Fatigue has played larger and lesser roles in the course of this hypothyroidism experience but I can always feel its breath on the back of my neck.
For extended periods of time it permeated every aspect of my life. Working through strategies to manage around it and have a life in spite of its grip, I found ways to cope.
Since putting in a full day of work was an unrealistic goal, I started work first thing in the morning. That’s when most of my energy was available – provided by my morning Cytomel 25mcg dose. I had a two part problem: an underdose, and running out of thyroid hormone in the afternoon. I was clueless about this however. It sometimes still surprises me that my symptoms got so bad. I was under medical care on a dose prescribed by an endocrinologist. So my doctor didn’t think it was my dead thyroid causing my ill health and I was left on a bad dose. For a long time. And the underdose became an overdose, which caused a different type of fatigue.
I worked through breaks and lunches to get as much productivity out as possible before I crashed. If I stopped, and I did try it from time to time, I had a hard time getting the energy to get back to it. I never knew if I could work tomorrow. Sometimes I lost the whole day to fatigue before I even got going. It arrived and it sucked the life out of me.
Fatigue shows up when I don’t have enough thyroid hormone and when I have too much. It also shows up when I am taking T4 only, regardless of the dose. T4 needs to be converted to T3, the active hormone, and my body has a harder time doing it.
Having symptoms that appear with both too little and too much thyroid hormone isn’t uncommon, I’m finding out. I thought I was a freak of nature. For me, the quality of the fatigue is different for each and I’m learning to identify the difference. When I’m underdosed the fatigue is more like a perma-tired. Like a weariness from morning to night. I sleep longer. I drag myself through my tasks. Everything. seems. so. hard. That’s a familiar feeling for most of us with hypothyroidism – from any origin.
On the opposite end, the fatigue from overmedication has presented differently at various times in my life. Lately it’s more like a weird spacey place in my brain. I start getting really disconnected and forgetting things and then I start getting sleepy. Just really sleepy. Everything feels a little dull and I’m listless.
Flashback six or so years ago, and my fatigue from overmedication was more like a crashing all the time. A trip to the grocery store would exhaust me so much I’d be unable to put the food away when I got home. Often I would lie down to rest and just lay there. Not sleepy at all, but entirely spent. It left me without the energy to even make a decision, so profound was the dysfunction.
I had to plan out my day and knew exactly what I could do and what I wouldn’t be able to accomplish, or to participate in. Paying hard when I stepped out of line and did too much, I learned how to take shortcuts and simplify everything. Things had to run smoothly because I didn’t have energy for anything extra – anything out of the norm demanded more of me than what I had to give. My life was stolen from me; piece by tired piece.
Life today isn’t as ruled by the little demon. I’m learning and finding my way. My own way. I’ve spent so much time searching for the right dose and making mistakes but I’m getting better. I spend less time way up or way down there in the extremes and I recognize when I arrive at either destination. I’m now becoming aware when I’m approaching, and that feels like a powerful step in the right direction for me.
I’ve started daily walking in the last couple of years and can now manage twice a day walks of about twenty to thirty minutes each. There’s a nearby path where I like to walk, and it astounds me that a distance that’s easy to cover now was a milestone to reach two years ago. Deciding to invest in my own health, I bought a swim spa, and now swim about three days a week too. I’m a gentle exerciser. I still have to be mindful of not wearing myself out. But my life is much, much bigger than it has been in many years. I can count on my energy frequently and it’s allowing me to do things other people take for granted, like making plans with friends.
Gosh, if you’re not a thyroid patient and you’re reading that you’re likely thinking, “what??” How could it possibly affect making plans with friends. Here’s how: first you have the agony of the trying-to-figure-out-if-I’m-going-to-have-the-energy-for-this-event moment. That’s how it feels in my body. Like anxiety. I want to go, participate, attend, whatever but part of me doesn’t want to. It’s a lot to do in a day, or it’s travel, or it’s a full day of people, or… when it arrives I may not be feeling well. As hard as it is to cancel events, it’s harder to be faced with the reality that it’s yet another day I am unwell.
I spend less time these days calculating how much energy expenditure something will take and more time jumping into life’s moments. There’s a little more of me to give and a whole lot more to experience. Bit by bit, I’m moving forward.
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