I's April! Time for a thyroid lesson.

Yup. Ignoring the blog again.

Might as well get used to it. I suspect a once a month post, maybe twice, might be all you get from me these days.

I can't say that my absence has been due entirely to being busy and living life. I find that I also get quiet, extremely quiet, when I am concerned. I was fairly stoic publically when I first learned I had breast cancer. I did not bring it up on my most frequented message boards. Only mentioned it on one of my many email groups. It really wasn't until the treatment was underway that I started to talk. Bizarre behavior for me because I am an open book. I talk about everything! Almost.

The last 2-3 weeks, I had some unusual for me symptoms. There's a rule of thumb in the breast cancer world. You wait two weeks and see if whatever the issue is persists. If so, then a metastatic work up will most likely follow. Fortunately for me, I decided to wait 3 weeks. 3 weeks is today. Today, there is a definite change for the better... so I am back. :) I'd like to attribute all of this to the dreaded anniversary reaction. I can't. But who cares? It's not an issue because it's getting better, not worse.

I'll also toss in that I just got back some more perfectly NORMAL blood test results. Well, not perfectly normal, but perfectly nonmetastatic normal. :D My thyroid function is actually hovering at the lower limits of normal. Which naturally led me to read up on thyroid function and tamoxifen. Those of you not on tamoxifen might want to move on to the next blog at this time. :)

Here's the deal. We all know about the complaints about weight gain and tamoxifen. My onc and others SWEAR that there are some women who actually have weight LOSS with this drug. My onc even thinks I am one of those women as I have lost weight on it. However, the amount of weight I lost and the amount of work I put into that loss do not match. I should have lost twice as much weight.. or more! I looked back at the calendar from 2005 and 2006 when I was actively working on weight loss. I actually lost 2-3 pounds most weeks! That would be a dream now. I am doing SO much more physical activity now than I did then and I am eating an even better diet. Still, no weight loss in over 2 months.

As part of my last round of blood tests, I had a full panel of thyroid tests. If your thyroid panel does NOT include a FREE T4, you are not getting an accurate picture. ESPECIALLY IF YOU ARE ON TAMOXIFEN. The typical (aka cheaper and more widely available) thyroid panel includes a calculated T4. One of the many things tamoxifen does results in an increase is the proteins that bind the functional thyroid hormone in our bodies. This will make the thyroid panel look normal when it actually is not... unless you are also getting a free t4 done as well. The free T4 measures the functional hormone that is available for use by the body. The hormone that is bound to protein is NOT available for use. The free T4 will give you a more accurate picture of your thyroid function. Even more so than a TSH.

Yeah.. I know that wasn't perfectly clear. I'd have to launch into a full lecture on how the thyroid and hypothalamus function and control metabolism and I have a ballet class to get to go today. And Pilates. If I can't lose weight, at least I can look toned. :) And without ovarian testosterone, building muscle mass is even more difficult, but that's another lecture!