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Mary Shomon

Should You Stop Thyroid Treatment Like Oprah Did? Thoughts from Dr. Marie Savard

By January 5, 2009

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Dr. Marie Savard is a physician, patient advocate, and Good Morning America's medical correspondent. After Oprah Winfrey's latest revelations about her health -- including her discussion of her thyroid problems and weight gain discussed in the January 2009 issue of O magazine -- I asked Dr. Savard if she had any thoughts about Oprah's decision to stop thyroid treatment.

Since Dr. Savard does not know the specifics of Oprah's medical history, she shared comments and questions based on the issues that Oprah's situation raises, drawing on Dr. Savard's 25 years of private practice as an internal medicine physician treating many women (and some men) with thyroid disease. She wants to be clear that she is not responding to Oprah's personal history, but rather, sharing some thoughts and questions that might be helpful to other perimenopausal 50-something women who are struggling with similar health issues, or perhaps themselves considering stopping all medications, as Oprah reportedly has done.

Here is what Dr. Savard has to say.

The patient is a 53 year old perimenopausal female who works 24/7 with a history of fluctuating weight problems but who has otherwise been in what seems to be good health. She presented in February of 2007 with symptoms of difficulty sleeping, lethargy and irritability, gradual weight gain and fluid retention, exercise-induced palpitations and high blood pressure, She admitted that she couldn't sleep for days. She was evaluated by many doctors and finally a doctor diagnosed an overactive thyroid condition which gradually converted to an underactive thyroid condition. Presumably she was placed on medication to treat her overactive thyroid at first (Tapazole or PTU) and later for an underactive thyroid (synthetic or natural thyroid hormones). She also was on medications for her palpitations and high blood pressure. As her weight continued to climb and she believed her medications made her feel like she was in a fog, slowed down and viewing life through a veil she again switched doctors and eventually stopped all of her medication except for daily aspirin. Although she doesn't say in her history, her description suggests she actually felt better after stopping the medication.

This patient's history raises the following questions and concerns for me:

  • What was the patient's thyroid diagnosis and what were the results of her thyroid function studies?
  • Did she really have an autoimmune disease of her thyroid and why then can she stop her thyroid medication without any ill effect?
  • Is she the infrequent patient who has transient thyroiditis and is now better - for the time being at least?†
It is unusual and often dangerous for a patient with an underactive thyroid from autoimmune destruction (or surgical removal for that matter) to stop their thyroid medication for more than a few days to weeks. Once the diagnosis of low thyroid is correctly made, lifelong thyroid replacement is life-saving. It can be difficult to find the correct thyroid replacement medication and dose - but what is not questioned is the continued lifelong need for treatment.

This leads me to question whether the patient really has thyroid disease. She may have had blood tests and symptoms that were borderline or conflicting and her doctors agreed to try empiric treatment to see how she would respond. Her lack of response to treatment suggests she does not have a thyroid problem however. Even if she was impatient and didn't give the medication enough time, she could not safely forego the medication altogether if her thyroid was underactive and not making enough thyroid.

  • Does the patient still have high blood pressure (hypertension) and exercise induced palpitations?
  • What is her resting heart rate and blood pressure?
One of the earliest signs of overactive thyroid can be a rise in the pulse rate at rest and it can often be felt as palpitations or rapid heart beat with exercise. In that case, a†class of heart and blood pressure medication is usually prescribed to slow the heart beat in cases of overactive thyroid while the thyroid medication to treat the overactive thyroid is taking effect. These medications are called†beta blockers with generic drug names such as tenormin or propanolol. These great medications very commonly however cause mental cloudiness, lethargy, feeling slowed down and even depressed. Often they can be taken at night with fewer side effects and patients gradually tolerate them better if they increase the dose slowly.

I suspect much of our patient's side effects from medications may be from beta blockers or other blood pressure medications. These drugs cannot be stopped suddenly as the risk of a sudden return of the rapid pulse could lead to a heart attack or even a stroke. I presume our patient lowered the dose gradually and was therefore weaned off these medications.

  • What is her blood pressure now?
Some patients with high blood pressure can safely stop their medications for long periods of time if they make the necessary permanent changes to their lifestyle - such as engaging in daily exercise, limiting salt intake, eating more fruits and vegetables and trying to limit stress or sleep problems.
  • What is the underlying cause of our patients weight gain and fatigue?
Our patient works almost 24/7 and admittedly was not sleeping for days at a time at the onset of her medical problems. A good night's sleep of 7 to 8 hours a night is now known to be critical to good health, a strong immune system and even to maintaining a healthy weight. Studies in children and adults have linked reduced sleep (less than 6 hours a night for adults) to impaired glucose tolerance and weight gain (specifically gain in waist size from accumulation of the dangerous belly fat from rise in cortisol). Increased stress and reduced sleep are perhaps occurring in epidemic proportions and is almost certainly a factor in our patients medical history.

In the end, every patient comes to us with their own unique and very personal story, and must work with their own physicians to regain health. But listening to your body is first and foremost. Your body's health radar works best -- partnering with a trusted doctor who takes time to listen to YOU.†

-- Dr. Marie

You can find Dr. Savard regularly appearing on ABC's "Good Morning America," and at her website, Dr. Marie's Healthy Dose, at www.drsavard.com. For more from Dr. Savard here at the About.com site, read:

Read all of Mary Shomon's About.com Thyroid site coverage of Oprah Winfrey's thyroid condition here.

Photo courtesy Marie Savard, MD

Comments
January 5, 2009 at 5:15 pm
(1) Lily says:

I wish Oprah would discuss her former thyroid treatment and test results. We know everything else about her, from psychic pain to bowel habits, this would actually be educational.

January 5, 2009 at 5:24 pm
(2) Amy says:

“Her lack of response to treatment suggests she does not have a thyroid problem however.”

No offense to the Dr. but this isn’t a logical conclusion. Her lack of response to treatment could mean 1) She wasn’t on enough hormone to feel the benefits 2) She was on a synthetic medication like Synthroid and would have, like many ofther patients, responded better to a natural treatment like Armour thyroid or 3) The extra thyroid hormone reveiled weak adrenals and when she stopped the medication she removed the adrenal stress. This doesn’t mean that she didn’t need thyroid, but without adrenal support it made her feel worse.

Feeling better without a medication dosen’t necessarily mean that it isn’t beneficial- often you just need to adjust dosages.

January 9, 2009 at 7:07 am
(3) Maureen says:

These articles are really to the point and very informative. Like many of you it took me years to be correctly diagnosed with my hypoactive thyroid. There were many hills and valleys and there still are. I feel Oprah has the right to the same amount of privacy as we all had when we were going through this journey.
This is a very hard journey. Bless her.

January 9, 2009 at 8:39 am
(4) Debbie says:

Oprah should have her adrenal glands checked and other hormone levels through the appropriate saliva tests. My doc did those and diagnosed adrenals failure, along with low levels of testosterone and progesterone. It’s been 5 months on this treatment plan (which is in addition to Armour Thyroid) and I’m finally able to exercise daily and I’m trying to get my life back. Oprah, I think you still need more appropriate testing!

January 9, 2009 at 4:27 pm
(5) Ezzie says:

I have had thyroid problems near all my life and I have done both synthetic and natural..nothing seems to help..But the one thing when a dr decided to remove all meds and start over I gained fast and hard even though I was excerising. Now that I am back on the meds I am gaining about 12 lb a month and I am still so tired that I can not stay awake. I use oxygen at night but not in the daytime..

January 9, 2009 at 10:46 pm
(6) tracy duggan says:

im feeling quite sorry to read this kind of respond on a site i felt was really informative, ive just however realised that unfotunatly here you are still discussing people like some kind of lame experiment & i wonder how much your supported yourselfs by the medical world, im sure you understand where im coning from. So where did the open mind that is fully almost in your face go? im a full beliver in people not statistics results & all the paper stuff, somehow i miss conceved the intentions i am know beliving, of this site & maybe your intentions. maybe im wrong but how can you publish this kind of material on this site? i belived this was an informative opend minded helpfull site, not so right winged! & conservative. I was unable to finish what that woman was saying in her report about whinfry, what does she know? talk about strait from the tex book reply, which is obvious from the way she erradicates any possibillity that any disfuncion can be cured! well heres news for you guys……… energy thats what you are!!! oh suprised well yes you can change energy, we do it everyday. Unfortunatly negative response to some peoples sucsess only keeps us beliving theres no chance, chain me to my meds pleaaase!!! oh come on theres 50 sides to the story why not try talking to the lady herself? instead of dicouraging millions of people who maybe where not going to just stop meds but where developing very important feelings of hope! patience is a virtue. in time you will see. im although sadly dissapointed today at what i have read here, funnilly enough with 3 of your books by my side !!!!!!!!!!! what kind of help are you really giving to the future & whos side are you really on? patient advocate?

January 10, 2009 at 4:44 am
(7) Kim says:

I’d like to comment on the effects of going without your thyroid medication. Due to no medical insurance to have my expensive blood work updated my Dr. refused to refill my prescription without the blood work being done. Therefore I literally went nearly 4 mo. without my Synthroid (I have Hashimoto’s. Not only did my body get to the point my muscles became sore and weak just trying to brush my hair, I slept LONG hours, gained MORE weight, felt completely listless and eventually was slurring my speech as though I was drunk. The left side of my face and neck began to swell. I was finally able to get medication, and within 72 hrs. felt incredible. The swelling finally went away, a little weight has come off, I feel rested after sleeping but my hair is falling out like leaves that fall to the ground during the fall. I’m worried about the internal aspect of being without my medication for so long. But without medical insurance, I’m limited to resources for help. I’m 44 yrs. old and grateful I’m still here! There is no way in **** Oprah would be able to be suddenly cured refusing to take her medication, unless Christ himself took pity on her and created a miracle!

January 10, 2009 at 8:34 am
(8) Metagee says:

Oprah will only be helped if she follows guidelines provided to all sufferers: take medication; avoid soy products and PLEASE avoid denial!!!! Remission???? Dr. Oz should be fired or shoudl find another patient. Oprah has demonstrated total disregard of a very serious condition. Perhaps she needs to be invited to another talk show and be educated by Mary Shomon and some of us sufferers!!!!

January 10, 2009 at 8:35 am
(9) Metagee says:

Oprah will only be helped if she follows guidelines provided to all sufferers: take medication; avoid soy products and PLEASE avoid denial!!!! Remission???? Dr. Oz should be fired or should find another patient. Oprah has demonstrated total disregard of a very serious condition. Perhaps she needs to be invited to another talk show and be educated by Mary Shomon and some of us sufferers!!!!

January 10, 2009 at 10:00 pm
(10) Shan says:

I think that Oprah is leaving a dangerous message. I mean we don’t really know what about her health or her thyroid state. She should not talking about leaving thyroid treatement. She is so an important person that other persons could do the same and do the wrong thing.

January 11, 2009 at 4:58 pm
(11) Ivette says:

As far as I understand thyroid desease is uncurable, treatable yes, but if you have no thyroid gland you will be on some kind of medication to keep you balanced.(syntroid,levoxil etc.)

January 13, 2009 at 5:10 pm
(12) A.K. says:

Perhaps in 2010 or 2011 we will see a show on how Oprah’s stance on her alleged thyroid condition plays out. The endocrine system is a marvel, a wonder, a confusing tempermental system. The challenge of thyroid disease is the biggest one of my life thus far. Good luck to us all because we need it to find a life-balance that works in our favor. If that even exists. I’m in the first year post-surgery and I haven’t found it yet.

January 16, 2009 at 6:27 pm
(13) cary says:

My comment is directed at Tracy. Are you for real? Do you actually walk around that naive? If you wanted to buy a commercial spot during Oparah’s show it would cost you 22K for a minute. Now, why do you think that is?. Millions of people watch Oparah’s show. It obviously has a huge influence on people because you have quite certainly lost all your critical thinking skills. Have you not been paying attention. It has nothing to do with believing in healing yourself or miracles, it has everything to do with a highly influential wealthy person presenting false information and packaging it as TRUTH! From Dr. Phil on down to her latest show. Many of us have tried alternative treatments along with going off our meds only to have a major health incident.
Try peddling your psycho babble to Tom Cruise. Would you tell a person with Type 1 diabetesís(an autoimmune disease) to go off their insulin?. Does that seem responsible to you? Anyone that does research on thyroid problems knows that hypo thyroid is not the same as Hashiís. Hypo people can (not always) over the years go in and out of hypo and sometimes hyper. So that explains why people with Hypothyroidism sometimes can go off their meds because sometimes their TSH DOES fluctuate. My personal prediction is that someday we are going to find out that using a 75 year old medication that is taken orally and has to metabolized, is not the most efficient why to deliver the needed hormone./ I believe we will find that our TSH, probably goes up and down more like insulin than has been generally believed.

Now Hashimotoís is different. People with Hashimotoís have an autoimmune disease and 3/4th of them also get another autoimmune disease. Myself I had 10 years of endometriosis and now 15 years of Hashimotos my thyroid is completely gone (it is a speck on the ultrasound) hundredís of my cells are now attacking my hearing and I am going deaf. It happened within 2 wks time and I am completely deaf in my left ear and going deaf in my right. It is called AIEM (autoimmune inner ear disease.) I take my thyroid pill because my TSH shoots up to 15 if I donít , but I also supplement with vitamins and alternative healing methods, but I would never tell anyone suffering an illness that it is NOT REAL and they should just go off their medís and everything would be ok.

When Oprah has an actual MD specialist in this field or Many Shannon on her show. People that can give information about different medís, and side effects and other alternative methods we can do to help us manage our condition .Then I will take Oprah Winfrey serious. What she has presented for the past several years is a bunch of unprofessional telling us that we just are stifled and our voices our not heard, so we have this thyroid condition. Oh myÖ.(the psycho lady from last yearís show. ) remember her. Oh and remember Dr. Phil and him beating up people and Iím listening to their complaints and screaming at the TV- my gosh lady go get your thyroid checked.

Tracy I pray for miracle but I live my life with faith and the facts before me and do the best I can.

January 23, 2009 at 3:14 pm
(14) Lori says:

Thank you Cary, I totally agree with you. I have been following Mary’s articles for some time now and the information she gives has helped me so much. I was watching the day Oprah said she was “cured” and was waiting for an explanation along with, I am sure thousands of other thyroid disease sufferers and felt that as the huge influence that Oprah is,and she knows it, she just left people hanging out there, making them wonder, is there a cure, and why did she not share any of that information? People, maybe not knowing the full details of the disease yet.

How many of those people watching that day went off their medication?? Not knowing any better due to lack of education of the disease, and how it will truly effect their health. I have been dealing with endometreosis for 30 years or so, diagnosed hypo 25 years ago and recently diagnosed with Hashimottos thyroid disease, along with another autoimmune disease and hello, shingles, PHN. If anyone knows what this is you know that it is nothing you would ever want someone else to go thru.

I Had at one point gone off my synthroid medication and suffered horribly due to it, it was the wrong thing to do. I am not saying that some people are not able to do this, but be very, very careful and make sure you have a doctor you can trust and check your TSH, T4, T3 levels. I did not do that and took the biggest dive ever into so hypo my body was shutting down. I hope and pray this does not happen to Oprah or anyone. I am just saying if you do show that you are level without the medication all of sudden be careful, it can change back to hypo quickly. It only took my body 10 days without meds when I could not even function and when your immune system drops that low other health issues can flare up.

Now living with Hashi’s I can be hypo one day and hyper the next, it can be a huge rollecoaster ride, it would great if you could check your levels daily, something like the insulin checks that diabetis patients can do. Honestly I do not know any facts about it but or if it is possilbe I am just hoping that there could be something like that so we can help manage our disease better.

But my point is, that if it was not for this web site and Mary’s articles, after Oprah’s comments I was lost, even as educated as I am in this disease, I was lost until I read Mary’s explanations and all the other comments here on her site. I thank you again Mary for all you do for others, and all of you for sharing your comments. At best we can all learn from each other, we all have stories, some the same, some different but we can all help each other by sharing are own experiences. Stay positive and educate, educate, yourself, and keep up the fight to stay healthy.

May 9, 2009 at 9:02 am
(15) Carol says:

Thank you Cary and Lori for your in depth comments.
I was diagnosed with Hashimotto 2 years ago and started taking synthroid 100 mg. I am blessed to have medical insurance, a doctor who is very thorough and an endocronolgist who does great follow up. I also read and trust Mary Shannon comments, and sometimes read Dr. Northrup’s articles.
Well, I was went abroad last week for a week’s vacation and did not take my synthroid for 8 days (I had forgotten to pack). I must say I felt less fatigued and tired, I slept better and overall felt much better. I wondered if this was attributed to being away but I do not think so as my trip was to nurse a friend who is terminally ill with cancer, and her daughter who is drinking a bottle a rum daily in a race to die before her mother so I was faced with much stress and anger at the health care system abroad not doing anything to help this daughter (44) who since 13 has suffered from lupus and epilepsy and was cared for by her mother. I tell this story because my vacation (or should I say trip) was stressful. I was tempted to stop taking the medication because I felt so good (I just returned 5/8/09) but trying to be sensible I decided to research if anyone had done this and what were benefits/effects of stop taking medication. Of course I stumbled on this site (I had no idea OPRAH had stop taking her medication). When Oprah speaks the world seems to listen and I am astonished to read from articles that she went on her show and talked about this. (I will have to research this some more). I do not believe Oprah has had Mary on her show and
I cannot understand is her resistance to having Mary on her show?

Again thank you all for your comments.

November 22, 2009 at 1:46 pm
(16) Healthy Dad says:

I went misdiagnosed for years for my thyroid and adrenal fatigue issues. I finally found a doctor who was able to properly diagnose and properly treat me. Dr. Fred Schultz in Wheaton IL has been such a blessing to me. I have never felt better. I am not sure of Oprah’s decision to discontinue her treatment for Thyroid problems but perhaps she has a truly knowledgeable doctor like Dr. Fred Schultz and Dr. Marie Savard.

April 8, 2011 at 8:59 pm
(17) sandy says:

i think i have been misdignosed on thyroid but tests come back ok but i do not feel right benn up and down ondosage for 20 yrs but have lost hair lost weight am depressed anxiety.tell what you foung out

March 14, 2012 at 9:38 am
(18) Jewelianne says:

First of all if she was having signs of overactive thyroid it could have been caused by medication, her meds should be adjusted accordingly. She never should be left on high dose thyroid hormone replacement and then treated for the symptoms caused by overdose of thyroid hormones,instead the doctors left her on high dose thyroid hormones (keeping her in an overdosed state continuing her issues) and treated the symptoms by giving her additional medications causing significantly more side effects to complicate her situation. She should have had her thyroid medication lowered to a suitable dose until she was no longer in a hyperthyroid state. Then if she still presented with signs of high blood pressure and heart palpitations (which can be a sign of overdose of thyroid medications) it could be investigated and treated appropriately. Now you have a woman so afraid of being handed pills just because the doctors can that she is not being treated at all and she may very well have a serious underlying condition that needs treatment.

May 14, 2012 at 2:53 pm
(19) Jim says:

This is just my own personal testimony which includes testing and experimentation on myself, along with the final results…

3 yrs ago I was diagnosed with hypothyroidism & 3 mos later developed Vitiligo. Initial TSH = 16. Took Synthroid for 1 month. TSH dropped to 3. Felt worse. Stopped for 1month. Felt a little better. TSH = 13. Began taking Synthroid again and felt worse again. Then developed Vitiligo. After about 6 mos, switched to Armour and felt great. TSH = 1. Took Armour for 2 yrs.

6 mos ago, made a fairly substantial change in diet. Also had hypertension for 30 yrs. For 12 yrs, big fruit and vegetable eater. Drank 8 cups of plain water a day.

Diet adjustment includes; elimination of plain water, reduction of anything that grows from the ground, increased in red meat. Increase in salt. A little alcohol and raw milk each day.

Soon, my blood pressure began to steadily decrease. After 2 months, half a dose. After 4 months, stopped taking blood pressure medicine. Vvalues were 100/55 and I was experiencing symptoms of low blood pressure(light headiness, dizziness…etc). No adjustments to Armour during this time.

After 4 mos, further reduced the sugar intake. Began to feel lethargic.

Started taking half a dose of Armour and felt better but still a bit lethargic. Completely stopped Armour and feel fine again. At this time, I feel best with no thyroid medication at all. Diastolic runs between 75 and 85, systolic 120 to 130, without blood pressure medication.

Since making the adjustment in diet, I’ve very slowly lost about 15 lbs of weight as well. As of today, no change has been observed in the Vitiligo.

Too much sugar(especially fructose) and over-hydration!

I’m certainly not making any recommendations at all. I’m very surprised by my own ignorance in the past concerning diet, health, and the processes of the human body. I can only ask, what else don’t I know?

P.S – 20 yr smoker and still smoking.

July 29, 2012 at 3:59 pm
(20) LamyHakyBek says:

couldnt have said it better myself

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