear by Usana Bio-Mega and Chelated Minerals; even my Yoga instructor recommended pig thyroid hormone, to combat Hashimotos.

A quick Google search "thyroid on the rise" will return results spanning 2008 to now, and India to America...But it still doesn't enlighten me to the pending question, why is hypothyroid (Hashimotos, or otherwise) on the rise? Fortunately for me, I still have access to the online medical library at Grad School, and even more fortunately, my class in research and theory taught me how
to properly read medical journals (typically pertaining to psychology, but that's neither here nor there).

 One study confirms that since the 1990's the detection of thyroid in newborns has been on the rise, ""The incidence of congenital hypothyroidism (CH) detected by newborn screening in the US has increased significantly since the early
1990s." However, in it's conclusion it determines it's strictly due to better testing methods, "Our findings suggest that this rise is attributable to enhanced detection rather than an absolute increase in numbers." (Mitchell, 2011) 

Long standing belief suggests that the introduction of iodine into table salt did assist with the goiter/hypothyroid problems of the 1920's when the government realized there was not enough iodine in our diets in America, and suggested that since people have decreased salt intake (avoid heartattacks!), thyroid is now on the rise. That might explain why during those ten years I was
unmedicated I was a "salt fiend" as my friends called me. I'm a firm believer our bodies know what they need, and maybe that's why it was telling me to oversalt everything.


What's really scary, is this article which indicates that there are iodine-blocker halogens in foods and medications, two which I frequently use- Sucralose (Splenda) and Flonase. Fortunately both products which I avoided during pregnancy (which might
explain why I never needed an increase in dosage). The majority of research I found pertained to China, Japan and Korea, and
referenced the salt intakes there.

The most profound article was published in 2011, and the study used participants from Slovenia, in conclusion it says, "The change from mildly deficient to sufficient iodine supply was associated with a marked change in the
incidence of thyroid epidemiology - a significant decline in the incidence of
diffuse goiter and thyroid autonomy and a marked increase in the incidence of
Hashimoto's thyroiditis. " (Zaletel 2011) Whoa. Isn't that utterly
contradictory? Suffice to say, there's an epidemic happening here...and it
warrants more research studies.


Sources:
Alexander, Erik K. M.D., et. al. Timing and Magnitude of
Increases in Levothyroxine Requirements during Pregnancy in Women with
Hypothyroidism, New England Journal of Medicine, Volume 351:241-249 July 15,
2004 Number 3 Online:  http://content.nejm.org/cgi/content/short/351/3/241).


Behrooz, Hossein Ghorbani; Tohidi, Maryam; Mehrabi, Yadollah; Behrooz,
Ebrahim Ghorbani; Tehranidoost, Mehdi; Azizi, Fereidoun. Subclinical Hypothyroid
in Pregnancy, Intellectual Development of Offspring. Journal of the American
Thyroid Association  Volume: 21   Issue: 10   Pages: 1143-7   Published:
2011-Oct.


Celik, Atac; Aytan, Pelin; Dursun, Huseyin; Koc, Fatih; Ozbek, Kerem; Sagcan,
Mustafa; Kadi, Hasan; Ceyhan, Koksal; Onalan, Orhan; Onrat, Ersel. Heart rate
variability and heart rate turbulence in hypothyroidism before and after
treatment. Annals of noninvasive electrocardiology : the official journal of the
International Society for Holter and Noninvasive Electrocardiology, Inc  Volume:
16   Issue: 4   Pages: 344-50   DOI: 10.1111/j.1542-474X.2011.00461.x  
Published: 2011-Oct


Milanesi, Anna; Brent, Gregory A. Management of Hypothyroidism in Pregnancy.
Current opinion in endocrinology, diabetes, and obesity  Volume: 18   Issue: 5  
Pages: 304-9   Published: 2011-Oct


Mitchell, Marvin L; Hsu, Ho-Wen; Sahai, Inderneel. Increased Incidence of
Clinical Hypothyroidism; Fact or Fancy? Clinical Endocrinology  Volume: 75  
Issue: 6   Pages: 806-10   DOI: 10.1111/j.1365-2265.2011.04128.x   Published:
2011-Dec .


Zaletel, Katja; Gaberscek, Simona; Pirnat, Edvard. Ten-year follow-up of
thyroid epidemiology in Slovenia after increase in salt iodization. Croatian
medical journal  Volume: 52   Issue: 5   Pages: 615-21   Published: 2011-Oct-15 

  Have you ever been to a theme park on a busy weekend in the summer? You stand in line waiting for literally the better half of a couple of hours waiting to get to the front of the line, and then, once you are only three or four people back you start to have second thoughts? It’s not because you don’t want to go on the ride, you signed up for it to begin with, no one drugged you and inserted you half way in the middle of the line…you rightfully walked up to the line and jumped in it on your own. But it’s because all of a sudden you hear the screams, and get terribly nervous that maybe you’ve made some grave mistake…that maybe something awful will happen like you’ve seen in the horror movies and you’ll fall out and die. Suddenly you become overwhelmed with the fear of the “what if” and you feel a tremendous urge to turn back, and it’s then that you realize you are now at the front of the line, and it’s too late, you can’t turn back.

From your new vantage point you see people exiting the ride with these confusing looks of exhaustion combined with elation and you feel pretty certain that this ride was worth the wait, and that maybe everything will be okay after all. Then you begin to hear comments like, “that was the best ride ever,” and “wow, totally worth the wait,” and “it’s AWESOME!”

That’s what the last 4 weeks of pregnancy feels like. That’s the line I’m waiting in right now. And right now I’m about three or four back from the front.

My husband and I were en route home the other day, after hearing some sad news and I made the comment that, “it’s moments like these that remind you life changes quickly and to embrace what you have now.” And to that he said, “Wow babe, you know I love when you say stuff like that, and you are absolutely right.” This made me feel special, because it’s usually him who drops the pearls of life wisdom followed by some incredible analogy- a talent I often wish I could suck from the depths of his mind.

And though my mind drifted on that moment, he followed his thoughts by comments like, “I’m sad that I only have a few more weeks of seeing your pregnant body” and “this is the last few weeks that it’ll be just us…for us…for the rest of our lives.”

And it really got me thinking…I’m half overly excited to welcome our little guy into our lives and this great big world, and I’m half sad that after 31 years of life, I’m no longer “for me” anymore. And it’s not to say that forty weeks of eating with him in mind, and living life with him in my belly hasn’t been a little preparation.  But in less than a month, I won’t be able to stop off at the massage place for a 60-minute and a pedicure on my way home from the grocery store…

And though it’s been tough at times toting him around in my belly, I’ve always known he’s been pretty safe in there…and relatively easy to drag along on “my” daily errands. Not to mention, I’ve really become attached to feeling his little nightly drum solo’s on the inside of my abdomen, and I’ve become attached to having him right there. I’ve become attached to the intimate moments my husband and I have daydreaming about him, and “waiting” to feel him kick.

And though I know that there’s a whole new bag of intimate and exciting moments waiting in store, I’m kind of sad to let these ones go.

The biggest “he’s coming” day was last Saturday. After a 12-hour shopping spree, careful and exciting planning and perfect execution by my Momma and Hubby’s Momma, it was EVERYTHING I’d ever hoped and dreamed. I’d requested on an all organic, “Garden Party” theme with lime, chocolate and teal colors to match the nursery. My Mom worked up a stunning glass tower veggie display with wheatgerm grasses spread over the table. My Sis-In-Law made her amazing PG-21 cupcakes, Lime Mojito and Chocolate Banana, frosting died to match the theme to a T. We decorated a tree with pics of the hubby and I when we were little with “advice for the new mommy” and “guess the exact delivery day/time” cards, we even found Teal “it’s a boy” Willy Wonka Whirly Pops to decorate the dessert table. And then friends and family showed up with diapers and gifts to welcome the little one into our hearts.

I had “stolen” the idea of a time capsule from a friend, and my Dad had found a brand new paint can at home depot. Inside people put notes and messages to our little guy, for him to have and open in 18 years. Everyone at the shower put messages inside.

After years of passing on traditions like these, I finally got my “girl” day and I embraced every moment of it, it was for my little guy and it was incredibly special. And as I pulled up the driveway  following the shower that afternoon, my husband said, “I think you blew out the shocks with the weight of these gifts…is this normal?” The gifts were one thing, but as I sat in the nursery later I began to read the messages in the time capsule…my heart broke as I realized how much he means to everyone, and the incredible hopes people have for him.

I began to think of my own hopes for him and for me…as a mom. I looked around at the nursery, a French-Paisley theme, perfect dark wood furniture against a lime wall, sprinkled with teal color and mellowed with beige. It has become the coziest space for me to relax in. The piles of diapers were filled with images of happy babies and mommies, and suddenly it struck me that all of this- months of planning and prep, and an overwhelming amount of gifts was because any day now, he’d arrive, and I wouldn’t be sitting in that chair daydreaming, I’d be nursing.

One day, very soon, I will wake up and be able to roll over and off the bed, without grunts and struggles. One day, very soon, I will not have a baby bump, instead, I’ll have a swaddle bundle of cuddly love. But still, I’m positive there will be a sense of loss, just a little, for the amazing journey that the last 35 weeks have been.

Because, see, I’ve not just come to like my new body, I’ve come to love it…and love what it stands for. They say that in the days before child birth, this sense of sadness goes away, and you come to a place of just being excited for the future…so I guess that’s what these last few weeks are about...finding a space of embracing the moment, whatever the moment might bring.