When I learned I was pregnant with our fourth child – Bibi – in early 2015, my doctor ran a full blood panel. The only abnormality was an elevated TSH level, earning me a hypothyroid diagnosis and a prescription for a synthetic hormone. I hadn’t experienced any of the symptoms of hypothyroidism, but some quick online research showed an association between untreated hypothyroidism and pregnancy risks, so rather than question it, I felt grateful that this insidious condition had been identified. Throughout my pregnancy, subsequent TSH tests and other tests to measure thyroid function were normal – the medication was working!
Don’t ask me what kept me so busy for the next 18 months (really, don’t ask me…it’s all kind of a blur now), but it wasn’t until a regular checkup well after Bibi had turned one that I thought to ask if I should still be on the medication. My doctor said we’d run labs again to be sure. I was shocked when I received a phone call the next day from the nurse saying that I should discontinue the medication immediately as my TSH had plummeted well below the normal level. She said my doctor wanted me to see an endocrinologist and provided me with referrals. I was surprised, I was nervous… but I was also skeptical. I just didn’t FEEL bad. For someone who was now dangerously HYPERthyroid, I hadn’t lost any weight, I wasn’t feeling sensitive to temperatures, and even chasing after 4 kids couldn’t zap the energy out of me. One of the most important things I’ve learned from my years of working with empowered patients is to be your own advocate, so I was determined to go into my appointment with a well mapped out history and some research under my belt.
“I am guessing your thyroid is completely normal and that you never even had hypothyroidism in the first place.”
As much as I tried to rationalize things, I’ll admit that it’s hard to argue with lab results. In the back of my mind, I worried that if my thyroid had run the gamut from hypo to hyper over the past couple of years it might be “burning itself out”. Luckily, before my inner hypochondriac could take the reins, I was fortunate to get in with a knowledgeable endocrinologist. We went through my history and lack of symptoms (he did question my shaking hands, but I assured him they were the result of being so anxious about my appointment) and I was shocked when he looked at me and said, “I am guessing your thyroid is completely normal and that you never even had hypothyroidism in the first place.” He went on to show me the little space on my chart where I had filled in my medications: Collagen, Super-B complex, Royal Jelly, a probiotic and biotin. I’ve often wondered if I should even list my vitamin regimen on a medical history; I figured it did more to show I was proactive about my health than it did to give any insight into it. Well, had I not listed biotin that day, I may have forever been treating a disease I didn’t have.
Like many women in the constant pursuit of thicker hair and stronger nails, I began taking the over the counter supplement biotin several years ago…around the time that the first test showed hypothyroidism. I stopped only after those amazing pregnancy hormones kicked in and gave me all-too-short-lived Pantene commercial locks. Once I had Bibi and began shedding like a St. Bernard, I returned to the highest dose of OTC biotin. I was also getting an extra boost from the biotin in my Super-B complex, whose ingredients I frankly hadn’t taken into consideration. As my endocrinologist – and numerous articles http://endocrinenews.endocrine.org/january-2016-thyroid-month-beware-of-biotin/ – shared, biotin is one of the binding agents of many TSH tests. It was perhaps helping my hair and nails look a little more lush, but it was also rendering my lab work completely inaccurate. Sure enough, after repeating the TSH two weeks after discontinuing biotin and again a month later, my levels were right in the middle of the range that is considered normal at the lab my doctor uses. My doctor said I could resume biotin as long as I discontinued it before any lab tests. Since you never know when something might happen in life to warrant a lab test, I think I’ll pass and just go for the fancier hair conditioners from now on. I will also never fail to list all medications – including OTC vitamins and supplements – on health forms. While this was a stressful few weeks, I am abundantly grateful for good doctors, smart friends and the wake-up call to be more mindful of what I’m putting in my body.