Thyroid Mystery Solved: Oprah Winfrey's Thyroid Problem Wasn't Actually Cured

Last week, I wondered if Oprah Winfrey really is cured of thyroid disease, as she had said in her show on January 5, 2009.

Now, at her website, there is a special page to clarify Oprah's thyroid issue, and whether Oprah's thyroid problem was actually cured. It says at Oprah.com:

When Oprah announced last Monday that her thyroid problem was cured, it sent many viewers buzzing on the message boards. Is it even possible to cure thyroid disease? And how did she do it? Oprah is now clearing the air. "Here's the bottom line," she says. "When I said I was cured, I meant I don't have the thyroid problem anymore because my thyroid levels are all in the normal range now and my doctors have taken me off of any thyroid medication." However, Oprah says she still has her levels frequently checked to monitor her thyroid gland.

Well, just to be clear, your thyroid problems aren't the usual thyroid problems. And by that I mean although the ailment itself is common, there's two issues that can happen with your thyroid. It can underperform—that's hypothyroidism—or it can overperform—hyperthyroidism. But your issue, Oprah, and you're so unique, is you were having a frat party in your thyroid. You were having a bunch of different things happening at once. And so you have these two ailments: One was stimulating the thyroid with antibodies; the other one was actually waging war on the thyroid. And so when those two level out, they actually can bring you into a place of peace—which, interestingly, is where you are right now.

Oprah herself has said that she had a period of where her thyroid was overactive (hyperthyroidism), followed by underactive (hypothyroidism). And Dr. Oz' description of the antibodies suggests that Oprah might have had Hashitoxicosis, a condition where you have antibodies suggestive of both Hashimoto's and Graves' disease-- and these antibodies are stimulating the thyroid to produce excess hormone, and at the same time, attacking the thyroid and attempting to destroy it.

Dr. Oz suggests that the antibodies have "leveled out," and that she's now in a "place of peace." And Oprah herself says her "thyroid levels are all in the normal range now and my doctors have taken me off of any thyroid medication."

What do I think is going on? I suspect Oprah is in a situation that millions of women face every year. She's overweight, tired, puffy-faced, and perimenopausal, but she's now being told that her thyroid levels are "normal." She's turned into a lab value -- and she may be inadvertently damaging her health, and sabotaging her weight loss efforts by remaining uninformed about thyroid disease, failing to ask the right questions, and failing to consult with experts and practitioners who actually understand thyroid disease.

So Oprah, if you or any other woman in this situation asked me what to do, here's what I would suggest.

1. Find out if you still have elevated antibodies.

Because if you do, even if the other thyroid levels are in the normal range, you can still have symptoms, including weight gain or difficulty losing weight. In fact, some studies have shown that in patients who have elevated antibodies, but normal thyroid levels, preventative treatment with thyroid medication can slow or stop the elevation of antibodies, help prevent progressive to overt hypothyroidism, and help relieve symptoms.

2. Find out what your doctors mean by "thyroid levels are all in the normal range."

There is currently a controversy among conventional physicians as to what even constitutes the so-called "normal range." Since 2003, many endocrinologists have recommended that the TSH (thyroid stimulating hormone) normal range of .3 to 3.0 be used for diagnosis and management of thyroid problems. And some physicians target a TSH level of between 1.0 and 2.0 to relieve symptoms in patients. Shockingly, most labs in America, and many physicians, still use the old, out-of-date range of .5 to 5.5. That means that if Oprah Winfrey has, for example, a TSH level of 4.0 -- some doctors will tell her that her TSH is normal; others would say she's hypothyroid.

The unfortunate reality: People who fall into the "limbo" between 3.0 and 5.5 have as much chance of being told they are normal as they do of being properly diagnosed and treated!

Being told that your levels are "normal," therefore, is definitely not enough information for any woman. Find out the exact numbers, and the range that your doctor is using to decide what is normal.

3. Find out if your Free T4 and Free T3 have been checked.

TSH is a pituitary hormone, but T4 and T3 are actual thyroid hormones, and the Free T4 and Free T3 tests measure the amount of these hormones circulating and available in the bloodstream. In some people, especially those with elevated antibodies, the TSH may be normal, but the Free T4 and Free T3 are low or borderline. This can point to a subtle problem that warrants treatment. TSH alone is not enough to truly assess thyroid function.

4. Find out if you are suffering from adrenal fatigue.

Oprah said that she went off of all medications because she didn't like how they made her feel. Clearly, if she had felt a benefit from thyroid medication, she might have continued, but the combination of medications for blood pressure, palpitations and thyroid disease apparently made her feel worse. While she may have been reacting to the other medications, we also know that, in some patients who have underlying adrenal fatigue, thyroid treatment actually makes them feel worse. These patients do better when they start with adrenal support (either nutritional/supplements, or a prescription hydrocortisone, or both), and then introducing the thyroid medication.

MORE ON OPRAH WINFREY'S THYROID AND WEIGHT CHALLENGES

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

_{Photo: Getty Images Entertainment / Alberto E. Rodriguez}