In the new CW series Jane the Virgin, Jane Villanueva, (played by actress Gina Rodriguez), is a hard-working, religious young Latina woman whose family tradition leads her to vow to save her virginity until her marriage. That plan is shattered when she learns at a doctor’s appointment that she was been mistakenly artificially inseminated during a routine pap smear.
But this scenario hit close to home for Rodriguez, who got some shocking news of her own at a doctor’s appointment shortly after filming the pilot episode of the program. Gina, 29, was diagnosed as having “thyroid disease” 10 years earlier. However, she did not realize that the cause of her condition was something called Hashimoto’s Thyroiditis (or Hashimoto’s Disease), telling Entertainment Tonight:
“While I was shooting the pilot, I was training for a half marathon and I went to see my holistic doctor right after the marathon was done.
“She said, ‘From your test results, let’s talk about your Hashimoto’s (disease).’ And I was like, ‘What are you talking about? I have thyroid disease’ and she said, ‘No, no you have Hashimoto’s and to be honest, I don’t know how you’re standing right now and why you’re not asleep. I thought somebody would be bringing you here.’
But Gina is undaunted. You may be tired,” but you get up and push forward!’ Asked if she experienced any symptoms of depression?: “‘Yeah, but mind over matter?”
Hashimoto’s disease, also called chronic lymphocytic thyroiditis or autoimmune thyroiditis, is an autoimmune disease. An autoimmune disease is a disorder in which the body’s immune system attacks the body’s own cells and organs. Normally, the immune system protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances.
In Hashimoto’s disease, the immune system attacks the thyroid gland, causing inflammation and interfering with its ability to produce thyroid hormones. Large numbers of white blood cells called lymphocytes accumulate in the thyroid. Lymphocytes make the antibodies that start the autoimmune process.
Hashimoto’s disease often leads to reduced thyroid function, or hypothyroidism. Hypothyroidism is a disorder that occurs when the thyroid doesn’t make enough thyroid hormone for the body’s needs. Thyroid hormones regulate metabolism—the way the body uses energy—and affect nearly every organ in the body. Without enough thyroid hormone, many of the body’s functions slow down. Hashimoto’s disease is the most common cause of hypothyroidism in the United States
The thyroid is a 2-inch-long, butterfly-shaped gland weighing less than 1 ounce. Located in the front of the neck below the larynx, or voice box, it has two lobes, one on either side of the windpipe.
The thyroid is one of the glands that make up the endocrine system. The glands of the endocrine system produce and store hormones and release them into the bloodstream. The hormones then travel through the body and direct the activity of the body’s cells.
The thyroid makes two thyroid hormones, triiodothyronine (T3) and thyroxine (T4). T3 is the active hormone and is made from T4. Thyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol levels.
Thyroid-stimulating hormone (TSH), which is made by the pituitary gland in the brain, regulates thyroid hormone production. When thyroid hormone levels in the blood are low, the pituitary releases more TSH. When thyroid hormone levels are high, the pituitary decreases TSH production.
Many people with Hashimoto’s disease have no symptoms at first. As the disease slowly progresses, the thyroid usually enlarges and may cause the front of the neck to look swollen. The enlarged thyroid, called a goiter, may create a feeling of fullness in the throat, though it is usually not painful. After many years, or even decades, damage to the thyroid causes it to shrink and the goiter to disappear.
Not everyone with Hashimoto’s disease develops hypothyroidism. For those who do, the hypothyroidism may be subclinical—mild and without symptoms, especially early in its course. With progression to hypothyroidism, people may have one or more of the following symptoms:
Diagnosis begins with a physical exam and medical history. A goiter, nodules, or growths may be found during a physical exam, and symptoms may suggest hypothyroidism. Health care providers will then perform blood tests to confirm the diagnosis. Diagnostic blood tests may include:
Treatment generally depends on whether the thyroid is damaged enough to cause hypothyroidism. In the absence of hypothyroidism, some health care providers treat Hashimoto’s disease to reduce the size of the goiter. Others choose not to treat the disease and simply monitor their patients for disease progression.
Hashimoto’s disease, with or without hypothyroidism, is treated with synthetic thyroxine, which is man-made T4. Health care providers prefer to use synthetic T4, such as Synthroid, rather than synthetic T3, because T4 stays in the body longer, ensuring a steady supply of thyroid hormone throughout the day. The thyroid preparations made with animal thyroid are not considered as consistent as synthetic thyroid (Levothyroxine) and rarely prescribed today.
Health care providers routinely test the blood of patients taking synthetic thyroid hormone and adjust the dose as necessary, typically based on the result of the TSH test. Hypothyroidism can almost always be completely controlled with synthetic thyroxine, as long as the recommended dose is taken every day as instructed.
More information is available in the Resounding Health Casebook on the topic.
Rice student Greta Shwachman responds to this story for Dr. Kirsten Ostherr’s Medicine and Media course:
“This latest post grabbed my attention right off the bat because I myself suffer from Hashimoto’s Thyroiditis. I first heard the term Hashimoto’s after being diagnosed with hypothyroidism back in 2007. I have been taking medication since my diagnosis, and for the most part, I feel completely normal. Truthfully, I was kind of surprised to see the headline: “Gina Rodriguez Surprised by Hashimoto’s Diagnosis.” I mean, is it that surprising? After all, Hashimoto’s is the most common cause of hypothyroidism. While I think the phrase “shocking news” is a bit extreme to describe Rodriguez’s diagnosis, this article raises some interesting questions, particularly when it comes to taking charge of our health and fully understanding our medical conditions. I think it’s great that hypothyroidism is being brought to the limelight. This story gives Rodriguez the potential to become a role model for other Hashimoto’s patients. It’s important that she and other patients fully understand Hashimoto’s and what they can do to successfully treat the disease. There are a variety of support groups and resources available to Hashimoto’s patients online. Stop the Thyroid Madness is a good one that has been very influential in my personal struggle with hypothyroidism. I wish Gina luck in getting the condition under control and encourage her to join the growing number of e-patients who are educating themselves and taking control of their healthcare.”