Hot Flashes vs. Hell Flashes

Here’s my story and I’m sticking to it.  Really I am.

Once upon a time I had hot flashes intermittently throughout my late 30s to late 40s.  It took THREE attempts to get off the combination hormone Estrogen/Progesterone, but I did!  After the third and final attempt, I was hot flash free after just over six weeks.  This final time I stopped hormones my mindset was different.  I embraced the burning ember feeling in my face, the formation of beads of sweat with the burning up sensation at night with cold shivers to follow.  I felt the heat rise and fall, reassuring myself this was a normal process when adjusting to being not so hormone-augmented any longer, hoping this feeling was transient.  The bothersome perimenopausal symptoms slowly faded, with the hot flashes and facial flushing being the last to go.

After this reprieve I decided to have my thyroid tested.  My TSH level (thyroid stimulating hormone) was barely elevated above the normal range of high — I was (still am?) sub-clinically hypothyroid.  I had some hypothyroid symptoms so my general partitioner put me on a low dose of Levothyroxine — 25 mcG to be exact.

For better or for worse, hypothyroidism is largely not under our control, [my emphasis] says Dr. Daniel Einhorn, M.D., an endocrinologist at Scripps Memorial Hospital La Jolla., who notes the disease is primarily genetic. Family history may be the greatest indicator of troubles ahead, but since so many people are undiagnosed, you could have a family history of thyroid disease and have no clue about it.

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After four weeks of Levothyroxine I felt like I had more energy.  Then just about six weeks into this medication regime I started to have WEIRD hot flashes — more like HELL flashes — periods where it felt like ice was dripping down my neck covering my back and upper arms while simultaneously feeling an inner burn. Nighttime became its own hell.  I couldn’t sleep through the night because I was sweated profusely. I was hot and freezing at the same time.  How was this possible?  I thought maybe these symptoms were from drinking coffee in the daytime and wine at night.  Ha ha ha!  Cute  me and my hypotheses!  These symptoms were different than those related to coming off the hormones.

I thought these problems instead could be from the Levothyroxine. 

If your thyroid is out of control, all of your efforts to curb perimenopausal and menopausal symptoms, like hot flashes, insomnia, weight gain, hair loss, and achieve hormone happiness will be for naught [my emphasis]. What’s more, your symptoms might not be perimenopausal or menopausal at all. So talk to your perimenopause and menopause specialist about your symptoms and when you’re experiencing them. It’s a great first step in determining if your so-called menopausal symptoms are really symptoms of an underactive thyroid.

Ellen Dolgen

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From The Awkward Yeti comic — Check it out!

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I broke the scored thyroid tablet in half and tried taking a lower dose daily for four weeks … the chest pain and palpitations stopped with this decreased dose.  Oh, did I forget to mention I was having those too — the chest symptoms?  Oh, and the hyperacusis  … read below:

Individuals with hyperacusis have difficulty tolerating sounds which do not seem loud to others, such as the noise from running faucet water, riding in a car, walking on leaves, dishwasher, fan on the refrigerator, shuffling papers [husband’s voice, his breathing or even his heart beating … possibly the sound of any new hair growth on his beard as well]. Although all sounds may be perceived as too loud, high frequency sounds may be particularly troublesome [good thing I am not married to a canary!].

By this time I’d had enough experimenting on my body and said “F-you Levothyroxine!” and stopped it.

I am sub-clinically hypothyroid and many people aren’t even medicated at the TSH level I had!  (I don’t recommend anyone stop their medication without consulting a real life professional … just so you know!)

Subclinical hypothyroidism, also referred to as mild thyroid failure, is diagnosed when peripheral thyroid hormone levels are within the normal range, but thyroid stimulating hormone (TSH) is mildly elevated. It is common, occurring in 3-8% of the population, and carries a risk of progression to overt hypothyroidism of 2-5% per year. There is no absolute consensus on which patients to treat, although there are some clear recommendations.

It took another four weeks until the weird hellish symptoms went away. In the meantime I kept drinking coffee in the daytime and wine at night — you know, a healthy balance!  I’m no longer having hot flashes or night sweats.  Hallelujah!  I feel fine and am off any routine medication.  So happy.  Hormones are just plain weird and their effects REALLY linger.

I have concluded that hot flashes from Levothyroxine’s thyroid-hormone effects are much, much, much worse than any hormonal perimenopausal symptoms — a very interesting comparison and an experience I don’t wish to re-experience.  On an interesting note, the Levothyroxine lowered my cholesterol though!

How Does the Thyroid Cause Cholesterol Problems?

Your body needs thyroid hormones to make cholesterol and to get rid of the cholesterol it doesn’t need. When thyroid hormone levels are low (hypothyroidism), your body doesn’t break down and remove LDL cholesterol as efficiently as usual. LDL cholesterol can then build up in your blood.

Thyroid hormone levels don’t have to be very high to increase cholesterol. Even people with mildly low thyroid levels, called subclinical hypothyroidism, [that’s me!] can have higher than normal LDL cholesterol. A study in The Journal of Clinical Endocrinology and Metabolism (JCEM) found that high TSH levels alone can directly raise cholesterol levels, even if thyroid hormone levels aren’t high.

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Why The Connection?

When thyroid hormone levels drop, the liver no longer functions properly and produces excess cholesterol, fatty acids and triglycerides. The liver, which metabolizes cholesterol, also has a key role in thyroid hormone metabolism. In addition, thyroid hormone serum level is very important for normal liver function. The liver in turn metabolizes the thyroid hormones and regulates their effects in the body. What’s more, thyroid dysfunctions are frequently associated with abnormal liver tests.

Another explanation for the thyroid-cholesterol connection is that hypothyroidism slows the body’s ability to process cholesterol. This processing lag occurs thanks to reduction in the number and activity of receptors for the bad LDL cholesterol. These receptors normally help metabolize LDL cholesterol. When the number of receptors decreases, LDL builds up in the bloodstream, increasing both LDL and total cholesterol levels.

Hypothyroidism also significantly changes the metabolism of steroids and other hormones that are made from cholesterol. For example, the hormone progesterone is made from pregnenolone, which in turn is derived from cholesterol. Likewise, vitamin D is produced through the action of ultraviolet irradiation on cholesterol in the skin. Hypothyroidism reduces the conversion of cholesterol into progesterone and vitamin D, contributing to total cholesterol load.

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Let’s just say that stuff quoted above EXPLAINS A LOT!

I had vitamin D deficiency.  I am now in the normal range (at least my Vitamin D is) after taking 10,000 units of vitamin D3 daily for three months.  I am eating oatmeal intermittently to help improve my cholesterol.  I simply can’t tolerate the thyroid medication.  I feel OK … but my ankles still have a slightly swollen butterfly appearance on the outer aspects.

Hormones are simply weird and mysterious.  Cats are also mysterious and often weird as well.

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