Connecting the dots uncovers thyroid problem

It was during Super Bowl XXXVIII that I first noticed my heart racing. Usually it beats in keeping with the second hand on the clock, one beat a second. Now I was almost at 2 beats a second, a heart rate of 120 beats per minute - while at rest.

My life-long favorite team New England Patriots scored a winning field-goal with 9 seconds remaining and Janet Jackson had her costume malfunction. They could have had something to do with my heart beating so rapidly!

But that night as I lay quietly in bed, my wife put her hand over my chest and felt the pounding. “Are you still excited from the game?” she asked, concerned.

“No. I think something is not right. I need to see the doctor,” I told her.

A week earlier I had noticed that my trousers – I have worn waist size 32 for the last 20 years – now hung on my body loose and baggy like pajamas. I stepped on the weighing scale - I had dipped 14 lbs from 142 to 128. I was impressed, but a little concerned. I wasn’t really dieting; as always I ate only 3 meals, limited my portions and snacking, and ate to 75 % capacity. Another thing I’d noticed earlier was that when pointing to something on a computer screen, I couldn’t control a fine tremor.

I began to join the dots; it began to all add up. Over the past few months people at work seemed very impressed by my performance. The infection control nurse had remarked, “I can’t believe you send off emails at 4:30 in the morning, when do you sleep?” The fact was, I wasn’t sleeping very much. My home-office light was switched on before the newspaper delivery man made his early morning rounds. I had four major projects going in addition to full time hospital and administrative work. My body was going full throttle, every time, all the time.

At 8 AM the next morning I called my doctor - a kind man, and an extremely thorough internist. He said, “I have an opening at 10:30 this morning, can you make it?” I was there.

He asked, “Do you think anything in your lifestyle has changed? Have you been drinking more caffeine, coffee…?” I never drink coffee and my lifestyle had not changed. We agreed; we needed to do some blood tests – the basic tests plus a thyroid test.

Next morning, he called: “Just as you suspected, you are hyperthyroid.” This is a condition in which the thyroid gland, a butterfly shaped organ located in the throat area, is overactive and produces excessive levels of the thyroid hormone. The more common disorder of the thyroid is hypothyroidism –where there is lack of thyroid hormone and patients complain of fatigue, cold intolerance, weight gain and depression.

I had hyperthyroidism, and I felt like a car in overdrive with the idle set several notches higher. In hyperthyroidism, the body up-scales the metabolic rate, so you lose weight, the heart beats faster, the hands become clammy, and an overwhelming sense of nervousness and anxiety develops.

If hyperthyroidism in not treated, then exophthalmos develops - the eyeballs start popping out of their sockets. If it continues unchecked, the body can slip into a coma or the patient can have fatal consequences if undergoingemergent surgery.

I saw an endocrinologist. He looked at the numbers, palpated a nodule on my thyroid gland, measured my eyeballs and said, “you have Grave’s disease” Grave’s disease is an inherited disorder where the body makes antibodies against it’s own thyroid gland and then stimulating it to overproduce thyroid hormone.

I started taking the medicine and the thyroid hormone came into balance. I felt much better, though, a bit less productive. My heart did not race as if I had completed a marathon after one flight of stairs. As a physician, I experienced both, the power of a hormone out of control and a medicine that controlled it.

Last week, when I noticed that I had gotten slightly heavier, and I had several important deadlines looming, I contemplated cutting back on the medicine to lose weight and put my body back in overdrive. But, on second thoughts, I decided not to tinker with my thyroid gland and leave the doctoring to my doctor.

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