Medication Adjustment + Comments about Online Thyroid Discussions

My thyroid medication also has just been adjusted, which will cause deep fatigue.

I wrote this explanation in 2019:

I always feel better for most of the first week, then the drop begins.  I can feel the very beginning of the drop coming on.

This happens because the hypothalamus detects the sudden increase in thyroid hormone in the body due to the medication increase.  The hypothalamus then secretes a hormone that tells the pituitary gland to shut down the thyroid, which then makes the patient feel sick for two to five weeks or possibly even longer.  The lengthy adjustment period is caused by the long half-life of T4.  It takes weeks for the hormone to stabilize, which is why many thyroid patients feel bad for a lengthy period of time after any medication change.

I am four days in right now, and I can feel that the drop has started.  It's going to be a steep drop this time.  I will feel crushing fatigue and will probably experience brain fog and other assorted symptoms.  I do not use the word "crushing" lightly.  The worst fatigue I have ever felt is the fatigue that I feel after a medication increase.  It is extreme. 

I'll be okay.  It's something that I have to deal with periodically, and I will get through it.  I am really looking forward to winter break.  I hope that the worst of the drop is during those two weeks.

I don't mention this for sympathy.  I like helping people.  Sharing my experiences can help others who are being gaslit by their doctors.  Unfortunately, many doctors do not understand the thyroid condition and think their patients are mental. 

I am quite fortunate in that I'm being treated at an endocrinology clinic by someone who has the same condition.  She understands while most providers don't.  Interestingly, on Monday my provider told me a story about how she was gaslit when she first started medication.  Her body's negative reaction to the medication was dismissed as nothing.

On Facebook, experiences that are different from the "group think" get shut down.  I have only ever made one comment on a Facebook page where I told someone that it is normal to feel worse for a time.  Someone else responded, telling me rather harshly that what I wrote wasn't true and that my provider was an idiot.  I have never commented again on Facebook about anything related to my thyroid experiences.

On Facebook, people aren't allowed to be different from whatever the expected norm is.  We see it in all of the groups, regardless of topic.  It's annoying.  It really is like high school with all the silly cliques.

I have cautiously made a few responses on Reddit in the last week or so and was received well.  The thyroid discussion on Reddit seems to be less prone to the "group think" effect.

Once winter break begins, I might have a couple of listings available on eBay.  I have some Aquaphor ointment that I was using on my dry lips until I suddenly developed an allergy to it.  Of course my body would develop an allergy to something as mild as Aquaphor.

Averting a Dental Disaster

This is a story about how important it is not to wait too long to fix any developing dental problems.

In late August, I gave a final update on what happened with my dental implants.

What Happened with My Teeth and Some Advice

The two teeth that were extracted and replaced with implants were #30 and #31 on the lower right side.  Tooth #18 and tooth #19 on the lower left side have been a concern for several years and were on hold due to the two extractions.  Both #18 and #19 had large fillings.  Tooth #18 was missing the inner back corner, and tooth #19 was missing part of the front of the tooth and the inner side was worn down.  

During the 14 months that I had to chew on the left side only as I went through the implant process, I was worried about whether #18 and #19 would continue to hold up.  Throughout late 2021 and early 2022 I checked on the appearance of each tooth around once per month.  They seemed to be holding steady, for which I was thankful.

In June as my implant crowns continued to be redone over and over due to them not fitting, I noticed that the filling in tooth #19 was wearing down further.  It had had three little craters on the edges of the filling which were growing slightly larger but were still quite small.  This was not a good sign, but the changes were minor.

On July 7, I finally got the implant crowns and had no desire for any additional dental work anytime in the near future.  I had had enough.  I continued to watch #18 and #19 hoping that they would last until at least early next year.

I began checking both teeth once per week due to my increasing concern.  #18 seemed to have lost a small piece of filling.  #19 had worn down some more, but I thought that the teeth would be hold together a bit longer.

During the evening of September 14, I did my weekly check on both teeth.  I detected that tooth #19 had changed some more.  As I carefully studied its appearance with my face close to the mirror and with a flashlight shining on it, I became quite alarmed.  I felt that this could no longer wait.  I had no way of knowing how long the filling had before failure, but I felt that it could be down to just weeks or even days.

I have such vivid memories of the pain I had from the infected teeth in the summer of 2021, which peaked from June 29 to July 2.  That was the worst pain I have ever experienced.  I wanted to avoid having a tooth break apart.  I didn't want to have that kind of pain again if I could avoid it. 

Even though the last thing I wanted was more dental work, I called the dentist the first thing the next morning.  I was thrilled that an appointment was available just one week later on September 22.  Since I had a date, I decided to go on a soft diet to prevent the filling from breaking before my appointment.

I was told that my insurance was maxed out for the year due to my implant crowns.  That was no surprise, and I didn't care.  I felt that this was an emergency.  My guiding motto is that I will pay more for something if it will improve the quality of my life.  Getting the tooth fixed before the filling failed was more important than trying to wait until January in order to reduce the cost.

At my appointment, my dentist assessed both teeth.  She felt that tooth #18 was completely fine with no cause for concern.  She asked if tooth #19 hurt or whether it was sensitive.  I replied "no" to both questions but stated that I knew that it was about to fail.  She deferred to my opinion, and we proceeded with tooth #19.  The plan was to leave tooth #18 alone, since she felt that it was okay.

I always remind my dentist that my thyroid condition causes me to need more local anesthesia than is typically needed.  While I don't know how much I need, I suspect from my past experiences that I need more than double the amount that most people need.  My thyroid condition causes my body to metabolize substances abnormally.  Local anesthesia just doesn't do much for me.

The area was numbed, and my dentist started on the top of the filling.  I could feel the drill, although the pain was just very slight.  I knew what would happen if we continued.  She stopped after around 30 seconds and asked if I could feel it.  Since I could, she gave me more local anesthesia.  This how my dental work always goes.

Since my dentist had taken a little bit of the top of the filling, she could see the three breached areas of the filling in tooth #19 better.  She was coming around to my opinion about the filling, commenting that a single firm bite might have been enough to break it.

She could now see that tooth #18 had a cavity in the part of the filling that had worn down some.  That was the part of tooth #18 that had concerned me.  Before continuing with the crown prep for tooth #19, my dentist removed the cavity from tooth #18 and fixed that filling.  I could still feel the drill, by the way.  It was only slight pain, not enough to worry about.  While it wasn't enough to be bothersome at all, it showed that I still wasn't properly numb after two doses of local anesthesia.

My dentist then proceeded with getting tooth #19 prepped for a crown.  As she finished up, I was definitely starting to feel some noticeable pain, but it was still pretty low on a scale of 1 to 10, so I got through it fine.

So, was I right about tooth #19?

After my dentist finished prepping the tooth, she told me that when she started on the side wall of the tooth that the filling popped right out.  She said that I was right and that the filling would not have lasted much longer, no more than two months at the very most.

Whew!  Disaster averted.  I made the right decision.  The filling would not have lasted until my coverage reset.

The entire time I've played this waiting game with tooth #19 I knew that I couldn't wait too long.  I didn't want to get more dental work done, but I didn't want to have a dental emergency, either.  I played the waiting game as long as I could, and I quit waiting just in time.

In order to avoid having the temporary crown come lose, I chewed on the right side only until my October 13 appointment.  That was really difficult for me.  I chewed on the left side only for 14 months, and I still prefer the left side.  In several instances, I put food in my mouth and starting chewing away on the left side and then realized with horror what I was doing.  I stopped myself and switched to the right side.  Fortunately, the temporary crown stayed in place until my appointment.

I got my permanent crown on October 13, and it fit perfectly on the first try.  Yay!  It feels really comforting to know that my teeth on both sides are now in great shape and that for the first time in several years, I don't have to fear disaster whenever I chew.  

Dessicated Thyroid Isn't for Everyone

My immune system has gone bonkers since I got the bivalent Moderna booster on September 23.  I have heard of people having strong vaccine reactions after having had Covid, and unfortunately, I seem to have joined the crowd.  I had Covid in July, and I believe my immune system has gone into overdrive in an attempt to destroy the vaccine.  The upside is that I should now have very strong protection from getting Covid.  

I've been dealing with hives and the most intense itching ever.  I have memory problems and a poor mental attitude, the likes of which I typically see in a strong autoimmune flare.  The problem is that I'm not exactly flaring, at least not in a normal fashion.  I feel certain that this is from the vaccine.

My thyroid levels have been unseated from where they stayed for three years, and I have an upcoming appointment where options will be discussed.  I think my current medication, NP Thyroid, causes the hives due to it being derived from desiccated thyroid.  I'm considering asking for a complete switch in medication, which will completely screw my body up for 2 to 2 1/2 months.

I explained in an old post what happens when thyroid medication is either increased or when a patient switches brands.

I am four days in and feel better than I did on Monday; however, I can tell that how I feel has just started to deteriorate.  I always feel better for most of the first week, then the drop begins.  I can feel the very beginning of the drop coming on.

This happens because the hypothalamus detects the sudden increase in thyroid hormone in the body due to the medication increase.  The hypothalamus then secretes a hormone that tells the pituitary gland to shut down the thyroid, which then makes the patient feel sick for two to five weeks or possibly even longer.  The lengthy adjustment period is caused by the long half-life of T4.  It takes weeks for the hormone to stabilize, which is why many thyroid patients feel bad for a lengthy period of time after any medication change.

I have until December 5 to decide for sure, but I will likely request a change, thus beginning the horrible adjustment process.  This is why I have put up with the itching, which has not been bad for much of the time.  It's just that the itching is now so out of control that I'm about to lose my mind.  I'll take the deep fatigue and muscle aches instead, please.

I'm open about sharing this information because my experiences are not the ones that are prevalent in online groups.  Everyone online believes that desiccated thyroid is the only good thyroid medication and that nothing else works.  It appears to have given me hives off and on for years.  Not everyone gets on desiccated thyroid and has a perfect life.

What Happened with My Teeth and Some Advice

 From June 13, 2021:

Graduation was three weeks ago.  The ceremony was held outdoors due to pandemic precautions.  Of course it rained on us...  I dealt with it okay, or so I thought.  However, my autoimmune disease does like to betray me.  The very next day I began dealing with horrific tooth and jaw pain that was quite intense.  It has really settled down in the last week, so I think I'm going to be okay without having to get major dental work. 

My dentist wants to pull a tooth and put a crown on another in an attempt to solve the problem, but that's like throwing the baby out with the bathwater.  They don't think that an autoimmune flare could be causing the pain, but I know my body.

From July 10, 2021:

Both tooth #30 and #31 have been quite painful.  #31 has been a problem periodically over the years due to a crack in the tooth under the crown.  #30 has never been a problem, but it was hurting with #31.

My dentist wanted to pull tooth #31 since it is known to be cracked, see if that helped, and then put a crown on #30 if it didn't.  I declined to do anything last month since I was having an autoimmune flare and I had a suspicion that #30 was the real problem.  I didn't want to remove #31 and risk whatever that might cause.  I couldn't figure out the status of #30, so I did nothing. 

Three weeks passed.  At first, the pain went away.  And then it came back, worse than ever.  Tooth #30 became obviously infected (I'll spare you the details, but it was bad.).  Ah-ha!  I then knew which tooth was the bigger problem, just as I suspected.

I went back to the dentist where it was determined that both teeth need to be removed.  I felt like I was a fool for waiting, but my dentist thinks that I made the better decision.  This way both teeth can go together so that I have a shorter recovery time.  That's better than doing one (what would have been the wrong one to begin), waiting for it to heal, and then having to do another tooth.

...I had suspected that #30 was a problem in June, but there appeared to be nothing wrong with it.  #31 has the known crack and a small air pocket that hasn't changed in the last couple of years.  When I went back to the dentist for the infected tooth to be checked, it had changed in just three weeks.  It now has a large air pocket that goes down into the root.  It now has a visible crack.  Those two things explain the horrific pain.

I've been on an antibiotic, and I have the consultation with the oral surgeon this coming week.  Hopefully we can get the teeth removed soon.  While I hate losing teeth, I will be better off without them.  I cannot chew at all on the right side due to the pain.  Even chewing on the left side causes the right side to hurt.  It will be easier to eat once the aching teeth are gone. 

I do plan to get implants, so this will be a long process.  

From January 1, 2022:

On May 22, two of my teeth began to hurt and continued to hurt through the summer until they were removed on August 3.  The pain was consistently a 7 to 10 on a scale of 1 to 10...

I mentioned the tooth pain that began in May.  My tooth and gum pain lasted a total of 4 1/2 months.  The pain was intense.  Once the teeth were removed, my gums became very inflamed.  It was an autoimmune reaction exacerbated by the stitches.  In short, I ended up with burning mouth syndrome which lasted for around two months.  I lost weight during that time due to how painful eating was.

I got my dental implants on December 22.  This wasn't anything near as bad as having the teeth removed, but I can tell that the gum inflammation has started up again.  I hope that it doesn't turn into burning mouth syndrome and also that it doesn't last for two months.

That was the last time that I mentioned my teeth.  I expected all along that I would get my new teeth in either April or May, and I was going to write about it during that time.  The process did not go as planned.

The gum inflammation wasn't too bad after the implant procedure, but I did have mild burning mouth syndrome for a few weeks.

On April 11, the oral surgeon cleared me for crowns.  My dentist took impressions on April 22, and I was scheduled to receive my crowns on May 10.  

On May 10, I learned that the crowns did not fit, as in not at all.  It was rather disappointing, to say the least.  Five new impressions were taken and set back to the lab.  My appointment for crown placement was rescheduled for June 1.

Once again on June 1, the crowns did not fit.  They were closer, at least.  I was told that this does not normally happen.  I assume that it doesn't, but I will say that I have only ever had one crown before, the one placed on extracted tooth #31.  That one took three attempts.  So for me, crown placement does not go well, and I don't know why.

I did learn that the bottom of my mouth is shallow and that the impressions must not have shown that well enough.  An impression was taken of the bottom of my mouth.  There was also another problem that I'm not going to attempt to explain, but it was the lab's fault.

My crown appointment was rescheduled again for June 23.  After two failed crown appointments, I fully expected that the June 23 appointment would fail.  My attitude was quite pessimistic.  

I wasn't at all surprised to get a call from the dentist on June 16.  The latest crowns had arrived, and the dentist was certain that the crowns were still wrong.  I was asked to come in for more impressions.  I showed up 30 minutes later, and new impressions were taken.  More impressions were needed because the original ones were getting worn down.  The dentist told me that she was having a representative from the lab come and look at the incorrect crowns and the impressions.  They were going to make certain that the lab did the crowns right this time.

After that, I felt hopeful.  If a rep from the lab was getting involved, then surely the crowns would get corrected.  What seemed like my 5000th dental appointment was scheduled for July 6.

As an aside, I started using some toothpaste for bleeding gums around a week before my July 6 appointment.  I thought it was a good idea since my gums bleed and are so sensitive.  Interestingly, my gums began hurting terribly.  I thought I was having an autoimmune flare.  It took me around two weeks to figure out that the toothpaste for bleeding gums was irritating my gums.  I quit using the toothpaste, and within 48 hours, my gums were fine again.    

I showed up for my appointment on July 6, feeling hopeful but wary.  Fortunately, the crowns had finally been done right.  The crown placement took four attempts altogether.

After the crowns were screwed into place, my gums hurt, which wasn't surprising considering how sensitive they are.  I was still using the bleeding gums toothpaste at that time.  I felt a lot of pressure on the lower half of my teeth.  Tooth #29 was impacted the most.  It apparently shifted some and felt completely out of place in my mouth.  The dentist adjusted my bite, and the new teeth seemed okay.  I use "okay," but in that moment, I truly had no idea.

I found that it hurt quite a lot to chew on that side.  There was enough pressure that my front teeth even hurt.  The pain wasn't anywhere near the level of last summer, but it was causing me to have flashbacks to that experience.  The pain when chewing on the new crowns was towards the moderate side.  As a result, I kept chewing on just the left side as I had done for well over a year, feeling concerned about whether this was actually going to work out.

The teeth looked really nice.  I was happy about that.

At least once a day, I chewed a little bit on them.  The pressure did begin to go down after a few days passed.  I then ended up with Covid on July 14, and the teeth began to hurt worse from all the inflammation caused by Covid.  Gradually, the pressure began to lessen again as I moved past Covid.  It took approximately three weeks for the pressure and pain to disappear.

The crowns now feel fine.  It looks like my gums are beginning to fill in some around them.

I also want to mention how oral health has an impact on the heart.  I now have proof of this.  Here's my story.

Tooth #31 had a crack in the tooth under its crown.  I saw that crack in 2014 before the crown was placed on it.  The tooth was split down the middle all the way down into the root.  The tooth seemed okay with that crown.  I had periodic minor and sometimes moderate transitory pain from that tooth.  The pain never lasted long and didn't happen often, so I didn't worry about it.  I believe that the tooth became cracked back when I was young.  I have a vague memory of some incident from my late childhood or early teen years.

I believe that I first developed a thyroid problem when I was a teenager.  I do not believe that the cracked tooth alone caused the thyroid problem, but rather, it was one of several triggers.  I had mononucleosis when I was 19, and that illness is a known trigger for thyroid disease.  Thyroid disease also runs in my family, and I was going to end up with it eventually no matter what.  

I know that the thyroid problem started when I was a teen since that was when I began to get rashes on my wrists.  Rashes are one of my main autoimmune symptoms.  Also during my late teens, I began to have heart palpitations after eating high-sodium foods.  The palpitations worsened as the years passed.  

It was in 2001 that my still undiagnosed and untreated thyroid condition began to progress and in around 2011 that the symptoms deeply worsened.  In June and July 2014, my heart palpitations reached the point to where I found them to be unbearable.

I want to be clear that I had mentioned heart palpitations to doctors multiple times over the years.  I had been given multiple EKGs and even once wore a Holter monitor for 24 hours.  My heart was found to be normal each time it was checked.  No one ever wondered why I had palpitations.  All that mattered was that my heart was fine.

In July 2014, I went to the doctor complaining about my heart.  At that point, my heart was beating hard and fast 24 hours a day.  I was honestly about to lose my mind.  I was aware of my heartbeat every minute of every day, and I needed it to calm down.

Note:  I'm going to rate the heart palps on a scale of 0 to 5 during the rest of this post.  Level 0 is none, level 5 is what I had in June and July 2014.

I was given yet another EKG, which found that my overly enthusiastic heart was just fine as always.  I was put on a beta blocker to slow it down, and my thyroid was finally tested for the very first time.  That was when my thyroid journey began.  My immune system (the autoimmunity) was quite offended by the medication, and it took approximately six years for me to stabilize on thyroid medication.  It is common for people who have Hashimoto's thyroiditis to take years to stabilize.

My heart palpitations were not as bad (level 4) after I got on the beta blocker and after I was on the thyroid medication for a couple of months.  I didn't have the palps all the time like I did in June and July 2014, but they were still quite problematic.  Mainly, I had to be careful about sodium intake and had to drink a lot of water whenever I ingested salty foods.

During the eight years I have been on thyroid medication, the palps gradually reduced to level 3 and did not occur as often.

Let's get back to the teeth being extracted.  I noticed after the teeth were removed that I was having even fewer palpitations, let's say level 2.  Bad teeth can affect the heart.  I began to wonder if the cracked tooth was the underlying cause of the palpitations.  The palps had not vanished, but there was an improvement.  

I have noticed in this past year since the teeth were removed that my palpitations have occurred less and less as the months have passed and reduced to level 1.  I do still have an awareness of my heartbeat at times, but it is so much less often than it was before the teeth were removed.  I don't have to drink nearly as much water when I eat salty foods.  The amount of water required for salty foods has decreased greatly in the last year.

I have also noticed that my thyroid condition has further stabilized.  I am still on the same dose of medication, and I still have autoimmune flares.  I am in what I call my "back to school" flare right now.  Even though I'm in a flare, it doesn't seem to be as bad as what I used to have when school started.  It seems that removing the bad teeth reduced inflammation which in turn has made my autoimmune symptoms less severe.

I am also intrigued by the idea that the mercury in amalgam fillings may have an impact on the immune system.  The FDA has issued guidance that certain groups of people may be at risk for side effects from amalgam fillings.  

Extracted tooth #30 had a large amalgam filling through the top and another one through the side.  The one on the side had gotten damaged around five to seven years ago, which could have caused some mercury leakage.

I estimate that around 70% of the amalgam in my mouth was removed when tooth #30 was extracted.  I have just one small amalgam filling left.  If I am sensitive to mercury, then the removal of tooth #30 and the mercury in it could have helped calm my immune system.

I probably am sensitive to mercury since I'm sensitive to all sorts of stupid things like toothpaste for bleeding gums.  Most body lotion burns my skin including the ones made for sensitive skin.  I can't wear jewelry since I get rashes from the metals in it.  If I'm sensitive to metals that most people can tolerate, then why not mercury?

It's not a stretch to say that my amalgam fillings could have caused some immune problems.  Removing the amalgam filling may have helped, and removing the cracked tooth helped for sure.  A positive change in my autoimmunity occurred after the teeth were removed.  

In conclusion, the tooth known to be cracked for many years should have been removed 30 years ago.  Removing bad teeth is better than having to deal with a host of health problems caused by the bad teeth.