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It comes with being a doctor, I suppose. I just can’t keep myself from reading about illnesses of the rich and famous. So when I saw Oprah’s name linked with the words “depressed,” “overweight,” and “thyroid,” I had to explore further.
You can read about her major health challenges in this link to her article in O magazine. In a nutshell, her problems started two years ago, when she was 53 and began feeling lethargic and irritable, couldn’t sleep, had palpitations, and says quite graphically that she “didn’t know her own body.” After blood tests were run by her doctor, she was diagnosed with hyperthyroidism (overactive thyroid) and later hypothyroidism (underactive thyroid). After getting nowhere with treatment, her trainer Bob Greene remarked that she seemed depressed. She was shocked by this, followed his program of healthful eating and exercise, was able to discontinue her prescribed medications, and is now feeling better, if still trying to shed the extra pounds.
I see a lot of women between 48 and 55 who are going through the same thing. And it’s really not thyroid disease. It’s the Triple Whammy combination of high stress, low serotonin, and the shifting female hormones of menopause.
As described in my book, Oprah’s health issues are a classic Triple Whammy, starting with the brain chemical serotonin, which acts as our factory-installed stress buffer. A woman’s serotonin buffer is about one-quarter that of a man’s, making women biochemically much more vulnerable to stress than men. Parenthetically, low serotonin confers some blessings. By being more sensitive to stress, women are also sensitive to the world around them in ways that men are not. Women are more intuitive and sensitive not only to people, but to colors, smells, and textures. Women “get it” in ways men don’t. It’s only when stress exceeds the serotonin stress buffer that problems begin.
Let’s review how that happens:
• Serotonin’s effect is linked closely to estrogen, like two cars on a roller coaster, estrogen up front, yanking around serotonin. When estrogen falls, as it does during PMS days or menopause (Oprah’s case), vulnerability to stress increases.
• Low-serotonin disorders begin to appear when stress exceeds the stress buffer. These include depression, anxiety, obsessive thinking, sleep disturbances, muscle aches and pains, palpitations, and fatigue. These are all actually symptoms–not disease. And then, when doctors can’t figure out your symptoms and you’re told your tests are negative, your stress escalates, worsening your symptoms even more.
• The fatigue from low serotonin occurs as a consequence of the stress hitting two glands hard: the adrenals and the thyroid. At first, as part of the stress response, both glands secrete too much hormone (Oprah gets diagnosed with overactive thyroid) and then, as they are depleted, too little hormone (she is later diagnosed with low thyroid). With too much thyroid hormone, she experiences palpitations and fatigue. Later, with too little hormone, she’s fatigued, sluggish, and gains weight. With too much of the adrenal hormone (cortisol, the stress hormone), she gains weight, especially in her midsection. With too little cortisol, her fatigue worsens. And now, in her own words, Oprah “doesn’t know her body.”
• All her life, Oprah likely has been low on serotonin. She herself says she eats to reduce stress, and there’s no faster way to boost your serotonin than some simple carbs like mac and cheese, cookies, or chocolate. Comfort foods.
• Here’s Oprah at 53: declining levels of estrogen in menopause are pulling down her already fragile levels of serotonin. Losing her stress buffer, she starts sleeping poorly, falls back on self-medication with carbs, gains weight, and gets depressed. In response to unchecked stress, her thyroid and adrenal glands go into temporary overdrive (palpitations, abdominal weight gain–diagnosis hyperthyroidism) and then collapse (adrenal/thyroid fatigue–diagnosis hypothyroidism). This is her low point.
• Her prescribed medications only made matters worse. She likely took beta blockers for her palpitations (side effects: depression, fatigue) and medicine to reduce overactive thyroid (side effect: fatigue). She’d already been on medicine for her blood pressure (side effects: depression, fatigue).
• Oprah doesn’t mention taking an antidepressant, but these drugs are a double-edged sword. On the plus side, an antidepressant would raise her serotonin stress buffer. On the minus side, about a third of women gain weight, lose their sex drive, and feel emotionally numbed out.
• To the rescue comes Bob Greene, who is shocked by what has happened to Oprah. He knows that exercise is even more effective than carbs in raising serotonin, so he puts her on a program nothing short of military basic training. He has her eating healthful complex carbs, which raise serotonin but don’t pack on pounds. He has her eat more flaxseed (whose omega 3s boost serotonin) and take supplements (vitamin B complex raises serotonin, too). And lo! She starts to feel better. With her stress buffer restored by exercise and healthful eating, her thyroid and adrenal glands begin to heal themselves.
• With the working out and weight loss, her blood pressure comes down and she’s also able to stop taking her blood pressure medicine.
Oprah’s doctors saw a patient presenting symptoms and, because they’re trained to do so, looked for disease. She was diagnosed as having hyperthyroidism and high blood pressure and her doctors, satisfied with their diagnoses, proceeded to treat her “illnesses” with medications that only made her feel worse.
Oprah’s problems weren’t illnesses at all–they were her body’s desperate response to her inadequate serotonin stress buffer. The falling estrogen levels of menopause had pulled down her serotonin, leaving her vulnerable to the imbalance from hell, also known as the Triple Whammy.
“I didn’t know my own body.” I have heard that very sentence from hundreds of women. If you have symptoms similar to Oprah’s, you can read more about the solution in The Triple Whammy Cure (hint: light therapy and fish oil help too). In fact, maybe we should forward this health tip to her too…
Be well,
David Edelberg, MD