The Democratic Presidential Candidates Are Both Hypothyroid: So What?

Candidates vying for the party's presidential nomination typically release official medical records after they become the nominee. In this election cycle, we have already seen former Secretary of State Hillary Clinton, Senator Bernie Sanders, former Governor Jeb Bush, and businessman Donald Trump release letters from their physicians.

On the Republican side, Governor Bush's doctor found him in good health, taking a statin drug, and supplemental Vitamin D. Mr. Trump's doctor declared his health to be "extraordinary" and said that the only medications he takes are daily low-dose aspirin and a statin drug to lower high cholesterol. According to their physician's letters, the two Democratic contenders are coincidentally both being treated for hypothyroidism, an underactive thyroid gland.

In our contentious campaign environment, where opponents look for any weaknesses to exploit, some detractors are suggesting that hypothyroidism somehow disqualifies the Democratic candidates from running for office. Let's take a nonpartisan look and clear up some misunderstandings about an underactive thyroid.

Hypothyroidism is extremely common, and even more so as you get older. In fact, by age 60, an estimated two out of every five women has an underactive thyroid. By age 70, two out of five men are hypothyroid. With hypothyroidism, the thyroid -- the master gland of metabolism -- slows, making less thyroid hormone available to your cells, tissues, organs and glands. The common symptoms of untreated hypothyroidism often include fatigue, weight gain, dry skin, low body temperature, and other signs of metabolic slowdown, such as constipation and hair loss.

Overall, in the US, it's estimated that as many as 60 million people are hypothyroid -- the majority of them women. The majority of people with hypothyroidism are also, surprisingly, undiagnosed and untreated.

The conventional treatment for hypothyroidism is thyroid hormone replacement therapy with a drug called levothyroxine. You may be familiar with the most common brand name, Synthroid. Levothyroxine is a synthetic form of thyroxine, a thyroid hormone also known as T4. Levothyroxine was introduced in the 1950s, and touted as the new "wonder drug" for thyroid hormone replacement. At that time, it was marketed as the modern alternative to the "old-fashioned" drug that had been on the market for 50 years -- Armour thyroid. Armour is brand of a natural desiccated (dried) thyroid medication, made from the thyroid gland of pigs. It contains natural forms of T4, as well as the active thyroid hormone T3. Before the introduction of natural thyroid, hypothyroidism was untreatable, and slowly killed its sufferers.

Natural thyroid fell out of favor with conventional doctors from the 1950s to the 1990s, but started to enjoy a resurgence again in the 1990s, as holistic and integrative physicians became more popular, and prescribed natural thyroid drugs more often than their conventional counterparts. At the same time, natural thyroid drugs also enjoyed renewed favor with some of the older doctors who had originally it, and recognized that some of their patients responded better to it compared to the newer synthetic drug. It also became clear that a subset of patients simply felt significantly better on natural thyroid drugs versus synthetic levothyroxine. Less commonly, a synthetic form of the T3 hormone is prescribed along with the synthetic T4 as a combination treatment therapy that works for some patients.

According to Senator Sanders' medical letter, his longtime Senate physician is treating him conventionally with daily levothyroxine. Secretary Clinton's doctor is, however, treating her with Armour Thyroid. This is somewhat unusual -- and to the thyroid patient community, encouraging news -- given that Secretary Clinton's doctor, DC area internist Dr. Lisa Bardack, does not appear to have a holistic or integrative practice or focus, and many conventional doctors reflexively and dogmatically oppose use of natural thyroid without exception.

As a thyroid patient advocate for two decades, my main concern is that amidst the passion of politics, we don't mistakenly label the millions of people with thyroid disease as being in any way less capable, less healthy, or less fit for public office. I don't care if it's Hillary Clinton, Bernie Sanders, or your spouse, sibling, coworker, child, friend, or even you yourself. When a person with hypothyroidism gets diagnosed, and receives proper, optimal, customized treatment -- whether that's levothyroxine, levothyroxine plus T3, or natural thyroid - they are simply replacing a hormone that the body is missing.

With the right treatment, someone who is hypothyroid can be as healthy, well, active, and vital as anyone without a thyroid condition -- regardless of age, gender...or party affiliation. (While we have yet to see medical information Republican contenders besides Governor Bush and Mr. Trump, don't forget that while in the White House, Governor Bush's parents, George and Barbara Bush, both were treated for overactive thyroid conditions, leaving them hypothyroid and reliant on thyroid hormone replacement medication. And many celebrities are also hypothyroid, for example Modern Family's Sofia Vergara, singer Rod Stewart, comedian Joe Piscopo, and Sex in the City's Kim Cattrall are just a few you might recognize.)

The reality is, when diagnosed and properly treated, hypothyroidism poses no impediments to living a healthy, energetic, productive and otherwise normal life, and certainly creates no impediments to a candidate's ability to run for office.

So, whether you're riding the Trump Train, feeling the Bern, going with the MarcoMentum, #withher, or you're backing another candidate in the 2016 election -- make sure that:

  1. If you or someone you know is fatigued, losing hair, gaining weight (or can't lose on a diet/exercise plan), has high cholesterol, or has other hypothyroidism signs/symptoms, make sure a complete thyroid blood panel is done, not just the TSH test, but Free T4, Free T3 and thyroid antibodies as well
  2. The test results need to be seen and interpreted properly. A call from the doctor's office saying "your thyroid is normal" is not enough. And it's not enough to be "in the reference range" -- the levels need to be optimal
  3. If the levels are not optimal, work with a doctor who truly understands hypothyroidism, who can facilitate the best treatment options that will safely resolve symptoms.

I now return you to the regularly scheduled program of Election 2016. But remember that when you're vetting your favorite candidate, or bashing your least favorites, you should take hypothyroidism out of the equation.