Thyroid Literary Challenge

This is an edited version of an earlier posting. This submitted for the Dear Thyroid contest - Thyroid Literary Challenge.

It was in the early 1990s when I noticed that I had a lump in my throat. I was still in Australia and only had a few weeks before I flew home, via Singapore and The Tioman Islands. I resolved that I would see my GP when I returned home.

Once back home I made the appointment and went along to the Doctor. He examined my throat and suggested that I might have a slight swelling, probably caused by over excitement after my year of traveling. Twit!

Another few months past and by this point I was back to work and feeling exhausted. I had numerous symptoms of Hyperthyroidism and demanded a referral to the Endocrinology department of the local hospital. The Doctor agreed and in due course I was given an appointment. The consultant was a nice fellow, who felt around then without me knowing what he was proposing to do, undertook a needle biopsy. It hurt like mad and I waited for the results. The verdict was I had a goitre, and therefore was suffering from Hyperthyroidism, but the cells could not be ruled out as cancerous and therefore surgery and the removal of the affected lobe was required.

After the surgery I was on Thyroxine and remained fairly stable for about 8 years, then started to notice that I had another swelling in the throat again. By this point I was no longer in Surrey, and was referred to my local hospital. The same process happened - a needle biopsy followed by the same diagnosis - another goitre and once again the cells could not be ruled out as cancerous and so more surgery ensued. Surgery always comes with a risk, after all the medics are not infallible, but surgery in the same spot comes with an increased risk.

Well that was two risks, but it needed to be done, and so I was admitted. The main risk, which would be to my vocal cords turned out fine.

Having had now the remaining lobe removed I was completely without any Thyroid. As it happens it is not possible to remove 100% of the gland, or in my case 2 x 50%, because of the location of the gland to the vocal cords & Parathyroid glands, but what is left is non producing.

So, now the problems started. With half a thyroid lobe I had been on 100mcg of Thyroxine, and remained on that dose for 8 years, with the remaining lobe removed I was to remain on Thyroxine at a dose of 100mcg. Logically it is not enough. I stated my case to the Doctor, who by now had passed from the surgical team to the medical team, who was less than supportive and I was discharged.

For the next 4 months or so the levels remained constant, and therefore I remained on 100mcg of Thyroxine. Then suddenly my levels became unstable, as did my general health. My pulse was so low I was almost readmitted to hospital. I was referred to the hospital. The Consultant, Dr P. Is truly a wonderful man. Firstly, he listened to me, discussed my treatment with me and after numerous tests, discovered that my absorption of the T4, Thyroxine was very poor. He prescribed T3 a drug called Liothyroline, which is not that commonly prescribed here in the UK. He was working as part of a drug trial based at a one of the UK teaching hospitals and did I mind being part of it. I actually could not feel any worse so I agreed. Within 3 hours, yes, 3 hours I felt so much better. My levels started to adjust and my symptoms changed.

I remained on the Liothyroline for 10 years, only stopping the drug in 2008. Since then I have continued to be, on the whole in good health.

The reason for my stopping the drug was the affects of the T3 could lead to other problems, and after 10 years I stood a good chance of suffering from them.

I should point out that during the 10 year time frame I had always had always had the odd day when I didn't feel "quite right" and really I can not be more specific than that. Unless you suffer from the condition the feeling can not be explained. I still have the other symptoms, but they are nothing that I can not cope with. I have my bloods checked every 6 months and since 2008 have had my Thyroxine reduced to 100mcg from 150mcg. When this happened I noticed that I did not seem to have a lot of colds. Readers of this blog may have noticed that since November I have had 4 such colds, but this I have put down to the effects of stress from my last day job,as my blood levels taken recently show that I am on the lower side of normal!

The big question for me was understanding if Thyroid Disease was inherited? There is some evidence that it is. It can not be caught like a cold, but the auto-immune condition linked into Thyroid Disease can be passed down through family members. I am the only one in my immediate family with the condition. None of my extended family have the condition.

I have an obsession for my family history. During the course of my research, I have researched a family with the name of Butcher, from a rural village in Surrey England. My 3 x Great Grandfather John Butcher born 1795 had a family of 9 children born between 1823 and 1844.

During the course of the last 24 years I have met two people who descend from John Butcher. I descend from the eldest child Charles born 1823, I have met a contact whose wife descends from John's son James born 1835 and another contact whose line descends from John's son William born 1826. Our common ancestors are John Butcher and his wife Mary, who were both born during the time frame of 1795-1800. That is approximately 215 years ago. Is it possible that a condition can be carried through the genes over that time period?

Consider though, if the condition is passed down and I suspect that it would come through the female line as statistically it occurs more in females. I have had pharmaceutical treatment, two lots of surgery and numerous blood tests. None of which would have been available with the same levels of success to our early ancestors. We are the recipients of medical and pharmaceutical science, something that our ancestors could only have dreamed of. Even if it had of existed could my ancestors have afforded it? I know how ill I felt, so how would my ancestors have felt with the condition. There was no welfare state, to support them if they were too ill to work. They would have continued to work and live their lives with an undiagnosed condition. Food for thought isn't it?