As a thyroid patient advocate/activist, I've written about Oprah's tortured relationship with thyroid disease for a decade. Thyroid problems affect as many as 60 million Americans -- the majority are women in middle age and beyond. The majority are also UNDIAGNOSED.

All this time, while her program featured women's health issues, Oprah did show after show about fatigue, fibromyalgia, infertility, low sex drive, weight gain, depression, postpartum problems, menopausal symptoms, high cholesterol, and other ailments, and NOT ONCE mentioned the fact that an underactive thyroid -- hypothyroidism -- could be the direct, treatable cause of these symptoms in some women. In fact, she seemingly avoided mentioning thyroid. Why she refused to discuss thyroid issues was a question I raised publicly as an advocate, and directly to her staff.

One time, on a weight loss show featuring Dr. Phil, a woman said she had trouble losing weight because of her thyroid problem. Dr. Phil gleefully berated her, saying something along the lines of "So, should we put a big ole sign on yer back that says 'I'm fat cause I have a thyroid problem?'" He was heartless -- and clueless -- showing no understanding of the metabolic impact of hypothyroidism.

Hypothyroidism, by the way, if undiagnosed, or if not treated aggressively and properly, can make weight loss impossible, despite the most rigorous diet and exercise program.

Did Oprah once suspect that a thyroid condition might be contributing to her weight battle, but test negative? Did she get the idea somewhere -- perhaps from Dr. Phil -- that it was merely a lazy, embarrassing excuse, and refuse to allow it to be discussed on her show? I have my theories.

Fast forward to a few years ago. Oprah appeared fit, and healthy, and a normal weight. It seemed like she had finally conquered her life-long weight struggle. But then, she started to gain weight. A few months later, she went "public" with the fact that she had been diagnosed with a thyroid problem, but claimed she'd solved it with a month-long Hawaiian vacation, and a diet heavy in soy (a known goitrogen which slows down and worsens hypothyroidism in many women.) The weight piled on. She had Dr. Christiane Northup on. Northrup claimed that women develop thyroid problems due to an inability to speak up. Northup also said that blowing kisses at yourself in the mirror and taking bubble baths were the solution -- along with more soy. The weight piled on. Oprah went on a 21-day vegan cleanse, at the direction of over-zealous Kathy Freston, eating a large amount of soy foods. Oprah gained even more weight.

Finally, Oprah had her big "reveal" last fall, when she admitted on tv and in her magazine that she was back over 200 pounds.

Oprah, who has access to best doctors, therapists, trainers, nutritionists, chefs, and counselors in the world, had gained it all back, and then some. So what was going wrong? It's no stretch to say it was likely her thyroid, given that millions of Oprah's viewers are going through the exact same situation -- they start out a normal weight, feeling well, and then suffer rapid weight gain along with the onset of a thyroid condition.

At that time, Oprah explained further: while she'd been diagnosed with Hashimoto's autoimmune hypothyroidism, she surprisingly chose NOT to take the prescribed medication. She even claimed her thyroid condition was "cured." (Though she never shared what that cure was.) She brought on her doctor du jour, Mehmet Oz, who said Oprah's thyroid condition was truly unique (despite the fact that it's the most common thyroid problem in the US and affects millions of women), and, ridiculously, he even claimed that the normal ups and downs in thyroid function that she was experiencing were a "frat party in her thyroid."

Ignoring the thyroid entirely, then, Oprah decided to head down the route of bioidentical sex hormone treatment. And rather than featuring one of the many reasonable MDs and clinics that work extensively with hormone balancing -- most of whom consider thyroid function essential to this balance -- she chose to follow and feature Suzanne Somers and the controversial "Wiley Protocol" -- created by a housewife with no medical background, who touts compounded hormones at high doses. (Newsflash, folks, but bioidentical doesn't necessarily mean "compounded." Generic prescription estradiol, the Vivelle patch and Prometrium are all "bioidentical," for example.)

It's not all negative of course. Thanks to Oprah, millions more women are now aware that the thyroid can cause fatigue and weight gain. Hopefully, some of those women are taking action to get their thyroid conditions properly tested and treated.

But sadly, Oprah also has an unfortunate thyroid legacy, because...

• Some women now mistakenly believe that there is a "cure" for autoimmune thyroid disease
• Some women will follow in Oprah's footsteps, and refuse thyroid treatment, thereby endangering their health in a myriad of ways
• Some women might think that bioidentical hormones like estradiol or progesterone are risk-free -- and they're not

  Some women might believe that bioidentical hormones are the right treatment for thyroid problems -- and they're not

• Some women might believe that soy milk and other soy foods are beneficial for thyroid function -- when they can actually harm the thyroid
• Some women might believe that their thyroid condition is their own fault for not "speaking out"

What's been a surprise to me is that, despite the money and experts at her disposal, Oprah is, in the end, just like like me and my fellow thyroid patients. She's having to learn the hard way about her thyroid problem. My only hope is that eventually, she and millions of other women in similar straits will get to a point where they get good medical advice and thyroid treatment, and don't have to continue to needlessly suffer.

Mary Shomon

Thyroid Patient Advocate/Activist

Author: Living Well With Hypothyroidism, The Thyroid Diet