My Thyroid Rollercoaster

I'm a bit mentally detached.  This is due to my roller coaster thyroid levels of the last year.  Here is a rundown of my year, indicating by month whether I was undermedicated or overmedicated based on how I felt.

August 2022 - under
September 2022 - over
October 2022 - over
November 2022 - under
December 2022 - under
January 2023 - under (even worse)
February 2023 - under
March 2023 - slightly under, felt normal for around 10 days at the end of the month
April 2023 - over
May 2023 - over (even worse)
June 2023 - under
July 2023 - under

My levels were just right for around 10 days out of the last year.  That is why I'm mentally detached and don't care one way or the other.  My books will sell, or they won't.  At least they are listed.  I have other concerns.

I go back to work on Thursday, August 10.  School starts one week later on Thursday, August 17. 

As of now, I plan to keep my stores open.  I have misgivings, which are increasing.  

In the middle of July, my medication was adjusted again for the fifth time since I had Covid in July 2022.  This is a slight dose increase.  I had trouble getting the prescription and had to go to mail order.  While I was waiting on my 81.5 mcg dose, I alternated between 75 mcg and 88 mcg, which averaged to 81.5 mcg.  It is okay to do that, although my body is so sensitive that it isn't ideal.

I started the new 81.5 mcg dose yesterday.  It's the same medication I have been taking (Tirosint) with the same four hypoallergenic ingredients.  My body shouldn't be able to detect a difference, yet it does.  My body knows that I've never taken the 37.5 mcg and 44 mcg (paired together to add to 81.5 mcg) capsules before, and I am already having a reaction even though I really shouldn't be having one.  My body is that extremely sensitive.  

Thyroid Update - Continuing to Seek the Correct Post-Covid Dose

I write these posts hoping that people seeking answers will stumble across them via their online searches.  The online thyroid groups and websites are full of misinformation.  Some of the information is helpful, but everyone is different.  I was extremely overmedicated in 2016 and 2017 and didn't realize the extent of it due to the widespread online content that indicated that everyone should have their T4 levels at the top of the range.  If I had known better, I would not have agreed to some of my medication changes during those years.  

I also now realize why I became so much sicker in 2014 when I started thyroid medication.  I had an increase in fatigue, aches, and pains plus a host of other symptoms that I never had in the first place.

It wasn't that I needed to take a bunch of supplements each day or that I needed to go on an extremely restrictive diet.  I didn't need to check my adrenals, detox my liver, or follow the dozens of bizarre suggestions that are recommended online.  

All I needed was to be on a clean thyroid medication. 

Tirosint, a name-brand version of levothyroxine, is a liquid gel cap with only four ingredients: levothyroxine, gelatin, glycerin, and water.  It is hypoallergenic.  Many thyroid patients, including me, are sensitive or allergic to the fillers used in all other thyroid medications.  We are forced to take medications that increase inflammation, thereby exacerbating our autoimmunity.  We then feel worse after starting treatment.

Generic levothyroxine (the first order of treatment) gave me terrible pain in my gums to where I had to go on a bland diet and could hardly bear to brush my teeth.  Even brushing softly with the most gentle toothbrush I could find caused intense pain.  I had awful aches and pains all over my body that I never had before treatment. The fatigue was far worse than before treatment.

Synthroid was the next order of treatment.  I was okay on the 50 mcg dose that was white with no dye added, but I soon needed a higher dose.  The 75 mcg dose had a dye in it that made me feel as if I had the flu for up to four hours each day.  During those four hours, I had a fever of above 100 degrees and felt very ill.  

I was placed on natural dessicated thyroid (WP Thyroid and later NP Thyroid) for a number of years.  These medications are considered the "be all to end all" by the online folks.  Not for me.  I was very allergic to them.  I had terrible itchy rashes that were nearly unbearable at times.  The rashes were so awful that I had to take four to six antihistamine pills each day to make the itching bearable.  Quitting the natural medication ended the rashes.

Now I am on Tirosint only.  My insurance dislikes Tirosint due to its high cost and will only approve it for one year at a time.  Each year, my provider has to give documentation that the other medications have failed.  One time the rejection letter was sent to me, and I found it a bit rude to be honest.  Insurance companies do their best to keep people ill.  It's infuriating.

Now to my update.

My thyroid situation continues to be problematic.  On July 14, I passed the one-year anniversary of getting Covid.  My thyroid levels have been screwed up ever since July 2022.  As I've said in past posts, that's exactly why I didn't want to get Covid...

Check out my TSH.  TSH is thyroid stimulating hormone.  For someone with thyroid disease, it should be at the bottom of the normal range, at 1 or less.  A rising TSH indicates that the pituitary gland senses that the body does not have enough circulating thyroid hormone.

Basically, my TSH has gone bonkers ever since I had Covid.  My immune system is in turmoil, and it can take one to two years for it to settle down.  I was in a similar situation back in 2016, and that took two years to resolve.

T3 is the active hormone, and I'm getting back to a good level.  The body converts T4 to T3.

T4 is the hormone that is produced by the thyroid gland.  My thyroid doesn't produce enough, so the Tirosint I take gives me the T4 that I need.

The T4 situation in my body is complicated, and I'm not going to attempt to explain fully.  I will say that I cannot have my T4 anywhere near the top of the range.  I believe around 1 is what I need, and that amount is too low for many other thyroid patients.  It angers me to see the misinformation in the online thyroid groups where everyone insists that everyone should make sure their T4 is near the top of the range.  If I did that, I would be miserable from being overmedicated.  

Most thyroid medications absorb at a rate of 60% to 80%.  Tirosint absorbs at about 100%, so patients can be overdosed if providers don't understand how cautious they need to be with it.  Many providers think that Tirosint absorbs the same as other medications, but patients need to be on a lower dose of Tirosint than they would with other brands of levothyroxine.

Thyroid patients are rather vocal about what they need regarding their condition.  This is because our condition makes us feel truly awful when the levels are off.  Being overmedicated and undermedicated are equally bad but in different ways. 

Levothyroxine is a Goldilocks drug.  This means that it must be dosed at the precise amount that the patient needs in order for the patient to feel okay.  This is hard to do, as you can see from my bouncing TSH level.  My medication has been adjusted five times during the past year as we continue to seek the precise amount that I now need post-Covid.

The vocal nature of thyroid patients causes general practitioners to think that their thyroid patients are difficult and have mental problems.  Their patients have results in the normal range, and they don't understand why the patients continue to complain about symptoms.  They don't understand that we tend to be allergic to most brands.  They also don't understand that each of us has a specific level within the very wide normal range which is the only place where we feel okay.  That specific level is different for every thyroid patient.

At each appointment, I am direct about how I feel and what I think I need.  I am fortunate that my provider also has Hashimoto's thyroid disease and works with me.  She has told me of the gaslighting that she suffered when she was diagnosed, and her bad experience led her into specializing in thyroid disease.  Sometimes I defer to her opinion, and other times, she goes with what I feel is right.  

In January, I was not on enough medication and had very low energy levels.  The fatigue was intense.  I was taking Tirsosint 75 mcg.  My provider prescribed Tirosint 100 mcg since I was doing so badly.  Oh, no!  If I were on one of the less absorbable versions of levothyroxine, that dose increase would have been fine. 

I said that I wanted to go with 88 mcg and that 100 mcg would be too much.  I instinctively knew it would be too much.  I know how well my body absorbs Tirosint.  She reduced the prescription to 88 mcg.  

I was correct.  In late March, I felt perfect.  88 mcg was the way to go.  Unfortunately, the additional thyroiditis caused by Covid then cleared up, and I became overmedicated.  I cringe when I think about how bad that would have been if I had agreed to the 100 mcg dosage.

I titrated down by skipping one dose of 88 mcg each week.  In early June, my prescription was reduced to 75 mcg, although I suspected that would be too low.  However, we needed to see, so I agreed to go down to 75 mcg.

I could tell very quickly that it wasn't quite enough.  By late June, I was definitely undermedicated.  I was getting tired more easily, and my gums began hurting.  My recent labs show the decrease in T4.  I requested that my dose be changed to 81.5 mcg (via Tirosint 37.5 mcg paired with Tirosint 44 mcg), halfway between my two previous doses.  My provider agreed and said that it's worth a try.

It could be that my thyroid is tanking again and that I do now need 88 mcg.  However, the high absorption of Tirosint makes me cautious, so I want to try the middle dose first.  Tirosint is the best thyroid medication for me as it has none of the horrific side effects I've had from every other medication, but I must be very cautious with these dose increases.  

I had a problem getting the new prescriptions filled.  This has happened before, so I've changed pharmacies several times over the years.  I end up at whichever pharmacy can get my specialized thyroid medication.  Here I go again.

The problem this time is that Tirosint 37.5 mcg and 44 mcg are new doses that have only existed since early April.  Suppliers aren't stocking them.  I knew that it take me awhile to call pharmacies in central Oklahoma trying to find one that could get those doses.  I didn't care to waste an hour or two with no guarantee of success, so I went with the Tirosint Direct program.  Highland Specialty Pharmacy in Hattiesburg, Mississippi, is a supplier of Tirosint through the Tirosint Direct program and is said to be the best source for Tirosint.

As I awaited the new capsules, I alternated the 75 mcg and 88 mcg capsules to simulate the 81.5 mcg dose.  I always have a variety of Tirosint capsules from past prescriptions and can use the leftover capsules when needed.

While I could have gone with a prescription for 75 mcg and 88 mcg and alternated, it's better for me to be on the same dose each day.  I can feel the difference when I take alternating doses.  On the days I take the 88 mcg, I feel hot for a short time.  That's a sign of too much hormone circulating.  I feel a bit cold on the days when I take the 75 mcg capsules, which indicates too low of a dose.  This variance tells me that I'm probably correct that I need 81.5 mcg. 

Before I conclude, I want to state that I don't feel bad at present.  I have some symptoms but am okay.  

June Thyroid Update

In past posts, I detailed what happened after I got Covid last July followed by the bivalent Moderna vaccine on September 23.  I have perpetual thyroiditis caused by autoimmunity, which means that my thyroid is always slightly swollen and never works at a normal level.

The combination of Covid and the bivalent vaccine caused a significant flare in my thyroiditis.  Last fall, I found an article on the CDC's website about how some people experience a six-month flare of thyroiditis after getting a Covid vaccine.  For that reason, I knew that the flare would likely settle down at some point.  That didn't help me in the short term. 

We had to increase my medication twice, in early December and again in late January.  I could barely function.  In early March, I still didn't feel that well, but my provider said that we needed to wait until early June to give enough time for my T3 level to recover before making further adjustments.  I'm glad that we didn't increase in early March, considering what then happened.

In late March, I began to feel better.  Around April 1, I felt optimal.  That was when I realized that I had just passed the six-month threshold after having received the bivalent vaccine.  That then meant that the thyroiditis caused by the vaccine was resolving.  And so it did...

As April progressed, I began to feel more and more overmedicated.  By April 28, I couldn't stand it anymore.  I was losing weight and had excess energy, tremors, heart palpitations, and insomnia.  I don't like wasting medication, so I decided to titrate down myself with what I had instead of getting tested and asking for a new prescription.  

I decided to skip one dose each week, which would gradually lower my dose to the next level down from where I was.  Thyroid medication has a half-life of one week, so it's okay to skip a dose once per week to titrate down.  How I feel at any given time is based on the previous six weeks' average medication level, since it takes around six weeks for each dose to completely clear the body.

Being undermedicated is truly awful with very low energy levels, but being overmedicated is also just as bad but in a different way.  It's terrible having too much thyroid hormone circulating.  I feel this weird pressure behind my eyes that is extremely unpleasant when I'm taking too much medication.  I also feel jittery and feverish.

In April and early May, I only slept around three hours each night.  One night I was so wired that I didn't sleep at all and ended up being awake for close to 40 hours before I was able to sleep, and even then not for long. 

I've been so hyperactive and distracted that I have had just as poor of motivation (maybe even worse) than when I'm undermedicated.  It really messes with the mind to be so wired that it's like I've taken speed.  Right now I'm sleeping around four hours each night.  That is somewhat of an improvement.

Despite skipping one dose per week, I still felt overmedicated until about when school let out on May 19.  I have felt off in a nonspecific fashion since then, probably because of starting summer break which likely improved my thyroid function even more since I now have no stress.  I have just started a new prescription at the next dosage down, which is what I was on prior to the second dose increase from late January.  I feel like I've been on a roller coaster since early April.  It's crazy.

I seem to be alternating between feeling overmedicated and undermedicated, and the instability will likely continue for another week or so.  Perhaps then I'll have an idea of whether I'm on the right dose.

March Thyroid Update

February 19:

I caught a virus around February 4, and it caused a significant autoimmune flare.  I got a little better, but then the extra website work of last week has caused another flare.  I thought my memory was bad last month; now it's even worse.  I am making a lot of mistakes.  I have cringed about a few online gaffes from the last week.  Oh, well.  I've gotten pretty used to embarrassing myself during flares and even sometimes when not in a flare.  

My next thyroid appointment is on March 7.  I feel certain that I am once again at a deficit and think it likely that my medication will be increased again.

March 16:

It didn't help that I caught two viruses in February.  The first virus from February 3 had mild symptoms but definitely impacted my thyroid levels.  I felt the hit.

The second virus from February 18 had moderate symptoms.  I had a lot of congestion, which lingered for around two weeks.  I didn't notice an impact to my thyroid.  I suspect that I was probably already so messed up from the first virus that any further impact from the second virus was negligible.

My thyroid levels were tested on March 6.

My TSH has come down.  Ideally, it should be no more than 1.  It is slightly higher than 1, but it's close to where we want it.  TSH is Thyroid Stimulating Hormone.  It increases when the body doesn't have enough T4, and it decreases as the T4 level improves.

My T4 level has improved, which is why the TSH decreased.

The problem is my T3, which has dropped.

I believe that the low T3 level is the sole cause of my mental stress.  I don't have enough thyroid hormone circulating in my brain, so my mental state is not that great.

I quit taking NP Thyroid in early December, which is a natural thyroid medication containing both T3 and T4.  I am now on T4 only.  The removal of the T3 in my medication has caused my level to drop.  My body should gradually adjust as more time passes.  The body converts T4 to T3, which is the active hormone that makes us feel good.  My body hasn't started doing that again like it should.

The viruses didn't help the situation, either.  Viruses impact conversion of T4 to T3.

I may need to add a synthetic T3 medication, but my provider wants us to give my body a little more time to recover from the two viruses.  Once more time has passed, we'll test again to see how I'm doing.  I have started taking a few supplements that are supposed to help with conversion of T4 to T3 in hopes of speeding up the process.  

That's where I'm at right now.

In summary, I feel like I can handle having my eBay store open.  I can fulfill any orders that I receive.  I hope that I do receive a number of orders, since my eBay shelves are packed.  In time, I will reopen my Etsy shop.  I will eventually begin listing new items for sale, but that's probably going to be awhile.

I look out for myself first, of necessity.  I didn't use to do that.  Now I know better.  Always be kind to yourself, and remember that you can always say "no" if a task is more than you can easily bear.  

The Irony of Covid Doing Me a Favor

With recent developments, I want to revisit what I thought happened and give my current perspective.  I continue writing about this in case the information is helpful to anyone who should run across it in the future.

This is from my November 12 post:

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...

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.

When I came down with Covid on July 14, it wasn't bad.  My thyroid took a hit for a couple weeks, and I seemed to get better.  I now think that my thyroid didn't recover. 

I do recall that I had intense hunger during most of September, to a degree that I hadn't experienced in many years.  I used to be intensely hungry all the time before I was put on thyroid medication nearly 10 years ago.  What I experienced in September was odd considering that I was supposedly stable on my medication.  The intense hunger started a few weeks before I got the bivalent Moderna vaccine.  The hunger wasn't caused by the vaccine, so my levels must have already become unseated.

I worsened noticeably after I got the bivalent vaccine, so it was also a factor.  However, Covid itself started the flare that worsened with the vaccine and then significantly worsened during the last two weeks.

I was stable on Tirosint 50 mcg combined with NP Thyroid 45 mg for three years, the longest I have ever been on the same medication.  I had intermittent hives for the entire time I was on NP Thyroid and suspected that the NP Thyroid was the cause.  I put up with the hives because I didn't want to have to go through the difficulty of switching medication and then months of trying to stabilize.

In early December, my provider agreed with my request to drop NP Thyroid and change to Tirosint only.  My Tirosint dose was increased to 75 mcg, and I quit taking NP Thyroid.

The hives continued until right around Christmas when they began decreasing.  Since then, the hives have continued to steadily decrease and then disappeared a few days ago.  I have no doubt that the hives were tied to the NP Thyroid.  

My T3 and T4 levels have improved slightly since switching my medication.  However, my TSH, which indicates whether my body is getting enough hormone, has increased significantly.  That is, significantly for me.  My numbers are never very high.  Apparently some people can have a TSH in the hundreds, while mine is always in the single digits.  More about that later.

Since my TSH went up, that means that I'm not getting enough hormone.  I am now taking Tirosint 88 mcg.  We will reassess in early March, and I may have to go up again.  Changing thyroid medication is a hassle since it can take months to get the dosage right. 

I want to share my test results since the average doctor would think that I am just fine and need no medication.  My levels are normal, yet I am quite ill.  The thyroid lab ranges are too wide, which is why many thyroid patients remain ill and untreated. 

Most doctors don't test the T3 free level.  T3 is what gives us energy.  Mine has been decreasing during the last three years, but I've been overall okay.  My body thought it had enough hormone.  When you look at where I am now, it seems okay.  I am not okay.

Always click on images to see them clearly.

Most doctors do test the T4 free level.  T4 is the inactive hormone that gets converted to the the active hormone, T3.  My T4 is down at the low end of normal.  Most doctors would think that this is fine.  It's not fine.

My TSH indicates that my body does not think that it has enough thyroid hormone circulating.  This is where you can see that I have a problem.

Even so, I am barely above the top end of normal.  I am quite ill if my TSH is anywhere above a 1.  Most doctors think that a 1 is borderline too low.  Most thyroid patients need to be at the very bottom edge of the normal range in order to feel okay.  That is where I was for the last three years, even though my T3 and T4 levels were kind of low.  My body was happy with the hormone levels.  It's not happy now.

Unfortunately, many doctors believe that thyroid patients should not be treated unless or until their TSH is above 10.  Mine is never above 10!  Doctors doom their patients to being ill their entire lives.  When the patients complain that they feel horrible, the doctors tell them that their labs are normal and that they need to see a psychiatrist.  The patients then become very upset, just wanting to be believed.

In closing, I take all of this in stride.  I stuck with the NP Thyroid for way too long because I didn't want to unseat my levels and have to go through months of readjustment.  Getting Covid and then the bivalent booster blew everything up, so I took the opportunity to drop NP Thyroid. 

I'm glad that I did drop NP Thyroid, and I can ruefully thank Covid for placing me in a position to where I felt able to face the fallout from making that change.  I will continue to have some hives as a side effect of my condition, but they should be at a much lower level from now on.

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 started 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.  

Warning about Online Thyroid Forums and Website Misinformation

I have spent countless hours in the last seven years searching online about my autoimmune disease.  First, I do not take advice from people online; I do not believe what I read online unless I have very good reason to believe it; and I certainly don't mess with my medication like so many thyroid patients do.  I take it as directed.

I was very difficult to stabilize on thyroid medication.  It took six years for my endocrinologist to get me on the correct amount of thyroid hormone.  She was often perplexed at my levels.  One time, she reduced my dosage, and my levels went up.  Another time, she raised my dosage, and my levels dropped.  During this time period, she pointedly asked me exactly how I take my medication.  She thought I wasn't following directions. 

I take my medication each day on an empty stomach when I first awaken.  It is my first act of the day.  I wait one hour or more to ingest anything other than water.  I wait four hours for supplements.  I learned through online searches how important that procedure is for thyroid patients, since just about everything reduces absorption.  I was first put on thyroid medication by my primary care physician, who didn't tell me any of those things.  So there is some good information online, but it's so hard to wade through the garbage.  

In the years when I was not dosed correctly, I spent countless hours reading other people's stories.  I was trying to figure out what was wrong with me and why my levels wouldn't stabilize.  I never did figure anything out during those years, but I did learn that thyroid patients need to be careful about believing much of anything that is on Facebook or on the popular thyroid websites.  

Before I continue, what happened with me was that my primary care physician had me on the wrong dose, causing more inflammation.  When I switched to the endocrinologist, she immediately changed my medication, which was wise, but I reacted quite badly to the medication she chose.  It caused a massive amount of inflammation.  I was then switched again several times, at least three times because of recalls and shortages.  I finally went through a relatively stable period on the medication that I am currently taking, and gradually, the inflammation reduced enough that my levels stabilized.  

Getting back to the thyroid websites, I finally figured out a couple years ago how wrong much of what they say is.  I knew all along that their commentary did not fit my situation.  What I mentioned in the above paragraph is not described anywhere.  Changing thyroid medications causes an autoimmune flare, which makes it hard for my levels to stabilize.  In the Facebook groups, so many people who don't do well on a medication claim that when they switched to another, they were immediately well.  Well, lucky them.  My body fights all thyroid medications really hard.  

When I am tested and find that my levels are slightly off, I prefer to stay on the same dose as my body gets offended at any change in thyroid medication, even a dose change for the same brand I am taking.  I prefer to be off some than deal with that mess for months.  And that just isn't accurately described by most people online.  They all act like changing to another medication is an instant cure.  That might be true for them, but it's very bad information for people like me.

These days I stay away from those websites as well as the thyroid groups on Facebook.  I occasionally visit the groups just to see what is going on.  I avoid the websites completely.  The websites are blatantly mercenary.  They also act like everyone is the same. 

According to those sites:

My thyroid hormone dosage is apparently never enough to treat anyone.  Oh, really?  Well guess what?  My thyroid actually more than halfway works.  That's why I don't need the high dosage that many other people do.  I would have a heart attack if I were to take the dosage recommended by the websites.  Much of the thyroid advice online is dangerous.  

Everyone's T4 level should be in the middle of the range and their T3 should be at the top of the range.  This is not true for everyone!  My levels were like that at one point.  I was so sweaty and wired.  I took a bath every few hours and could never get rid of the stickiness on my skin.  I could not sleep.  It was awful.  Both my T3 and T4 levels should be right in the middle of the range or slightly below the middle of the range.  I feel such scorn each time I see that stupid optimal T3/T4 chart that everyone shares.  I don't fit what it says at all.   

If one of those people should ever stumble upon this post, they'll comment and tell me that I'm wrong.  They'll say that the optimal T3/T4 chart is right and that they actually know better than me how I feel and what is right for me.  That's how bad it is.
 
I also felt scorn when I saw how the webmaster of one prominent site acted after a drug recall.  This person kept linking to a video of a song on YouTube as their response to each person who commented on the post.  I don't recall the song, but the title or content was such that it was supposed to be a way of trashing the company.  It was an odd response, especially to do it on every comment.  I lost respect for that person that day.  I think that person may have removed all of those video comments from that post as they don't seem to be there now.  It was a lapse in judgment for sure.

In the Facebook groups, everyone seems to assume that everyone is just like them or should be just like them.  It's so annoying.  Of course, that seems to be true of most everyone on social media, not just the thyroid patients.  

Let's talk about supplements.  Some of the supplement groups on Facebook are basically cults.  Be very careful about the supplement groups.  For that matter, be very careful about all Facebook groups that fall under the umbrella of heath.  There is one supplement group that I in particular think is very much like a cult.  I remain a member only because I sometimes check on them around once every couple of years just to see if they are still acting the same.

For another supplement, I am a member of several groups.  I think many people in those groups are obsessive about their supplement in a way that isn't healthy, although those groups are not as odd as the one I first mentioned.  I'm not going to say which supplements, since I don't wish to hurt anyone's feelings.

I will say that the people in these groups claim that the supplement has to be taken in a certain way, like with certain food or drink, in a certain amount, with a certain brand, and with certain other supplements.  It is quite restrictive.  Members in these groups often get upset, because they are overwhelmed with all the rules.  

Here's the truth.  Just take the supplement you want by itself.  Take it with food if it upsets your stomach.  Don't take it with a certain super-special food just because someone said so.  Don't take it with a bunch of other supplements just because someone said so.  

I have seen people's pictures of their supplements.  Some of these people take 20 to 30 supplements per day.  !!!

People who join the supplement groups tend to have autoimmune diseases, which means they have brain fog.  Blindly taking the advice of people with brain fog is a bad idea.

One last observation:  Searches on the Internet for various complications after a tooth extraction reveal results that are inaccurate.  The results are from dentists, so you think they would be accurate.  No!  The Internet is full of garbage.  If I am to believe what I have read, apparently how the extraction went for me was highly unusual and very few people have the kinds of problems that I have had.  Of course, I mentioned one complication to a colleague, and she nodded, "Oh, right!"  She had an extraction a couple years ago.  She had the same problem.

What I noticed is that every dentist has the same explanation, all copied from some source that is not accurate.  Ugh.