Young 22 yo male w/ Hashi's ... will I lose my career?

[sben3726]

Hi all,

I'm 22 and male in college. After I graduate in a few months, I will be working for wall street investment bank in New York this summer.

Yesterday, I was diagnosed with Hashimoto's Thyroiditis by an endocrinologist. Hashimoto's has made me feel like crap for the last 6 months. I used to be the type of guy you'd expect to do great things, but now I've hardly been able to go to class or see my friends for about three months. To return to being functional, I have had to make a lot of lifestyle changes. The lifestyle changes have helped, but I still have probably 30% less stamina than I used to and I absolutely need to stick to these strict lifestyle habits to stay functional.

For obvious reasons, I am concerned about my career choices. As an junior investment banking analyst, I will work between 70 and 120 hours per week under stressful conditions, with 90 hours being an average. I will work on hundred million dollar deals regularly and mistakes or lapses are not forgiven. It is without a doubt brutal for your first two years in this career path. You do not have time to prioritize anything over the job, including your health. The best of the best who are extremely healthy will approach burnout after 2 years - that is expected. But, after these 2 years, the world is your oyster. One day, I want to to use my training in New York to great things for the world one day outside of finance, I really do. Yet, part of me feels like trying to be a banker or in finance more generally while having Hashimoto's is like trying to be a runner with an artificial leg. Work stamina is the key trait of a Wall Street analyst, yet Hashi's may take this away from me. I've worked so hard all of my life to do well in school and train my mind. I cried in front of my doctor when I received my diagnosis because I thought all my dreams were over.

When I read about Hashi's I tend to read that hypothyroidism is a well-understood disease and that synthetic hormones can solve the problem. But that's doctors and studies talking, not patients. When I read these forums, many people still seem to suffer from severe fatigue even after getting on these hormones. Part of me thinks part of this is a function of age too, and perhaps since I am an unusually young Hashi's sufferer I may be better able to tolerate this especially well with treatment.

All that being said, will there be times where I can expect my hypothyroidism to relapse after treatment? Will the severe work conditions cause a relapse in hypothyroidism even with treatment? Will the stress make the autoimmune systems worse and/or the hypothyroid symptoms worse? What about the lack of sleep? I plan to have a good attitude about this and I am NOT going to give up easily in the face of a setback. Please give me the opinions that you feel are honestly the truth - I will not be offended and just want to hear opinions to help me make the best overall decision.

Thanks,
Ben

[Red_Star]

My hypothyroid symptoms worsen when I'm stressed (mental and/or physical stress).  And this is not just my thyroid gland but also at a cellular level. Nutrients to help with stress: magnesium, B vitamins, zinc, vitamin C.  And selenium may help lower thyroid peroxidase antibodies (TPOAb).

[goolarra]

I completely agree with everything Barb had to say.

I'm just throwing in my two cents' worth because I'm in the investment business, and I'm well aware of what the first couple of years on Wall Street are all about.  Fiscally, the country is being run by a bunch of 22-25 year olds, and you're right...you have two years to make it.  Lots of pressure, lots of work, pays big dividends when you're done.  

That being said, there are off Wall Street ways to break into the business that don't come with nearly the pressure and physical stress.  The investment business is highly lucrative in almost every aspect.  I broke into it many, many years ago by going to work for an investment advisor.  The first few years were still rough, but nothing like what you'll be going through.  I'm just saying that there are other ways to get to the same place, so if you do find it too much to deal with, don't think your career is over.

That being said, you seem to have a great attitude, and that's a huge part of conquering this disease.  Bear in mind that people who participate in medical forums are not the people who are satisfied and happy with their care.  We are the people, who for one reason or another, did not fit the textbook treatment model.  Many people take their pill every morning, and that's the end of their story.

Learn all you can.  As Barb's already said, and I still have to re-iterate, find a doctor you can work with.  Don't give up until you are feeling good again.  Under treatment is rampant because so many doctors treat by the numbers.  

Best of luck...    

[Barb135]

There's no reason you can't have a successful career, even with Hashimoto's; it's not the end of the world.  Hashimoto's, itself, doesn't cause your symptoms; it's the resulting hypothyroidism that makes you feel tired, hair fall out, etc.

Most likely, your doctor has, or will, put you on some type of synthetic thyroid replacement medication.  Many/most of us do just fine on these.

Hashimoto's is progressive, in that thee antibodies are continually destroying thyroid tissue, and as they do, your thyroid makes less and less of the hormones you need.  You will need to be tested periodically, to make sure your levels of the active hormones, Free T3 and Free T4 are adequate and that you have attained symptom relief.  

Typically, when actively adjusting thyroid hormone medication, testing is done at 5-6 week intervals; as you get to your optimal dose, testing can be put back to the 3 month mark, then 6 months or even a year.  Any time you don't feel well, you should contact your doctor for testing to be sure your levels are still optimal.  

The key to getting to the symptom free stage, is having a good doctor who is well versed in thyroid.  Many doctors believe on only in testing TSH and ignore the Free T3 and Free T4; others will insist that as long as one is "in range", they should be fine.... you need one who will look at, and consider the lab numbers, but who pays more attention to the patient and is more concerned about symptom relief than the numbers.   Your doctor should also be willing to consider any type of medication that might help you get well.  This includes the use of T3, such as that found in cytomel or generic liothyronine and/or desiccated hormones, which contain both T4 and T3 or even compounded meds.

Do you have copies of your lab work, so we can see what your status is now?  You should get a copy of every lab test you get, so you have them for your record.  I write on each lab sheet, the med(s) I was taking at the time of the blood draw and what, if any symptoms I had at the time.  This has become my running record of my disease.  

If you have a copy of your thyroid labs, please post the results, here, so we can see where you are with it all.  Be sure to include reference ranges, which vary lab to lab and have to come from your own report.

There are a variety of things that can cause hypothyroidism to worsen... the main one being that your thyroid will produce less and less hormones, as the antibodies destroy it, so you'll have to adjust medication periodically, to accommodate that.  Once the thyroid no longer produces any hormones, you should level out, though there are still things that can cause you to go hypo again.  If you become very "in tune" with your body, you'll be able to catch these changes before they have a very profound effect on you.

I can't stress enough, the need for a good thyroid doctor.  Keep in mind that many endos specialize in diabetes and may not be good thyroid doctors.