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How the Thyroid Gland Mystifies Doctors and Patients

By Oona Zenda and Andy Miller

About 25 years ago, Andy Miller learned he had hypothyroidism, a condition that afflicts millions of other Americans. Curious about how this condition was affecting others, the 吃瓜不打烊 journalist interviewed endocrinologists who treat hypothyroidism and several patients who live with it. Their stories revealed how mystifying thyroid and autoimmune conditions can be.

The first page of an eight-page comic about hypothyroidism. At the top of the page, a cartoon version of the reporter, Andy Miller, is introduced. He is the narrator for this series. The next panel reads 鈥渁bout 25 years ago, I was overcome by constant fatigue,鈥 and shows him exhausted, lying in bed with the words 鈥渃onstant fatigue鈥 weighing him down. The following panel reads, 鈥渆ven though I slept 10 to 12 hours a night, I would still wake up tired!鈥 and shows him holding an alarm clock with spinning hands. The final and bottom panel reads, 鈥渕y voice dropped to Darth Vader-like depths 鈥 and my kids were worried about me, which added to my alarm,鈥 and shows, on the left, Miller as Darth Vader. On the right, his children look spooked as they observe and listen to their 鈥渄ad.鈥
(Oona Tempest/吃瓜不打烊)
This second page reads, 鈥渕y doctor was initially stumped, too. Then a friend suggested it could be a鈥︹ at the top of the page, and leads into a large arc of text that says, 鈥渢hyroid problem鈥 above a drawing of Miller鈥檚 neck and head. The thyroid, a butterfly-shaped gland in the neck, is highlighted with radiating shades of pink and yellow. Beside Miller, text reads, 鈥渢he thyroid gland releases hormones that regulate metabolism. When not enough thyroid hormone is produced, it causes hypothyroidism.鈥 The final panel below shows a doctor saying, 鈥淪ome typical symptoms are fatigue, weight gain, hair loss, and changes to menstrual cycle.鈥
(Oona Tempest/吃瓜不打烊)
The next page opens with Miller holding a doctor鈥檚 prescription in one hand and a bottle of thyroid hormone medication in the other. The prescription reads, 鈥渁fter running a test, my doctor prescribed a thyroid hormone medication.鈥 Below, Miller is drawn with raised arms and a smile; butterfly wings on his back lift him as he jumps for joy and says, 鈥淚t was like a switch turned back on! The pill restored my energy! My voice returned to normal!鈥 Beneath him reads, 鈥渁nd so鈥 I joined millions of Americans taking daily medication to keep my body functioning well.鈥 The text has a border of pills with butterfly wings.
(Oona Tempest/吃瓜不打烊)
Page 4 begins with text that reads, 鈥淟evothyroxine, a synthetic thyroid hormone, is among the most prescribed drugs in the U.S.鈥 Beneath the text is a dizzying pattern of pill bottles. On top of the bottles is an image of the United States, with text that reads 鈥淭hat鈥檚 about鈥 100 million prescriptions annually! But why??鈥 The following text addresses the question with, 鈥渉ypothyroidism is most commonly caused by an autoimmune condition in the U.S. It鈥檚 called Hashimoto鈥檚 disease.鈥 An image of a wilted thyroid gland covered in butterflies is centered below. The final line of text reads, 鈥渢his occurs when the immune system mistakenly attacks and damages healthy thyroid cells.鈥
(Oona Tempest/吃瓜不打烊)
The top panel of this page shows Miller from the back as he looks at two other people he interviewed for this series: a doctor and a patient with hypothyroidism. The accompanying text reads, 鈥淚 talked with doctors and patients and found out I was one of the lucky ones. While generic levothyroxine works for me, it doesn鈥檛 work for everyone.鈥 In the bottom panel, another interviewee is introduced, named Beth VanOrden, a teacher. She is lying on a couch and says, 鈥淚 would crash for 3 hours on the couch after school.鈥 Below her, additional text says, 鈥渉er condition brought years of frustration. It took an alternative drug regimen for positive results.鈥
(Oona Tempest/吃瓜不打烊)
Page 6 continues to introduce people Miller spoke with. The first panel shows a rendering of Misty, of South Carolina, digging out from beneath a pile of medical bills as she reaches for a set of pill bottles. She says, 鈥淚 have about $6,000 in unpaid hospital and medical bills over the past two years.鈥 In the panel below, Jennifer Silvestri, of New York, is introduced. She鈥檚 pictured having blood drawn while saying, 鈥渕anaging pregnancy with hypothyroidism can be difficult. I hope to have a baby.鈥 Additional text reads, 鈥渉ypothyroidism decreases fertility, and there鈥檚 a higher risk of miscarriage. During pregnancy, medication often needs to be adjusted.鈥
(Oona Tempest/吃瓜不打烊)
The next pages introduce the illustrator of the comic, Oona Tempest, as an interviewee with hypothyroidism. The intro text reads, 鈥渆ven our illustrator has faced challenges. Her symptoms began at 22, far below the average age of onset. Doctors didn鈥檛 initially pick up on the cause.鈥 This is accompanied by a drawing of her sitting in a doctor鈥檚 office. The doctor beside her says, 鈥淗mmm 鈥 you鈥檙e fine,鈥 while scratching his chin. In reply, she says, 鈥渂ut I am soOoOo tired.鈥 The following text reads, 鈥渂y the time they did, her thyroid was beyond repair. So she, too, joined the millions taking thyroid meds for life.鈥 The next panel shows a referee holding up the hand of a butterfly with boxing gloves, and says 鈥淎nd the winner is 鈥 Hypothyroidism caused by Hashimoto鈥檚 disease!!鈥 while Oona鈥檚 shriveled-up thyroid slumps to the side, defeated. The next line of text reads, 鈥渂ut before the pill kicked in, extreme fatigue led to a fraught period of unemployment,鈥 followed by a drawing of Oona, fallen to her hands and knees beside a pill bottle.
(Oona Tempest/吃瓜不打烊)
The final page of the comic starts with a drawing of Miller, who says, 鈥渁ll these conversations pointed to a need for more research, education, and support related to these often-mystifying conditions. But despite these gaps, there鈥檚 more awareness of hypothyroidism and of autoimmune diseases in general 鈥 which is in part prompted by social media and the internet, where people are speaking up about their conditions.鈥 A drawing of two figures jumping over steppingstones is in the center panel, while two women exchange a text of this comic at the bottom of the page.
(Oona Tempest/吃瓜不打烊)

This illustrated report has been adapted from a 吃瓜不打烊 article, 鈥Many Autoimmune Disease Patients Struggle With Diagnosis, Costs, Inattentive Care鈥 by Andy Miller.

Illustrations by Oona Tempest.

Creative direction and editing by Hannah Norman, with additional editing by Sabriya Rice.

Copy editing by Terry Byrne.

吃瓜不打烊 is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF鈥攁n independent source of health policy research, polling, and journalism. Learn more about .

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