When first diagnosed should one continue at work?

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Hi, I am a 55 year old Early Years Teacher and went to the doctor with heart at 125 beats resting. He sent me to A &E. There I had blood test and they came back overactive thyroid. From then was referred to the endocrinologist who said it was Graves. For many years I have had some of the symptoms but just put it down to the menopause. Have started n 30mg carbimazole and 20mg propranolol the latter twice daily. Feeling better in some ways no heart palpitations but in other ways worse. Have little energy, feel tired and a terrible mind fog in the mornings. Am feeling very guilty about having time off work. My work is very stressful as I have a big nursery and a high proportion of special needs children. Every time I try and work I feel not on top of the job. Has anyone out there had experience of how long one should struggle on or rest? P.S I'm sure that my stress at work has triggered this. I asked my endocrinologist and she just said see how you feel it's not serious!

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  • Posted

    Hello Gillian,

    Yes...I'm sure stress triggered it, as it triggered my overactive thyroid (I don't have Graves, however), and triggered others, too.

    I can get back with you further, but in the meantime, please look at the other discussion threads from both me (Veronica), and also Linda.

    Linda has recommended acetyl-L-carnitine (please read the details of what she wrote) and it has helped the individuals with Graves.

    I didn't have any results, but I don't have Graves, just hyperthyroidism (most likely "thyroiditis").

    Regardless, both of us have written quite extensively and have given lots of info regarding lifestyle, holistic health, mind/body connection, diet, viruses, inflammation, etc...

    Only YOU know that you're not feeling right. Don't let the doctors tell you it's not serious. It needs to be addressed, for sure. It's debilitating and takes away your quality of life. You'll need to start focusing on yourself a bit more. I know it's difficult, but those kids need a teacher who is HEALTHY and HAPPY!

    There is a product you may want to research. I got the perimenopause version (I'm 47 and almost, but not quite, to menopause). It's in a white box and contains organic maca root which helps with all kinds of hormonal issues. I've only been taking for 2 days but I'm feeling MUCH better. Of course, I'm doing other things, too. It can be complex and may take a while to figure it all out, but just be sure to listen to your intuition and educate yourself so you feel good about what decisions you make.

    FemmenessencePRO 180 vcaps ...search Forrest Health to find the site

    Also, I just ordered some products on amazon. Particularly, FOLATE (NOT Folic Acid!), and Curcumin (Turmeric), and an active form of vitamin B12...methylcobalamin. Look for high quality, organic, and bioavailable. You don't want to put cheap, potentially harmful, fillers in your body. And besides, poor quality supplements don't work!

    I can give you further info on the products I purchased if you want.

    Happy reading...there's a lot that has been shared!

    Veronica

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  • Posted

    Hi Gillian,

    I agree with you. I am sure stress at work triggered it because that is certainly what happened in my case. However, no matter what triggers it, once you have it, you have to take responsibility for doing all you can to recover and to take care of yourself, even nurture yourself. In my case, I dealt with the abusive co-worker by telling my boss I would no longer work for her. That didn't exactly materialize but at least she got the message that I was not her gofor and I would be happy to do anything for her if she spoke to me respectfully and asked respectfully. We also got her additional clerical help but my boss called her in and told her he would demote her if she didn't clean up her act as she wasn't fit to be a manager. She then took a course in leadership and the only time I had problems after that was when she was given too much of a workload and was stressed and I headed that off ahead of time by telling my boss that she did indeed need help but it wasn't clerical help she needed, so he got her appropriate assistants.

    So setting good boundaries is part of it and that is a skill you have to learn, (especially if you come from a dysfunctional family like I did).

    Even doing that though you have to address the medical aspects and your doctor has started appropriate treatment.

    I have posted on this Board before that though my symptoms of rapid heartbeat improved, other symptoms did not and my TSH did not until I added Acetyl-L-carnitine (an amino acid naturally found in the body but sold as a supplement in health food stores in Canada and the USA) to my treatment. I read a research paper by Dr. Salvatore Benvenga from Italy on the use of L-Carnitine for hyperthyroid patients. I am sure you can find it on the web. If you have difficulty getting this in your country, you can order it from the States or find it on Ebay.

    Initially I used regular L-Carnitine and that improved my symptoms somewhat but even though my TSH went from less than 0.01 to 0.05 (which was certainly in the right direction), I did not get normal TSH levels until I added Acetyl-L-carnitine to the methimazole I was taking. It allowed me to require less methimazole so I was able to decrease the dosage after discussion with my doctor. Others on this Board are finding that it was helpful also and Veronica posted a lot of information on other natural remedies that Graves patients have found helpful.

    It is helpful if you bring a copy of the Benvenga paper to your specialist or family doc and let them know that you have recently learned of how helpful L-Carnitine is to this condition but that you need his/her help in monitoring your thyroid blood levels a little more often as you can expect shifts in your values and improvements in some symptoms like brain fog and muscle pain very quickly. You might even ask for a blood level of L-carnitine to be measured to see if you are deficient in body stores of L-carnitine (I was and I think the disease itself causes the deficiency).

    If you are not feeling better, you may need to take time off in order to take care of yourself. I did not require that but my disease was caught early and once starting treatment and especially the L-carnitine, I was very functional.

    Hope that helps and if you do decide to use Acetyl-L-Carnitine, please let me know how it works for you.

    Thanks.

    Linda

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  • Posted

    It is easy in treating the hyperthyroidism for the treatment to cause it to swing the other way, or to feel worse just because your hormones are being suppressed too quickly. I don't think the doctors truly understand what they are doing but they just follow the recommendations of other doctors whose treatment practices are based on the same flawed thinking. --just my personal opinion.

    I know it can feel like you have to quit your job. I was just glad my husband was supporting me without my going out to work, anyway. But some people are able to continue work. I would just say that if you miss some doses of the anti-thyroid drug, be sure to inform the doctor when you see him afterwards. Don't be tempted to lie. They should know how the drug and the dose is affecting your lab results.

    Get copies of your lab reports. You should stay on the same dose of medication for 4-6 weeks between lab tests. What worked for me, once my Free T4 and T3 were within the normal range was to take 2.5 to 5 mg less per week, staying on the dose per week consistently for the 4-6 weeks before the next blood test. My TSH rose, I felt better able to cope with life, and the doctor was happy, too. I was eventually able to go off the Methimazole (MMI, much like Carbimazole), but when I felt like I needed supplements my doctor was unwilling to prescribe them.

    I also started out with 30 mg MMI, and 20 mg Propranolol, with instructions to reduce the MMI to 20 and discontinue the beta blocker after the first month. (My heart rate was also high.) Later, I was told to take my resting pulse and if it was over 80 to take the beta blocker again.

    A lot has happened to me in between seeing Endo #1 from 2009 to 2010 and now: A summer of rebellion against taking the medicine, Seeing Endo #2 from Fall 2010 to early in 2013, having been allowed to go off the MMI in December 2012. In May 2013, seeking a second opinion about supplemental thyroid hormones from another Endo (#3) an 8 hour drive away. [I am in the western US, and traveled out of state.] Having Endo #2 refuse to see me after that in June 2013. Having my primary care physician begin treatment for me with Cytomel (LT3). Then, on my 3rd blood test after increases to 7.5 mcg on that, and starting 25 mcg Levothyroxine (LT4) my TSH dropped below the normal range to 0.009 with Free T's still in the normal range, and my PCP insisted on sending me to another Endo (#4) who I have been seeing since January 2014, with one blood test that showed my Free T4 and total T3 in the normal range and the TSH having risen to 0.17 or so, (still not up to normal.) I am still in the middle of dealing with this new Endo's office, and I don't quite know what's happening now. I should be tested again on April 1st.

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  • Posted

    Fern,

    I can't remember if you had both Hashimoto's and Graves disease? If so, your treatment and results might be different than someone who just has Graves. I think Graves is difficult enough and someone who has both has a double whammy and a fine line to keeping results where they want them.

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  • Posted

    Linda,

    Yes, I have both types of antibodies, and I believe, like you, that the treatment should be different. I do feel like I am walking a tightrope, but as far as the endocrinologists are concerned, I simply have Graves' Disease and that is what they want to treat me for. They downplay the Hashi's antibody effect and really have never directly said that I have Hashimoto's Thyroiditis. I was tested for anti TPO and anti TG antibodies all along, but no one told me they were HT related until I went to Endo #3. Even Endo #4 and his colleagues seem to ignore the HT factor.

    I still think that it takes finesse to treat the thyroid, especially with both GD and HT antibodies, and it takes immediate response to changes in symptoms, but it is impossible to have that finesse when the doctors expect rigid compliance with their direction and want to direct it by remote control.

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  • Posted

    Ah yes. Training the doctors is more difficult than the disease.

    It helps if you get a doctor like mine who will write lab requisitions for you as often as you want so you can be in charge of managing your symptoms with his help of course. This has been especially important for me with the acetyl-L-carnitine because it was so powerful in changing my TSH values that it requires constant adjustment of doses.

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  • Posted

    Hi Gillian,

    I also felt guilty about taking time off work with Graves Disease. I was diagnosed after a blood test at my doctors but he wouldn't give me any treatment except for beta-blockers until I'd seen an endocrinologist. As I had to wait six weeks for an appointment I struggled back to work and hoped that I could just keep going. My job is very physical and also fairly stressful and I managed about two weeks before I had to throw in the towel and take some time off. I stayed off until I'd seen the specialist who started me on 40mg of Carbimazole and asked to see me again in four weeks. I didn't go back to work until after I'd seen her again.

    I felt a bit of a fraud because I didn't exactly feel ill if I was just sitting down relaxing. However, if I tried to do anything physical I struggled - I could barely drag myself upstairs some days - so I figured that I couldn't really do my job properly. When I went back to work, despite having an Occupational Health consultation, I was basically expected to do my job normally with very little allowance for the fact that I was ill so I was quite glad that I'd had so much time off.

    My dose has gradually been reduced and I'm now on 10mg of Carbimazole, which will drop again to 5mg in the next month or so. I'm hoping to get off it completely by August and see what happens with my symptoms. My levels are now 'normal' although I don't feel full of energy or my usual self.

    Don't ever feel guilty about taking time off work. Someone once said to me no-one on their death bed ever said "I wish I'd spent more time at work" and I think that's true! If there are financial implications to being off then that is a different matter but your health is important and you need to take care of yourself.

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