[cathycnm]

in reply to: Eye exam was nonthreatening #1072527

Yes – There are lots of kinds of steroids. It has to do with carbon and fat and how the molecule is made of these. Our own ovaries make steriods in the form of estrogen. Anabolic steroids are the male steroids or androgens we often think of as "steroids" that build muscle, cause women to masculanize, and are abused. We could not live without steroids in our body – so there is a big difference between that and the misuse of anabolic steroids.

I have some good drops and ointments I use. They are going to see if my insurance will pay for punctal plugs. With post graduate school and a full-time job – there is a lot of eye stress and stopping to put in drops every hour or two and waiting to be able to focus again adds several minutes to my study time each day. And I am virtually going 80 hours a week most weeks so it would be nice if this was less frequent and my eyes were less bothered by the reading.

We also talked about correction for the lower lid swelling eventually – he said if I did do it, he would advise going to Denver to someone who does this well. I don’t mind the bags in some ways – but I do look sadder and more tired – and I don’t like that image. I think it influences how people see my personality. I don’t know – it will wait a couple years either way – so I have time to decide.

[cathycnm]

in reply to: Eye exam was nonthreatening #1072525

belldandy – Sounds like a good day for you. I see my opthamologist for a 6 mo follow-up (and for the #@#@ dry eye). Thanks for sharing your hopeful thoughts!

You are right – the glucocorticoid steriods are like the ones we make to deal with stress – and at higher doses, they help with inflamation. It is the androgens (male steriods) that athletes take and they are considered controlled substances like narcotics. Both are endocrine hormones but very different uses and actions.

[cathycnm]

in reply to: Anyone that tried natural methods/diet? #1073676

Melissa – The RDA for vit D is currently being looked at and is probably too low. The national osteoporosis foundation has guidelines on their site. I know we cannot post URLs here – but google it. There is a button for prevention – then supplements. Cathy

[cathycnm]

in reply to: Graves Disease and Osteoporosis #1072728

One more PS – I like to call calcium and vit D the building blocks. Again – osteoblasts and osteoclasts are the construction workers. For people with osteoporosis or osteopenia (bone less dense than normal but not yet osteoporosis) just supplying more building blocks (calcium and vit D) may not be enough. You may need meds to slow down osteoclasts and/or speed up osteoblasts. I had a couple health food folks tell me calcium and vitamin D alone would "cure" my osteoporosis (which is severe for my age). That is not true. I have actually been active and taken calcium with D for years. I needed to speed up the builders and slow down the distruction crew, too. Piling more bricks on the situation was not enough to speed the building. A bone scan is the only accurate way to know what degree of bone loss you have – and the tool used to follow progress. Had I just done calcium and D, as this well-meaning person suggested, it would have meant I would have lost a lot more bone. And once bone is lost – there is only one med on the market that will speed up the osteoblasts and that is reserved for severe forms of the illness and requires daily shots. So – best to catch it earlier. At the same time – speeding up the building or slowing down the distruction crew will not help if there are no building blocks. So – again – I encourage a bone scan and following with an MD – then use the naturals to supplement the treatment. I would give anything if I had asked for a scan 5-10 years earlier, before I lost so much bone. There is a real risk of serious disability in my future now – though I am hopeful that the new meds will prevent this. C

[cathycnm]

in reply to: Graves Disease and Osteoporosis #1072727

Elf – Sounds like you are boning up. There is some good info on supplements on the Ntl Osteoporosis Foundation site. The main thing in selecting supplements is that some calcium can be contaminated. Calcium citrate or calcium carbonate are safe. There are a couple of types of calcium that health food stores sell that is less safe. Oyster shell and one of the other ones carry more risk. So – I would suggest checking that. Otherwise – the mix sounds great!!! I lived in the healthfood store last summer when my endo put me on the low iodine diet before RAI – There is a lot of interesting stuff there. Just be wise – be sure you web search anything you are not familiar with and be sure to look for credible sites. Unfortunately, the health folks are out to make money just like the rest of the world and some of the claims are not correct. At the same time, I can understand the frustration with medicine. You are not alone with that. I, personally, like to balance the two but I do need to read a lot to be sure I am making wise choices. Sounds like you are off to a good start. Cathy

[cathycnm]

in reply to: Graves Disease and Osteoporosis #1072725

PS – Be sure you are taking a good calcuim supplement with vitamin D every day. Talk to your doctor – general recommendations for folks 19-50 are 1,000 calcium/day and if over 50 – it jumps to 1,200. Remember we cannot absorb more than about 500 mg at a time – so split dosages are more effective. We also cannot effectively absorb calcium without vitamin D – and the RDA is now 400 IU daily – but there is serious consideration going into raising that pretty significantly – so talk to your doctor about their own recomendations. Also VERY IMPORTANT – calcium can cause your thyroid replacement to be less well absorbed so you need to wait 4 hours before taking your calcium.

Weight bearing exercise – walking, running, lifting weights, etc – is also very important to our bone mass. It is really important to stay with a program of weight bearing exercise if you have or are at risk for osteoporisis. Astronauts have a very hard time with osteoporosis because of the weightless environments they often work in – so they have developed a lot of ways to counteract this – mostly resistance exercises. Cathy

[cathycnm]

in reply to: Graves Disease and Osteoporosis #1072724

Elf – You ask some good questions. Our bones reach a peak density when we are about 35 years old – from there out, all of us (men included) typically loose some mass every year. For women – estrogen is the major factor. Estrogen promotes bone density. When we go through menopause – estrogen drops because it is our ovaries that provide most of this hormone every month when we have periods. So, if your periods are more irregular (meaning you may not ovulating every month), then your estrogen may already be dropping. However – if you are past 35, you are probably dropping just because of age.

Bones are very alive – they are like any other tissue in our bodies. They are constantly breaking down and then adding new cells to replace the old ones. One type of cell (osteoblasts) build the new bone and another type (osteoclasts) break down the old bone. I think of construction workers – some knock down the old brick while others lay down new brick. In Graves (only when we are hyper) – the thyroid hormone speeds up the osteoclasts but not the osteoblasts. So – imagine we give a lot of coffee to those who break down brick and they speed up – but the ones building new go at the regular speed. That is how we loose bone with Graves – so once the stimulant (in our case, thyroid hormone) is normal – the two processes equalize.

I encourage you to talk with your doctor about a bone scan. With Graves and the possible break – it would seem reasonible. There are many good medications to help osteoporosis – this has really changed in the last few years, as we know a lot more about how bones work now. Many of these meds keep the osteoclasts from breaking down bone as quickly – and the earlier you catch this, the sooner you can slow down the process and the less bone you will be at risk to loose. With menopause in your future – this makes prevention of further loss even more important if you are already low. Good luck – let us know how it goes. Cathy

[cathycnm]

in reply to: diet/supplement suggestions #1072756

hwalter – If zest is a stength of yours, and it sounds like it may be, Graves has to be frustrating. I don’t think we can be at our vibrant level until our levels are stable. I feel exhausted all the time again right now – and tearful, angry, irritable. I really feel a shift in my happiness – and school along with a stressful job and less than optimal support feed that. At the same time – I try to savor a few minutes each day. Maybe just writing down 3 good things that happened that day each night before you go to bed (actually shown to be as effective as antidepressants). Or really savor something – be it a long bath, an ice cream, a glass of wine or whatever you enjoy. I need to take my own advise on this. Cathy

[cathycnm]

in reply to: Graves Disease and Osteoporosis #1072722

Liz – I concur with Ski. I would like to add that osteoporosis is something like 80% genetic – so most people with osteoporosis can blame their ancestors. That said – if you have Graves then that is a big risk factor in and of itself and can lead to osteoporosis.

I had osteoporosis first – was on treatment and failed to improve so that is when I went to the endo and we found the Graves. I had some symptoms – but had no idea. My TSH was 100% normal the year before. The med usually increases bone by about 10-20% in the first year. I increased less than 2% – so in my case the Graves may well have resulted in 8-18% less bone in less than one year!!! That may be overstated a bit because bone scans mid therapy can appear lower than the improvement. Still – that is a chunk of skeleton.

I don’t know your age – but menopause and the 5-10 years after are the times for biggest bone loss in women. So if you are in this window, have Graves and have the genetics for osteoporosis – that can result in big bone loss rapidly because there are lots of factors at work. Good luck – be sure they check your vitamin D level, too – many of us are deficient and need more than the RDA for supplement. I take some horrific dose everyday just to stay in normal range because I lack some of the chemicals to convert D to its active form in my system. But have your doctor guide you on dosages for vit D and calcium based on your blood levels because vit D overdose can cause toxicity. Good luck! It is a journey. Cathy

[cathycnm]

in reply to: diet/supplement suggestions #1072753

Interesting about muscle strength. I have a suspicion that I am on too much thyroid replacement at the moment. RAI in August –> hypo by early October –> high normal TSH by November –> normal (a little on the low side for my age according to endo) in January. I have stayed on the same dose since October. I am aware of the normal dose per kilo (1.6 mcg) and my dose is clearly more than that – more like 2 mcg/kg or a little higher. I am clearly irritable and tearful, and my eyes have been worse. I am exhausted. And for about a month – one of my theigh muscles aches during my walk. Last week, I pulled a ligament in this area just walking down the street – yes, it was cold out – but I was slow walking. Just – twang! (Honestly – I thought for a sec I had broken my hip!) I get a TSH next week.

As far as diet – I agree – eat balanced and healthy. It is important, as women, to take care of our hearts and bones, too. High protien diets are not the best for bones. Hearts like fruits, vegies and good fats. I have been aweful with school about eating too much fat due to eating out more. I get my lipids rechecked next week, too, because I had become moderate risk for heart disease on my last check in the fall. We are all hoping it was that I was hypo at the time. It seems diet is so important to health and aging. Cathy

[cathycnm]

in reply to: Anyone that tried natural methods/diet? #1073671

Diane – You raise good points. As one with osteoporosis and vitamin D deficiency (now being treated) that predated my Graves – I follow some of the new research on vitamin D. Some of it suggests that vitamin D may play a role in preventing cancer – and as an adjunct cancer treatment. I believe I read that when we are hyper, we have a lowering of vit D by 40% (I don’t remember which book but that # stuck out for me).

There are some studies that point to vit D as preventative against cancer – though at this point we do not know this for sure. It will be interesting to follow and see what we learn. As you stated so well, it takes many well designed studies replicated over time and different populations to really get a handle on what impacts what.

I would only add that RAI is very specific for Thyroid tissue and is not absorbed much (if at all) by other tissues. (My mom died of stomach cancer 2 years post RAI – but it was 50 years of smoking and over-use of alcohol for many years that we (the researchers) believe is the set-up for that gene to manifest. I would guess mom had pre-cancer going before she ever had the thyroid issues – I don’t know if RAI would impact a precancer but I guess it might be possible. To think one dose of something that has less iodine than a glass of milk would cause the same harm as years of alcohol and tobacco abuse seems far fetched. Now if we took RAI everyday for 20 years, my guess is the outcomes would not be so good ” title=”Smile” /> Cathy

[cathycnm]

in reply to: Weight Loss Success Stories #1073026

Elf – Good point. All weight loss gain is a matter of calories in vs calories burned. When we are hypo – our metabolisms just don’t burn as much. Fortunately, thyroid replacement hormone stabilizes this once our levels are stable. It is that our metabolizisms are slow for a while that is the problem.

I saw my PCP after RAI to talk about weight – and it was basically a reaffirmation to focus on calories in/calories burned. I thought about going off the antidepressant thinking that if that caused a 20 pound gain and hypothyroid caused a 20 pound gain, I could get in real trouble (I am 5’1"). I have exercised more this winter than ever – the snow and cold usually cause a cyclic decrease in exercise. This winter – I stuck with 8-10 thousand steps a day even when that meant taking my i-pod and dancing around the living room for 2 hours. I think I wore a hole in my carpet.

I think weight watchers is wonderful!!!! Great idea. Cathy

[cathycnm]

in reply to: Weight Loss Success Stories #1073023

erobinson – It is daunting. First, I will start with the lesson my dietitian mom taught me over and over – it takes 3,500 calories to make a pound of fat. So, 3,500 calories of extra food – or 3,500 calories less burned off when our heart and other metabolic functions slow. Think about it – that is a lot of calories. The best weight loss comes from adopting a lifestyle change we can live with forever – be it eating healthier or increasing exercise or both. For most women – 1-2 pounds a month is actually pretty good – I would say no more than a pound a week if you are not robbing yourself of nutrition. I always suggest talking with a dietitian, though, for an individualized plan. And of course – your doctor to be sure it is time to start the process.

That said – I can tell you that I put on my weight while I was still hyper. I was up 7 times a night and more irritable than an elephant with PMS. So – thinking it was job stress – I was started on remeron. I slept like a baby – I was exhausted enough that, with the med, I slept 12 hours a day. And my appitite increased. So, in about 2-3 months, I put on 15 times 3,500 calories. Spring came, and I felt good enough to cut the Remeron in two (I think I had SAD on top of everything else). I began to garden, hike – all my normal activities. By June – I was only a few pounds above my normal weight. Then was when the found the hyperthyroidism/Graves – from a bone scan that did not improve with the latest, greatest osteoporosis med. It was early and mild enough that I kept some physical activity going through the summer. I was blessed – because I know many cannot do this. I felt a race with not letting my bones get worse – so I balanced lots of mellow slow walks and frequent pulse checks to get through. I only slowed down when I was hypo and on beta blockers – which made my pulse so low it was a real cardiac risk. I have not lost any more weight. Part of me would like to loose another 5-10 pounds – but it is protective to be a little more on the high side with BMI with osteoporosis – so I now focus on just keeping my exercise enough to build bones and good nutrition (which has slid with full time work and going back to school).

That said – my pedometer has worked well. It gives me instant feedback on my steps and the calories burned. It works well for me. Others like the gym machines. I just really like the instant feedback with exercise – it is motivating. Again – be sure to check with your doctor on exercise and a dietitian can help on the diet side. My best to you – let us know how it goes.

[cathycnm]

in reply to: Eye plugs????? #1073097

Thanks Nancy – good to know. I have my humidifier right by my side now while studying – and my drops in a cup on the table (so my cat’s won’t play with the little bottles). I will wait to see what my opthalmologist finds. The humidity seems to be helping, too. I will let you know!

[cathycnm]

in reply to: Eye plugs????? #1073095

Thanks for all the great info. I had not thought about insurance – but I have very good coverage. Graves – always something new to learn about.

I did get a humidifier for the area where I study – I live in the bone dry western part of Colorado and I am sure that is not helping the volumes of small type reading. Funny – it was a year ago this month that I thought I had pink eye – that turned out to be one of my early Graves symptoms. There could be a seasonal component. I will also check my TSH in a couple of weeks as it is time and I really feel exhausted and irritable again. However, having sand in one’s eyes and spending every waking second either working or reading (except for my joyful 10,000 steps a day) could make one a fearce grump. Thanks – you have given me much to consider!

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