Do you have Oprah’s thyroid trouble?

Photograph of Oprah Winfrey by AFP/Getty.

My cat had it. My sister-in-law had it. Now I have it: a thyroid disorder. And so did Oprah. Bless her little butterfly-shaped neck gland; she has once again changed the way middle-aged American women go about their business. Now, in addition to wearing waist-cinching belts and wielding a pneumatic staple gun, Oprah’s viewers are running in droves to get their thyroids tested.

It’s a good thing, too, because thyroid disorders are the second most common endocrine problem after diabetes. What’s weird, though, is how stealthy these ailments are. You walk around feeling a little tired and stupid, just assuming that’s life, especially after Labor Day, and then you find out there are actual tiny hormonal signals to blame.

Some 13 million Americans have a thyroid-related health problem, and 80 percent of them are women. Most are over age 35. Another 13 million Americans are probably walking around with undiagnosed thyroid conditions, according to estimates from the American Association of Clinical Endocrinologists. By age 60, one in five women will have thyroid trouble.

While Oprah was surfing through the high end of the weight scale a couple of years ago, she went for a walk with her exercise guru, Bob Greene. She recounts the day: He said to her, "I think something's wrong. You're listless. Your movements are slower, even when you're just doing normal stuff. Twice I've told you something and you don't remember it. There's no sparkle in your eyes. I think you're in some sort of depression."

At my last annual check-up, my doctor asked the standard assortment of stuff, including if I felt tired.

“No more than usual,” I said. I’ve been tired for eight years, since the day my first child was born and I had to learn a whole new definition of the word juggle. I got my annual scrip for Ambien, the Valium of the new millennium, and stopped in the lab for some blood tests on the way out.

Two days later, the nurse called me. “You have Hashimoto’s thyroiditis,” she burbled. Cool syllables aside, this turns out to be the most common of the glandular disorders, in which the body makes antibodies that are slowly menacing to the thyroid. It often happens after pregnancy, possibly because the immune system surges after being tamped down for nine months. As a consequence, my gland was not quite producing enough of the thyroid hormones that do mission-critical things like regulate metabolism, reproduction, growth, and mood.

For an obscure chunk of tissue below the Adam’s apple, the thyroid is surprisingly important. “The thyroid is a master gland,” explained the nurse. “When it goes wrong, it impacts the entire body.” Intricately tied in to the rest of the body’s endocrine system, the thyroid takes orders from the midbrain’s hypothalamus and the pituitary gland in the brain’s underbelly. The gland’s job is to mix dietary iodine with an amino acid called tyrosine and pulse out T3 and T4. These hormones are released to every cell in the body to regulate cellular metabolism. It is, in short, the body’s fuel refinery. But the thyroid is easily buffeted by our steroidal hormones, estrogen and progesterone, and it appears to be sensitive to environmental assaults such as smoking, radiation, industrial chemicals, and diet.

I scanned the description of symptoms: Tired? Check. Weight gain? A wee bit around the belly, I admit. Brain fog? Check—I love it that there’s a clinical term for this symptom. I started getting excited. I often can’t think of the word for something. And I’m a writer. My husband will say something like, “Have you seen the grilling tongs?" And I’ll say, “They’re in the washing machine, I mean the fridge, I mean the, the whatsit-thing, the dishwasher!” Last month after one such exchange, he said, “For someone so smart, you sure are dumb.” What if I could take a cheap pill that makes all of this go away?

Tags: hormones

Florence Williams is a contributing editor to Outside Magazine and also writes for the New York Times Magazine, the New Republic, and other publications. Last year she was a Ted Scripps Fellow at the Center of Environmental Journalism at the University of Colorado.

Comments

thyroid disease and other autoimmune conditions

By: kitINstLOUIS | Thu, 10/22/2009 - 19:09

There is research now being done based on the theory that, since so many people with one autoimmune condition manage to develop another one, or more (I have four), that all autoimmune diseases are different branches of the same disease. That disease is one that causes our immune system to attack various tissue proteins in the body. This can manifest itself in as many ways as there are body systems. Autoimmune thyroid disease affects the largest number of people. Other autoimmune diseases include rheumatoid arthritis, celiac disease, pernicious anemia, Type 1 diabetes, Lupus, MS, Addison's disease, eczema, Sjogren's syndrome and many many more.

It's a travesty that there isn't more attention paid to this subject. There isn't a medical specialty for autoimmune disease, so patients, most of whom have multiple manifestations, are forced to go to more than one specialist, and sadly, each specialist is under-trained in the implications of multi-system autoimmune disease, how they affect each other and what the best tests and treatments are. Because of this, the great majority of patients go undiagnosed or get diagnosed too late to prevent organ damage. Many patients, mostly women, are treated like hypochondriacs and made to feel guilty for not being able to stay well.

One in five people in this country actually has an autoimmune disease, although only one in twenty people can even name one. I want to beg everyone in virtual earshot to call or write congress in support HR 2084, which has now picked up 18 sponsors on the Hill. Go here for easy access to your Senators and Congresspeople and to find tips on how to write an effective letter. http://www.aarda.org/congress_connect.php

Thyroid

By: hlenny | Wed, 10/07/2009 - 08:01

Thanks so much for the article about Thyroid troubles. I have been battling this for 6 years now. I saw so many DRs and they all went by the test #'s and said that I was fine and in the "norm" WELL I did not feel fine so I kept searching for someone who would listen to me. I finally found a Natropathic DR and she listened. I am still on my Levothyroxine I agree I need the medication, but with diet changes (cutting out wheat and gluten) due to an intolerance and getting rid of my IUD Mirena I finally feel great. I have lost 40 pounds, I exercise and actually enjoy it I feel amazing I feel more in control and not so "foggy" all the time and I am HAPPY. I will be checking in with my Endcrinologist in a few months and I am curious about my test #'s. All I can say is you know your body and you need to listen to it. Don't let everyone tell you that you are fine if you don't feel fine. The numbers aren't always the most accurate, what is normal for one is not for another.

Here's why it wasn't found sooner

By: whitecat | Tue, 10/06/2009 - 13:15

When I was diagnosed I had health insurance with an HMO. The LPN kept telling me I was menopausal/depressed/lazy/overeating/just getting old. I kept insisting on a thyroid test, because not only did I have all the symptoms, I was hyperthyroid in my adolescence, which required me to destroy part of my thyroid with doses of radioactive iodine. Hypothyroidism later in life was a slam-dunk diagnosis. The HMO just didn't want to make that diagnosis. They refused to test me for months.

When I was tested and the diagnosis was finally confirmed, the LPN was cranky - she said "I don't think you realize that this means you'll be on medication the rest of your life." I said "I don't think you realize that this means I was right and that it's not my fault I'm fat, tired and unable to think clearly."

All they cared about was avoiding providing me prescription medicine and periodic blood tests to make sure it was working. These things cost them money. They couldn't have cared less about my health.

Medication, however, does not mean all your symptoms will go away. Many doctors underprescribe because they go on test numbers, not how you actually feel. Many endocrinologists consider the range of acceptable T3 and T4 numbers currently used too narrow and too low. You will still probably retain the extra weight.

But it's not your fault - you really do have a glandular condition.

FINALLY!

By: Bo | Mon, 10/05/2009 - 16:09

The thyroid blogs, esp. Mary Solomon's excellent About.com site, have been speculating about this for years. I don't know why Oprah--with probably the world's best health insurance and access to great medical care--has taken so long to figure this out.

thank you!!

By: yossarian | Mon, 10/05/2009 - 14:23

I too have Hashimoto's. So great to see an article that mentions mainstream medication. Oprah did women a great disservice by stating that she "blew out her thyroid" and just went on vacation for 5 weeks and got better all by herself, without meds.

Florence, have faith - it takes awhile for the meds to kick in (for me, a couple of months), but yes, that foggy feeling will go away and you will wonder how you could have felt so bad for so long and not realized something was wrong. Best wishes!!

great information

By: keri40brk | Mon, 10/05/2009 - 11:57

I love seeing articles about thyroid problems. Ten years ago I had Graves Disease, which is hyperthyroidism. Luckily, the affect was so fast; a 30 pound weight loss in a month, chunks of hair falling out and protrouding eyes, that I was quickly diagnosed. My thyroid was radiated and I'm now on pills to supply the hormone. I have my levels checked several times a year and when they get too low, weight creeps on, I'm tired and have the brain fog that is like a low-grade depression. I've suggested to many women to get their thyroid checked, it's a simple blood test, and many have and turned out to have a problem. It's easy to think you're just being lazy or eatting is out of control when it's very real disease. Thanks for the piece!

Thanks for this,

By: Mariadne | Mon, 10/05/2009 - 10:38

Thanks for this, Florence--it's really gratifying to see more mentions of hypothyroidism popping up in the media (and in pop culture--on the Simpsons last week!) I also the auto-immune variety (Hashimoto's) and I had always figured it was genetic--can environmental factors like low iodine really trigger an auto-immune disease?