There are times in your thyroid life that your thyroid medications (no matter what type you take) may need to be changed or at least tracked. Sometimes these moments in life will only last a few days, other times it may be months and it may not even occur to you to check your thyroid medication needs.
1 CHANGE IN CLIMATE
This could be you have gone on holidays to a different climate, you have moved to a different climate, you are transiting through different climates or whatever the case may be. If you are suddenly in much hotter or much colder climate you may think to yourself that "oh I just don't handle climate changes very well because of thyroid disease" but that's not always the case. It could be a situation where you need more thyroid medication because it is colder, or you need less thyroid medication because it is hotter.
This may not be an issue if it's a short amount of time, however if you are for example going on an extended holiday to a tropical paradise and you live in the snow, you may need to speak with your doctor about adjusting your medication for the time you are away.
You may also live in an environment where the summers are super hot and the winters are ridiculously cold, in which case it may be that you need a different dosage for each season. So work with your health care physician and start paying attention to when your symptoms flare up.
If you are changing climates for longer than a week or two, talk to your doctor
If you struggle through winter or summer, talk to your doctor as you may need to alter your medication needs depending on the season
2 MOVING HOUSE
Moving house is one of the most stressful things you can do in life. It is up there on the official list of stressors with Divorce, Death, Separation and all those horrible things. Even if it is an exciting move and you are looking forward to it, the move is still stressful just organising the logistics of it alone.
Physically it is even tougher am I right? If you have moved your home before, then shout out to you because it takes its toll big time on our bodies.
Add to that you are moving to a different environment. So your body, your microbiome, your gut health, your allergies, your skin is set to the current environment you live in. When you move there are new plants, new bacteria, potentially hidden mould, or maybe you had hidden mould at the old place and you don't aat the new place.... there are so many aspects of how moving house could physically affect your body and your thyroid health.
So you need to be constantly checking in with yourself and asking yourself questions. Being a detective and picking up on any clues your body is giving you is priority after your move. How are you feeling? Are you feeling tired? Have you got the sniffles? Have you developed a cough? Have You.....????? Ask this question for at least a month after you have moved and check in with yourself to see where things are at. We always forget to ask ourselves how WE feel so this is a must!
A change of environment, bacteria, flora and fauna can all affect your thyroid medication needs.
If your moving is because of a death, divorce or other type of major life event, then the stress will also affect your medication needs.
3 MAJOR EMOTIONAL TRAUMA
It doesn't matter what the trauma is... death, divorce, seperation, something has happened to your child, to your parents to your home, or abuse and bullying or even a trauma that you have witnessed that happened to someone else, it will still leave a traumatic marker on you which causes major stress.
If it was an Acute situation that happened swiftly and you moved through it swiftly then there may not be a need for a change in medication however if it becomes a chronic trauma that you can't let go of then first of all - You need help to let go of that - but secondly you may need to adjust your thyroid medication.
Any stressor on your body WILL affect your body, because it affects your adrenals, and anything that affects your adrenals, affects your thyroid pathway. So when it comes to emotional traumas, if you still haven't let go of something that happened when you were 5 years old and you are now 55 years old you need to get help with that because there will be times that you relive that trauma in situations that remind your subconscious of the original event and you feel terrible and sink into depression, however it could be that the trigger has put a burden on your adrenals which in turn affected your thyroid.
Emotional traumas are tricky and you don't need to hold on to them. You absolutely can move past them however you have to be prepared to put the work in to do so.
Major traumas in life are tough, and we tend to forget the effect it has on our medication requirements.
Along with seeing somebody for the emotional issues, book a doctors appointment to check your thyroid hormones
4 PHYSICAL TRAUMAS
If you have been in an accident, you have fallen over, you bumped into something, you were in a car accident, fell off a horse a bike a fence, or more severe like a sudden heart attack they are all a stressor to the body and dependent on how long the recovery is you may need to tweak your thyroid medication until you are healed.
When you are in doctors appointments for the trauma, ask them to check your thyroid hormones while they are running the other tests.
Continue to recheck every 2-3 months until a year after the accident to be sure
5 ONGOING ILLNESSES
This could be physical, mental or emotional. This would include ongoing mental health issues also.
Chronic illness is categorised by the need for daily intervention to help that illness or issue for longer than 3 months. So if you require painkillers for longer than 3 months for an injury it would be classed as a chronic injury, just as thyroid disease is classed as a chronic disease and in most cases requires indefinite use of some kind of medication.
So any kind of chronic illness that is ongoing will most definitely require you to keep a track of your thyroid status, and any time you are having blood tests for the other issue, in most cases health physicians will also track the thyroid bloods.
Even if it is something like you have hurt your back and 3 months later you are still having problems and still require painkillers to climb up the stairs or sit for long periods you will need to keep an eye on your thyroid. This is because many pain medications are processed down the same pathway in your liver that your thyroid hormone or medication is processed which can cause a problem with the actual conversion.
So if you have an issue that requires painkillers for an extended time you may need your thyroid medication dosage changed while that is happening.
If you have a chronic illness (longer than 3 months) other than thyroid disease you will need regular checks
Any kind of ongoing mental, emotional or physical issues longer than 3 months will impact your thyroid medication needs.
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6 PUBERTY, PREGNANCY & MENOPAUSE
While these are all extremely different they all share something in common and that is times of high hormone activity.
I have included puberty because there are many children being born with congenital hypothyroidism now, to the point that they actually test the bubba's in the hospital, or children that are diagnosed young like my own mother who was diagnosed at 11.
It would be awful, particularly for a little girl to go through all the puberty issues with an undiagnosed thyroid condition or an under or over medicated condition on top of all the things we go through at this time of our lives. So do your girl a favour (although this is relevant to our young boys also) and if you already know they have thyroid issues, then keep the testing regular through that tricky puberty stage, for as long as you think is necessary.
In Pregnancy, if you have the Autoimmune version of Thyroid Disease then often this goes into remission during that time, but also that means when you come out of it you will potentially go back into it full swing straight after the baby is born. Generally doctors are on the ball with this now and test your thyroid every 6 weeks, which if you are like me and getting blood out of you is tough work, then it's a long 9 months! BUT it is important that we do this, as your thyroid health will directly affect your babies thyroid health.
When it comes to Menopause, if you are stressed in any way shape or form you will get the horrible menopausal symptoms. So if you are getting heat flashes, if you are getting irritable, if you can't sleep at night... you know what I mean... then it simply means you are too stressed for your Adrenal Glands to produce the hormones that your ovaries have stopped producing, because it is not a priority to your adrenals if it is having to pump out cortisol all day.
So if this is an issue for you, then you may need more or less thyroid medication until your adrenals are addressed or the stress in your life is lessened.
Any high hormonal times in your life requires your thyroid to be checked regularly
Pregnancy requires very careful monitoring every 6 weeks through gestation for the health of the child
7 SURGERY & RECOVERY
If you have followed me for awhile you will remember that 2 years ago I had a double knee replacement (thanks so much Lipedema!). At that stage I had reduced my thyroid medication down to about 75mcg (from my starting point of 250mcg for 20 years) of levothyroxine. Yes I take Levothyroxine, don't come after me.... I have actually tried all of the natural versions and ended up with severe depression. Thyroxine was the only medication that did not put me in that space. So they are not for everyone.
The whole platform of Thyroid School is about me sharing with YOU my journey and telling you that you are UNIQUE! It doesn't matter what this person or that person is doing, or what this person or that person is saying... you take what you need and you leave the rest for someone else. You have to know what works for you! For me it is Levothyroxine.
I went from 75 mcg and went back up to 150 mcg after surgery. It took till now, 2.5 years later working with my doctor, to get back to 100 mcg and it is getting lower with each test. I had another surgery last year (2022) that has seen 3 reductions since then. You can read about that HERE.
Generally with any surgery you are going to be taking painkillers. For me it was the hard core type for about 3-4 months and since those painkillers have to be processed down the same pathway in the liver that our thyroid medication goes, I was aware ahead of time that my dosage would need increasing in some capacity after surgery. It is not just the painkillers though, the shock of the surgery, the trauma, the pain and the fear are all implicated and our poor adrenals have to not only pump out the cortisol to cope with those emotions, but our adrenals are also our body's pharmacy when it comes to natural steroids.
Because I knew ahead of time that this would likely happen, I didn't beat myself up about it, I didn't get angry with myself that all my hard work had gone down the drain, I just knew, because I know my thyroid pathway, I understand what happens in the body so I knew it was going to happen and I let it happen and concentrated on healing my knees instead. Eventually it started coming down again.
Knowing these things are about being at Peace with your body and yourself because if you are not at peace with what is going on because you don't understand it, then you are going to add to the adrenal load which will make it pump out more cortisol.
Any kind of surgery requires a check of thyroid levels prior to, and after surgery.
Continue to check the thyroid until after all pain medication or other associated medicine has been finished.
8 MAJOR LIFE CHANGE
This could be a major emotional trauma such as divorce, separation, a death of a spouse or death of a loved one. A major life change might also mean completely changing your life such as up and moving to another country like hubby and I are planning. It will mean not just changing countries but changing cultures, money systems, lifestyle and diet. That is a massive life change where I will need to check my medication needs regularly once we arrive there and continuously for the first year at least.
Major life change could also be a change in jobs or career, a change in how you approach life, a change in belief systems such as joining a church which makes you feel fulfilled and happy and at peace which could result in the need for LESS medication. So it is not just the change, but how it affects you emotionally and mentally. Does it scare you or excite you?
Part of any life change requires a list (in my humble thyroid opinion) so on that list needs to be checking in with a new doctor (or existing) and checking in on your thyroid.
A major life change could be positive or negative, it doesn't matter which it is, you need to check in on your thyroid to see what's happening
Continue to check your thyroid more regularly than usual until the life change has well and truly settled down as you may go back to your original dose.
9. CHANGE IN DIET
We all do them right? You have probably been doing them since you first got thyroid disease in most cases. Even HYPERthyroid people have probably changed diets not so much for weight loss but in an effort to calm your symptoms, sleep better, calm the heart palpitations and that kind of thing.
If you change your diet and after 2 weeks you give up because you had a really rough 2 weeks it may have been potentially because you did not need as much medication anymore OR it didn't suit you and needed you to take more medication but you have give up because you think the diet isn't working or the protocol was making you feel worse. And potentially it could have been the diet - it may have been detox for example from all the things you removed or it could be your thyroid struggling to adjust. The thing is, the diet may have been perfect for you but you first need to get through that stage, the detox and check in with your thyroid.
A change in diet is a massive time for the thyroid and requires you to work with someone who will do blood tests and is onboard with support with whatever type of diet you have chosen to try. You will need assurance and back up that everything is ok and that any symptoms you are experiencing could be from a number of different sources and not just the "diet doesn't work for me".
Any change in diet can cause the thyroid to need more or less medication
Find a doctor that is supportive of your chosen diet and is willing to support you through your journey
10. CHANGE IN WEIGHT
When your weight changes by a considerable amount you will not require as much medication to "run" your body. It doesn't matter if the change was on purpose or not (although a weight loss without trying requires medical attention ok?), whatever the situation might be, if your weight has gone up or down significantly then you may need more or less medication.
If you have put on weight, don't sit around beating yourself up because you have put on 10kg or 20 lbs or whatever it is you need to get to the doctor. What will happen is if you have put on weight and therefore need more medication, if you don't get it addressed it will contribute to further weight gain because everything is going to slow down.
So really important to take a breath and face the fact that you have put on that amount of weight and therefore you need to get your levels checked, and even more importantly if you have lost that amount of weight without trying, you will need more tests than just your thyroid.
Weight gain or weight loss more than a couple of kg or lbs without trying requires attention and checking
Weight gain or loss can affect the amount of medication required and if not actioned can make you feel extremely ill and potentially lead to further problems
11. CHANGE IN EXERCISE
First of January what do we do? We join the gym, let's go walking, let's do all the things. We do this solidly for 3 weeks, we're doing great and then we start to feel CRAPPY! Is it the gym? Is it too draining on our already busy lives? Or is it because we need less medication?
When you state that the gym, or exercise routine is "making me really tired" can be a hyper symptom brought on by needing less medication. When you exercise your thyroid pathway runs better, your hormones get to where they need to be better and it reduces stress. So in as little as 3 weeks of consistent exercise you may need to have your medication reduced and if you continue, then it will need to be checked 4 times a year if you are doing this for the first time in forever. Sadly this is part of the deal of having thyroid disease, we have to take care of ourselves in so many ways.
If you are exercising and getting severely fatigued, you might need less medication
Everything in the Thyroid Pathway runs better when we exercise.
12. CHANGE IN BODY PRODUCTS
When I began getting "curious about my thyroid" and had started reading books (this was prior to home computers) from the library the first thing I tried towards thyroid health was changing my toothpaste out for one that didn't contain fluoride. And my medication needs DROPPED. I don't remember if I started feeling bad or was just due for a check up, but the next time I had my bloods checked after that I needed far less medication because the fluoride wasn't interfering with my thyroid pathway.
Our thyroid is a magnet for chemicals and anything we put on our skin soaks in within about 26 seconds, so if you understand that all the blood in our body goes through our thyroid once every 15 minutes, then everything we put on our skin, or in our hair is going directly through our thyroid which again, is a chemical magnet!!!
So heavy metals, formaldehydes, preservatives, and all those nasty things are going through our thyroid. For years I have used organic hair dye (Naturlique) but even then I finally decided it was time to let the grey happen and you won't believe the amount of regrowth that started from then.... even though it was organic!!
If you have found a natural product that you love to replace a commercial one and you have used it long enough (maybe 6 weeks) to know you are sticking with it, then it would be time to get your thyroid checked.
Chemicals are attracted to the thyroid and can slow down the pathway
After 6 weeks on a natural alternative for any body product, have your thyroid tested.
That is the 12 reasons or times that you may want to, or should, have your thyroid medication needs checked.
Not all times or all situations will require it, however your first thought should be when you start to feel bad, or crappy or really tired and you weren't feeling like that 2 weeks ago is "what has changed or happened for me in the last few weeks that could possibly have impacted my thyroid?" This needs to be your very first thought.
This is why Thyroid Disease is so tricky, because the times that you go to the doctor, it may have been 3 weeks since the event and you're fine now. Our thyroid goes up and down depending on what is going on in our life, with stress being a major driver in thyroid disease, so it is always going to be up to us to know when our body is letting us know we need help.