A Grave Situation

I knew I was pushing my luck.

A month or so ago I ran out of methimazole. I take it when I am out of remission for Graves Disease. It's an anti-thyroid medication. But when I ran out, I got careless.

I had been down to 5mg a day and my thyroid levels had been good. Things at work were busy, and I really meant to call in for a refill. Instead I delayed and delayed and after a while I thought I'd just let it go and see if I was in remission.

I keep track of my heart rate as the primary warning sign when things start going south. And over the past couple of weeks that and the usual constellation of symptoms started flaring up.

Elevated resting heart rate, difficulty sleeping, my hand tremor returned, it shows itself most strongly when I'm eating as I approach my mouth with the utensil. (When I was in the worst throes of Graves Disease back in 2005, I could not eat soup at all!) Then this past weekend, the irritability set in. Time to call for a refill.

I didn't want to talk to my endocrinologist about it, just wanted to get the prescription. I didn't want to get lectured, and I didn't want to have yet another discussion about doing radioactive iodine to eliminate the problem permanently.

Fortunately just a quick request online and I got my refill.

The reason I'm resisting killing my thyroid gland is partly because of my Dad's advice. He had Graves Disease in his mid 30s and had a thyroidectomy. Since then he's had to take thyroid supplements, that's nearly 50 years now, a situation he recommends against.

On top of that it's actually not the thyroid itself that is misbehaving. It's the immune system. You start producing something that ends up activating the same receptors on the thyroid as the TSH (thyroid stimulating hormone) that is pumped out by the pituitary gland. This immune system misbehavior comes and goes, and its arrival seems to follow very stressful times in my life. (1st a job change in 2004, then a very stressful situation at work in late 2007, then another job change late in 2008.)

So I figure if I can ride it out using anti-thyroids and get into remission and try to avoid excessive stress, I can keep my thyroid gland and avoid taking pills for the rest of my life. I figure it's better for my body to produce and regulate its own thyroid levels than to take a fixed dose of some synthetic hormone that needs regular monitoring to see if your using the right amount.

So it's back on the methimazole. But at least I'm lucky. My physiology is such that I do not get the eye component of the condition. (That did happen to my brother.) So no bulging eyes for me.

It's annoying to have to go back on it, but I'll take this over the nuclear cocktail, as my dad likes to call it. I'm kind of attached to my internal organs and would like to keep them for as long as I reasonably can.