writer burnout

(This post first appeared on Substack: Writing Magick with Maggie Sunseri. Click to subscribe.)

Right before I left for Europe in June, I needed a follow-up test to see if my thyroid levels had improved since starting medication three weeks prior. I wrote a great deal about my negative experiences and feelings about Western biomedicine in an article back in May. I highly suggest you start there if you haven’t already!

Long story short: I’d been on a low dose of thyroid hormone medication in order to treat subclinical hypothyroidism. Subclinical refers to the fact that my thyroid stimulating hormone (TSH) levels were higher than they should be, but only by a little bit compared to those with overt hypothyroidism. Other markers were normal. Upwards of 95% of hypothyroidism is caused by Hashimoto’s disease, which is an autoimmune condition where the your body begins to attack the thyroid, destroying its ability to function.

Now, knowing these basic facts, one would assume that my doctor would be interested in testing for the presence of thyroid antibodies to ascertain whether or not I have Hashimoto’s. When I went in for my follow-up to see how my medication had improved my TSH, I was ready with my list of questions. A few of the things I asked were:

Q: Shouldn’t I be tested for Hashimoto’s?

A: Well, it doesn’t really matter. The treatment is the same either way.

Huh???? It doesn’t matter to know whether or not I have a lifelong autoimmune condition? A condition that often causes other autoimmune conditions when left untreated? How could that not matter?

Q: But if it’s not Hashimoto’s, or at least it hasn’t progressed to it yet, wouldn’t that mean there’s a chance I could turn this around?

A: No.

Q: There are no other causes of thyroid dysfunction? Supplements or diet changes that would help? Could it be stress? I’ve been under a lot of stress, especially when this all started. I also struggle with other hormonal problems, and I know hormones are all connected. You’re really saying there’s no hope of not being on medication for the rest of my life?

A: These things just happen.

Bullshit. To all of it. 

At the time, I wanted to trust my doctor. I was tired of sticking up for myself only to be condescended to, rushed, and walked all over. I was exhausted from the endless scrolling and researching that was stressful for someone who struggles from health anxiety and OCD. I wished that I could trust my doctor to order the right tests, to listen to my concerns and actually care enough to take me seriously, to provide the best treatment and information possible for my health and well-being.

In the end, I pushed for the antibody testing, and it came back negative. I do not have Hashimoto’s. My TSH was down from 6.53 to 5.26 in just three weeks, with the upper end of the reference range 4.4. (However, I later learned from my integrative doctor that the ideal range for someone my age is below 2.5.) The point being, the medication was moving the needle in the right direction, I felt much better, and most importantly, I wasn’t autoimmune. My doctor said that news changed nothing, but in my gut I knew that was wrong.

Then, my doctor decided to double my dose of medication right before I left the country. This seemed sketchy to me based on everything I’d read in studies about treating subclinical hypothyroidism. People with overt hypothyroidism had double, triple, even ten or twenty times the TSH that I had. Doubling my dose was a lot, and it didn’t make sense when this dose was clearly working with no negative side effects. I tried calling and explaining I was leaving in two days and needed answers before I picked up my prescription, but no one would get back to me. I started taking the doubled dose anyway, and finally I got a call back in the airport from a nurse who had no idea what she was talking about. She said the medication needed to be doubled because my thyroid levels were way too high. I gently told her that they actually weren’t—they were just barely out of the normal range—and my original dosage was already moving the needle in the right direction. I knew she was just improvising because she actually didn’t really know what was going on, and it wasn’t her fault. But the message was clear: My doctor did not have time for my questions and she did not see my concern as valid.

Soon after, while at my first writer’s conference in Madrid, I started having alarming symptoms. At first it was horrific vertigo that made it difficult to stand and network, and then the cardiac symptoms began. Palpitations, racing heart, horrible anxiety, sweating, generally feeling like my body was on speed. In the Madrid airport, where I was headed to my second conference in Italy, I called my mom in tears because I thought my heart was going to explode. (I would say that’s the first time I’ve cried by myself in an airport, but that would be a lie. At a certain point, you just roll with it. )

We talked it through, and we both realized it was clearly the doubled dose of my medication. I had never felt more mistreated—the way I had advocated for myself about this just a week prior and was talked down to or straight up ignored, only to find out I was right all along. My mom called her pharmacist friend, and she was equally angry and alarmed at the doctor’s decision. She told me I wasn’t in any danger, and just to cut my pills in half and go back down to the right dose. So that’s what I did, and eventually my hormones stabilized again.

I carried out the rest of my trip, but other strange symptoms I attributed to other hormones continued to plague me. I started getting strange heat rashes and breakouts, and I just generally felt like there was more to the story. In London, at the end of my otherwise life-changing, beautiful adventure, I decided enough was enough. I was never going back to my old doctor, but I still needed to recheck my thyroid as soon as I got home. So I scheduled an appointment with an integrative and functional medical practice, and I had my first appointment on July 25th. They told me that it might take up to a half a day to get in and out, because they pride themselves on treating the whole patient and never rushing an appointment.

At first I wasn’t sure what to expect. I was a little sketched out by the in-house supplement store, which I assume made up for the loss in profits that came from not rushing patients out the door during appointments. I was also initially turned off by some of the recommended reading that was handed out, which included some random New Age self-help and inexplicably, the Bible. However, I wanted to keep an open mind, and I was at least comforted by the fact that the doctor I was going to see wasn’t the doctor that wrote the strange welcome materials, and she was also a DO. That means she went to medical school, but specializes in treating the whole person and has extra training in integrative and functional medicine. For me, that was a necessity. Because as much as I push back against the many failures of biomedicine, I’m also not going to put my faith in just any alternative “doctor.”

I could only describe the nurse who checked me in as a ray of sunshine. She was genuinely so kind that it almost made me cry. She asked about my life, about my summer travels, and she did everything in her power to put me at ease with her calm, happy energy. It really set the tone for the rest of the appointment, which is what true healing is all about. 

My doctor definitely still had the air of a doctor, but this time she actually listened. I filled out multiple pages of paperwork painstakingly going over everything from my spiritual life and life’s purpose to my symptoms, exposure to heavy metals, mold, or other toxins, and full medical history. She ended up asking me about my life from the very beginning, which brought interesting insight to the full range of my health over the years. She understood that everything affects everything else, and she also knew that true healing provides the space to be heard. When I asked questions, she was happy to answer them. It felt like we were actually having a dialogue, a back-and-forth that went both ways, which was something I had never experienced in a medical setting before. She ordered basic blood tests, another antibody test to make sure Hashimoto’s hadn’t developed in the last couple months, and a few others based on what we talked about and potential nutrient gaps. And hey, it was all covered by insurance! (Non-Americans: That’s a HUGE DEAL. Especially for anything remotely “alternative.”) 

When the results came in, they reconfirmed the absence of Hashimoto’s, and my TSH was down to 3.3. If you’ll remember, that’s normal baby!!! And only a point away from being ideal. At our follow-up appointment, she told me there was plenty of hope for getting off of my medication after working to improve the function of my thyroid naturally. So, basically, the exact opposite of what my old doctor told me. She reminded me not to blame my doctor for it; in med school they just weren’t taught these things. They were told to stick people on medication for the rest of their lives and that was that.

I also found out that many doctors won’t even treat Hashimoto’s patients until their thyroids are completely destroyed, when treating them early and helping them to address autoimmune triggers could have slowed the disease’s progression and decreased antibodies significantly. This is the same for a great many diseases. Because doctors are primarily concerned with treating pathology, not preventing or reversing pathology. 

My new doctor showed me a diagram of how thyroid hormones are metabolized and the multitude of factors that contribute to improper functioning all along the conversion pathways. From stress and trauma, to liver and kidney functioning, to key nutrients, exercise, and infections, there was so much more to how my thyroid worked than I was ever told by a general practitioner. Paired with the results from my other labs, which she annotated and went through with me step by step (compare to having a nurse barely mention lab results before saying they called in a new prescription), we were able to come up with actionable steps to improve my health.

I had some low grade inflammation and suboptimal nutrient levels, both of which could also be contributing to the health of my thyroid. Working on managing stress was a key factor in all of it, as it is for pretty much everyone in our society. She encouraged me to only take supplements when necessary, and she said that the hope is to only be on most supplements for the short-term. This was very reassuring to me, especially given the in-house supplement store. I’d never before felt like I could truly trust my doctor and put my healing in her hands. It was revolutionary. It made me wish that everyone could access this level of healing, all the time. And it broke my heart to know that in our world today, that just isn’t possible.

Every day I wake up and take my Levothyroxine pill, and I think positive thoughts that next time I check my levels, I’ll be safe to wean off of it. I take my zinc supplement and my three brazil nuts (a natural, food-based selenium supplement), and I imagine them helping my thyroid function at its best. I’ve really worked on my sleep hygiene, which includes a steady bedtime as well as an electronic cut-off point where I transition to only reading or other relaxing, spiritual activities, and my mood and energy levels have improved tremendously. I also swapped coffee for tea, which I’m still kind of bitter about, but I can’t be too mad when my anxiety levels are so much lower. I’ve been really working on getting back into my spiritual, witchy practices, and I’ve been pouring my heart and soul into my work in progress, The ScornedThe Lost Witches of Aradia Book 5

I try to stay away from the news and social media, and I stick to a diet and exercise routine that make me feel my best. If you want to know more about the daily habits, foods, and routines that have changed my life, comment that! I feel like that could take up a whole other article.

This is true healing, at its core. It’s belief in our healers to guide us on the right path and belief in our body’s own ability to self-heal. It’s the recognition that everything affects everything else. My thyroid function does not exist in a vacuum. It is effected by all hormones, by stress and imbalance, by nutrients and the microbiome, by every other organ. There is no treatment of the thyroid, as a distinct individual pathology. There is only treatment of the whole person: mind, body, and soul. 

When I write, I am healing. When I eat, I am healing. When I sleep, talk to friends and family, practice gratitude, unplug from social media, meditate, take time off, read a book, ride the bike or go for a walk, it’s all just as healing as supplements and medications. Sometimes even more so. 

I’d like to think that this article will reach the people that need to read it. My story is only one example of how doctors refuse to treat illnesses until they’ve already progressed to dangerous levels, and how medical practitioners are indoctrinated into a epistemologically narrow system of meaning-making that runs contrary to true healing and disease prevention. Our modern society is a giant petri dish for illness and imbalance, and our expensive, frustrating healthcare system has been largely ineffective in promoting overall well-being and longevity.

I only hope that one day the system itself can be brought back into balance. In the meantime, all we can do is treat ourselves with care and respect, advocate for our bodies, question biomedicine when necessary, and have faith in the power of healing, for ourselves, for each other, and for the planet.

(This post first appeared on Substack: Writing Magick with Maggie Sunseri. Click to subscribe, like, or leave a comment.)

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