What a TSH of 12 actually feels like — before you know it's a thyroid

The cold hands in August

There was a summer when I started keeping a sweater on the back of my office chair. The air conditioning was loud that year, and everyone complained about it, but the sweater was not for the air conditioning. My hands were cold in the afternoons in a way they had not been the previous August. The sweater was for that.

I thought it was strange, and then I stopped thinking about it. There was a lot to do that summer. The sweater stayed on the chair, and I put it on without ceremony after a while, the way you stop noticing the chair itself.

There would be a list, eventually. That was the first thing on it. At the time it was not on a list. It was just one cold thing in a warm month.

The list, in retrospect

The brush had to be cleaned more often than I remembered cleaning it before. I noticed once, then I noticed every time, and then I stopped noticing again because there were other things to notice.

The eyebrow pencil had to draw farther toward the temples than it used to. I bought a new pencil and did not think about the pencil.

Every day at 2 PM there was a wall I had to walk through. The wall was not new. The wall was higher than it had been. I drank a third coffee, sometimes a fourth, and the second wind that used to come in the late afternoon stopped coming.

There were weeks when the bathroom became a chore I didn't mention. There were months when the calendar reminders started arriving at the wrong time, off by days, then off by a week. I told a friend at lunch and she said hers had done the same in her early thirties, and I let it go.

None of these things were connected to each other in my head. Each had its own file. The files were small, and I checked them rarely, and I did not put them next to each other on a desk and look at all of them at once. Nobody does. That isn't how a person lives inside their own body.

The "you're fine" visits

I went to three doctors over two years. Each ordered a reasonable panel. The CBC came back fine. The lipid came back fine. The basic metabolic, fine. Nothing to worry about, the portal said, in the tone the portal uses when there is nothing to worry about.

The first doctor said it was probably stress, and I should drink more water. I was, at that time, drinking a great deal of water.

The second doctor, six months later, suggested we check in again in six months. She was kind. She was not wrong, exactly. The numbers in front of her were unremarkable. I left feeling slightly older than I had when I came in.

The third doctor asked, gently, whether I had considered seeing someone for anxiety. I went to a therapist for two sessions. The therapist said this didn't sound to her like anxiety, and sent me back, and I sat in the parking lot afterward for a while without turning the car on.

I don't blame any of them, looking back. The thing that was wrong with me was not on any of the panels they ran. They had not run the panel it was on. Neither had I asked them to.

The fourth doctor and the test that wasn't there

The fourth doctor was new because I had moved. She scrolled through what was now a small thicket of normal results and asked, almost in passing, whether anyone had checked my thyroid.

I said I thought they had. I was certain they had. I had been in three offices over two years. Of course someone had checked my thyroid.

She tilted her head. I'm not seeing it. Let's add it.

A week later the TSH came back at 12. The reference range topped out under 4. I read the number on my phone in the waiting room of a different appointment, and I had Googled what 12 meant before the front desk had finished checking me in.

The strange relief

The relief was not the kind I had expected. It was not thank god they finally found it. It was something underneath that, harder to name.

It was: it was not me.

It had been the gland for two years. The cold hands had been the gland. The brush had been the gland. The wall at 2 PM had been the gland. I had been carrying these as character traits — slow, soft, vague, tired — and they had been a number in my blood the whole time.

The relief was edged with something almost like grief, for the woman who had spent two years thinking the explanation was her. She had not been making it up. She had not been making it up for a long time.

What it actually felt like to live with a 12

In the months that followed, each of the small things took a name. The cold hands were a thing that happened with low thyroid. The eyebrow ends thinning at the temples were a known pattern, recognized in any chart that knew to look for it. The 2 PM wall was a metabolism slowing down without permission, hour by hour, every afternoon, for two years.

The cycle stuff had been the gland too, in its sideways way. The bathroom thing had been the gland. The hair on the brush had been the gland. I had filed each of them in a different drawer of my attention, and they had been the same drawer the whole time.

Later there were anti-TPO antibodies on a follow-up. Later there was free T4 sitting at the low end of its range, and free T3 at the low end of its own. TSH leads, the others follow, the doctor said. I did not dwell on either. The information was useful, and then it was background, the way information becomes when you stop being afraid of it.

It is a Tuesday in November. I take a small thing in the morning, the way I sit in the chair I sit in to take it. My hands are warm. My brush is full of normal hair. The wall at 2 PM is a window now, not a wall.

If you recognize yourself in any of the small things, the bloodwork is one number away. The number won't fix anything. It will just give it a name.