Oprah admitted tonite on her Best Life Webcase that she was on Methimazole (Tapazole) when treating her thyroid problem. Methimazole is an anti-thyroid drug. So it appears that Oprah had Hashimoto’s Toxicosis – an autoimmune combination of Hashimotos and Graves. Treatment with Tapazole can be common in treating Hashimoto’s Toxicosis. But you are left wondering about the weight gain and depression — common symptoms of hypothyroidism. Whatever happened. Oprah will need to be prepared, because hypothyroidism is a good possibility for the near future. So we’ll keep our fingers crossed that she’ll become informed about desiccated thyroid.
Anybody had Hashi’s Toxicosis and treated with Tapazole?
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ibeji said:
Jan 14, 09 at 12:49 amAFAIK, a treatment of Hashimoto-toxicosis with thyroid inhibitors is not very effective, because it doesn’t prevent the uncontrolled rupture of thyroid follicles as a consequence of the autoimmune process (attack on the thyroid gland by the immune system), but only prevents the thyroid from producing more thyroid hormones. Eventually this will lead to a drop in levels of thyroid hormones in the blood, but only after the worst peak is over anyway (after many follicles produced by the thyroid before the treatment was started have ruptured) — at least as far as I understand the process (I’m not a doctor, just a patient with Hashimoto’s myself).
Again AFAIK, a treatment with corticosteroids is sometimes used to dampen the autoimmune process which is the direct cause of the toxicosis.
Anyway, the fact that Oprah Winfrey has had weight problems and other symptoms of hypothyroidism for years (if not decades) makes it very likely that she is actually suffering from Hashimoto’s.
With Hashimoto’s, recurrent transient phases of toxicosis are common.
ibeji said:
Jan 14, 09 at 1:03 amP.S.: In 1996, when it was discovered that I had a prolactinoma, the thyroid was also checked. My TSH at that time was suppressed, fT3 and fT4 were normal, and I had high titers of anti-TPO– and anti-TG-antibodies but anti-TSH-receptor-antibodies well below the threshold. This was (mis-)diagnosed as Graves’ and treated with Carbimazol, and later with hormonal replacement. After a year or so of treatment, and after stopping treatment without relapse, I was told to be cured (and also was told I had a 50% chance of a relapse in the coming 10 years).
I think this was really a Hashi-toxicosis and Hashimoto’s from the very beginning.
aprillv68 said:
Jan 15, 09 at 12:05 pmI was prescribed Tapazole as initial treatment for my thyroid (it turned out to be Hashi’s) 4 years ago by the first endo i ever went to, she had me convinced that i had Grave’s Disease, yet i had high thyroglobulin antibodies (above 90, normal is 20 or below, every lab is diffent) I felt great for about a month, then i relapsed on it and ended up with a TSH of 11, that was when the drug was stopped, had another TSH a week later, it was a 7. I was then diagnosed with Hashi’s and put on Synthroid ‚i’m now on Armour & the rest is history, the same goes for the idiot endo, who i fired several months later.
gina said:
Jan 15, 09 at 5:04 pmi had the same response as ibeji did: it sounds like oprah had the wrong therapy for the wrong diagnosis!
i believe i had an occurence of Hashi-toxicosis, which led me to this excellent overview of “Subacute Thyroiditis”, which seems to be a more general name for it.
http://emedicine.medscape.com/article/125648-overview
a few quotes:
“Only suspicion by the clinician and use of radioactive iodine uptake measurement can distinguish Graves hyperthyroidism from silent thyroiditis.” in other words, an under-educated md can mistakenly conclude that the appropriate diagnosis is graves, as in ibeji’s case (and probably in oprah’s as well, altho she and dr. oz continue to be maddeningly vague).
“The high thyroid hormone levels are a result of destruction of the thyroid follicle and release of preformed thyroid hormone into the circulation [and are] not a function of new thyroid hormone synthesis and secretion. Because no new hormone is being made, antithyroid medications are not effective in these conditions”. (exactly as ibeji said.)
finally, the recommended medication for this condition: “The treatment of subacute thyroiditis is generally supportive to reduce the symptoms of thyrotoxicosis … Therapy is directed to reducing the signs and symptoms of the hyperthyroidism with beta-blockers or iodine agents.”
does oprah have graves? probably not. should she have been treated with tapazole? almost certainly not. but then what do i know — i’m not a doctor!
Josee said:
Feb 09, 09 at 4:44 pmYES!!!! My daughter has Hashitoxicosis with high Thyroid Peroxidase, Thyroglobulin and TSH Receptor Antibodies. Sure we can do nothing and eventually she’ll go HypO and she’ll also be left with a high risk of TED (Thyroid Eye Disease) and other proven health problems unless the TSH Receptor Antibodies magically disappear into thin air.
Her doctor, unlike most mainstream American doctors, believes we have to get rid of the TSH Receptor Antibodies — all three types: stimulating, binding and blocking; to reduce her risk of complications down the line.
She takes a small dose of an anti-thyroid drug and at the same time thyroid replacement hormone. You see the only way to rid the body of these Graves’ related antibodies is with an anti-thyroid drug — this has been proven repeatedly in medical research studies.
My daughter has elevated TSI, TRab and TBII; her TSH is low normal with below range FT4 and mid range FT3 along with high TPOabs and TGabs. Before treatment she had very high FT3.
Likewise she was diagnosed with Graves’ disease by several doctors, but I never bought it. Her symptoms screamed hypO. Many Hashi patients have been hypEr before becoming hypO and still have blocking TSH Receptor antibodies and they also have eye problems along with various other conditions.
Mainstream medicine ignores treating thede TSH receptor antibodies other than the stimulating (TSI) antibodies. When a Graves’ patient becomes hypO just give them thyroid replacement and pretend that TED and other risk factors don’t exist.
Many HypOs still have blocking TSH receptor antibodies and will never feel well. Most hypO patients don’t know that they even have TSH receptor antibodies because they are never tested nor treated. Unless you happen upon a knowledgeable provider, like we did — which are few and far apart.
Also — Scientists recently found MANY other places in our bodies have TSH Receptor sites (not just on the thyroid). We already are aware about the eye muscle (TED) and the skin (pretibial myxedema) and acropachy (bone issues in the fingers) are seen in some cases of Graves disease when TSH Receptor antibodies attach to them. But TSH Receptors are also found on the adrenal and pituitary glands. Maybe that explains why TSH Receptor antibody positive people often have adrenal/cortisol issues and even when they are severely hyPO they have pituitary TSH suppression. Some other locations where TSH receptor sites have been found are in the bones, brain, and pancreas. And we already know that people who have TSH Receptor Antibodies can end up with thyroid encephalopathy, and diabetes.
Nancy said:
Feb 14, 09 at 10:49 amI also was misdiagnosed with Graves Disease by my endo. He put me on Methimazole 10 mg 4x per day and Inderol 40mg 2x per day back on December 12th. On February 11th he finally admitted I had silent thyroiditis although he had blood work sitting on his desk since December 10th suggesting it probably was not Graves. The following blood work was normal: TSI,(TPO)Ab, Antithroglobulin AB. The other blood work was not normal: T uptake(high), Free T4(high), Free T3(high),Reverse T3(high),TSH .01(low). As of Feb 11th,I now have Free T4(normal),Free T3 (low), TSH .05(low).Endo is now weening me off of Inderol, but Still has me on Meth 10 mg 2x per day. I developed Raynauld’s Syndrome because of Inderal. I am questioning why endo still has me Meth. Does any one know? Or is endo wrong again? Would it hurt me to go off Meth?
BK said:
Mar 31, 09 at 8:47 amShe probably had “Hypothyroid Graves disease”, rather than Hashitoxicosis. Hashitoxicosis is when the cells of the gland are destroyed, and stored hormone is released.
If you have TRab antibodies (TSH receptor antibodies) then you *DO* have Graves disease. Graves disease is also known as “TSH RECEPTOR AUTOIMMUNITY”.
Methimazole doesn’t work on a gland that is releasing stored hormone. It only works at the first level — at the iodine molecule binding level, by preventing the creation of hormone.
HypOThyroid Graves disease is when the TRab antibodies are more potent in the “blocking” stage, and less potent in the stimulatory (TSI) phase. Getting TRab/TBII tested will often tell you if the TRab are causing you to swing back and forth from hypO to hypER and back, like Oprah is.
Methimazole also has immunomodulation effects — which can reduce TRab in as little as 4 days. If she has both type of Graves TRab antibodies, then MMI will indeed be a big help. It will reduce the TSI quickly and promptly.
Donna Marble said:
Apr 06, 09 at 12:50 pmI have been on mithimazole for almost 4 years to treat Graves Disease.
It is working fine.