Strategies to Overcome Hypothyroid-Induced Depression

As anyone who is an EZH* can attest, having your thyroid out of whack causes all sorts of troubles. When you choose to treat it naturally, you are jumping into the deep end of the pool with a bunch of lead weights tied to your waist. And then, of course, you have to figure out how to swim back to safety.

Even to me, it sounds pretty dire as I write this. As an EZH, you are constantly trying to tread water any way you can. You don't have the energy that healthy people have. You don't have the oomph to get things done. And on top of everything else, you tend toward depression. It's enough to make you just want to go get the water wings of Synthroid (the medication that helps replace the Thyroid hormone your thyroid should be making but isn't, for whatever reason) and be done with it.

But, if you stick it out and go the natural/holistic route, you need some strategies to handle the depression. Below, is a list of things to think about and perhaps do to help.

First, and foremost, increase your awareness of what is going on with your body. Pay attention to what it's trying to tell you and act accordingly. So, if you have been pushing yourself and your poor body is vainly trying to tell you to slow down, listen. Leave the dishes in the sink overnight if you are too exhausted to clean them before bedtime. Keep your exercise to a minimum (more on this in a future post). Don't go out to the next event if it's going to exhaust your further. Even though they say that being out and being social can help alleviate depression symptoms, I believe it's different for EZHs. If we try to party like it's 1999, we will pay dearly for it later. Perhaps, you might think about inviting people over to your place for an early movie night rather than going out and partying. Whatever you do, don't overdo. 

Second, Frankie says: Relax. Yeah, I know. It's way easier said than done. But, you still have to. Often, part of an EZH's depression will be a certain amount of anxiety. And if you aren't relaxed, those two (depression and anxiety) will combine to stress your entire endocrine system even further. So, what's the first rule of relaxing? Breathe. Breathe, breathe, breathe, and when in doubt, breathe some more. Here are a couple of techniques and exercises you might consider doing to help with breathing.

First, have a seat and relax. Put one hand on your belly. Take in a deep breath. Feel if your hand moves and your fingers expand. Notice if your shoulders came up as you inhaled. If they did, try the same thing again and this time try to keep the shoulders relaxed and down. Instead, as you inhale, imagine that your belly is a submarine. As you breathe in, let the air flow all the way down into the submarine. When you exhale, let the air come back out the periscope that is your air passage and your mouth/nose. Try to breathe this way three more times. When you feel you have the hang of it, put your other hand on your side, a bit higher than the hand on your belly. This time breathe into your belly and then when that is full, let the breath keep entering your body and feel your sides expand (the hand on your side should move at this point). Try these two steps for the next three breaths. Once you have done that, breathe into your belly, then into the sides, and then last up to the top of your chest. Keep your body expanding and opening. Your breathing apparatus is like a ballon that is being filled as you inhale. Your entire trunk can expand and you can get lots of good oxygen into your lungs this way. Try this breathing technique for three more breaths. That ought to help you relax. Take a minute and note how you feel. 

Here is another set of breathing techniques. In addition to breathing, this one contains a bit of vocalizing. We as a species generally begin to vocalize right after birth. In fact, when we are born, that is one of the ways they test to make sure all is okay. If we aren't crying our presence out into the universe, they think something is wrong. So, in addition to breathing, another relaxation technique is to use your voice (we will get a lot more into using your voice and speaking your truth at a later time). This technique is accompanied by an audio guide. Here is the link to Breathing3.mp3. Feel free to utilize it to help you relax. The instructions that accompany the audio file appear below.

1. Deep breathing correctly. Your stomach is relaxed and expanding out on inhalation. Your ribs are relaxed and expanding and your shoulders are relaxed and down. (You’ll find when you breathe deeply like this, that your shoulders start to ride up and get tense around your neck. Consciously lower and relax them whenever you notice this.

a. Inhale and exhale full deep breath five times.

b. Inhale a full, deep breath using good technique and exhale on a whispered “Ah.” (five times). Horse noise is great for finding where you are using your breath.

c. Inhale and exhale on a closed-mouth low “Mmm.” (five times)

d. Inhale and exhale on an “Ah” sound.

e. Yawn an “Ah” sound. (five times)

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Until next time, Izolda. http://IzoldaT.com

*EZH: Exhausted Zombie Hypothyroidic

Aside from weight gain and fatigue, depression is one of the most prevalent symptoms of hypothyroidism. Bottom line: if you are hypothyroid, you will tend towards depression. And it's not that you might be predisposed toward depression naturally. It's more that when your thyroid is distressed and is underperforming, depression will often rear its ugly head and bite you on the butt. There is not really anything you can do about it. Even if you normally would never tend toward depression, you will often get depressed if you dip into being an EZH*. Distress and a sluggish thyroid, your slower metabolism, the weight gain, the slowing down of all your bodily functions, all of these things combine to depress you even if depression doesn't normally figure into your world view or your physical symptoms (not to mention the fact that the sluggish thyroid is a depression cause all on its own).

That's kind of what I go through. You see, I'm not normally a depressed person. So, when I first went very hypothyroid, one of the things that I noticed was that everything looked bleak. I found myself being depressed for the first time in my life. What the hell? I thought. Why was I depressed? My life was full. I had a partner I loved. I had good friends. I was doing work I enjoyed. So, what on earth was it that was making me depressed?

When I got the diagnosis, I found out. Since I had hypothyroidism, I was also likely going to be depressed. On top of all the other crap you have to wade through, on top of all the murky fatigue and other symptoms, I was also going to be depressed, perhaps too depressed to do anything at all about the thing that was making me depressed in the first place. So, as I've gotten myself together, and as I started treating the hypothyroidism, one of the things that started happening was the depression reached a manageable level without me needing to address it specifically, at all (this might not hold true for people who tend toward depression naturally).

In fact, one of the clues that tells me that I'm very hypothyroid is I get depressed. When I get depressed, for no reason, I know that I need to check my thyroid. But the tricky thing is that when I get thyroid-depressed, fatigue usually follows closely behind. And if I get it to that point, I might spiral down into the "why bother?" place and that is a bad place to be if you are an EZH. That is hard to come back from.

Normally, I don't feel that things are bleak. In fact, I tend to have a sunny disposition. I tend to want things to work out. I tend to hope that they're going to work out. But when the hypothyroidism grabs me by the throat, I don't think things will work out and I sink into depression. And here's the sneakiest part of all: if I'm all stressed out, the depression gets worse. That's one of the funny things about being hypothyroid. Hypothyroidism is supposed to make you tend toward depression. Hyperthyroidism (an overactive thyroid) is supposed to make you tend towards anxiety. But, if you're under stress and hypothyroid, then you might achieve that most egregious of double whammies: both anxiety and depression.

So, how do you deal with it? How do you handle your depression if it's coming on because of hypothyroidism? The trouble here is it's a double-edged sword. Your depression makes you feel that it's too much work to fix anything at all (and that it probably won't work so why bother trying)?  The hypothyroidism makes you so tired that it's almost not worth it to push out of bed and do the things you need to do, the things that you must do, in order to make yourself better. There have been times in my life when I basically turned myself inside out trying to maintain my life and when depression compounded the trouble, it became practically impossible to fix.

Nowadays, I try to take it easier on myself. I try to catch things early. I do daily check-ins. First thing in the morning, I ask myself how I feel. Here are some of the questions I try to answer:

1. Am I fatigued? (More often than not, yes)
1. What can I do about it? Sleep? Maybe. Exercise? Only a little.
2. Am I aching? (Ditto)
1. What can I do about it? Yoga, ultrasound, massage, bath, or passionflower supplement (before bed).
3. What is my outlook for the day? 
1. Open ended answer but it often depends on what my deadlines are for the day.
4. Do I feel stressed out? (Often, yes, though I try to mitigate the stress with my daily yoga practice.)
1. What can I do about it? Breathe. Breathe. Breathe (at least five, deep, full breaths before I do anything else). Yoga or Tai Chi. Reach out to a friend or my husband. Do something I enjoy even if it is only for a few minutes before I jump into my day. 
5. Do I feel anxious? (Again, this depends on the deadlines for the day)
1. What can I do about it? This one depends on the time of year. A cup of hot tea (no caffeine) will often have a soothing effect. I go for a hike with the dog and focus on the things I see in nature. And breathe breathe breathe. Taking full, deep breaths is one of the best ways I've found to handle anxiety if it comes up as part of my hypothyroidism. We'll talk more about how to breathe in the next post.
6. Do I feel sad? (If the answer to this one is "yes," I start looking at other indicators that I might be in thyroid-depression. This is because I'm not generally prone to sorrow.)
1. What can I do about it? This one often necessitates an increase in kelp in my life (the iodine in kelp helps in thyroid hormone production). Then, I try to do something I enjoy even for a minutes. For example, I play one of my favorite songs to dance to and I go crazy dancing. I move my body, even for a little bit. It helps break through the layer of sorrow very nicely. 
7. Do I feel depressed? (If this one is a "yes" well then, I need to be ready to try to deal with it.)
1. The answer to this one is similar to the one for sadness. I know I need to look at my TSH level if the depression persists for any length of time. So, in addition to trying to mitigate the depression, I will get my TSH levels tested. Here's a place where you can order and conduct the test online (not sure if you then have to have your doctor read the results, since I've not used this particular company before). http://www.healthhometest.com/product_info.php?products_id=38

There are more things to be done. And next time, I'll list more possible ways to combat depression. First on the list: Breathe. We'll talk more about how to breathe to get the most out of your breathing apparatus. Please note: I am not telling anyone to not see their medical professionals to treat their depression. This is a blog on treating the issues naturally so the topics of medication will not be addressed here.

Until next time, Izolda. http://izolda.info

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*EZH=Exhausted Zombie Hypothyroidic

Perseverance and Perspective: Hypothyroidism and Energy Level

Perseverance and perspective: that's what I am thinking about this morning. Oh how seductive it is to jump on the meds bandwagon. Oh how I sometimes crave chucking it all in and just going on Synthroid or some other drug to regulate what my body ought to be doing on its own. And then I remember, my body *ought* to be doing this stuff on its own. I remember distinctly hearing from Dr. L, the endocrinologist, that this hormone, Thyroxine, is something my thyroid should be pumping out and that the *only* thing the Synthroid will do will be just to replace what ought to be happening already. So, with that thought in mind, I persevere and come back to the idea that if it's what ought to be happening, then that is what I will work towards.

That attitude I have? It comes with a price and that price can be too high for many people to pay. When I was younger, my energy and vitality wrapped around me like shining, electrical veils. I could do anything I wanted to do and would still have sufficient energy for all the necessities. As I got older, I now believe, I burned my thyroid out with all of my frenetic activity. Did I party? You bet. Did I under sleep? By a lot. Did I rush headlong from one frantic task to the next? Always. And I never, and I mean never, gave myself any time to recuperate and recover my energy. Add to that my Type A personality, and I had the perfect recipe for endocrine disaster.

When it took me down, it did so hard. When I chose to treat they hypothyroidism naturally, I approached it from my Type A perspective. I jumped headlong into figuring out a treatment. I radically changed my life. The only things I didn't change? I remained a vegetarian despite all the literature that says I need to be eating fish (at least) and I didn't stop or even curtail my frantic and stressful pace.

Here are some of the things I do/have done: professional musician/singer/guitarist/violinist. Leader of various bands and performing groups, author (two books and working on a third and fourth, articles, etc.), volunteer at various shelters (for humans and non-humans alike), professional tarot/palm reader, educator (environmental education, music, violin, voice), website designer, filmmaker, photographer, jewelry maker, spiritual officiant, priestess, friend, and wife. I'm sure there are others, but you get the point.

The reason for the above list? I do them all, now, still. What does that mean for my thyroid? I constantly try to maintain the balance between getting to do all these things and my sluggish energy level. The price I pay: I can no longer do the partying, the under-sleeping, and the stress. Over the last year, my Type A personality has transformed. I no longer attend all (or even many of) the parties. I try hard to get enough sleep, and I try even harder to release the stress whose appendage-like presence has been such a constant for the last 40 years.

Yes, I do believe that my stress began that early (if not earlier). I was born in the former Soviet Union, and I'm sure that in itself was stressful. My early life is a bit of a blur, but I definitely remember when we emigrated. The journey felt exciting at the time, but I am sure it had its share of stressors on me. I was and still am a true extrovert and thrived on the new places, face, and ideas, emotionally and intellectually. Physically, I had an overabundance of energy and raced through life. But, I'm sure that kind of radical lifestyle change has its share of issues. Even if I didn't feel them at the time, I believe they had a long-term effect.

My activities have allowed me an incredible life full of friends, adventure, travel, creativity, and joy. They have also taken their toll on my vitality and now, as I try to regain some of the long-term vitality so I can keep doing what I'm doing (and then some), I am going through a period of relative stillness. I am blessed in that I often receive invitations to events by old and new friends. And right now, I attend almost none of these events. Why? It's because I am choosing to go inward and check in on what I feel I can do, right now, today. I used to jump up and run. "On to the next thing," is one of my favorite phrases. Now, I have to go inward before any activity to see whether or not my body can handle it. You know that saying, "the spirit is willing but the flesh is weak?" That holds true for me, now, as well but from the thyroid perspective.

Sure, I could push myself and go do whatever it is I want to do. But then, I will pay a steep price. So, I introduced the mental/physical check-in. It's not that I don't want to attend the party or the show or the X. It's that unless I feel like I can actually handle it and not be completely debilitated afterward, I need to step back and bow out. Luckily, my husband understands my current state or we might have problems in our relationship. He often has to attend events solo because I am not able to go and he gets that it's not that I don't want to go. It's much more that I just can't go.

As an EZH, I often sacrifice the immediate activity in order to maintain the fragile balance that will allow me to function tomorrow. That's where both perseverance and perspective come in. I have to persevere in my choice to make my health a priority, and I have to maintain perspective on the balance between what I might want to do and what is best for my health.

Until next time, Izolda. http://izolda.info
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Hot/Cold/Miserable: Hypothyroidism and Temperature Regulation

This week, I have been at a terrific annual meeting for the environmental education program for which I consult. The people (from 25 countries) are amazing. The work inspires me. The opportunities thrill me. What kicks my ass? The temperature. They keep it so cold that yesterday, I simply shut down. I was so freezing that while everyone else was at lunch listening to a talk on communicating climate change, I was in the room in which I was teaching, lying in a fetal position, aching, barely able to move, and trying not to throw up from the misery. My nails and skin turned blue. I hurt everywhere. I wanted nothing more than a very hot bath. The trouble is that while I would have benefited greatly from that hot bath, it might have gotten too hot and then I would have been miserable in the heat.

One of the most insidious symptoms of being an EZH*, is that your body can't regulate and adapt to temperature changes. You think you're going along fine. You think you can handle whatever is going on and then you get too cold, or too hot and BAM, you are miserable and feel like you have gotten the flu.

It takes me a while to get to the too cold state. I really will keep going for a long time and move or stretch or run in place to keep warm, but when the cold overtakes me, I am lost. EZHs typically have a lower resting body temperature than normal people. And our thyroids kick our butts by not letting us adapt easily when the external temperature is at an extreme or when it changes quickly.

Oh, how I'd love it if I didn't lose my ability to function when I am too warm. But, I do. I absolutely do. I get flu-like symptoms and would welcome a quick death. When I get too cold, like yesterday, I add layers (I bought a university sweatshirt from the bookstore and wore it the rest of the day. I practically kissed the feet of the students who had the store open.). But, when I am too warm, there are only so many clothes I can remove before I get arrested. I used to power through and just deal with it, but that has become less of an option for me. Now, I have to stop and take care of whatever it is that is making me either boil or freeze. 

And that's the important point here: EZHs have a special problem with temperature. We don't just feel a little cold. We turn into human popsicles, like Luke Skywalker on the Ice Planet Hoth. We don't just feel warm. We melt and have the same mental and physical acuity as liquified butter on a mid-summer's day.

When it starts to happen, step back, get warmer if you are cold and colder if you are warm. Take care of yourself, first and foremost. Stop trying so hard. Just because you can turn yourself inside out to get something done, doesn't mean you have to do that. I get that it's vulnerable to admit, publicly, that you have an issue, that you need help, particularly because there are no real outward symptoms. People can't tell how miserable you are by looking at you and so don't know that you have special needs.

The advice here: take it easy on yourself. Because we have an invisible disease (and not just invisible to others but often to ourselves as well), we might try to carry on regardless of how crappy we feel. We tend to feel like we ought to be able to do whatever it is we are trying to do and so we keep pushing. Our endocrine system can not take the strain and while other people who try too hard might be exhausted from the effort, we might end up curled up on the floor, barely able to move or worse, passed out or at worst, in a coma. This downward spiral will end in agony.

There is a lot to be said about our own perceptions of how much we should be able to do while living with this disease. Often, because it is invisible, we push ourselves further than is healthy. We don't necessarily let other people know and even if we do, few people have the knowledge to appreciate just exactly what EZHs go through. That makes it tougher to be honest and to communicate our situation properly.

Every time you get on an airplane, the flight attendants always give that spiel in the beginning. One of the things they say is, "When the oxygen masks drop down, put your own on first before taking care of others around you." Truly, those are golden words. If you don't help yourself, if you don't take care of yourself, you will be no good to anyone else.

Be honest with them and more importantly with yourself. Educate yourself and others. Assess your needs. And ask for help. It is crucial to your well-being and might even be vital to your survival.

If you enjoyed this post, please consider sharing it. Until next time, Izolda. http://izoldat.com

*Exhausted Zombie Hypothyroidics

Hypothyroidism Treatment Requires Permanent Lifestyle Changes

Treating hypothyroidism is like being on a maniacal roller coaster ride. When you're doing well, you have energy and can even fly pretty fast and loose. When you aren't doing well, life feels like it's taken a jello-filled body suit that weights three hundred pounds, forced you to wear it and still try to run marathons on a regular basis. In other words, it crushes you.

In my own process of treating it, things ebbed and flowed. For a little while, I was okay. When I wasn't, I thought I might turn inside out from the fatigue. At my lowest ebb, I ended up with an 83 TSH count (remember, normal is somewhere between .3 and ~4.5). I remember I was so exhausted that I barely made it in to see Dr. L, the Endocrinologist. She had advised me strongly that I needed to go on meds the first time she diagnosed me and at that point, my TSH level was a 14. So, when she saw 83, she was incredulous.

"How are you up and about?" she asked.

"What do you mean?" I replied.

"An 83 TSH count means you should be having trouble getting out of bed."

"Well," I was getting a bit nervous now. "Actually, I've been very busy. I've been doing a lot of running around."

Then, she said something that completely freaked me out. "With an 83 TSH count, you ought to be in a coma. Nobody walks around and does anything with this much Thyroid Stimulating Hormone in their system. This could get worse and very quickly. Your bodily systems could all shut down. You need meds. Right now."

"I still don't want to do that."

"At least, you can go on them for a few months to give your thyroid a break. Or it will burn out. You will have nothing left and you don't want to get to that point."

It's hard to describe how freaked out I was. I was barely hanging on, as it was. Moving through my days was taking every single iota of effort I could eke out of my exhausted body. The tiniest little thing took everything I had to give. And I had little left. So, I decided to trust her and try the meds.

"So, what you're saying is, I can go on them for a little while and then stop?"

"It's highly irregular, but yes, you can do that. You can wean yourself off them when your thyroid has had a rest."

"Okay," I agreed. "I'll do it."

I went on Synthroid for three months. I weaned myself off and here's why. Nothing changed. I had no more energy than I had had before. I didn't lose weight. My metabolism stayed the same as it had been. With the exception of the fact that I guess my thyroid got a little break, everything else was completely the same as it had been when I wasn't on the meds. So, my body had enough thyroid hormone, but nothing else changed. I decided that I might as well feel like crap without the meds since I still felt like the exact same form of crap with them.

It turns out that my form of hypothyroidism is the kind where my thyroid is making (just) enough Thyroid Hormone, but it's very inefficient. It's working too hard to make it. So, the pituitary gland was doing its job and pumping out more TSH to keep my thyroid on task. And the inefficiency spiral went on and on.

So, even going on the meds, made no difference in my life. What did make a difference? Grabbing my life by the balls made a difference. I had to step away from the "tie-myself-into-knots" life I had been leading. The "I work best under pressure" paradigm had to shift or I was going to burn myself to a crisp. I had to bring balance back into my life or I could have died. Here's another insidious thing about this seemingly innocuous little gland. It governs so many aspects of our bodies that we would be shocked at just how much it controls.

Here is the webmd article on the thyroid, its functions, diseases, and issues. I took this entire situation to mean that I needed to change my life. I obviously couldn't keep going the way I had been. It was impossible to sustain. So, I stepped back and changed.

In my early 20s, I'd been working a job (that I loved) but I was working 14-hour days seven days a week. I started having pains in my gut. When I finally went to the doctor, she told me that I was developing an ulcer and that if I didn't de-stress, I would be in deep trouble. I changed my ways. I stopped working so much. I took care of it and the ulcer never fully developed.

The same had to happen now. Maintaining the level of stress and activity in my life would lead to permanent shut-down. So, I walked away from much of my busy life and started on a different path. Here's the thing: for the most part, I loved and still love the vast majority of the activities that make me so busy. I could list all the things I do/have done but I will spare you the details. Suffice it to say, there are and have been plenty. But, in order to chill out, I needed to get a grip and make some choices. And then, I had to stick to them. Forever. If I didn't, I'd keep riding the same roller coaster indefinitely.

And that's the crux. These changes that need to be made aren't temporary. They aren't about temptation and willpower. You can't just resist the temptations. You need to make a permanent lifestyle change. You cannot maintain good thyroid health naturally if you are still engaged in the activities and habits that kicked your thyroid's ass to begin with.  It will not work.

In my personal tale, allow me to talk about bread. I should. not. eat. bread. Period. For whatever reason, it exacerbates my drop into the fatigue hellhole. Bread exhausts me and enough of it slams me into sleep. Sometimes, the only way I stay awake is to literally slap my own face. It's not a good way to go, for me. And yet. And yet. I still go back to eating it and have done so periodically over the last fifteen years. I love bread. I really love it and once I have that one little piece, I start making excuses for myself about why I should have the next one tomorrow. Before I know it, the yoyo cycle of quick energy boost/fatigue hellhole has run amok again. And it can take weeks or months for me to get off that particular merry-go-round. Right now, I'm off bread and have been for the last five months. I feel great! But, and this is a big but, I have to remain vigilant about what I put in my body because even the tiniest crumb will start me down the cycle. Ideally, I want to become one of those people who just doesn't eat bread. I have done that with chocolate (which I love but which I have to avoid). I haven't had chocolate in three and a half years. Every once in a while I still miss it, but it's nowhere near how much I craved it before I gave it up. Potatoes are another temptation. they sing their crispy or buttery siren song and I am lost. But I am trying, hard, to be the kind of person who just doesn't eat them. That one might just take the rest of my life to attain, but I will not give up on myself. My health is too important to do that.

So, the big decision needs to be made by you. Am I going to change my life? Can I stick with the changes that are necessary? If the answers are Yes, then go to it. If not, then I would suggest you take the time to assess and evaluate your options. This method works if you work it, but only if you work it daily and permanently.

Do you have foods/habits/activities that exhaust you? What are they? How do you handle your fatigue?

As always, if you have questions, please ask. I will either answer them or try to point you in the right direction.

---

Until next time, Izolda. http://izolda.info

Weight gain. Yep, I worried about it. I started getting heavy in my teens (right around when I likely became hypothyroid. Coincidence? Don't think so). I worked out. I tried to eat well. I did all the stuff you're supposed to do to stay in shape. In my early 20s, I became a vegetarian, I regularly did aerobics. I rode my bike. You get the picture.

But still the weight piled on like I was secretly eating four slices of cheesecake a night. And no matter what I did, I could not get the weight to come back off. When I got diagnosed with the hypothyroidism (I just realized I wrote it like it's a major epidemic like, The Plague, or the Black Death and heck maybe it is), it started to make sense. It wasn't my fault the weight had piled on. My thyroid was sluggish and the weight gain was one of the major symptoms. My metabolic rate firmly sat in the toilet and refused to budge. And exercising and eating healthfully made no difference whatsoever. (And the heavy exercising made things worse by taxing my already distressed thyroid.)

Now that I knew what the problem was, I was faced with a decision. Meds or no meds (oh and another thing they don't tell you: even if you go on meds, that doesn't mean that you will lose any weight at all. And you know, if you have read any other posts here, that I chose the non-meds method.)

You have to understand, the weight gain wasn't the main reason I finally went to the doctor to figure out what the problem was (the lack of energy and a menstrual cycle that wouldn't turn off was what did me in), but it was up there. I didn't like that my body hurt. I hated some of my other symptoms, but the weight gain and the accompanying issues pressed on me as if I was doing something wrong by not taking the weight off.

That's the thing, I think. Somehow, I felt guilty for not being effective enough in my effort to control my weight and my body. To top it off, as I gained more weight, people started commenting on my appearance. "Lose some weight!" or "Why don't you get some exercise?" were just two of the milder things I heard in the street from complete strangers (of course any friend that said something like that to me would stop being a friend immediately, but that's another story). The people who took it upon themselves to "advise" me on my weight/health/appearance had no idea about my efforts to maintain or lose weight. The only thing they saw was a fat girl/woman and for some bizarre reason they felt it was within their purview to harass me about it (sometimes under the guise of "caring." One particular woman said, "You're so pretty. If only you would lose some weight.")

I am sure there are some people out there who would like nothing better than to lie around, eat cheesecake and gain weight. I am sure there are people out there who are perfectly happy with their weight (no matter their size) and who don't give a da*n about the fact that they are fat. And I'd love it if we lived in a world where people of different sizes were just that, people of different sizes. And no one would say jack to them about it. But the perception persists that if you are fat or heavy that you are only that way because you don't care enough to get off your fat butt and do something about it (and that they get to talk to you about it). Is that perception appropriate? No. Is it still prevalent? You bet.

The idea that I didn't/don't care about my health and my weight, is patently untrue. I tried. I tried, hard, to lose the weight, but with hypothyroidism, it wasn't going to happen. So, I have had to deal with the lack of energy in combination with weighing more. And here's the thing, when you weigh more, it takes even more energy/effort to do the simplest things. So, it's a double-edged sword. Not only does the hypothyroidism make you gain weight, but you also have no energy, and then because you are heavier, it takes even more of that already scant energy to accomplish just about any task. It's enough to make you want to tear your hair out. Oh wait, the hypothyroidism takes care of hair loss for you, because, yes, that's another symptom.

Here's an image of a typical hypothyroidic.

This body shape often characterizes people with hypothyroidism. Often, the person will be barrel-shaped with smaller arms and legs but with a big, rounded torso. The upper abdomen will sometimes protrude further than than the lower.

We tend to carry our weight in the middle. Often, the upper part of the belly is big while other parts of the body are well within what would be considered a normal range by the CDC. They say that the stress hormone, Cortisol can be responsible for fat that gets stored in the middle of the upper belly. (Here is more information on Cortisol: http://www.webmd.com/a-to-z-guides/cortisol-14668 and here is information on Cortisol and belly fat: http://www.webmd.com/balance/stress-management/stress-body-shape?page=3). This is the way I am shaped as well. Because of this, I have been asked many times when I'm due, as if I am pregnant. It's quite shocking really that people don't realize that this isn't something they ought to be asking about.

For some reason, a person's weight (or reproductive status) seems to still be a subject up for discussion.  It boggles my mind.

Regardless, what can we EZH* do about the weight gain? There are things. First and foremost, get more sleep. I don't care what you have to do. Figure out a way to get more shut-eye. First, it will help you relax and release some of the burden on your thyroid. Second, it will give your body a chance to repair itself. Third, fourth, fifth ... there are lots of reasons. It might sound counterintuitive but it's so very true. So, get more sleep.

Second, keep your exercise consistent but minimal. That means no major heart-blasting super nuclear aerobics that blow the top off your head. The most important thing you can do for your thyroid and your metabolic rate is to give it time to recharge. Big, explosive exercise will kick your metabolic rate's butt straight into that commode from above. Do a little bit of exercise every day and consider doing whatever exercise will make you calm. Raise your heart rate a little but not too much. (More on all this at a later time.)

Third, regarding your food intake. Oh boy does it matter what you eat! EZHs tend to crave fast carbs and sugar. I think we do that because we desperately need energy, at all times. It is crucial that you stop eating white sugar (and all sugar, if you can). It fools your body into thinking you have more energy than you do. Don't trust the energy you get from it. It's pulling its sucrose-y wool over your eyes. Here's another counter-intuitive idea. Eat slower foods, in general. Instead of white rice, eat brown rice. Instead of white bread, try not to eat any bread and if you must, make it the really crunchy whole grain stuff. It will take longer to digest but it will give you better long-term energy. No, it won't be the quick fix, but the quick fix just leaves you desperately burning for more quick-fixes.

And that's the crux of it. Dealing with my thyroid issues naturally is a long-term proposition. There is no quick fix. Even meds won't be a quick fix. It takes consistent, daily work. I find that it's taken a daily commitment to myself. It takes me away from other things I could be doing, but it's worth it. The changes in my exercise regimen, awareness of what and how I eat, sleep patterns, and stress levels have raised my energy, brought the weight down, and gotten me *this* close to normal range. Oh how I will celebrate when I get there.

Until next time. Izolda http://IzoldaT.com

*Exhausted Zombie Hypothyroidics

Stress: the Thyroid's Enemy #1

Stress! It kicks all our butts. They've done studies about which countries are the most stressed out and hey the USA is close to the top of the pack (I'm shocked. Shocked, I say! Not.). Here are some numbers from the Expat Channel. A list of the four most stressful locations to move to: South Africa, USA, Australia, Southern Cyprus. According to Forbes, the most stressed out cities in the USA won't surprise us: They are (in order): Los Angeles, New York, Chicago and Washington, DC. There are also studies on the most stressful jobs. 

People are out there studying stress because let's face it, it's a killer. (In case you need more proof, here's a list of scholarly work on stress and heart disease. I know I could find other ways in which stress kills, but I'm sure you get the point.) Here's an American Psychological Association study that links stress directly with depression and obesity. "And respondents who reported higher levels of stress were more likely to be obese or suffering from depression." (This is from a yahoo article about the study.) Another shocker: stress leaves you depressed and makes you gain weight.

Here's the thing: Two of the most prominent symptoms of hypothyroidism: (unexplained) weight gain and depression. So far, no studies have confirmed the direct link between stress and hypothyroidism. But, I'm here to tell you that I think it just hasn't been discovered yet. In my personal tale, the only time I ever go deeply hypothyroid is during stressful times in my life. At my most stressed out, my TSH level hit an all-time high 83 (remember normal range is somewhere around 0.1-~4.5).

I believe stress kicks the butts of people with the potential to become hypothyroid straight into the desolate land of the Exhausted, Zombie Hypothyroidics (yes, I know it's not a real word, and no I don't care, because I've written "people with hypothyroidism" way too many times already. In fact, I think from here on in, I will refer to us as EZHs.)

EZHs tend to gain weight easily and they have a hard time taking it off regardless of their exercise level or healthy eating habits. In my opinion, a lot of exercise (depending on the type you choose to do), will lower a EZH's metabolic rate even further. That will lead to less energy and more weight gain. Talk about irony... So, even when you do all the right things, if you are a EZH, you might just be making yourself worse, rather than better.

For example, they say that we should get 30 minutes of moderate-intensity aerobic exercise five times a week for optimal health (Here's the CDC list of recommendations on that). Or they want an hour and 15 minutes of vigorous-intensity exercise a week. But, and this is a big "but," intense aerobic exercise when the thyroid is already sluggish, makes the thyroid go into a tale spin (at least it does to mine and I don't know about studies on that so this is my opinion, here). Depending on what's causing your pituitary to pump out TSH (testing for Thyroid Stimulating Hormone [TSH] levels is the usual way medical professionals first test you for hypothyroidism and often what the diagnosis is then based on), you could be doing yourself damage by keeping up with a lot of exercise if you are an EZH. 

What's good for the goose, isn't necessarily good for the gander, here. EZHs need to look at what they are doing to raise their heart rate extremely carefully. Yes, we all need to exercise our hearts and our entire cardiovascular systems. No question. But, EZHs need to monitor themselves and not do too much (and that is going to be based on the individual) because I believe they will knock themselves further down the EZH Hole of Doom.

The same goes for the food we eat. We are told: eat dark, leafy greens. Yes! Let's do that. Let's eat lots of spinach. If you are an EZH, however, you need to watch your spinach intake. Spinach is a goitrogen. It contains substances that interfere with the production of thyroid hormones. Read more on foods to eat or not to eat, here. So, while regular people can and ought to eat spinach, EZHs might want to be wary of it. And the same can be said for other foods that regular people can and ought to eat. More on that later.

So, when EZHs are stressed or have gained weight or are depressed, we might reach out to exercise to help with that. We might start eating those dark, leafy greens. After all, that's what we're told to do. But, those very things can make things worse for us. So, then, we need to figure out what we can do.

First and foremost, Deal. With. The Stress. Alleviate what you can and try to handle what you can't. And breathe. Keep coming back to your breath when you start to feel like you are in that never ending loop of craptastic stress. Your breath can calm you down and get your nerves and stress levels under control. So, next time you find yourself in that "Crap! I'm perpetually reenacting the Luke Skywalker/Darth Vader fight scene from the end of "The Empire Strikes Back," (You know. It's the one where Vader tosses too many things at Luke and Luke just ends up flailing and failing.) just stop and take three, full, deep breaths. Stand or sit still for a minute and just breathe. You will feel a trickle of your own power and (dare I say it) sanity, return. That will alleviate some of the immediate pressure on your thyroid and your adrenals and that will help you take the reins again more calmly. Then, you can take this opportunity to take a stand for your own health, to lay claim to your own well being.

Take the power into your own hands to look at what you and your body need. It's incredibly empowering and can also be really frightening to stand up and take our own health in hand. I'm not saying ignore your medical professionals. I'm saying work with them. I'm saying educate yourself on the literature. I'm saying check in, really check in with your body. No one, and I mean no one, knows your body better than you. You live in it every day and you know your aches, your pains, your issues, your victories, your everything better than anyone else on the planet can possibly know. The thing is that sometimes, exactly because we live only in our own bodies, we start accepting our aches, pains, and issues as normal. This is my life, we might think, and this pain/pressure/fatigue, etc. is just how it is. 

Maybe other people experience it the same way and maybe they don't, but it doesn't matter. Your pain is your pain and your thyroid is your thyroid and ultimately, the person responsible for the state of your health is you. The doctors, the medical professionals, physical therapists, nurses, acupuncturists, faith healers, whatever - they can tell you the diagnosis, they can prescribe the meds, they can lay out your options, they can suggest what you should do. They can even tell you strongly. But ultimately, the decision on whether or not to follow the advice, take the meds, go on the regimen, get the treatment, stop eating high-fat food, stop eating sugar, start eating carrots, start exercising, read up on your condition, or do none of the above? It rests with you.

So what to do? I'm going to ask you to sit down, right now, and make a list. Write down the things that you enjoy doing, the things that relax you. Are they: reading? Walking? Listening to or making music? Seeing a movie? Meditating? Write them all down. Make the list as comprehensive as you can. Write down anything you can think of that makes you feel peaceful and relaxed. 

Are watching television, surfing the internet, or drinking alcohol on the list? If so, those are the three biggies, I would advise against doing. They all get you out of your body and what you need to do when trying to do things naturally is be absolutely in your body so you can note and acknowledge (and perhaps act on) your status and any changes. (If you want to share some of your relaxation activities, please comment here and let me know. I'd love to see them.)

Once you have your list, start choosing one or perhaps two to do every day. Do only what you can. Remember, you don't ever want to put unnecessary pressure on yourself or your thyroid. Take it slowly. Start small. If you only spend two minutes dancing like a crazed marionette in your living room (one of my relaxing rituals), you will reap incredible benefits by opening the steam valve, even a little. (More on opening the steam valve at later date.) Do the things that will help you relax and remove some of the stress on your thyroid. It will thank you. Mine has thanked me by coming down to a TSH level of only 4.79. I am this close, .04, from being in the normal range. And I'm going to keep working on getting it completely back to being smack dab in the middle of that range. It's more work but it's worth it.

http://IzoldaT.com

How I've Been Treating My Hypothyroidism: Yoga is One Way

(When last we met)

I had my diagnosis and had just gotten zinged with just enough energy to start my own campaign toward health. Since I had some energy, I was going to strike while the iron was hot!

Here's one thing they don't tell you about hypothyroidism. If it's bad enough, it might make the soreness you get from playing professional football look like you've been napping on bales of cotton candy - all day, every day (not dissing athletes, I promise. I'm just trying to make a point). Add to that the utter lack of energy to get your body moving to dispel the soreness and you have a potent combination.

The intense bone-deep aching in pretty much every part of your body just doesn't go away. I had been hurting like this, for years. I figured that was the way things were with me. My mom had (and has) similar issues with pain, and I thought it was my lot in life.

Imagine my surprise when I researched hypothyroidism and determined that the high levels of pain I experienced constantly were a symptom of my sluggish thyroid. I couldn't recall a time when I wasn't in pain. My back, legs, neck, arms, and shoulders, muscles, joints, tendons, pretty much everything hurt, all the time. And again, before I was diagnosed, I had lived with it for so long that I simply never gave thought to the fact that it might be something I could alleviate.

So now, I went into major research mode. I devoured everything I could find out. The symptoms, the signs, the treatments, the therapies - that knowledge became my heart's desire. In one book, after I read the depressing list of symptoms yet again (of which I experienced pretty much all), the author suggested a course of treatment that included a daily yoga practice.

"Yoga, huh." I thought. Sure, I'd heard of yoga. My mother had been a practitioner when we lived in Moldova in the former Soviet Union. I remembered seeing her lie on her belly and then lift her legs and a healthy chunk of her torso off the ground where she balanced seemingly effortlessly. I had thought it beautiful but it did not hold my interest. Instead, I chose aerobics and Tai Chi (more on Tai Chi in a later post). I had studied Tai Chi for a few years but my practice of Tai Chi had lain dormant for some time. Aerobics were my exercise of choice. And, I did aerobics (through VHS tapes made by Kathy Smith) every single day. (It turns out that aerobics were exactly what I *shouldn't* have been doing, but that's for a later post as well.)

So, yoga. YOGA! I did some research and purchased a Yoga VHS tape. You want to talk sore?? I hadn't know from sore. I thought I'd been in pain before I started doing it. Boy did I get a rude awakening. The main difference between aerobics (which I was used to doing) and yoga (which I obviously wasn't) was that in aerobics, I moved quickly but hardly ever consciously. The yoga tape, on the other hand, showed me a very different method. Doing the tape required slow, deliberate, and conscious movement. And the instructor didn't let you get away with *anything*. She constantly gave cues to keep your legs aligned, or your arms straight, or whatever was necessary in the asana (or pose). And you did everything, glacially. So, one asana held, meant resigning myself to straining, shaking muscles that made me want to die.

The first weeks my stiff, sore body begged me to quit, but I persevered. I kept with it and eventually (read about six months), I improved to the point that I was able to get through the tape without breaking down and weeping bitter tears onto my yoga mat. And, my muscles felt better. I wasn't in as much pain! (Here's the kicker, though. You lose any advances you make in yoga, and in feeling better, if you stop doing it for even a few days. So, once you start, you pretty much have to keep it going consistently. I believe there is some research on hypothyroidism and muscle tone [with slow build and easy loss] but I can't find the citations. Anytime, I've stopped for any length of time, I've paid the price, big time. This seems to hold more true for people with hypothyroidism than for others. Here's Mayo Clinic's list of symptoms)

Although I had left aerobics behind and embraced yoga, my numbers failed to improve a whole bunch. I hovered around a 14 TSH even though I was now popping kelp supplements with the zeal of an addict, and I had cut out spinach, broccoli and my beloved cauliflower. I also radically reduced tofu, another thyroid inhibitor (which made me cry because I *love* tofu).

So, I did more research and found out that asana that open your throat and chest are good for stimulating the thyroid. Okay. I bought my first yoga book and looked up any and all asana that worked that area of the body.

I will get much more into the asana I use and how to do them in a later post, but I wanted to give you at least a couple to review. The Yoga Journal has a great visual dictionary about asana and they have broken things down into their anatomical focal points. Here are their recommendations for asana to affect the thyroid. http://www.yogajournal.com/poses/finder/anatomical_focus/thyroid

I am not sure agree with all of them, and certainly a good few them are likely too challenging for a beginner.

(And before we go further, please note: pretty much anything you want to do that opens your throat and allows you to spend some time breathing and allowing the airflow to massage your thyroid is great.  [By the way, I know the airflow isn't actually directly massaging the thyroid. The stretch of the area combined with breathing seems to impact it and that's the best way I can describe it.] Something I do when I need a pick-me-up: I sit back in my chair, I look up, and I breathe deeply. I allow my eyes to softly gaze up at the ceiling as I stretch the area around my throat. Again, don't let the back of your neck pinch. Keep it long and relaxed. Thirty seconds to a minute, or ten long, full breaths ought to do.)

Now, I'm going to list a few asana that have worked beautifully for me, but first, a note. Opening your chest and your throat requires bending your back. However, bending your back does not mean pinching any of the vertebra. When you bend your back in any asana, you want to maintain a feeling of elongation in the entire back (which might mean you don't bend as far but that's okay). So, while you are doing a back bend that looks suspiciously like you have transformed into a pretzel, you still want to protect the back by keeping everything as long and relaxed as possible.

To me, yoga is about proper alignment, balance, strength, flexibility, and doing only what you can on that day. I encourage all my students to progress gently. Some days, you will rock a full pose, but on other days, you might want to go only half way. Reserve judgment about all of it. It's where you are today that matters. If you focus on what you are doing right now, in this moment, whether it's yoga or brain surgery or flying a spaceship, concentrate on that and not on what you could be doing better/faster/more.

So, here are a couple that have helped me a great deal. Remember. Start slowly. Do only what you can. Listen to your body. If it even thinks about hurting, stop. But if you do a little (with comfort and conscious awareness) you will be surprised at how well you do, eventually.

Sphinx Pose: (Yoga Journal Description: http://www.yogajournal.com/poses/2464#)

(Attribution: Creative Commons)

This is one of the first back bend poses you do when you start practicing yoga. The pose allows an opening of the chest and throat without creating much tension. To do the pose, lie on your belly with your legs flat and touching each other. The tops of your feet should be on the floor. (Note: for beginners keeping your legs flat and touching like that can be challenging. Do the best you can, but remember not to do it until it hurts. Start small.) Bend your elbows, set them directly under your shoulders and hug them into your sides. Inhale and left your torso and head off the ground. You will do a mild backbend. Keep the back of your neck elongated and press your hands into the floor as you gently open your throat.

The direction to open your throat might sound strange. It's really about focusing on the throat and imagining that it is bigger than it is. See you if you can become aware of the muscle bands around the area of your throat. They might be tight so try to relax yet engage them. Feel the stretch. Now, gently lift your lower belly off the floor by pulling the muscles of your lower belly toward your spine. Keep your eyes soft and looking forward and little above eye level. Concentrate on the breaths. Make them full and long. And see if you can feel the sort of internal massage your throat/thyroid gets while the air progresses over the area, while the area is being engaged/stretched. After five or ten breaths (whichever works for you when you try it), lower yourself back down on an exhale.

[Note: Here is a terrific book that takes you through yoga in a way that makes real sense. It's a progressive eight-week program that starts small and lets you move on your own terms and in your own time. It's Rodney Yee's "Moving Toward Balance." 
http://www.amazon.com/Moving-Toward-Balance-Weeks-Rodney/dp/0875969216/ref=sr_1_1?ie=UTF8&qid=1340835870&sr=8-1&keywords=moving+toward+balance (I'm giving the amazon.com link for it because there is a great description and comprehensive reviews.)]. I love this book. You don't need to do everything in it. You don't need to complete it in eight weeks. Again, do what works for you.]

Cobra Pose (Yoga Journal Description: http://www.yogajournal.com/poses/471#) is one of the best poses for thyroid stimulation. Fair warning: you might cough after doing it. If you look at the image, you will note that the back is pretty well bent in the full pose. At first, you might not be able to get all the way there. Please, don't hurt yourself trying. It is a challenging pose. To start, lie on your belly, and put your hands directly under your shoulders. With your eyes moving first, look up and allow your head to follow as you curve your neck and elongate your throat. Remember, keep aware of the back of your neck. You want it long and relaxed rather than pinched. Support your torso with your hands by pressing them into the floor. If you can straighten your arms, and move fully into the pose, that is terrific. If you are not there today, then go only as far as you can without hurting yourself. Be sure to keep the eyes looking upward and elongate your throat. Breathe five to ten deep, full breathes. When you are finished, lower yourself slowly back onto the mat on an exhalation. Cobra will leave you buzzing and stimulated and once again, you don't want to do it for too much or too long. Oh, and do Child's Pose after any backbend poses to release the spine and give you a cooling stretch in the opposite direction.

Hypothyroidism is a tricky bugger. Just when you think you've found the panacea, you find out that too much of a good thing really will kick your butt. That's exactly what happened to me. I threw myself into yoga (the physical aspects of it) but I didn't do much about how busy and tense I was. And even the busy-ness of my new mission of getting myself healthy took enough out of me that my thyroid remained sluggish and got a lot worse.

That's another thing they don't tell you. With hypothyroidism, the thing that will kick your butt? Staying (too) busy, active, and stressed.

Next time: Stress: the root of thyroid evil!

http://IzoldaT.com