Living Well With Hypothyroidism: What Your Doctor Doesn't Tell You . . . That You Need to Know 

by Mary J. Shomon

Editorial Reviews
Amazon.com
As many as one in eight women have a thyroid condition. In Living Well with Hypothyroidism, Mary Shomon outlines the most common of these--too little thyroid hormones in the body. Weight gain, depression, fatigue, and what patients call "brain fog, Brillo hair, and prune skin" result. Because the symptoms of hypothyroidism mimic so many other conditions--chronic fatigue, PMS, clinical depression--it can be very tricky to diagnose, especially since patients with HMOs may not get the thorough testing they need. Shomon knows of what she speaks: she's a health writer and thyroid patient herself. She also manages a thyroid Web site and writes a newsletter on hypothyroidism. In Living Well, she offers an extensively researched guide to this complex condition. She covers conventional, alternative, and late-breaking approaches to treatment--such as challenging the gold standard of Synthroid as the thyroid replacement therapy of choice. (Synthroid replaces T4, the less active of the two thyroid hormones, and Shomon features new research on adding T3--the more potent thyroid hormone--to treatment.) With her down-to-earth, patient-centered approach, Shomon explains everything from how to choose a thyroid specialist to how calcium, antidepressants, and a high-fiber diet affect thyroid hormone absorption. The book includes a chapter on depression, which is a typical misdiagnosis of hypothyroidism--as well as a symptom that often persists even after treatment. She also covers infertility (women who are hypothyroid don't ovulate as regularly and miscarry more frequently) and thyroid cancer, one of the less common causes of hypothyroidism. She explains how to spot hypothyroidism in kids, and ends with a glossary, international resources, and journal references. Shomon creates a sense of community by excerpting e-mails from her vast network of patients--voices that bring a sense of humor so often missing from health books. One quibble: she could have avoided the antidoctor stance in the beginning of her book, where she blames physicians, rather than incomplete science, for the misdiagnosis and treatment of hypothyroidism. --Rebecca Taylor

Elizabeth Lee Vliet, M.D. Women's health specialist
Ms. Shomon's book is an enlightened godsend to hypothyroidism sufferers, providing a wealth of cutting edge medical information and alternative approaches for surviving ...and thriving ...with hypothyroidism. Mary has debunked longstanding "myths" and misinformation about thyroid diagnosis and treatment options that have come from both alternative and conventional thyroid specialists. If I could recommend only one book on thyroid problems for my patients, this would be it.

Dr. John Lowe, author of "Speeding Up to Normal"
Mary Shomon is the harbinger of the latest scientifically-sound information on hypothyroidism. With keen intellect, loyalty to truth, and plain language, she sweeps away the medical dogma that bars millions of patients from rational thyroid hormone therapies. In this book, she describes practical thyroid therapies that can improve patients' health and extend their lives. The book is vital for hypothyroid patients who want to get well, and for physicians who want to help them do so.

Los Angeles Times, March 27, 2000
"Hypothyroidism is a common, very treatable disorder that is also poorly managed by doctors. In this first-rate book by Mary Shomon...the disorder, its myths, and medicine's successes and failures at dealing with it are thoroughly examined. This is not a book that rehashes old facts on thyroid disease. Shomon instead challenges patients and their doctors to look deeper and try harder to resolve the complicated symptoms of hypothyroidism...In a fascinating chapter, Shomon, who also has a Web site (http://thyroid.about.com) and an online newsletter about the disease, explores recent evidence that the addition of the thyroid hormone T3 to the standard T4 (levothyroxine) may help some people feel better. In addition, the section on babies born with hypothyroidism, although brief, has the best advice on how to give medication to an infant that I've seen. As Shomon writes: 'or years, thyroid problems have been downplayed, misunderstood and portrayed as unimportant.' With he! r advocacy, perhaps no more." --Shari Roan

Elizabeth Lee Vliet, M.D., Founder and Medical Director of HER Place Centers
"If I could recommend only one book on thyroid problems for my patients, this would be it."

Book Description
Is hypothyroidism your problem?

For millions of Americans, fatigue, weight gain, hair loss, depression, and other symptoms often go undiagnosed and untreated. Endured by weary patients and ignored by doctors, common warning signs of hypothyroidism are often attributed to depression, stress, age, or simply dismissed as "all in the patient's head." Even diagnosed, hypothyroidism is frequently treated improperly, preventing countless numbers of people from feeling and living well.

This book, exhaustively researched by a professional writer and hypothyroidism patient, is written for patients, their families, their doctors, and the countless number of people with undiagnosed or under treated symptoms of the disease---frustrated, as the author was, by the lack of information on the subject.

Living Well With Hypothyroidism includes dozens of compelling, first-person accounts from people who have learned to triumph over the disease and thoroughly answers such questions as:

What is hypothyroidism?
What are the warning signs, symptoms and risk factors?
Why is getting diagnosed often a challenge and how can you overcome that obstacle?
What treatments are available (including those your doctor hasn't told you about)?
Why is the most frequently prescribed treatment often insufficient?
What are the options and benefits of alternative therapies?
What effects does hypothyroidism have on infertility and pregnancy?
How do you recognize hypothyroidism in infants and children?
What is the outlook for future treatment of hypothyroidism?
And Much More!

About the Author
Mary J. Shomon, a thyroid patient herself, writes and manages several professional patient-oriented Web sites on thyroid disease and serves as editor-in-chief of the popular patient-focused monthly thyroid newsletter "Sticking Out Our Necks." She is the author of several pervious books and works as writer and consultant in the Washington DC area, where she lives with her husband, Jon, and daughter, Julia.

Excerpted from Living Well With Hypothyroidism: What Your Doctor Doesn't Tell You . . . That You Need to Know by Mary J. Shomon. Copyright © 2000. Reprinted by permission. All rights reserved
Chapter 1 - What is Hypothyroidism? They do certainly give very strange, and newfangled, names to diseases.--Plato

The thyroid is not a particularly well-known or well-understood organ in the body. Some people have a vague idea of the thyroid as something in the neck that, when malfunctioning, makes you gain weight or develop a goiter. That's about all the information marry people can muster.

The thyroid gland, however, is an essential organ, governing basic aspects of nearly every facet of your health. In the long term, you can't live without the hormones produced by your thyroid. Those hormones regulate the body's use of energy, an essential function to life and health.

What Is The Thyroid?
The thyroid gland is shaped a little like a butterfly, and is located in the lower part of your neck, in front of your windpipe. You'll know generally where the thyroid is located if you think of it as sitting behind the Adam's apple, which usually sticks out farther from a man's neck than from a woman's.

The name "thyroid" comes from the Greek word, thyreoeides, meaning "shield-shaped." The two "wings" of the butterfly are known as the lobes of the thyroid, and the area connecting the two lobes is known as the isthmus. It's a small gland, and normally weighs only about an ounce.

Roughly speaking, a gland is a discrete and separate soft body made up of a large number of vessels that produce, store, and release-or secrete-some substance. Your thyroid is one of these glands.

Some glands secrete their products outside the body, some inside. Those that secrete their products on the inside of the body and, more specifically, secrete hormonal and metabolic substances, are known as endocrine glands. The thyroid is an endocrine gland, as are the parathyroids, the adrenal gland, the pancreas, and the pituitary gland. Diabetes, like thyroid disease, is considered an endocrine disorder. A doctor who specializes in treating patients with endocrine problems is called an endocrinologist.

Hormones are internal secretions carried in the blood to various organs. The thyroid's main purpose is to produce, store, and release two key thyroid hormones, triiodothyronine (T3) and thyroxine (T4). Thyroid cells are the only body cells that are able to absorb iodine. The thyroid takes in iodine, obtained through food, iodized salt, or supplements, and combines that iodine with the amino acid tyrosine, converting the iodine/tyrosine combination into T3 and T4. The "3" and the "4" refer to the number of iodine molecules in each thyroid hormone molecule. A healthy, functioning thyroid produces about 80 percent T4 and 20 percent T3. T3 is considered the biologically active hormone and is several times stronger than T4.

The T3 and T4 thyroid hormones travel through the bloodstream throughout the body helping cells to convert oxygen and calories into energy. Thyroid hormones control metabolism-the process by which oxygen and calories are converted to energy for use by cells and organs. There's not a single cell in your body that doesn't depend on thyroid hormone for regulation and for energy in some form.

The thyroid produces some T3, but the rest of the T3 needed by the body is actually formed from the mostly inactive T4 by the removal of one iodine molecule, a process sometimes referred to as T4 to T3 conversion, or by the more scientific term mono-deiodination. This conversion of T4 to T3 can take place in some organs other than the thyroid, including the hypothalamus, a part of your brain.

Now that you have some idea of what the thyroid is and its location and function, let's look in more detail at how it fits into the overall functioning of the body.

The Thyroid Gland: Setting the Pace
When the thyroid works normally, it produces and secretes the amount of T4 and T3 necessary to keep many bodily functions at their proper pace. However, the thyroid does not do this alone. It works instead as part of a system that also includes the pituitary gland and the hypothalamus. The pituitary gland is another endocrine gland, located at the base of your brain.

Here's how the system works. The hypothalamus constantly monitors the pace of many of the body's functions. It also monitors and reacts to a number of other factors, including outside environmental factors such as heat, cold, and stress. If the hypothalamus senses that certain adjustments are needed to react to any of these factors, then it produces thyrotropin-releasing hormone, (TRH).

TRH is sent from the hypothalamus to the pituitary gland. The pituitary gland then produces a substance called thyrotropin, which is also known as thyroid-stimulating hormone (TSH). The pituitary gland also monitors the body and can release TSH based on the thyroid hormones in the blood. TSH is sent to the thyroid gland, where it causes production, storage, and release of more T3 and T4.

Released thyroid hormones move into the bloodstream, carried by a plasma protein known as thyroxine-binding globulin (TBG).

Now in the bloodstream, the thyroid hormone travels throughout the body, carrying orders to the various bodily organs. Upon arriving at a particular tissue in the body, thyroid hormones interact with receptors located inside the nucleus of the cells. Interaction of the -hormone and the receptor will trigger a certain function, giving directions to that tissue regarding the rate at which it should operate.

When the hypothalamus senses that the need for increased thyroid hormone production has ended, it reduces production of TRH, the pituitary decreases production of TSH, and production of the thyroid hormone, in turn, decreases. By this system, many of the body's organs are kept working at the proper pace
 

Great Information For Everyone, March 20, 2000
Reviewer: A reader
Everyone should know what is available for hypo-thyroid patients. This book has all the necessary facts to assist the patient to be a partner with their physician. Thank you Mary Shomon for your extensive research and your caring about the thyroid community. Keep up the good work. Love the hardcopy newsletter.

Comforting, inspiring - the best source for thyroid info, March 20, 2000
Reviewer: Dara from Boston, MA
This is the absolute best book ever written on thyroid disorders. I have struggled for 13 years to get a proper diagnosis and treatment for my Hashimoto's disease and have read countless books on thyroid disorders. This book is outstanding in the amount of helpful, pertinent information and it insight it contains. It truly made me realize that I am not alone in my struggles with Hashimoto's or with my struggles to find someone to believe me or treat me. It is a truly inspiring effort. Bring this book to your doctor's office and make sure they read it. The list of risk factors and symptoms is extremely thorough and should be brought to your doctor - especially if they tell you all your symptoms are just in your head. This book empowers you to demand proper and adequate treatment!

Finally! Someone tells it like it REALLY is!, March 25, 2000
Reviewer: Georgie from Florida
Mary Shomon's book is the first I have read (out of a LOT of books) that tells the whole truth about hypothyroidism, as experienced by a patient who has been there. I wish that every doctor that treats thyroid patients could be made to read this! So many doctors seem to think that hypo is a simple, easily treated disease, and it isn't. They also tend to focus on individual symptoms without looking for the overall CAUSE. If I had had this book years ago it would have saved me several years of suffering and being told there was nothing wrong with me. Mary's list of symptoms is very thorough, her book is easy to read and understand, and it tells the real truth. I especially like the way she pays attention to the emotional impact of this disease and the depression that often accompanies it. Her weblinks are very helpful in finding out more information. This book is EXCELLENT, and a great resource. It can literally change people's lives. I could barely put it down once I started reading. I can't recommend it enough, especially for newly diagnosed patients or those who SUSPECT they are hypo but haven't been able to find a doctor to test them. Mary's list of symptoms is great to take to your doctor to help them see the overall picture, and her compassion and understanding are very comforting and empowering for patients. She makes sense out of what to most of us is a very confusing disease. If you only buy one book on this subject, make it this one!