I’m pretty sure I’m dying

By Mir
October 25, 2012

In case I haven’t mentioned it 72,000 times already, my hand is broken. I know, you haven’t heard this before. It’s totally new news! And so, complaining that my hand really really really REALLY hurts is also news. (Feel free to punch me in the face, now.) (Maybe it will distract me from the pain in my hand?) I have been a bit preoccupied with the pain in my hand, is my point. Because it hurts. DUH.

Unfortunately, life still requires that I do tremendously demanding things like get dressed, take care of my kid, leave the house for appointments, and work. Harumph. At this point, anything with a “simple,” no-fuss solution is a-okay with me. Basically the less that is required of me, the better I like it.

So when I was at the doctor last week and she said my thyroid was off, and she said she was giving me some medication, I thought that was fantastic! There was a problem; there was a solution; done. Perfect. (Also, I’m not gonna lie—it was vindicating to know I haven’t been imagining my symptoms.)

So this was all fine and dandy, right up until I went to see my therapist this week. And I got to spend the first part of the appointment retelling the “I broke my hand on an apple” story, as expected, so that was fun. And when I got to the part about going to the doctor for the orthopedist referral, I mentioned that yes, my thyroid really was being wacky, and I gotten a prescription for Synthroid. I then launched into a retelling of my orthopedist appointment, but my therapist interrupted me.

“Wait, wait,” she said. “Go back. What’s up with your thyroid?”

“It’s low, I guess,” I said. “She gave me a prescription.”

“How low?” she asked.

“I don’t know,” I admitted. “I forgot to ask. Maybe on account of, you know, MY HAND WAS BROKEN.”

“Okay,” she said, slowly. “Why is your thyroid level low?” I stared at her blankly. She tried again. “To what is she attributing the problem?”

“I… don’t know?” This was weird. How was I supposed to know? “She didn’t say.”

“Did she do any imaging of your thyroid?” I shook my head. “Order any additional blood work?” I shook my head again. She sighed, loudly. “Did she set you up with an endocrinologist for a follow-up appointment?” Realization was dawning. I shook my head once more. She threw her hands into the air, visibly appalled. “So let me get this straight: Your doctor determined that there is a problem with your thyroid. But she has no idea what caused it, no clear idea of why it’s happening, but she put you on thyroid medication, and that’s it.”

I nodded, feeling chastised. When she said it like THAT, it did seem a little bit weird. “I probably would’ve asked more questions,” I protested, weakly, “if I’d gotten any sleep the night before. Or if I was, you know, thinking straight. I should probably call her back.”

I was then treated to a brief lecture on the nature of thyroid dysfunction. Apparently the causes are many, and the treatment varies, of course, depending on the origin of the problem. As we talked, my therapist’s incredulity over a prescription having been handed out without any further information continued to grow. In the space of about five minutes I became convinced that my primary care doctor was negligent at best, or trying to kill me, at worst. I promised to call for a follow-up as soon as possible.

“Please tell me she at least told you there certain things you can’t eat now,” my therapist continued, undeterred in her mission to make me feel as incompetent as possible. I raised my eyebrows, signaling for her to continue. “You know you can’t have caffeine anymore,” she said. “If you have a thyroid issue, caffeine is absolutely off the table.”

This was too much. “Are you just trying to depress me?” I ask, frustrated. “You can pry my morning coffee out of my cold, dead hands.”

“I’m serious,” she said, “ask her about that when you call back. Caffeine can really jack you up when you have a thyroid issue. You need to stop drinking coffee immediately.” I slumped on her expensive leather couch. No coffee? That hardly seemed fair.

“Wouldn’t she have mentioned that?” I asked. “I mean, if it was that important?”

“Yes, I’m sure she would have,” she said, barely keeping a chuckle out of her voice, “right after she did all that thyroid imaging and additional blood work.” Touche. “There’s other stuff, too. Like, you can’t have chocolate. Or leafy greens. Broccoli! Broccoli is right out.”

I dropped my head into my hands. “You’ve gotta be kidding me,” I muttered. “No coffee? No chocolate?? And I love broccoli. Stop laughing! You’re telling me I can’t have anything good! You’re like the angel of death. I hope you’re happy with yourself.” I rarely see her lose her composure, but I was a little afraid she was going to hurt herself laughing by the time I finished my rant.

We agreed I would call my doctor to discuss all of this. We agreed it seems that the diagnosis had been somewhat, shall we say, hasty and perhaps incomplete. We did not agree that she was trying to make me cry, but I call it like I see it. Eventually, we moved on to talking about the kids, work, Otto, and everything else.

When my hour was up, we scheduled an appointment for the following week, and I stood up to leave. “Call your doctor!” She reminded me as I headed out the door. “No caffeine!”

“Killjoy!” I tossed over my shoulder as I left. “thanks for your ‘HELP.’” I could hear her laughing as I walked out to my car. I’m glad the fact that I’m both dying and not being treated properly can be a source of amusement to her. It’s only because she’s so good at her job that I didn’t just tell her to shut up.

So, I am totally going to call my doctor. I thought about it all morning. While I was drinking just half a cup of coffee. Shut up.


  1. Otto

    Love the thyroid ad in there now … and can I claim I have a thyroid problem every time I see broccoli now? Is it possible that a thyroid problem can cause one to be sickened by the smell of it?

    Because, then, I have that.


  2. meghann @ midgetinvasion

    Aren’t you glad caffeine is a legal drug? The future would be very bleak for you and I otherwise. “I can stop any time I want!”

    Enjoy your half a cup. I won’t tell.

  3. Beth

    I’d let my thyroid be broken.

  4. Lydia

    Wait, what? I have had hypothyroidism since birth and I have NEVER been told not to have any of those things!!!

  5. Genevieve

    My endocronologist has never, ever told me that certain foods were off limits, or that caffeine was off limits. The only thing he told me not to have was magnesium supplements (because they inhibit synthroid absorption), or calcium within half an hour of taking the synthroid (ditto).

    That’s including the endocronologist I saw from childhood when I was first diagnosed, and my current endo, one of the best in my major city.

    So I would take all that with a big, big grain of salt. And some coffee.

  6. Therese

    Wait, my hubby has been on thyroid medication for YEARS now, and I have never, ever heard any of this!!!! Dear Lord, broccoli is about the only vegetable we ever eat and chocolate is also a staple. He does watch his caffeine, however, because he says high test coffee makes him “feel weird.” Wow, I really learned something today. Off to Dr. Google I go!

  7. MomQueenBee

    I’m with Lydia. I’ve been on Synthroid for, oh, approximately a thousand years, and NO ONE in my medical past has told me to avoid any of those things. Not my family doctor, not my OB/GYN, not my dentist, not my other family doctor, not my…well, only YOUR therapist. So I’m ignoring her.

  8. Javamom

    Each time someone gives you meds you might want to provide them with a list of the other meds you are taking in case there is a contamination problem. It should be standard question: are you allergic to anything? Followed by; what other meds are you taking currently?

    I have never realized how many drugs people are taking on a regular basis. Sounds really dangerous to me.

    I hope you do feel better soon. The broken hand situation is such a drag…wishing you good vibes and all of that from me to you.

  9. ste

    I have a friend who has had a thyroid issue for a very long time. She drinks caffeine. So maybe if you do have to be off it right now so that you can get everything balanced out (she’s a pharmacist that says it can take awhile to get the exact right dose) you can go to town on coffee!

  10. Dee

    I have hypothyroidism due to an auto-immune disorder, and have been on varying levels of Synthroid for nearly 20 years. Neither my endocrinologist nor my primary care physician has ever mentioned those dietary restrictions, so I’m eagerly waiting to hear what your doctor has to say.

  11. DreA

    I have _no_ thyroid at all (removed, yuck!) and my wonderful endocrinologist never told me any of that stuff. The only thing is, you have to take the Synthroid on an empty stomach (when you wake up in the morning) with a full glass of water, and then wait an hour before you have anything else (aside from more water). It’s also best to wait to take your vitamins until later in the day. Food and stuff hinders absorption. I’ve been drinking tons of coffee for the past year and a half since they took my thyroid out and my thyroid hormone levels are totally fine. Your counselor is on the right track, but is driving a bit too far on the curb.

  12. Karen Chatters

    Do you even really need your thyroid? I don’t think so. I’m buy some chocolate coffee and sit around eating broccoli all day.

  13. Christine

    I’ve seen an endocrinologist who did imaging and blood work and was never told any of those things. I mean, you should probably have more diagnostics done, but I wouldn’t worry about the food stuff (she says, drinking her mocha).

  14. Vi

    And here I thought that was just the way doctors did things! “You have symptoms. We no care why. You get drugs to make better. We no care how.” (That’s how my doctors sound in my head. In real life they may be mildly more coherent than cave men.)

    Glad that you’re figuring things out – but I think Otto is on to something with the broccoli!

  15. Mir

    Y’all are making me feel better. However, I left out the explanation she gave me about fluctuating hormone levels—her point was only that caffeine can cause spiking and if we don’t know the origin of my particular problem I may spike on my own, then with the meds and caffeine on top of that, it can cause the opposite problem (which includes things like palpitations and anxiety, which is bad news for someone with a history of anxiety issues). While I think her directives are a bit militant, I think her point was that until I know more I should be extra-careful to avoid the stuff that could be problematic.

  16. Pictou

    My endo appointments are early and fasting–so I’m always there with a cup of coffee waiting for the blood tests to be finished. She sees me with the coffee in hand and has NEVER commented on coffee, broccoli or chocolate.

    Are you sure your therapist is not confusing blood thinners?

  17. Genevieve

    Though . . . I am seeing something at a couple reputable sites, now that I’m googling. Will ask my doc next time I see him. It may be that what you have to avoid is large amounts of these things, but not avoid ever eating them? Or avoid the timing of eating them (this is what it’s looking like for coffee, based on a couple things I’m seeing — which is another good reason to take the thyroid med at night). Definitely ask an endo.



  18. Kim W.

    I agree that caffeine can make things worse (I’m hypothyroid due to Hashimoto’s, though my thyroid has been stable for years). At first I was going to say — YOU CAN HAVE CAFFEINE! — but then I realized that as soon as I switched to decaf coffee and occassional black tea, my thyroid became more stable and I became more sane. But some caffeine, in my opinion, is probably OK. Wean yourself to decaf, anyway.

    I eat some broccoli, but never raw. I stay away from cabbage and cauliflower. Mainly — stay away from the raw versions, and keep the cooked versions to … once per week? I don’t know. Of course it totally depends on HOW low your thyroid is, and the cause of it.

    My biggest concern for you is this — sometimes us sensitive people do not need as much synthroid as other people. My medication is very very low, and when I was first prescribed, I was given such a big dose that it made my hyperthyroid, which is a miserable (manic, racing heart, anxiety, hot flashes, etc.) thing to be, and is the last thing you need. If you have any uncomfortable symptoms from the medication, let your doctor know ASAP. When I was first prescribed medicine, they didn’t even tell me that there are potential side effects. What the hell.

  19. Jenn K

    Yeeeeah, I’d take all that with a big grain of salt too. I’ve been on synthroid for 9 years and my doc has never said anything about broccoli, caffeine, or chocolate. Actually, I’ve had four different internists in that time, and not one of them has ever said that, nor have they sent me to an endocrinologist for that kind of workup. If everybody whose thyroid is a little bit low was referred to an endocrinologist, endocrinologists would be VERY VERY BUSY.

  20. Kim W.

    Oh, and yes! Iron in your multivitamin can hinder the absorbtion, as mentioned by others. Did I spell that right? I’m postpartum, please ignore my lack of brain.

  21. Jen

    I have to agree with everyone above here. I’ve been on Levothyroxine for approximately forever, and have nevereverever been told to take those things out of my diet. So unless your therapist is also a closet endocrinologist, ignore her suggestions. Either she was messin’ with you or she waaay overstepped her bounds with a woman already on the edge. ;) To suggest dropping caffeine? She may have a death wish. Just sayin’. ;)

  22. BethRD

    My mother, who was one of the most medicalized persons in modern history, was on Synthroid for *years* and I never noticed her avoiding chocolate, broccoli, and caffeine, all of which she loved. Now, doctors always tell you to avoid caffeine, so that one I believe to some extent, but leafy greens and broccoli?

    After Googling, I cannot help but observe that the advice that people with hypothyroidism avoid broccoli seems to be coming from ‘medical’ sites rather than medical sites. I can’t find any real medical sites that make this recommendation. Pubmed, when consulted, has a bunch of articles on hypothyroid in pigs that were fed rapeseed meal as 8% of their diet, but nothing about people eating normal people amounts of broccoli, which is probably a lot less than 8% of the diet. If you put ‘cruciferous vegetables thyroid’ into Pubmed instead of ‘broccoli thyroid’, you get some articles debating the relationship between consumption of these vegetables and thyroid cancer in some groups, but not with hypothyroid. So I’m calling shenanigans on this whole claim. Although obviously I am not a doctor so I’ll be interested in what yours has to say, let us know! And I hope your hand feels better soon! Because pain

  23. Zilla

    Maybe she meant don’t take your thyroid medicine with your coffee. ???

  24. Sandra Tayler

    I’ve been hypothyroid since 2001 and no one has ever given me dietary restrictions. I suppose it might depend upon the cause of the thyroid issue, but my experience was blood test then prescription.

  25. BethRD

    … sorry, kind of trailed off there, but was gonna say, because pain is not good, and you are a busy person with Things to Do (and pretty of course) so get with the program, hand.

  26. Em

    Sounds like your therapist is resentful that she didn’t get to be an endocrinologist. I’m sending you some chocolate covered broccoli to stir your coffee with. If you’re going to die of bitched up thyroid, you ought to go out happy.

  27. Thumper

    Yeah…count me in on those who have seen multiple docs over the years, including 4 different endocrinologists and a neurosurgeon, and none of them have suggested I give up any particular food or said caffeine is contraindicated. Not even when every hormone in my body was all over the place (pituitary tumor) and my thyroid was being a spastic little pain in the tuckus.

    I wouldn’t even be all that concerned about the why of your thyroid levels being off (though I would follow up and ask.) Your doc can pretty much tell by the numbers on the TSH panel, T3 and free T4…but they don’t always pass that along. And unless those numbers were wildly out of proportion, or they change too much over a year or so, you wouldn’t likely be referred to an endocrinologist.

    Enjoy your coffee…it’s not really going to do anything it doesn’t do to everyone else who drinks it.

  28. Karen R

    Your therapist may be confused. There are things that shouldn’t be taken within 4 hours of thyroid meds (mine, anyway), but completely eliminated? I can’t answer to the caffeine, because I’ve been uber sensitive to it since my teens. I can have two cups of green tea in the morning, and have to switch to decaf or herbal teas after noon if I have any plans to fall asleep at night. Leafy greens? I have a veggie smoothie for lunch every day (that is the only form I can stomach vegetables in) and it is mostly composed of leafy greens. Excessive amounts of spinach can cause digestive issues (ask me how I know…), but moderate quantities are fine. Yes, talk to your doctor, and maybe see an endo, but Don’t Panic!

  29. Kim W.

    Just for the record, excess cruciferous vegetables are the cause of some thyroid issues, like goiter. Though not directly attributed to hypothyroidism, it is a medical fact that it can affect the thyroid hormones. You probably don’t eat them in excess, but because my thyroid caused me so much trouble for years, I limit them in my diet.
    Here’s a reputable source: http://www.merckmanuals.com/home/hormonal_and_metabolic_disorders/thyroid_gland_disorders/goiter.html

  30. Lindsey

    I also have hypothyroidism due to an auto-immune disorder, and have been Levothyroxine for the last 5 years. My doctor did basically what yours did – handed me a prescription. She tests me every few months to be sure things are stable but, like everyone above, I’ve never been given any other ‘directives.’ I did switch to drinking mostly-decaf-coffee because I was having trouble sleeping. No idea if that was thyroid-related.

    Probably a good idea to try to find out what’s causing the hypothyroidism, but otherwise I think your therapist might be being a bit histrionic. :) Good luck!!

  31. Karen R

    One other thing — the lab numbers are not the be-all and end-all for deciding the dose. I start to show symptoms when my labs are normal. I do best when my labs indicate I am taking a little bit too much Levothroid. Fortunately, my doctor goes by symptoms, rather than relying 100% on the labs.

  32. Genevieve

    I am mostly seeing info on alternative medicine and natural healing sites, and on about.com which has a thyroid page. I’d be more concerned if I was seeing it in one of the medical sites — Mayo Clinic, American Thyroid Society, Endocrine Web, etc.

    The Mayo Clinic says “There’s no truth that eating or avoiding certain foods will improve thyroid function.”
    They do list some foods not to eat at the same time as the thyroid med.

    “If you have hypothyroidism, take thyroid hormone replacement as directed by your doctor — generally on an empty stomach. It’s also important to note that too much dietary fiber can impair the absorption of synthetic thyroid hormone. Certain foods, supplements and medications can have the same effect.

    Avoid taking your thyroid hormone at the same time as:

    Soybean flour
    Cottonseed meal
    Iron supplements or multivitamins containing iron
    Calcium supplements
    Antacids that contain aluminum or magnesium
    Some ulcer medications, such as sucralfate (Carafate)
    Some cholesterol-lowering drugs, such as cholestyramine (Questran) and colestipol (Colestid)
    To avoid potential interactions, eat these foods or use these products several hours before or after you take your thyroid medication.”

    Now it is true that when increasing your thyroid intake, you may want to be careful about your caffeine intake, i.e. not increase it and note if you have symptoms of high thyroid like she mentioned (palpitations, anxiety, etc.), because caffeine could increase those symptoms. I would not think that means you have to completely avoid it, however.

    When I have too much thyroid hormone, I can tell because of those symptoms plus a kind of insomnia I don’t usually get — waking up in the morning completely wakeful, lying down at night completely wakeful, sometimes waking up in the middle of the night and finding myself completely wakeful. That’s a tip-off for me. Hand tremor is another tip-off, and increased sensitivity to heat (when I’m not cold in situations when I’m usually cold, I know it may be time to get my thyroid checked even if I’m not due for it yet).
    Complete list of symptoms of overactive thyroid here, good to review when you’re increasing thyroid hormone intake, to know what to be aware of:http://www.mayoclinic.com/health/hyperthyroidism/DS00344/DSECTION=symptoms

    Soy is the main food I’ve heard can interfere somewhat, and so it ideally shouldn’t be used in extremely large quantities, and not near the time you take the pill (another good reason to take it at bedtime).

  33. Janet

    I’m going to join the skeptical crowd here. From where did your therapist earn her M.D. with specialization in endocrinology? Where are the published peer-reviewed studies counter-indicating leafy green veggies for your particular thyroid issues? AND CHOCOLATE OMG CHOCOLATE. I’m reserving judgment here.

  34. Tracy

    I’ve been diagnosed hypothyroid since 1989 and I agree that you need a better workup than oh, your thyroid is low, here’s the drugs. And yes, replacement thyroid hormone needs to be taken on an empty stomach, no eating for a bit. But no caffeine? Ever? I’ve never heard that from any of my endos, and never seen it in any of my readings. Just another two cents…

  35. Rebecca

    Yeah no. Not even. Your doctor was NOT negligent. Your therapist was over reacting.

    My Dr treated my hypothyroidism just like yours did and I’m fine. Have been for YEARS. I can’t believe she’d get you all jacked up like that. Full on NOT COOL. Watching dosage, tests every 6 weeks to start, then 6 months upon a normal reading, then once a year unless you feel off. That’s pretty much IT. You know how you feel and your Dr knows what your body is doing via blood tests. Sheesh.

    As for foods… eat what you want. Just listen to your body. It knows FAR more about what you should be eating than anyone else ever could.

    ((hugs)) And maybe doubt the therapist before your primary caregiver next time.

  36. Becky

    Many doctors seem thyroids completely baffling in terms about informing patients how to correctly cope with them when they misbehave. I was diagnosed with Hashimoto’s back when I was thirteen and have been on Synthroid since then. The pediatrician neglected to mention how you should NOT simply pop your Synthroid with your vitamins, because, hello, Iron prevents absorption. Eventually found that out in college. I get blood-work done every six months or do to make sure my levels are normal. I’ve never heard anything about those dietary restrictions though! Good luck prying the chocolate and broccoli from my my fingers.

  37. diane

    My Mom and my best friend from childhood both have thryoid issues. My Mom (hyper) just has to be careful with the caffeine, but my friend (hypo) had to stop it immediately . I think it depends on the nature and severity of the problem.
    Related–I recently transferred jobs into a slightly less crazy department and my sweetie asked me if that meant I would stop drinking so much coffee. I just laughed.

  38. Amanda

    I’ve been hypothyroid for nearly a decade. There is kind of a fringe group of hypothyroid suffers who make a *much* bigger deal about it than it really is for most people.

    Be wary of the extremists, until you know you have to manage yours differently than most of us (which is a daily pill and that’s about it).

  39. Mandy

    My therapist just might be related to your therapist. Drives me up the flippin’ wall. ‘Cept my therapist runs marathons. I don’t. She’d like me to take up running, and I’m treated to lectures about how great running is (I’ve tried it but with my weak ankles – history of breaks in both – I’m not any good at it. And I’ve never felt the mythical “runners’ high,” which I believe is a big fat lie.) I also get metaphors about how challenges or life are comparable to marathons, not sprints.

    Would love to tell her to shut the f&^% up, but I’m too lazy to break in another one.


  40. Liza

    I’m with everyone else. Get the thyroid imaging done. Get the extra bloodwork done. Get a followup with a top notch endocrinologist. If you think cutting back on coffee (or chocolate, or broccoli) as you work your way through this is a good idea, do that too, but don’t go crazy.

  41. Diane

    All I can say is me, too. I’ve been hypo for about twenty years, on synthroid – a relatively low dose – all that time. My levels have been pretty constant, and I am a dedicated coffee drinker, though usually just a couple of cups a day during the week (more on weekends).

    It’s worth it to have the tests for your peace of mind, but until then, it may be overkill to cease and desist from most of the great pleasures of life (at least your therapist didn’t suggest that um…more physical pleasures should be avoided). While it’s true all doctors are still human and can make mistakes, your M.D. has a lot more experience with thyroid issues than your therapist.

  42. Nelson's Mama

    So, the therapist isn’t a thyroid expert, that’s what you have us for. :)

    But, I love her suggestions about the imaging, blood work and follow-up with an endocrinologist.

  43. Midj

    Ha! You crack me up. That you can provide me with a laugh in the middle of this hard day/week/month/year is what makes me love you even more…

  44. Arnebya

    Giggling because EVERY TIME I go to the doctor I get the whole “Thyroid. Check the thyroid. It’s gotta be the thyroid.” It is never the thyroid. I have resigned myself to believe I’m simply crazy, imagining it all. It’s easier.

    I’m sorry your hand hurts this much and that you’re probably too afraid to take a full dose of pain meds because of, um, reasons. Whenever I hear people lament 2012 almost being over, that soon it’ll be Thanksgiving, then Christmas, where’s the time going? I want to yell Shiiiiiiiiiiiiiiiiiiiiid! Fly by, time! Fly by straight into 2013 which I have deemed The Year of Better.

  45. Mel

    The thryoid is a crazy thing, and hasn’t the percentage of women with diagnosed thyroid issues really jumped in the past while? I’ve been on Synthroid for 20 years, and this year I had more complete bloodwork done, and my lovely new doc upped my dosage significantly. And shazam! My hair started growing back and my menstrual cycle became regular for the first time EVER. I wish I’d had someone paying close attention (including me!) back when I was struggling to get pregnant.

  46. RL Julia

    I too have been taking Synthroid since practically the beginning of time and I can tell you the following few things:

    I have never been told to avoid any particular foods.

    I am sort of surprised that no one mentioned avoiding certain anti-histimines because sometimes that effects how the Synthroid works.

    Your thyroid isn’t a terribly complicated gland -nor do things happen in thyroid-land very quickly. I am sure that your internist probably palpitated yours and noticed the absense of nodules, tumors and etc… felt it was o.k. to proceed to the next step in giving you a Rx – to at least start getting you back to normal – which might take a few weeks/months depending.

    As above posters mentioned – for most of us, having a thyroid problem is a very low-intensity sort of problem and pretty much a no brainer. However, for a select few, it is a huge pain in the neck (hahahaha!) that requires more effort to manage sucessfully. Wait until you are sure you are part of that lucky club before cutting out the caffiene and etc… in the meantime enjoy the cheery colored pill you get to take each morning.

  47. Christa

    Your therapist should perhaps leave diagnosing and treating hypothyroidism to someone with an “M.D.” behind his/her name. Her intentions are good; however, she is overreacting. There’s no need for you to stop drinking coffee. If you had hyperthyroidism, it would be wise to avoid any stimulant (including caffeine) since they could worsen the symptoms of the condition. Thyroid imaging may or may not be necessary. You should ask your doctor if it is or isn’t. You should also ask about any other blood tests that may or may not be necessary to rule out underlying causes of hypothyroidism. A referral to an endocrinologist may or may not be necessary. Plenty of internal medicine and family medicine physicians manage hypothyroidism appropriately. I am certainly not advocating that your physician rapidly prescribe medications without explaining the reasons behind it; however, your therapist’s alarmist reaction is overkill. I am also not a physician, but I am a clinical pharmacist practicing in a family medicine clinic (with physicians) whose job it is to counsel/educate patients on medications and certain diseases. Hope you feel better soon!

  48. Kimberly

    I have hypothyroid due to Hashimoto’s and actually take my Levothroid every morning with my coffee! I talked to my doc about this and her take was that yes it may hinder the absorption a bit, but the key is to be consistent. I’m at a level of medication that works even with that absorption factor – if I only occasionally drank coffee within an hour of my medication then I would have ups and downs, which all of us thyroid folks know sucks.

    But as long as I’m consistent it works just fine. Has been for over five years.

    Good luck Mir – they’ll start you on a very low dose so it may take a few adjustments to get you where you feel a difference. But you will :)

  49. RuthWells

    Oh, dear. Yes, do follow up, and keep us posted.

  50. dad

    How come there are no diseases where the official treatment protocol is 4 cups a day of strong coffee and lots of chinese food?…and of course ample amounts of wine.

    Some people just don’t know how to ail.

    Has your surgeon ventured an opinion about how long your hand is going to hurt?

  51. Alix D

    I have to add my voice to chorus of ‘I take levothroid and no one told me that.’

    In most cases, if you are taking thyroid medication, you should wait half an hour to an hour before eating anything, and four hours before eating anything high-calcium. As far as I can tell from a quick web research of medical abstracts, the rest of it is correlative, at this point, not necessarily causal. For instance, one study freely admits that it did not distinguish between caffeinated and decaffienated coffee.

    So, yeah, a little skeptical of that part.

    However, your doctor dropped the ball in a big way. If the thyroid is under or over producing, you need to know why. There are a LOT of different reasons, with varying degrees of severity and available treatments.

  52. CuriousCat

    What Crista said. Seriously. DON’T google anything about this. Call your doctor and ask some questions, if you want, but I’m guessing your blood counts were low enough to indicate medication but not so low you needed to be referred to an endo and for imaging.

    Advise your therapist to stick to the problems you’re seeing her for.

  53. Gaylin

    Certain vegetables contain goitrogens ( http://www.whfoods.com/genpage.php?tname=george&dbid=47 ). I was told when I was diagnosed to avoid cabbage and cauliflower and to take it easy on broccoli (and only eat it cooked) and ‘hard’ leafy greens. As well as no caffeine because it can exhaust your adrenals, making the rest of your endochrine system work too hard.

    Best book I ever read on this (I have Hashimoto’s) The Thyroid Solution: A Revolutionary Mind-Body Program for Regaining Your Emotional and Physical Health, by Dr. Ridha Arem.

    I have been on Synthroid for 15 years, I have tried the natural, bio-compatible versions and they didn’t work for me at all. I was seriously ill a couple years ago and since then my thyroid levels have bounced all over the place as I have been recovering. All I can say is if and when possible – take it easy.

    Yes, iron can screw with your synthroid absorption, so can calcium/magnesium supplements. I take synthroid first thing in the morning, breakfast at least an hour later, iron I take at supper, cal/mag before bed (helps with sleeping).

    Also, when you get blood work done, they should be checking your iron level (anemia goes hand in hand with thyroid problems, as does gluten intolerance) and check your calcium levels, the parathyroid is what helps maintain calcium levels.

    I think this is the longest comment I have ever made – anywhere!

  54. Tracy B

    I do the same thing, Kimberly. I take my Synthroid with my coffee every morning. But I don’t eat anything for 30 minutes after taking my meds.

    I had my thyroid removed 3 years ago due to nodules on both sides of the gland. There are a number of things that can cause you to have either a hyper or hypo. I’m not sure your doctor can tell you the “cause” of either but can tell you which of the two yours is and treat it accordingly. Of course, having nodules on the gland was a huge red flag but I was also having other problems that I never thought had anything to do with my thyroid. I had 3 ultrasounds and ended up having 6 biospies (one of each nodule). I never would have imagined what all that little gland controls until I ended up not having one. I just told my doctor on Monday, that I wanted to be on the “transplant” list if there ever was one! :) A definite follow-up is in order, Mir.

  55. karen

    Hmmm… well, my husband has been on synthroid for low thyroid for years, and he has never been told about those diet restrictions either. He has also not been sent to an endocrinologist.

  56. Tenessa

    Hypothyroidism, thyroid cancer (two kinds), Bartter’s syndrome and various other endocrine disorders run in my family. No one, including me, has been told to restrict our dietary intake of caffeine, chocolate, or broccoli. There are rules to successfully taking synthroid, as previously stated though.

  57. Kana

    If you can crack your therapist up, you’re doing something right….wait, thyroid issues preclude coffee, chocolate, and broccoli? I gotta call my Mom – I think someone else missed “that talk” with her doctor…

  58. Amy

    My sister had thyroid cancer and now has no thyroid and has been on Synthroid for like ten years. My mom and cousin both take Synthroid and all three of them drink Diet Coke like its going out of style. If their doctors told them that they couldn’t have caffeine they certainly have not followed the doctor’s orders.

    I have heard that if you have thyroid issues period that you shouldn’t consume caffeine, but I don’t know that it has anything to do with the Synthroid.

    I am also troubled along with your therapist that the doctor didn’t do ANY other tests before giving you meds. The levels of Synthroid have to be so carefully determined that it seems odd that she would just prescribe the meds without more tests. Kind of like how my neurologist just gave me meds without doing any tests (MRI, EEG, etc) even though I’d had a brain injury! (Completely different rant there though)

  59. Ali

    I have no opinion on thyroids except that I sometimes wish for the hyper one. But I am a therapist and wanted to comment on the “source of amusement” part.

    Only because I have one patient in particular that is so hysterically animated and hilariously descriptive in his retellings that I find myself wiping tears of laughter away. So I laugh and then we talk about how he uses humor to deflect the pain of the hard stuff. Before every appointment, I tell myself “Don’t laugh, Don’t laugh”.

    Not going to lie. He is one of my favorite patients because he is funny and he can make me laugh in a sometime sad job.

  60. Brandy

    I’ve been hypothyroid for four years now. Yes, there are some rules with taking your meds, either take them two hours after you eat or one hour before. I’ve read up on goitrogens, but not every goitrogen affects every one the same way. Different types of soy affect me, so I avoid it like the plague. I like the about.com help site for hypothyroidism, it’s a forum and everyone is very nice.
    I’ve NEVER heard of avoiding caffeine, though.
    It is best to know your numbers and not just be tested for the T3, but also the T4.

  61. Jeanie

    Just reading about the few things you can’t have makes me hope like heck your diagnosis was incorrect. I have a hard time fasting before my lab appointments simply because I can’t have coffee as soon as I get up. I occasionally still have chocolate, and broccoli is pretty much a staple around here. It scares me to think of what else might be on the “can’t have” list. I do not have a thyroid problem, btw.

  62. Gretchen

    Yup. Add me to the list of people who have been hypo for years and never been told to avoid those items by any medical professional, nor come across it in my reading.

  63. Michelle

    I didn’t read all the responses but I have to tell you that I think your therapist might be overreacting just a smidge. I have Hashimoto’s disease and I’ve read a bunch of books on diet and thyroid and while I will give your doctor the fact that broccoli (and many cruciferous veggies) do affect your thyroid I can’t imagine completely cutting them out. . .you really should read and decide for yourself how best to handle your health. Look for books by Mary Shomon, she does a great job of explaining things.

  64. Kay T

    I was going to google this, but I KNEW that you would get the real word here from all your faithful followers. Especially if the caffeine restriction is based on how it makes you feel, then the question from the therapist should have been – DO YOU FEEL anxious, etc. If so then maybe you need to cut back on caffeine. Now why the therapist did not jump on the anti-apple bandwagon, I don’t know! Clearly more dangerous than coffee, or chocolate, or broccoli.

  65. erma

    I have had thyroid problems for a year now. It skyrocketed high and now is very low, but the endocrinologist is watching the numbers every three or four months. It is slowly going
    up, and I have not been told to watch what I eat. I asked about that, and he said it wasn’t necessary to change my diet….

  66. Steph

    Add me to the list of those saying your therapist is not an endocrinologist. ;-) I’ve been hypothyroid for almost 15 years. I have never ever been told by my PCP, my endocrinologist, or anyone, that I can’t eat certain things. Also, to the best of my knowledge it’s not always necessary to do imaging studies depending on other test results. I have a VERY thorough endo – when I was going through the process of being diagnosed with PCOS, she did an MRI. I got some interesting looks on that one. And I just finished a biopsy because there was a small nodule on my thryroid that might possibly have been an issue maybe. And even SHE has never told me to change my diet, nor did she feel the need to do any imaging studies when I first moved to her. Short version is, I’m sure your therapist means well but I would get a second opinion before giving up your morning coffee.

  67. Kateebee

    Oh dear lord. Have been taking Synthroid for over 20 years thanks to post-partum hypothyroidism that was caught in time. Have never heard any of this – even while trolling those very scary newsgroup people who have personal labs in their basements. I take my meds at night (brush teeth, take meds, take out contacts, wash face, put in night guard – so glamourous). I’m more likely to take them at night than while running out of the house to catch transit in the morning.

    I am known to have a cup of coffee in my hand until about noon at work. People don’t expect much of me until the second double shot Americano from the magic machine in the office kitchen.

    Chocolate is a food group right up there with brocolli. Deal with it “therapist”.

    After getting removing the hyperbole and the hypochondriacs who figure they’ve hit the motherlode with this condition (and please excuse if you are one of the people seriously affected) it’s just something to deal with along with the osteo arthritis and the mild case of fibro that makes RMT a medically covered form of S&M.

    It is one of the most common and treatable conditions. Cut yourself some slack. We have Monday night rules in my house. One day a week you get a pass and only have to do things you want to. e.g. go to exercise class, watch something on the DVR, eat popcorn for dinner – all good. clean up spilled OJ? let the cats have it, step around and deal with it tomorrow… UNLESS YOU WANT TO.

    So sorry that you’ve had this next bale of hay added to the camel’s back. Use it for Halloween decorating.

  68. Laura

    Whoever said “bitched up thyroid” made me say HA!!!

  69. Rocky Mountain Woman

    If someone told me I couldn’t have coffee, i’m not sure i could go on…


  70. Nancy

    I can’t help but wonder if your therapist reads your blog.

  71. Mandy

    Just delurking to jump in and say both my parents are on thyroid medication (20+ years for each of them) and they’ve never been told about dietary restrictions including caffeine which they both still drink. No offense, but I think your therapist is dead wrong.

  72. mamaspeak


    I too would like some chocolate covered broccoli to stir my coffee with. No, I don’t have thyroid problems, but I like your style.

    Take your pain drugs (even though you don’t want to, I know, trust me, I KNOW,) but it’ll help you feel faster. Drink your coffee & eat your chocolate, until you hear otherwise from your endocrinologist. I suspect going cold turkey on those things could also have some not so great side effects. Everything in moderation, until you’re told otherwise.

  73. bonuela

    my endocrinologist never offered to give me a boob job and my dentist never offered me a pap smear. perhaps your therapist should stick to his/her area of expertise? a bit more rude than my normal comments, but if you have anxiety issues and your therapist brings up stuff you weren’t freaked out about to begin with, that is practically malpractice in my opinion.

  74. Amanda

    Add me to the list of people on thyroid meds that had no idea there were dietary restrictions beyond the take it on an empty stomach and don’t eat for 30 minutes after. Which, btw, is sometimes a very long and torturous 30 minutes. Although, I also have had more testing and seen an endocrinologist. The only advice I got was that I needed a sleep study. You know, because thyroid problems don’t cause sleep disturbances at all. *eyeroll*

  75. Renee

    Bonuela said it perfectly!

  76. Amy

    My thyroid was pronounced dead about eleven years ago after treatment for Graves disease and I’ve been on Synthroid ever since. I hadn’t heard any of those restrictions before. However, I would find out what is causing the issue and also go see an endocrinologist. If you don’t start to feel better after your levels are ‘normal,’ and the endocrinologist doesn’t want to do anything further, see another endocrinologist. Not every one’s levels fall within ‘normal.’

  77. Little Bird

    I’m thinking I need to read up on thyroid issues. My cousin had serious problems with hers, went untreated for waaaaaaay too long and subsequently started exhibiting schizoid behaviorisms.
    I think people around me would suffer if I had to give up caffeine.

  78. Mary

    I have a thyroid issue as well as Type 1 diabetes. I practically LIVE in the endocrinologist’s off ice, and I never heard any of the warnings issued by your therapist. I dutifully take my synthroid and my thyroid is a non issue. I’m thinking that your primary doctor is just fine.

  79. Andrea

    I’ll refrain from politics here but…

    it is probably cheaper to give the Rx and then see if the problem resolves before seeing an endocrinologist, running scans, etc…

    My doc always told me they monitor the thyroid as you age (as if it can be a normal sign of aging).

  80. Chris

    Ok. I know I am a bit late here but are you sure she wasn’t playing with you? :)

    Seriously I think she added a lot of unnecessary worry to your day.

  81. Mame

    I told my doctors I had thyroid symptoms for 15 years and the doctors said my TSH was in the middle. Finally an arrogant doctor told me he would send me to an endocrinologist to prove to me there was nothing wrong with my thyroid. The endo sent me for a sonogram that found 17 nodules. I had the thyroid out 9 years ago. The endo told me to take my synthroid first thing in the am with water. No breakfast for an hour but I could drink coffee immediately as long as I did it consistently. I have a cup of coffee every morning after my synthroid. My thyroid hormone replacement did not require any adjustment for 7 years, I believe that says the coffee hasn’t been a problem. It appears now that I am not converting T4 to T3 and need a T3 supplement. I avoid raw goitrogenic vegetables due to my own reading but I’ve never had a doctor tell me to. I avoid soy because I’m concerned that an increase in gm soy in the American diet coincides with a rise in thyroid disease.

    BTW How is Chickee’s rash?

  82. Paula / Hamburg

    You have an excellent expert in self-help on thyroid issues over there in the USA (in case you should have the hypothyreosis caused by autoimmune disorder): Mary Shomon (http://thyroid.about.com/bio/Mary-Shomon-350.htm).

    I have a thyroid issue, too, it started with hyperthyroidism caused by a similar autoimmune process. In both cases you should try to avoid additional iodine (although that is almost impossible because almost all food is contamined with it nowadays). So, to avoid brokkoli and coffee does not really make sense to me.

  83. Stephanie

    Yet another person who went to the dr, got diagnosed and got a script years ago without any further follow up. I take it alone, an hour before food, but drink caffeine, eat broccoli, and chocolate. No one has ever suggested I needed to stop.

  84. {sue}

    I haven’t read the other comments yet, but it is most likely autoimmune hypothyroiditis – or Hashimoto’s, which is VERY common in women. I’ve had it for 15 years and I drink an obscene amount of caffeine. I’ve never heard that. And I’ve done a ton of reading. Also, you may have discovered, but researching thyroid stuff on the internet is like research vaccines – lots of crazypants stuff out there. Stick with sites affiliated with a major hospital or NIH. I do agree about the endocrinologist.

  85. {sue}

    Also? You can tell if it’s autoimmune related by testing for thyroid antibodies. That should be a follow up test if your TSH came back high.

  86. {sue}

    Last comment – I swear – I also take my synthroid at night before bed. My stomach is empty and I’m not eating for several hours after. Some doctors actually recommend nighttime instead of daytime. Ask your new endocrinologist about it. :-)

  87. suz

    It really doesn’t matter what’s causing your hypothyroidism as long as you’re getting the right amount of replacement hormone. And I join the loud chorus of hypothyroids who have never been told to avoid any foods, or coffee. Might I add that your medical doctor may have a little more knowledge than your therapist. I mean, I don’t know your therapist, but I prosecute for professional licensing boards and the requirements to have a medical license are just a TAD more extensive than to have a license to be a psychologist or a licensed professional counselor.

Things I Might Once Have Said


Quick Retail Therapy

Pin It on Pinterest