My own blog

Live in each season as it passes; breathe the air, drink the drink, taste the fruit. - Henry David Thoreau

The No Exercise - Exercise Diet

[INLINE] What exactly does it take to lose weight and keep it off? With so many people searching for the "holy grail" of dieting, I was thinking - what about good old-fashioned exercise? Just take a look at all these benefits:

- Helps control weight, develop lean muscle, and reduce body fat.

- Reduces the risk of dying from coronary heart disease and developing high blood pressure, colon cancer, and diabetes.

- Helps maintain healthy bones, muscles, and joints.

- Reduces symptoms of anxiety and depression, and fosters improvements in mood and feelings of well-being.

Yet, even with all this, the Centers for Disease Control and Prevention reports that more than 60 percent of Americans do not engage in the recommended amount of daily physical activity. Current government recommendations range from 30 minutes to 1 hour of moderate activity each day. Not only that, a report from the National Weight Loss Registry states that most dieters who have lost weight and kept it off for 5 years or more incorporate 60 minutes of daily physical activity into their lifestyles.

But I have another benefit of exercise, and you don't even have to move a muscle. You see, maybe losing weight is as simple as being conscious about what we eat - having something to compare "the value" of the foods we freely toss in our mouths. My suggestion is to use exercise as an appetite suppressant. I'm not trying to depress you. I really think this is a new idea for a diet: "The No Exercise - Exercise Diet." For every single thing you eat, you don't count calories; you just figure out how long you have to exercise to burn off what you just ate.

For instance, if we were to translate a Twinkie into exercise - it would add up to the equivalent of a 30-minute walk. The Food and Drug Administration (FDA) could even require food manufacturers and restaurants to put the "exercise equivalence" on the food label. Imagine, a statement right there on the Cinnabon Caramel Pecanbon: "Warning: Eating This Product Could Require an Additional 4 Hours and 10 Minutes of Walking or 5 Hours of Continuous Vacuuming."

Just think about the implications. Knowing that we have to walk for 14 hours at a moderate pace for a distance of roughly 43 miles in order to burn off one pound of fat - well, that would certainly discourage me from eating. But if we apply it to specific food items - now that could actually work. After all, it's much easier to imagine passing up a double-decker burger with fries, a couple super-sized Cokes, and a banana split for dessert than it is to see yourself out there walking 43 miles.

Right now calories are more like a secret code for nutritionists - it's easier to learn a foreign language than to understand and track calories. At least with this proposed new diet and labeling, you'll know exactly what it means to eat a box of Entenmann's chocolate chip cookies.

If we were able to translate all of our calories into some type of "cost" system, well, it would certainly put our food choices into perspective.

The following will help get you started on the No Exercise - Exercise Diet:

McDonald's Big Mac, French Fries (large), and a Coke (large)
Warning: Eating This Product Could Require an Additional 7 Hours of Dog Walking.

Pizza Hut Stuffed Crust Cheese Pizza (2 slices)
Warning: Eating This Product Could Require an Additional 1 Hour and 17 minutes of Jumping Rope.

Hershey's Chocolate Kisses (5 kisses)
Warning: Eating This Product Could Require an Additional 15 Minutes of Running.

Hungry Man Fried Chicken Entree (mostly white meat)
Warning: Eating This Product Could Require an Additional 1 Hour and 9 Minutes of Kickboxing.

The Cheesecake Factory Black-Out Cake (1 slice)
Warning: Eating This Product Could Require an Additional 3 Hours and 52 Minutes of Lawn Mowing (and not on one of those riding mowers).

Dry Roasted Peanuts (3 oz - about 90 nuts)
Warning: Eating This Product Could Require an Additional 1 Hour and 30 Minutes of Low Impact Aerobics.

Ben and Jerry's Cherry Garcia Ice Cream (1 1/2 cups)
Warning: Eating This Product Could Require an Additional 2 Hours and 9 Minutes of Riding a Stationary Bike.

Oreo Double Stuf Cookies (3 cookies)
Warning: Eating This Product Could Require an Additional 18 Minutes of Swimming Laps.

Pina Colada (8 oz.)
Warning: Eating This Product Could Require an Additional 1 Hour and 5 Minutes of Golf, Carrying Your Own Clubs.

PowerBar ProteinPlus (1 bar)
Warning: Eating This Product Could Require an Additional 55 Minutes of Vigorous Dancing.

One thing to keep in mind - these activities would be in addition to the normal physical activity or exercise that you get each day. If you would like to find out how many calories you burn in any activity from gardening to praying, you can go to the activity calorie calculator on the following site: http://www.efit.com/calculators/calorie.jsp

Charles Stuart Platkin~Nutricise Editor editor@...

As you slide down the banister of life, may the splinters never point in the wrong direction! ~Irish Blessing
-:¦:-
¸.·´ .·´¨¨))

Here is the kind that I get for DH (NO I do NOT eat oatmeal. My dream
as a young child was to never have to eat oatmeal again!!).
http://www.netrition.com/mccanns_oats_page.html

HI Pam or Whoever,

I would like more info on Steel Cut Oats. I love oatmeal but I understand that Steel Cut has to be handled different and that there is no such thing as Quick Steel Cut Oats. LOL. Where would I find them?

I only ask because my boyfriend's Aunt was the first to mention them to me and I would really like to try them. Oatmeal in the morning seems to help my with my weight loss. She was telling me that Steel Cut is better for us because you get more nutrition out of them.

Donna

Hi Lucy,

I quit using it after the first test results came back with my new doc...he wanted to test me while NOT usuing it to see if I really needed it, since my levels were very good while using it...so far I have not heard from them on my latest tests, so I plan on calling them on Mn...they were doing a lot more of the female hormones this time, plus ever since I went on the compounded armour, I am retaining quite a bit of water...I have tried everything I know of to lower the amount of edema that I am experiencing and it is not working...it started right after switching from regular armour to compounded "thyroid"...I am assuming it is also a generic since the bottle says "thyroid" instead of armour...I also figure the edema could be from something they are compounding it with to make it time release...

Take care, Bee
Kimberly Walker <Thyroidlucy595@...

Bee.

Are you still using the progresterin cream? I stopped using it till I get my levels better.

Lucy

Bee.

Are you still using the progresterin cream? I stopped using it till I get my levels better.

Lucy

Hi!

I just bought the latest issue of Women's World today and it has an article in it about curves and the routine they do...what it is is they have all of the workout stations in a circle and when you get there, you hop on whatever machine in the circle is open and then you do whatever you need to on that machine for 30 seconds and then move to the next machine and exercise...and keep going like this until after 30 minutes, you should have made it around the circle 3 times...

Supposedly this type of workout is much more efficient and you get a much better workout than other routines and regimens and a lot of people who couldn't lose before working much harder, are losing with this...

The article also has pictures and tells you what to do with one of the stretch rubber band gizmos and says this was authorized by curves for those who want to workout at home...you might want to take a look at the magazine before you make your decision...the date on the mag is June 17, 2003

Best wishes, Bee

Mary <me394ever@...

I was wondering if anyone has had success with the Curves , women's
exercise program. I am thinking of joining and would love some info.
To unsubscribe from this group, send an email to:

Hi Birdie!

I used to be on both unithroid (synthetic t4) and cytomel and really improved a lot on it...I am now on armour...I am on a much higher dose of armour than I was on with the combination of the other 2, so it is really hard to tell if the upped dose is what has me doing so much better or if it is the armour...Best wishes, Bee
birdie572002 <birdie572002@...

Good Morning,Just want to know if anyone is taking cytomel along
with their levoxyl or synthroid.Also,Anyone tried the Armour?If
so,has it helped more? Thanks, birdie
To unsubscribe from this group, send an email to:

I was wondering if anyone has had success with the Curves , women's
exercise program. I am thinking of joining and would love some info.

Pam -

Those are good questions for asking a doctor! I'm going to try some of those when I check out the 2 recommendations I have. Hopefully one of them will be worthwhile. My FT4 has been sitting on the low end of normal for over a year now. I wonder if a little bit of replacement hormone would do me some good.

Michelle

Pam, I got this today from Dr. Weil, wondered if this would be okay on the LC diet. I have been looking at labels on carrots and those are high in Carbs, I like to snack on 10 of the baby carrots while watching tv, but the carbs, jeez! So I wondered if this would be okay to eat on a daily basis? Leaving out the Soy Sauce of course! lol And how much would you recommend to be one serving? Thanks, Linda

Subject: Good Morning From Dr. Weil -- Weekend Chef: Chinese Green Bean Salad

[INLINE]

06.13.2003
Tip: Weekend Chef: Chinese Green Bean Salad
This bright green, crunchy salad is bursting with Asian flavors and easy to prepare. Look for fresh, plump, organic green beans. Cook them until they are bright green and still crunchy-tender. At this point, you can keep the green beans refrigerated. Toss them with the dressing just before serving, or the acid in the dressing will dull the bright green color.
1 pound fresh green beans, organic if possible 1 tablespoon finely chopped, fresh ginger root 1 cup slivered red onion
Dressing:
4 teaspoons dry mustard powder
1 tablespoon cold water
2 tablespoons reduced-sodium soy sauce
3 tablespoons rice or cider vinegar
2 teaspoons dark-roasted sesame oil
1. Trim and cut the green beans into 1-inch lengths. Cook in rapidly boiling water, about 5 minutes or until crunchy-tender.
2. Drain beans, immerse in cold water to stop the cooking until they are cool, and then drain well.
3. Mix the dressing ingredients in a small bowl with a whisk until well blended.
4. Toss the green beans with the ginger root, red onion, and dressing. Serve immediately. Serves 4.
Click here for preparation and nutrients per serving.

My Optimum Health Plan
Dr. Weil's best-selling book "8 Weeks to Optimum Health" is now brought to life on the Web with interactive tools to help you track your progress, monitor your health, communicate with other members, and plan healthy and delicious meals the good doctor's way. Take the tour today and see what the buzz is all about.

[INLINE]
[INLINE]
Today's Question
[INLINE]
[INLINE]
[INLINE]
Licensing Naturopaths?
more
[INLINE]
[INLINE]
[INLINE]
Monday's Tip
[INLINE]
[INLINE]
[INLINE]
Swimming Without Worries

[INLINE]
[INLINE]
[INLINE]
Sponsor
[INLINE]
[LINK]

[INLINE] DrWeil.com
[INLINE] Vitamin Advisor
[INLINE] My Optimum Health Plan

Home Ask Dr. Weil Vitamin Advisor My Optimum Health Plan Balanced Living Marketplace Community

Good Morning,Just want to know if anyone is taking cytomel along
with their levoxyl or synthroid.Also,Anyone tried the Armour?If
so,has it helped more? Thanks, birdie

HI all!

A very long article or i would have printed it...so you'll have to got it it...here is the link... Hugs, Bee

http://www.biomedcentral.com/1471-244X/3/4

Research article
[LINK]
Risk factors of thyroid abnormalities in bipolar patients receiving lithium: a case control study

As you slide down the banister of life, may the splinters never point in the wrong direction! ~Irish Blessing
-:¦:-
¸.·´ .·´¨¨))

Hi Kyra,
Thanks for that! It's a real encouragement! I'm also really hoping when
my dosage is right, I'll begin loosing. I'm fighting discouragement in that
I work and work at it yet to no avail. I go back for bloodwork tomorrow,
with results next week to adjust meds. I know they are not right yet. I
had been on Armour prior, but then got diagnosed with Hashimoto's and
somehow the armour then triggered almost an allergic type response....don't
fully understand it, but bottom line is I can't take it anymore because of
the Hashi. I am feeling a lot better on the synthroid, but I can just tell
it's not the right dose yet.
Valerie

Someone posted about weight loss or gain with synthroid I just wanted to say I went for a reg check up with my Gp yesterday in which he informed me that I had lost 13 lbs scene December I know it isn't alot of weight but this is with no change in diet just medication adjustments seeing how I am still not at my right level with my thyroid I see this as a good sign that when I get to my right level with this medication that weight loss will be a bit easier

Kyra

Hi Michelle,
I could have written the same post!! Exactly the same, except I was
thrown into menopause at 42 along with everything you went through!!!
The final diagnosis: I test positive to Graves---but don't "have it",
and I have Hashimoto's and Sjogren's disease and RA.
So---you just need to be treated. My endo treated me for over a year
with a "block and replace" therapy---meaning giving me beta blockers
for my heart palps, and replacing the thyroid hormone I needed in
teeny, tiny increments over the course of the last 2 1/2 years.
Have you looked at the about.com's "Top Thyroid Doc's" list for your
area??? If you don't want to say where you live to everyone, feel
free to go into members, and just click on my screename and email me,
or Beefuddled. There is a certain endo between Toledo and Youngstown
that is closely associated (business wise) with my endo. Pam--- In

Pam -
I'm in Dayton, which is between Columbus and Cincinnati. I've checked
in the Top Docs list, and there are 2 in Dayton listed. They also are
the same 2 that the neuro-opth in my eye doc's practice recommended
recently. So maybe that's a good sign. There's also a bunch in both
Cincy and Columbus, so there are a lot of choices, more so than I had
before. I think with the last experience I had with a doctor, I'm
afraid to go to another one for fear that a) they'll say there's
nothing wrong with me or b) there is something wrong, but they can't
do anything about it! I'm not sure which is worse at this point :) Or
they'll want to know why I'm wasting their time when I have "normal"
levels!
My FT4 is low enough now that no one wants to put me on an ATD, but
yet no one wants to give me any replacement hormone either. So really
I just sit and wait for the one day that I catch the labs at an
abnormal level before something can be done.
Are you still on a block and replace? Sorry about the Sjogren's and
RA. That must be tough to deal with in addition to the thyroid
problem! Do you happen to know what your Graves' and Hashi's antibody
levels were?
Thanks for info!
Michelle

You are very, if not already there, close to maintenance, Elizabeth,
and if I were you, I do believe I would be looking at "Protein Power"
(they have menu's and a plan worked out for 55 grams of carb per day)
and also Schwarzbein, as both of those plans have been designed to
help with hormone levels---and particularly those of thyroid, and
female hormone issues.
Kimmer happens to have Hashimoto's, too, but is on Synthroid, and
doesn't pay much attention to T3. Some of us have no conversion, and
some have lots. All I know is that I think it has something to do
with energy expension (Kimmer doesn't exercise at all), your
height/weight ratios. I'm small---only 5'2", and can't handle more
than 45 grams of carb a day, therefore, it's hard for me to get full
unless I'm eating a LOT of veggies and fruits----lots of fiber. I
think I eat less than 60% fat, and about six ounces of protein per
meal, but with the butter, olive oil, etc. I still end up with about
1400 calories---which is a lot for me. I exercise every day, too.
Kimmer hasn't fully hit menopause yet, either, so that really screws
everything up, but I eat a lot more berries, peaches, four cups of lc
veggies a day than what Atkins calls for. Might want to give those
books a look-see, you wouldn't be changing your eating habits so much
as just your menu in order to balance your hormones, especially the
glucose. Hope this helps, I really empathize with you!! Pam--- In

Hello everyone!
I am new to this board. I was diagnosed with Graves' disease in 7/01,
but that wasn't the whole story. Apparently I have Hashitoxicosis
(took 4 doctors to get that diagnosis). I belong to a Graves' board,
but thought I might look at it from a different perspective and see
if any of you who are hypo have similar experiences. I'm on my 5th
doctor in 2 years and none of them can agree what my diagnosis is,
let alone what to do with me. I'm beginning to reach the end of my
rope!
As I said, diagnosed with Graves' very early in the disease
(accidentally found when I went in for a virus). Initial labs were
FT4 1.97 (.93 - 1.7), FT3 747 (180-460), TSH .01 (.27 - 4.2), Thyroid
Stimulating Immunoglobulins 5.4 (< 1.3), Thyroid Peroxidase Ab's
1:6400 (normal < 1:100) and RAI uptake scan of 32% after 4 hours. So
definitely did have Graves'. GP and endo both agreed I should have
RAI immediately.
But I waited making the decision and 3 months later in 10/01, my FT4
was down to 1.57 (.71 - 1.85) - normal range! I was on no meds during
that time. I still had no TSH. By 1/02, FT4 was .85 (.71 - 1.85) and
FT3 was 293 (230-420). Still no TSH. However, by 3/02 I had normal
range TSH! It was .91 (.49 - 4.67), FT4 .80 (.71 - 1.85). I was still
on no meds ever during this.
From then on, it's been a rollercoaster ride. Ever since my TSH has
come back, it's been all over the place. And for the most part, I've
felt lousy during it's ride. Here's the lab history:
3/19/02 TSH .91 (.49-4.67)
FT4 .80 (.71-1.85)
Total T4 6.5 (4.5-12)
4/24/02 TSH 2.34 (same ranges for all)
FT4 .90
TT4 6.6
7/15/02 TSH 1.40 (same ranges for all)
FT4 .80
TT4 6.5
7/25/02 TSH 0.78 (same ranges)
10/30/02 TSH 0.97 (same ranges for all)
FT4 1.0
TT4 7.5
FT3 310 (230-420)
2/11/03 TSH 2.81 (.4-5.5) moved, new doctor and lab
FT4 .90 (.80-1.8)
Total T3 155 (60-181)
5/7/03 TSH .73 (.4-5.5)
FT4 .96 (.8-1.8)
Total T3 140 (60-181)
Whew! Sorry that's a lot of info. Congratulations if you're not
asleep yet :) So my FT4 has been consistently between .8 - 1.0 for
about a year and a half, but the TSH is all over the place! Most of
the time I have what seem to be hypo symptoms. Cold all the time
(wore long sleeve shirt and 2 sweaters most of the winter), very dry
skin, tired all the time, terribly aching joints (especially knees,
fingers, hips), not hungry, no energy, low body temperature, brain
fog, poor memory, and mysterious weight gain. However, since I keep
testing "normal", no one will do a thing for me.
Doc #3 sent me to a rheumatologist to be tested for lupus, arthritis,
fibromyalgia, etc. because I kept complaining about joint pains.
Rheumy (doc #4) tested and said I don't have any of those things,
that I had Graves' and Hashimoto's and that all my symptoms were from
the thyroid fluctuations. (That I believe - now convince my other
docs!) I just recently moved to Ohio and had to get a new doc :( Doc
#5 seems to be clueless. He is an endo, but told me after test
results in 2/02 and 5/03 that I "categorically do not have a thyroid
problem" and that I probably have a rheumatology problem. When I
explained about seeing the rheumy and all those things were ruled
out, then he said all my symptoms are in my head. So now I've gone
from the extreme of "have RAI immdiately" to "you don't have a
thyroid problem". Sigh. So I still have never been on any medication
and still feel bad most of the time. I did feel OK in Oct. and Nov.
of '02. But by Dec. I felt lousy again.
By the way, in terms of family history, my mom, her 2 sisters, and
their father all have Hashimoto's.
Do I have a point yet? I don't know, I've forgotten what my point
was! Oh yes. Has anyone ever had such strange ups and downs of the
TSH like this without real corresponding changes in FT4? Does anyone
have experience with subclinical hypo and is this it? As I said, none
of the doctors could really decide what to do about me, and it looks
as though I must look for another doctor here in town. Either that,
or it really is "all in my head" since I'm "normal".
Oh, and if anyone can recommend a doctor who has a clue about
autoimmune thyroid diseases in central/southern Ohio, I'd appreciate
it!
Sorry to carry on so long! I promise to try not to write a novel in
the future!
Michelle

Hi,
I'm glad you're asking Pam this ques Elizabeth.....I was just going to write and ask her about Protein Power and the difference between that and Atkins. Pam.....is Protein Power an eating plan that you have to measure your portions or do you eat till you're full? I'm wondering if my carbs need to be upped a bit. Sometimes I feel dizzy or lightheaded or feel like my blood sugar is low while I'm doing Atkins and it's scaring me. I'm on induction with Atkins, although I don't measure my carbs out, I know I'm not getting nearly 50 a day, like I remember someone saying that people with thyroid disorder should be eating. Is Protein Power a low fat way of eating?
Thanks!
Dana

Hi,
I remember reading somewhere where you said that 50 carbs a day is
optimal for thyroid health and I wondered why. Also when you
explained that when the merk manual said that low carb was not good
for thyroid that meant low carb low cal. So does that basically mean
low carb with too much protein? If that is the case isn't the lowcarb
my way (kimmers way) a recipe for disaster for many people?
Thanks,
Elizabeth

http://my.webmd.com/content/article/64/72348.htm

GABA Makes Old Brains Act Young Again~~Boosting the Amino Acid May Fight the Effects of Aging in the Mind~By Jennifer Warner
WebMD Medical News~Reviewed By Brunilda Nazario, MD
on Friday, May 02, 2003

May 2, 2003 -- Boosting levels of a chemical found in the brain called GABA may help keep older minds sharp and reduce the effects of aging. A new study shows elderly monkeys that were given drugs to increase GABA levels responded more like younger monkeys and were able to process visual cues more efficiently.

Researchers say the study may help explain why the brain's most complicated visual processes slow with age and offer a new way to counter these effects of aging. Their results appear in the May 2 issue of the journal Science.

Researcher Audie Leventhal of the University of Utah School of Medicine, and colleagues say the elderly tend to respond much more slowly in visual tests and have a harder time discerning different shapes compared with the young and middle aged. Many of these effects of aging have been related to a decline in function in the area of the brain known as the visual cortex.

GABA is an amino acid that acts like a chemical messenger in this part of the brain to relay information back and forth from the sensory organs like the eyes back to the brain.

In this study, researchers studied the effects of increasing the level of GABA in the brain in a group of young and old macaque monkeys. The monkeys in the older group were about 30 years old, which is equivalent to about 90 in human years.

When GABA levels were increased, researchers found that certain brain cells in the older animals exhibited responses typical of cells found in younger animals. It improved their ability to respond to visual stimuli and seemed to help cells within the monkey's brains be more selective and effective at filtering out unnecessary background activity, which allows them operate at peak levels.

Interestingly, researchers say GABA boosting had less of an effect on younger monkeys. These monkeys already had a greater proportion of brain cells that were strongly selective, and GABA supplementation had little effect on these cells.

Researchers say the findings suggest that drugs that increase GABA production, such as the anti-anxiety drug Xanax, might be effective in warding off some types of age-related problems in brain function.

But they say the recovery of these brain cells in the study was only partial, which indicates that other factors may also play a role in the gradual decline in visual processing that is a common effect of aging.

Ok, so today I took my med sublingual. I'll try this and see if it
helps.
I was thinking of upping the dose, but I'll try this first.
sincerely,
Naomi

In the Spotlight
[INLINE]
[INLINE] [INLINE] [INLINE] [INLINE]
[INLINE] Extrasensory Perceptions
There are four primary types of human extrasensory perceptions. Many people use a combination of these. But it is not uncommon to have one more developed than the rest. What is yours?
- Holistic Healing Guide Phylameana lila Desy http://healing.about.com/library/weekly/aa001006.htm
[INLINE]
More Topics
Cranberry - (V. macrocarpon) Profile
Herbs for Health http://herbsforhealth.about.com/cs/hotherbs/a/cranberry.htm
Johrei Healing
Holistic Healing http://healing.about.com/cs/holistictherapies/a/aa_johrei.htm
Usnea: A Lesser-known Antibacterial
Alternative Medicine http://altmedicine.about.com/library/weekly/aa122200a.htm
Are You In the Right Relationship?
Holistic Healing http://healing.about.com/library/uc_soulmates_0205.htm
Ask the Therapist
Alternative Medicine http://altmedicine.about.com/cs/askthedoctor/index.htm
Yoga -- The Path to Enlightenment
Thyroid Disease http://thyroid.about.com/cs/yogathyroid/a/yogaenlighten.htm
[INLINE] Preparing a Homeopathic Travel Kit
Find out how to prepare a homeopathy travel kit to help with common travel ailments such as jet lag, motion sickness, bites and stings, cuts and bruises, vomiting, traveler's diarrhea, and fears about travel.
- Alternative Medicine Guide Cathy Wong http://altmedicine.about.com/library/weekly/aa071701a.htm

As you slide down the banister of life, may the splinters never point in the wrong direction! ~Irish Blessing
-:¦:-
¸.·´ .·´¨¨))

Hey Naomi,

Great post! I am sure that others will find this very informative and it explains things in an everyday kind of way that makes it easy to understand!

Hugs, Bee
Lisa Naomi <lisanaomi@...

I got the following off webmd http://www.webmd.com . I typed in thyroid lab.

As you slide down the banister of life, may the splinters never point in the wrong direction! ~Irish Blessing
-:¦:-
¸.·´ .·´¨¨))

http://www2.us.elsevierhealth.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=amjd03257&nav=abs

[LINK]

May 2003, part 1 Volume 48 Number 5

Continuing Medical Education
Autoimmune thyroid diseases: Etiology, pathogenesis, and dermatologic manifestations

Julia Ai, MD, JD [MEDLINE LOOKUP]
Janie M. Leonhardt, MD [MEDLINE LOOKUP]
Warren R. Heymann, MD [MEDLINE LOOKUP]
Camden, New Jersey

Next article in Issue
View full-text version
View print version (PDF)
Drug links from Mosby's DrugConsult
Genetic information from OMIM
Citation of this Article
View on PubMed
Download in citation manager format
Download in Medlars format
Related articles in PubMed
Abstract TOP

Autoimmune thyroid disease (AITD) including Graves' disease, Hashimoto's thyroiditis, and idiopathic hypothyroidism (atrophic Hashimoto's thyroiditis) is of vital concern to the dermatologist. This article reviews the cutaneous manifestations of Graves' disease and Hashimoto's thyroiditis. Recognition of dermatologic manifestations of AITD may alert practitioners to investigate for these disorders. The immune response involved in the pathogenesis of AITD is detailed. Current understanding of the role of genetic and environmental factors, antigens, and apoptosis are elaborated. The future holds exciting insight into the etiology, pathogenesis, and treatment of AITD. (J Am Acad Dermatol 2003;48:641-59.)
Learning objective: At the conclusion of this learning activity, participants should better understand how to evaluate and treat patients with dermatologic manifestations of autoimmune thyroid disease. Participants should also gain insight into the pathogenesis of these disorders, including the role of genetic and environmental factors, antigens, and apoptosis.
Publishing and Reprint Information TOP
* From the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Camden.
* Funding sources: None.
* Disclosure: Dr Heymann holds US Patent No. 5,951,989 for the use of topical thyroid hormone for the treatment of xerosis.
* Reprint requests: Warren R. Heymann, MD, 100 Brick Rd, Suite 306, Marlton, NJ 08053.
* Copyright © 2003 by the American Academy of Dermatology, Inc.
* 0190-9622/2003/$30.00 + 0
* doi:10.1067/mjd.2003.257

As you slide down the banister of life, may the splinters never point in the wrong direction! ~Irish Blessing
-:¦:-
¸.·´ .·´¨¨))

I got the following off webmd http://www.webmd.com . I typed in thyroid lab.

Thyroid Hormone Tests

Test Overview

The thyroid is a butterfly-shaped gland that lies in front of the windpipe (trachea), just below the voice box (larynx). The thyroid gland uses iodine from food to make two thyroid hormones, thyroxine (T4) and triiodothyronine (T3). The thyroid gland stores these thyroid hormones and releases them as they are needed.

Thyroxine (T4) is produced by the thyroid gland when the pituitary gland releases thyroid-stimulating hormone (see the medical test topic Thyroid-Stimulating Hormone). Almost all of the triiodothyronine is made from thyroxine released by the thyroid gland, with only a small amount produced directly by the thyroid gland itself. T3 and T4 help control the body's metabolism.

Special cells within the thyroid gland (called parafollicular cells, or C cells) also produce a hormone, calcitonin. Calcitonin may help to regulate use of calcium in the bones.

Thyroid hormones are needed for normal development of the brain, especially during the first three years of life. An infant whose thyroid gland does not produce enough thyroid hormone (congenital hypothyroidism) may, in severe cases, become mentally retarded. Older children also need thyroid hormones to grow and develop normally.

The most common blood tests to evaluate thyroid function are:

Thyroxine (T4). Most of the T4 in blood is attached to a protein (called thyroxine-binding globulin). Less than 1% of the T4 is unattached. This is called free T4 or FT4, and it affects metabolism.

Triiodothyronine (T3). T3 has a greater effect on metabolism than T4, even though T3 is normally present in lower amounts than T4. Most T3 is made from T4 by body tissues after T4 is released from the thyroid gland. The rest of the T3 is produced directly by the thyroid gland. The total amount of T3 in the blood or the amount of free T3 (FT3) can be measured. Normally, less than 1% of the T3 is free.

Triiodothyronine uptake (T3U). The T3U test is an indirect measurement of the amount of the protein (thyroxine-binding globulin) that can bind to T3 and T4. The results of this test are useful only when evaluated along with other thyroid function tests.

Free thyroxine index (FTI or FT4). The FTI is a measure of the amount of T4 in relation to the amount of thyroxine-binding globulin present. The FTI is calculated from the T4 and T3U values. The FTI value can indicate when an abnormal level of T4 is due to an abnormal level of thyroxin-binding globulin in the blood.

This test is done on a blood sample taken from a vein.

Why It Is Done

Thyroid hormone tests are done to:

Determine whether the thyroid gland is functioning properly. An underactive thyroid gland (hypothyroidism) can cause symptoms such as weight gain, tiredness, dry skin, constipation, a feeling of being too cold, or frequent menstrual periods. An overactive thyroid (hyperthyroidism) can cause symptoms such as weight loss, rapid heart rate, nervousness, diarrhea, a feeling of being too hot, or irregular menstrual periods.
Help evaluate an enlarged thyroid gland (goiter).

Screen newborns for underactive thyroid gland function, a condition called congenital hypothyroidism. This condition can interfere with normal growth and development and can cause other severe problems (such as mental retardation) if not discovered soon after birth.

Monitor the effects of treatment for thyroid disease (such as Graves' disease). The total thyroxine (T4), free thyroxine (FT4), and free thyroxine index (FTI) values are often used to monitor treatment for hyperthyroidism or to guide thyroid hormone replacement for hypothyroidism.

How to Prepare

No special preparation is required before having this test.

How It Is Done

The person drawing blood will wrap an elastic band around your upper arm to temporarily stop the flow of blood through the veins in your arm. This makes it easier to put a needle into a vein properly because the veins below the band get larger and do not collapse easily.

The needle site is cleaned with alcohol and the needle is inserted. More than one needle stick may be needed if the needle does not get placed correctly or if the vein cannot supply enough blood.

When the needle is properly placed in the vein, a collection tube will be attached to the needle. Blood will flow into the collection tube. Sometimes more than one tube of blood is collected.

When enough blood has been collected, the band around your arm will be removed. A gauze pad or cotton ball is placed over the puncture site as the needle is withdrawn. Pressure is applied to the puncture site for several minutes and then a small bandage is often placed over it.

How It Feels

You may feel nothing at all from the needle puncture, or you may feel a brief sting or pinch as the needle goes through the skin. Some people feel a stinging pain while the needle is in the vein. However, many people do not feel any pain (or have only minor discomfort) once the needle is positioned in the vein. The amount of pain you feel depends on the skill of the person drawing the blood, the condition of your veins, and your sensitivity to pain.

Risks

There is very little risk of complications from having blood drawn from a vein. You may develop a small bruise at the puncture site. You can reduce the risk of bruising by keeping pressure on the site for several minutes after the needle is withdrawn.
Rarely, the vein may become inflamed after the blood sample is taken. This condition is called phlebitis and is usually treated with a warm compress applied several times daily.

Continued bleeding can be a problem for people with bleeding disorders. Aspirin, warfarin (Coumadin), and other blood-thinning medications can also make bleeding more likely. If you have bleeding or clotting problems, or if you take blood-thinning medication, tell the person before your blood is drawn.

Results

Normal

Normal values may vary from lab to lab. Labs generally measure free T4 (FT4) levels, but may measure total thyroxine (T4) and T3 uptake (T3U) as well

CAPTION: Thyroid hormone tests

Total thyroxine (T4):

512 micrograms per deciliter (µg/dL)

Free thyroxine (FT4):

0.92.4 nanograms per deciliter (ng/dL)

Total triiodothyronine (T3):

70195 ng/dL

Free triiodothyronine (FT3):

0.20.6 ng/dL

Free Thyroxine Index (FTI):

411

Greater than normal values may mean

High values for these tests may indicate hyperthyroidism. This can be caused by Graves' disease, thyroiditis, a goiter that contains one or more abnormal growths (nodules), or from receiving too much thyroid hormone medication.

Lower than normal values may mean

Low values for these tests may indicate hypothyroidism. This can be caused by thyroid disease (such as thyroiditis), pituitary gland disease, or destruction of the thyroid gland by surgery or radiation.

The T3U value may be useful in interpreting the other thyroid hormone test results.
A higher-than-normal T4 value combined with a high T3U value usually confirms the presence of hyperthyroidism.

A higher-than-normal T4 value combined with a low T3U value often occurs during pregnancy or in women who take birth control pills.

A lower-than-normal T4 value combined with a low T3U value usually confirms the presence of hypothyroidism.

A lower-than-normal T4 value combined with an increased T3U value may indicate kidney disease or long-term (chronic) illness. This can also occur normally in some healthy individuals.

What Affects the Test

Many medications can interfere with thyroid function test results, including:
Corticosteroids and hormones such as estrogen, progesterone, and birth control pills.
Large doses of aspirin. Warfarin (Coumadin), diphenylhydantoin (Dilantin), carbamazepine (such as Tegretol), amiodarone (Cordarone), lithium (such as Eskalith, Lithonate), clofibrate (Atromid-S, Abitrate), phenytoin (Dilantin), heparin, propranolol (such as Corgard, Inderal, Tenormin), and phenylbutazone.

Contrast material used for certain X-ray imaging tests may affect T4 results.

Pregnancy can affect thyroid function tests results.

Rough handling, contamination, or inadequate refrigeration of the blood sample can cause inaccurate test results.

What to Think About

Other blood tests to help evaluate the thyroid gland include:

A thyroid-stimulating hormone (TSH) test. TSH is a hormone released by the pituitary gland that triggers the thyroid gland to produce thyroid hormones. A TSH test measures the amount of TSH in the blood and is considered the most reliable method of detecting a thyroid problem. For more information, see the medical test Thyroid-Stimulating Hormone.

A thyroid antibodies test. This test measures the presence of antibodies against thyroid tissue. If antibodies are detected, an autoimmune disease (such as Hashimoto's thyroiditis or Graves' disease) that may cause the body to attack its own thyroid gland may be present.

A thyroxine-binding globulin (TBG) test. TBG is an important protein in the blood that carries the thyroid hormones T3 and T4. TBG testing is rarely needed and is done only after more commonly used thyroid tests produce abnormal results.
Problems with the thyroid gland can be further investigated by a thyroid scan, ultrasound, or biopsy. For more information, see the medical test topics Thyroid Scan, Thyroid Ultrasound, and Thyroid Biopsy.

Hi Kim,
Sorry about your foot, hope you feel better soon. Well, I just have
to say that The Zone is nothing like Atkins for me. I did Zone to the
letter and lost only two disgusting pounds in a month!! I thought it
was something I wasn't doing right.
Then I read "Protein Power" and it explained why it works (and Zone
doesn't as well), and I lost really close to 20 pounds my first month
on it. After I had lost about 60 pounds I read Atkins, and used some
of the ideas in there to "tweak" my plan. My favorite phrase from Dr.
Atkins is "One mouthful of sugar, one small cheat is the kiss of
death on this regimen." Ha, ha, and he was soooo right. People who
don't eat the "Frankenfoods" made for lc'ers and who stick right to
plan, only "legal" foods, lose at almost double the rate.
Then the major "trick" is to start raising the carb level and your
exercise level. Weights go with lowcarbing really well. There are
about two days a week when I can have fruit, or more carbs. I still
do not eat any sugar, or flour, or rice, it's just not part of my
diet anymore.
I hear all the time about the "lack of conversion" and I'm not
impressed. I feel better than I ever have eating this way, and my T3
doesn't seem to be suffering. People have misconstrued that "eating
under so many carbs means no conversion". The original statement said
reference to BOTH lower carbs and under 800 calories. So....I eat
about 1400 calories a day to maintain, and about 45 grams of carb,
but did 30 grams for two years, and over 1800 calories.
Anyway, enough of this book!! Hope your foot heals quickly and if you
can, get your hands on a copy of "Protein Power", good stuff in it.

Bee, thank you for the link to endocrineweb.com. I
was recently diagnosed with hashimotos. The pictures
were very helpful. I have the symptoms of waking up
suddenly, choking at night and have noticed my neck
getting larger. I have severe muscle pain and
weakness. I was originally dignosed as having lupus
but rheumatologist ruled that out. The amazing thing
is that all the doctors I have been to have never
examined my neck! I am making an appointment with
endocrinologist right away! Thanks again, Georgia

Hi!

FT4...right at mid range...most feel best and have less symptoms when higher in the range...

Tsh...looks good, but a lot of us feel best when a little lower...

FT3...3.25 would be the 1/2 way point, so this is way low, as far as being at an optimal place for feeling your best...

Take care, Bee
junquedealer2000 <junquedealer@...

I got my results back from my blood draw yesterday. Am I fine?
Laboratory Results
Test Code Description Result Range Units
3693 FREE THYROXINE (FT4) 1.3 0.8 - 1.8 NG/DL
3703 THYROID STIM. HORMONE 1.28 0.40 - 6.00 MCIU/ML
4145 TRIIODOTHYRONINE FREE 2.9 2.3 - 4.2 PG/ML
To unsubscribe from this group, send an email to:

Hi Linda,

I recently posted a bunch of links to EndocrineWeb.com and it has some good info...

Although I have to say that Mary's site is not so mainstream as far as the "rules of thyroid"...

Some big medical sites I go to, post all of the "good old boy network" bs that has kept us all ill for so long...I mean, at least her info is coming from the view point of another thyroid patient instead of being tainted by pockets being lined by drug companies...

I know that a lot of these big medical sites still post the old "normal ranges" and make no mention whatsoever of the fact that there are changes going on...

Take care, Bee
Matt and Linda Williams <mnlinc@...

Thanks for the information Angel. I put the TRH test, from the article you posted, into WebMD.com's browser and came to the following article. This article is a very basic description of the process dx'ing hypothyroidism.

http://my.webmd.com/content/healthwise/17/4121.htm?lastselectedguid={5FE84E90-BC77-4056-A91C-9531713CA348}

Today I took Brennan to Children's Hospital for the lab draw to see if he has Chromosome and/or Fragile X Syndrom. The Behavioral Pediatrician had also ordered "Thyroid Antibodies" test. The lab tech called to see which tests specifically he wanted and I believe they decided on something like TSA's and also a test called TBG (A thyroxine-binding globulin (TBG) test. TBG is an important protein in the blood that carries the thyroid hormones T3 and T4. TBG testing is rarely needed and is done only after more commonly used thyroid tests produce abnormal results. PER WEBMD SITE). I tried convincing the lab tech to ask the doc for a TSIg also, because drawing blood on Brennan is as painful for him as murder would be - he is only 3 and terrible behavior problems. Doc wouldn't go for it so I suppose if he comes back Graves' positive we will need more bloodwork. Poor Brennan...it took 3 nurses and me to hold him down and get the 3 tubes of blood. Mind you...my little guy is
between 28 and 30 pounds...not like he is a giant or anything. Hell, he weighs less than my damn leg...so you can see how freaked out he gets drawing blood if it takes 4 of us to get the job done. I am rediscovering labs names and their importance. If anyone else has a good site for thyroid review, an educational site - not one chock full of opinions such as the "esteemed" Mary Shomon's...pass the site names over...I really need the refresher.

~ Linda

Aw shucks [INLINE] ...LOL...

Just remember, Bee learned a lot of what she learned at M. Shomon's site...when I first got on the internet a little over 2 years ago, I knew almost nothing except the lies that everyone else has always been told about this disease...I got on here and just kept typing in thyroid, thyroid disease and hypothyroidism and eventually clicked on the link to Mary's book and after a couple of times of going to amazon to look at the book description I noticed that it said she had a website...I clicked on the link and was literally "walking around with my mouth hanging open"...probably a lot of the best info and wisdom I got was in the chat room there from the regulars...

There were others like me!!! I was like a kid in a candy store! All the lies I had been told that kept me un-well were being de-bunked...I was so thrilled!! But then my euphoria became depression and hopelessness, partly because of the disease, but also, because there were so many like me and we were all looking for that one elusive entity...A Thyroid Enlightened Doctor! I was like...ok I know I am not nuts...this is really real...I am not on a high enough dose of meds and the med I was on had had dozens of recalls during the time I had been on it and complained that I felt like I was on a roller coaster and to top it all off they were not even fda approved, yet my doctors insisted that this was the drug of choice...

Thanks Linda. It was my regular doctor that gace me the BC prescription. I
go to see my Endo on Monday. I just went today and gave them three more
vials of blood (had already given them two last friday.). If I wasn't
anemic I am now. I know about the Anemia. I was sevelyl anemic after I had
my daughter (major blood loss), and just got over it about 5 months ago, so
I was not happy with this current situation. The doctor tested my blood,
and as he so rudely put it (the regular dumb one, not my endo) I have
plenty of blood left to lose. I started the BC pills, hoping they would
work, but it just made things worse. Yes it is medium bleeding, no
spotting. So when I go into see my Endo I am going to request an
ultra-sound, he is pretty good about those things. Glad to hear I am not
alone with this one, but also not so glad to hear that others have to suffer
this annoying issue. Smiles.
Ashley

Hi Linda,

Save your money and eat as healthy as you can in spite of all your allergies...there is absolutely no reason to eat things that you know cause a bad reaction just because someone else lost weight eating it...

Start exercising & eat whatever lean meats you can handle and try to get as many of your carbs as possible from fruits and veggies...and don't forget to add the good for you fats and eliminate the bad ones...drink water constantly...

Cook healthy things ahead, so that when you get a craving, you don't reach for the cookies or potato chips...have some protein ready, like some chicken breasts, hamburger patties or other lean protein that your body can handle...

If you want to do atkins, look up the glycemic index and start reading labels and ask Pam lots of questions...and you'll probably want to buy the atkins book and Protein power...

OK, did I sound like your mother??? LOL! Take care, Hugs, Bee
Matt and Linda Williams <mnlinc@...

I did a little survey at Atkins and they can create a diet plan online, through e-diets, for me for 5.00 a week. But when I did the goal and current weight it said I am restricted to 20 carbs a day PLUS I can't exclude both dairy AND soy...as my friends know well - I have a high milk allergy and also am allergic to soy. I use Rice Milk for cooking and rarely allow dairy.

My question for Pam...you know about my pork/corn/milk/soy/peanut allergy a little bit, and you also have been frank in saying once your diet was controlled many health problems went away...would it be worth the risk to try their diet with milk, see what I can tollerate and skip the remainder of milk products in the diet scheme...hoping my allergies would get better? (Reminding you I have Graves' and my allergies are pretty bad.) Also what do you think about a 20 carb a day diet? going from a diet of about 60% carbs to only 20 carbs a day...is incredibly drastic...what health withdrawl problems could I be looking at?

Anyone else checked out this e-diets site? What did you think...did you do the diet they recommended or not?

~ Linda

To unsubscribe from this group, send an email to:

http://www.nytimes.com/2003/05/30/business/30DRUG.html?ex=1055727962&ei=1&en=efb1bfd6b1b233e6

Court Papers Suggest Scale of Drug's Use

By MELODY PETERSEN

D ocuments released yesterday in the case of a drug company whistle-blower shed light on how extensively doctors were involved in promoting unapproved uses of a Warner-Lambert drug, Neurontin.

Warner-Lambert paid dozens of doctors tens of thousands of dollars each to speak to other physicians about how Neurontin, an epilepsy drug, could be prescribed for more than a dozen other medical uses that had not been approved by the Food and Drug Administration. The top speaker for Neurontin, Dr. B. J. Wilder, a former professor of neurology at the University of Florida, received more than $300,000 for speeches given from 1994 to 1997, according to a court filing. Six other doctors, including some from top medical schools, received more than $100,000 each.

[INLINE]

[INLINE]

Other doctors were paid to write reports on how Neurontin worked for a handful of their patients, the court papers said. Still others were paid to prescribe Neurontin in doses far exceeding the approved levels as part of a clinical trial that Warner-Lambert created to market the medicine, according to the court papers, which are new documents filed in the lawsuit by the whistle-blower. The papers are backed up by hundreds of pages of corporate documents and memos recently filed with the court.

The whistle-blower, Dr. David P. Franklin, a former Warner-Lambert employee, contends that the company's marketing tactics, which have helped make Neurontin a top-selling medicine, with more than $2 billion in revenue, were illegal. He says that federal and state governments paid hundreds of millions of dollars for Neurontin as doctors prescribed the drug to Medicaid patients for various conditions including pain, bipolar disorder and restless-leg syndrome.

It is illegal for a drug company to market a medicine for uses the F.D.A. has not approved, but doctors can prescribe a drug in any manner that they think is best for their patients.

Lawyers for Dr. Franklin argued that the company relied on the doctors to market Neurontin for unapproved uses because it was illegal for the company to do so. The speaking program, which also included paying doctors to listen to the speeches at hotels and resorts, was called peer selling, according to the documents.

Also this week, prosecutors filed a brief supporting Dr. Franklin. The United States attorney in Boston, Michael J. Sullivan, asserted in the brief that his lawyers had "presented evidence of an illegal off-label marketing scheme that is rife with false statements and fraudulent conduct."

For example, Mr. Sullivan said, Warner-Lambert had invited doctors to continuing medical education classes that the company said would provide unbiased information about Neurontin. In fact, Mr. Sullivan said, some of these classes were "a massive promotion" in how Neurontin could be used to relieve pain and were planned by Warner-Lambert employees.

Mr. Sullivan's brief, filed on Tuesday, was significant. Even though prosecutors have said in court that they are conducting both a civil and a criminal investigation into the accusations, the federal government has not formally entered the case as a plaintiff. Mr. Sullivan filed the brief after Pfizer, which acquired Warner-Lambert in 2000, asked the court to throw out the case, arguing that Dr. Franklin had not proved that the company violated the law.

A spokesman for Pfizer, Andy McCormick, said yesterday that the lawsuit dealt with events that occurred about four years before Pfizer acquired Warner-Lambert. He said Pfizer had helped to write and develop a code of ethics that was adopted by large pharmaceutical companies last year. "We strive to adhere to the highest ethical standards," he added.

Corporate documents made public in the case yesterday state that a Warner-Lambert strategy was to focus on respected doctors in the major teaching hospitals who would serve as "Neurontin champions."

One of those was Dr. Steven C. Schachter, a professor at Harvard Medical School and a physician at Beth Israel Deaconess Medical Center in Boston. Dr. Schachter received $71,477 from May 1994 to September 1997 to speak about Neurontin to other doctors, according to the court papers.

At a meeting Warner-Lambert sponsored for physicians at the Ritz-Carlton Hotel in Boston in 1996, Dr. Schachter said that "pain specialists are finding that low dosages of Neurontin are effective" a statement that lawyers for Dr. Franklin called misleading.

Paul Cirel, a lawyer for Dr. Schachter, declined yesterday to comment

http://www.nytimes.com/2003/05/30/business/30DRUG.html?pagewanted=2&ei=1&en=efb1bfd6b1b233e6&ex=1055727962

Another doctor, Ilo Leppik, a professor at the University of Minnesota, received $49,250 to speak about Neurontin. According to the court papers, Warner-Lambert also paid $303,764 to publish Dr. Leppik's textbook on epilepsy.

Dr. Leppik said yesterday that in his speeches he had talked only about how Neurontin could be used in epilepsy. He said his textbook mentioned not just Neurontin, but also all other epilepsy medicines.

[INLINE]

"I'm an academic," Dr. Leppik said. "I'm not a marketer. I'm proud of that book. I don't think of it as a marketing vehicle at all."

Dr. Wilder, who received the most money for speaking about Neurontin, could not be reached yesterday. His wife, Eve Wilder, said that Warner-Lambert had never told her husband what to say. "He had total freedom on all the education programs he put on," Mrs. Wilder said.

Warner-Lambert tracked doctors' prescriptions to see if the numbers increased after the doctors attended Neurontin meetings or after they were hired to speak about the drug.

For example, Dr. Joseph De Mayo, a Connecticut physician, wrote 58 prescriptions for Neurontin for unapproved uses like gastric ulcer, osteoarthritis and backache in the 14 months after he attended a meeting at the Ritz-Carlton in Atlanta where other doctors had spoken about Neurontin, according to court documents. In the year before that meeting, Dr. De Mayo did not write any Neurontin prescriptions for Medicaid patients, the papers said.

After the meeting, Dr. De Mayo also became a Warner-Lambert speaker and was paid more than $1,000, according to the papers.

Dr. De Mayo said yesterday he had not seen the lawsuit and could not comment.

In 2000, 88 percent of Neurontin sales were for uses not approved by the F.D.A., according to the lawsuit. Until last year, Neurontin was approved only for use in epilepsy as an add-on medicine when the patient's primary drug did not work. Last year, the F.D.A. approved Neurontin for use in pain suffered by patients with shingles.

Dr. Franklin has said that Warner-Lambert also told its sales representatives to promote Neurontin to doctors for unapproved uses.

Until now, that accusation has largely rested on the testimony of the whistle-blower, who visited doctors as a Warner-Lambert medical liaison. The newly filed court papers, however, give details from Scott-Levin, a health industry consulting firm in Newtown, Pa., that Warner-Lambert hired to track what its sales representatives were saying to doctors.

According to computer records from Scott-Levin, almost half of the 503 doctors surveyed from October 1995 to December 1998 said they had received marketing appeals from the company's sales representatives on unapproved uses. And of those doctors, about half told Scott-Levin that they intended to increase their prescribing of Neurontin, the court documents say.

Dr. Franklin is represented by Greene & Hoffman, a law firm in Boston.

As you slide down the banister of life, may the splinters never point in the wrong direction! ~Irish Blessing
-:¦:-
¸.·´ .·´¨¨))

Hi Carrie,

I did this with synthroid, unithroid and cytomel...all of which don't taste bad at all...now armour was a different story...lol NOT good tasting at all!!

So, with it I tried the between the cheek and gum method and it worked good, lots less saliva, so you don't taste it near as much...when I tried it under the tongue, I literally gagged!

Right now, my doc put me on a compounded natural thyroid, which is in a capsule and is time release...I have been taking this by swallowing it whole with (usually...my bad???) my morning coffee and even though it is a higher dose than before, it feels like a smaller dose...I am planning on asking to go back to the regular armour, since I am also retaining water since the switch and think maybe one of the fillers or something it is compounded with is causing the edema...

Best wishes, Bee

csayler1 <csayler1@...

I read in the posts someone mentioned putting their meds under their
tongue and it seemed to work well.
Does that work with any thyroid meds? Is that a common trick of the
trade? I am on armour but typically swallow my meds in the
morning...although this is interesting to me!
Carrie
To unsubscribe from this group, send an email to:

Dear Pam and Bee,

Thank you both for your words.

Sincerely,

Naomi

I read in the posts someone mentioned putting their meds under their
tongue and it seemed to work well.
Does that work with any thyroid meds? Is that a common trick of the
trade? I am on armour but typically swallow my meds in the
morning...although this is interesting to me!
Carrie

http://archinte.ama-assn.org/cgi/content/abstract/163/11/1367

Raloxifene Causing Malabsorption of Levothyroxine

Elias S. Siraj, MD; Manjula K. Gupta, PhD; S. Sethu K. Reddy, MD

Arch Intern Med. 2003;163:1367-1370.

To our knowledge, raloxifene hydrochloride, a selective estrogen^ receptor modulator, has never been reported to interfere with^ absorption of levothyroxine. We describe a 79-year-old woman^ with chronic, treated primary hypothyroidism, presenting with^ increasing levothyroxine requirement while taking raloxifene^ at the same time as levothyroxine. For two 6- to 8-week periods,^ we separated the ingestion of raloxifene and levothyroxine by^ about 12 hours. In addition, we tested the absorption of 1.0^ mg of levothyroxine sodium with and without the coadministration^ of 60 mg of raloxifene hydrochloride on 2 separate occasions^ by collecting serial blood samples for 6 hours. Hypothyroidism^ occurred in a reproducible fashion whenever levothyroxine and^ raloxifene were administered together and improved whenever^ they were taken separately. Combined administration of levothyroxine^ and raloxifene resulted in lower levels of serum thyroxine compared^ with administration of
levothyroxine alone. By a yet unknown^ mechanism, raloxifene caused malabsorption of levothyroxine^ in our patient when coadministered.^

From the Department of Endocrinology, Diabetes & Metabolism, Cleveland Clinic Foundation, Cleveland, Ohio. The authors have no relevant financial interest in this article.

As you slide down the banister of life, may the splinters never point in the wrong direction! ~Irish Blessing
-:¦:-
¸.·´ .·´¨¨))

Highly Effective Treatment of Fibromyalgia and Chronic Fatigue Syndrome: Results of a Placebo Controlled Study and How to Apply the Protocol by Jacob Teitelbaum MD http://www.townsendletter.com/Oct_2002/fibromyalgia1002.htm
Rethinking the TSH Test: An Interview with David Derry, M.D., Ph.D.
http://thyroid.about.com/library/weekly/blderryb.htm?terms=Derry
Chronic Fatigue, Fibromyalgia, and Autoimmune Thyroid Disease
http://thyroid.about.com/library/weekly/aacfsfms.htm?terms=Chronic+Fatigue%2C+Fibromyalgia%2C+and+Autoimmune+Thyroid+Disease
Gail's Thyroid Tips - Fibromyalgia
http://home.earthlink.net/~wurmstein/

The Thyroid/Fibromyalgia Connection http://thyroid.about.com/cs/fibromyalgiacfs/a/fibrothyroid.htm

MYCOPLASMA The Linking Pathogen in Neurosystemic Diseases~Several strains of mycoplasma have been "engineered" to become more dangerous. They are now being blamed for AIDS, cancer, CFS, MS, CJD and other neurosystemic diseases. http://www.whale.to/m/scott7.html

As you slide down the banister of life, may the splinters never point in the wrong direction! ~Irish Blessing
-:¦:-
¸.·´ .·´¨¨))

Ah interesting...Had not thought about histamine's. Thanks for bringing that word up Kelly! ~ Linda

When I first start running after a layoff, I get horrible itching on my behind and thighs. I can scratch, but I just get welts and itch more. But after a week or so, it goes away. It is almost like an exercise induced histamine reaction! Kelly

Hi Naomi,

The insomnia and finally getting to sleep only to wake up numerous times a night was something that only went away when they got me on a high enough dose that most of the other symptoms went away...one thing that didn't help was the limbs going numb and waking up in bad pain because the side I was laying on was like when you leg goes to sleep after sitting on it too long or the carpal tunnel type symptoms I get in the mornings when I need a dose adjustment...

Don't waste your money on diets...now exercise equipment or videos are another story if you will use them...most diets don't work, but eating healthier does if you are on the right amount of meds...and even if you don't lose right away, you will be healthier than if you load up on junk and sugar...

Try to keep most of your carbs to vegetables and fruits...choose leaner meats...avoid preservatives...try to eat as natural as possible...try to add a salad to every meal or an extra helping of veggies...eat raw fruits and veggies as much as possible, so the enzymes are still there...

I can't promise that this will help you to lose weight, but it will make you feel better...I know with me, it wasn't until I got on a high enough dose of my meds that I was able to lose, and it is still a struggle...

Just remember. you are not the only person this is happening to and this is no reflection on you...keep plugging away adn work on being as healthy as possible...getting your meds adjusted and tweaked to the dose that is right for you can take a long time because they don't want to up you too much too fast...if they do it can have really bad results...

One thing that I noticed a big difference with was when I started taking my meds sublingually...let it disolve under your tongue or between your cheek and lower gum...this way the meds go straight to your blood & lymphatic system...I noticed a huge difference when I started this a couple of years ago...AND because you are bypassing the stomach for the most part, you are having less interference from things you take, eat and drink...

Hugs & best wishes, Bee
Lisa Naomi <lisanaomi@...

I must say my swelling and exercise reactions are different depending on quite a few things. When I was pregnant, about 8 months ago, doing exercise actually made my swelling, particularly in my legs, subside. Now that I am not pregnant, and actually living in a different body than before I was pregnant, this is not the case.

I must say, Bee, drinking enough water....(thanks for reminding me yesterday) makes a world of difference, but it is not the solution I hope it could be. However, I have purchased an herbal diuretic which I will try today. I had used hydrothalimizine for a few months after pregnancy and preeclampsia, I got it from my internist, when I mentioned it to my ob, she said that it was a very low dose and she wouldn't be surprised if it had no effect. I asked the internist for a higher dose, and he said know, it's weight related, if you lose weight, you'll lose the fluid. What a donkey's but.

Now, I still have the fluid, I have lost weight, but the scale doesn't show it so well because of the swelling. I am on a higher dosage of levoxyl, but I don't think it's enough. I am still having trouble sleeping and staying asleep, I am moody, lethargic, swelly, etc etc. I am going back for blood work in a month and a half. Does anyone else think this should be making a difference by now, besides just me.

I am being more persistant with exercise, but as almost everyone know, hypothyroids can have some problems losing weight. I think I am losing, I can tell it in my clothes, but I think the swelling is making it seem like I am gaining, staying at the same weight. I am smarter than the diet industry, though I want to feed my need to spend the money that I don't have, that seems to be burning a hole in my pocket.

Anyway, after I had the baby, my OB said she would guess I probably have 10 pds of fluid retained in each leg. Granted, my legs are down considerably since delivery and the passing months, but something just isn't right. Also, I am sure with all things combined AND a good night's sleep I would help.

I would appreicate any suggestions about how to resolve this, with vitamins, supplements and exercise.

Sincerely,

Naomi

As you slide down the banister of life, may the splinters never point in the wrong direction! ~Irish Blessing
-:¦:-
¸.·´ .·´¨¨))

***head tipped back, deep throaty laughs*** What an idiot that Primary Care Physician was! OMG...hypo has nothing to do with your bones...what a damn joke! (see everyone, yet another early menopausal woman) And I suppose your hotflashes were just the thermometer turned up too high in your house too, right? HAHAHAHAHA

I must say, since reading you did not even get instruction to take calcium...which is incredibly scary that a surgeon would the gland off and not do proper aftercare instruction...I have "slightly" changed my mind about my first Endo...the one who wouldn't let me have surgery when hyper. He told me the risks of surgery included accidentally cutting or damaging one or all of the parathyroid glands and that we have to have those for calcium. At the time I was angry and though...who cares if it is cut, I want surgery...now in hindsight - it is an important risk to be aware of thinking of surgery. I see he isn't the devil incarnate...maybe just one of his henchmen.

~ Linda

In a message dated 6/11/03 3:23:48 AM US Eastern Standard Time, mnlinc@... writes:

I am thinking about our good friend Tracey out in R.I., she had swelling upon exercise to the point it deters her from working out at the frequency and pace she wants to.

When I first start running after a layoff, I get horrible itching on my behind and thighs. I can scratch, but I just get welts and itch more. But after a week or so, it goes away. It is almost like an exercise induced histamine reaction! Kelly

Welcome to the group!! Selenium increases conversion of T4 to T3 in
some people. But...just like if you need thyroid hormone, and not
just iodine for hypothyroidism, you may need T3 added to your
synthetic T4. You also need to get your lab results COPY from the doc-
-make sure it has the lab ranges for each particular test, and we can
have a shot at telling you what you might need in the way of "med
tweaking".
I lost weight even before I was dx'd, but I'm a strict lowcarber. Pam-

In a message dated 6/11/03 8:32:27 AM US Eastern Standard Time, promenea@... writes:

Hey, chopped chicken liver is the food of the gods!

My mother was anemic most of her life. After she had breast cancer, her doctors disagreed as to whether or not she should continue taking high doses of iron (some doctors feel that high doses of iron have a cancer correlation but others don't) so one of her docs told her to eat lots of chicken livers. She loved them but I think they are nasty! Kelly

I like your remark about money and the diet industry. Actually, it
took me 6.95 cents to lose over 112 pounds. The book "Protein Power"
cost me 6.95, and although I'll tell you right now, hypothyroid
people will lose all their water weight on that first off, and then
we will lose a bit slower than others (where others lost an average
of 10 pounds a month, I would only lose about 6), it's what works for
me.
Oh, yeah, I'm quite sure all of you know that no diet or way of
eating works by "osmosis"---meaning you have to eat this way the rest
of your life if you want to stay in shape----I guess I'm just
sensitive to some of the "fan mail" I've gotten lately, where the
person tells me "It didn't work for me. As soon as I went back to
eating the "normal" way.........etc. Pam

i have lost about 2lbs in the last month since starting the meds... I do workout heavily and also have slighty modified my diet.. so i am not sure which is responsible for what... but i'll take it.. i have been trying to lose 2lbs for about 6-8 months . Very frustrating!!

Now that is an interesting thought... I infrequently have severe swelling of my hands.. I spend a lot of time in front of the computer.. but not always doing a lot of typing.. now.. maybe I should keep track of which days the swelling is most noticeable and how much finger manipulation/typing I've done on those days...

...very interesting....

Topper (Linda)

I did a little survey at Atkins and they can create a diet plan online, through e-diets, for me for 5.00 a week. But when I did the goal and current weight it said I am restricted to 20 carbs a day PLUS I can't exclude both dairy AND soy...as my friends know well - I have a high milk allergy and also am allergic to soy. I use Rice Milk for cooking and rarely allow dairy.

My question for Pam...you know about my pork/corn/milk/soy/peanut allergy a little bit, and you also have been frank in saying once your diet was controlled many health problems went away...would it be worth the risk to try their diet with milk, see what I can tollerate and skip the remainder of milk products in the diet scheme...hoping my allergies would get better? (Reminding you I have Graves' and my allergies are pretty bad.) Also what do you think about a 20 carb a day diet? going from a diet of about 60% carbs to only 20 carbs a day...is incredibly drastic...what health withdrawl problems could I be looking at?

Anyone else checked out this e-diets site? What did you think...did you do the diet they recommended or not?

~ Linda

years ago, and have since had all the salivary glands removed on the
left side of my neck. I was told that my facial nerves are now "lax"
and will not remain taut, therefore, when I get a cold, sinus
infection, etc. I lose my voice, also. Unfortunately, this is one of
the little things you sign away your right to do anything about prior
to treatment and surgery (I know, I read the fine print!!).
It's not enough I had to lose my voice at those times, I also was
never advised to take a calcium supplement after the parathyroid
surgery, and now (17 years later) I am post-meno, and having problems
with calcium in my bones. BTW, if ya want to hear something really
silly here: I asked my PCP "Shouldn't I have a bone density exam
because I'm asthmatic, and took steroids a lot, and now am post meno,
and have Hashi's, etc." PCP said "Oh, heavens NO!!! You JUST became
post meno (at 42 yrs. old!) six years ago, and hypo has NOTHING to do
with your bones, and besides, women get that bone loss in their 60's,
you are only 48!!!" Yep, I'm looking for a new doc, BTW, and anyone
who lives in my area, I'm open to suggestions. I have an "opposite"
problem----my endo is wonderful, but can't find a PCP to save my
bones!! Pam

thanks linda I would think it might be the exercise but i have been doing that way before the meds... my hands did not swell. the ache in my legs/knee too,made much worse when i took bcp pills then went away when i stopped that brand it went away..

, now since taking the meds the aches are back BIG TIME. it is uncomfortable to stand for more than 5 minutes.. actually they are aching as i sit here,, i will probably call the doc today. don't know it they will change my meds before my next appt.

Hi Everyone,
I hear a lot of people saying that Synthroid causes weight gain. Is that
true for everyone? Do some people loose weight on it? Thanks for the
input.
Valerie

I must say my swelling and exercise reactions are different depending on quite a few things. When I was pregnant, about 8 months ago, doing exercise actually made my swelling, particularly in my legs, subside. Now that I am not pregnant, and actually living in a different body than before I was pregnant, this is not the case.

I must say, Bee, drinking enough water....(thanks for reminding me yesterday) makes a world of difference, but it is not the solution I hope it could be. However, I have purchased an herbal diuretic which I will try today. I had used hydrothalimizine for a few months after pregnancy and preeclampsia, I got it from my internist, when I mentioned it to my ob, she said that it was a very low dose and she wouldn't be surprised if it had no effect. I asked the internist for a higher dose, and he said know, it's weight related, if you lose weight, you'll lose the fluid. What a donkey's but.

Now, I still have the fluid, I have lost weight, but the scale doesn't show it so well because of the swelling. I am on a higher dosage of levoxyl, but I don't think it's enough. I am still having trouble sleeping and staying asleep, I am moody, lethargic, swelly, etc etc. I am going back for blood work in a month and a half. Does anyone else think this should be making a difference by now, besides just me.

I am being more persistant with exercise, but as almost everyone know, hypothyroids can have some problems losing weight. I think I am losing, I can tell it in my clothes, but I think the swelling is making it seem like I am gaining, staying at the same weight. I am smarter than the diet industry, though I want to feed my need to spend the money that I don't have, that seems to be burning a hole in my pocket.

Anyway, after I had the baby, my OB said she would guess I probably have 10 pds of fluid retained in each leg. Granted, my legs are down considerably since delivery and the passing months, but something just isn't right. Also, I am sure with all things combined AND a good night's sleep I would help.

I would appreicate any suggestions about how to resolve this, with vitamins, supplements and exercise.

Sincerely,

Naomi

***wrinkled up top lip and nose* saying ewwwwwwwwwww, I sure hope not...lol ~ Linda

Should we be
eating more liver?

Inatic, now that you mention fingers swelling...I am searching the recesses of my insane mind...whoop, there it is...I remember years ago when exercising I would get fat fingers when I sweat, got all stiff and tingly feeling like when your leg is asleep...know that feeling? I heard on an exercise show that it was the amino acid buildup in the body that makes the muscles sore after working out...and I also - myself mind you and I am absolutely no expert - think it could be the same for the swelling. Could just be the body's way of adapting to the medication conversion - causing some edema in the extremities.

It could be a bunch of whoey, but even when using the keyboard so much, like I am doing tonight, my palms and fingers get a bit puffed out. Was just thinking about Carpal Tunnel Syndrome...and came to this idea...

What if those of us who swell unpredictably are so highly sensitive to drugs, or physical activity for that matter, that make our metabolism increase, therefore our blood is pumping in our organs more, and the chemical reaction causes the edema. Anyone buy that idea? And if this IS what happens, what are the chances it will get better over time and what are the chances this is just how our body reacts? I am thinking about our good friend Tracey out in R.I., she had swelling upon exercise to the point it deters her from working out at the frequency and pace she wants to.

Deep thoughts ~ Linda

Excellent advice Bee, glad you thought of sticking with natural hypoallergenic rather than going to synthetic right away. I'd get off synthetic in a heartbeat if I could find a doc to give it to me. ~ Linda

Pam, I had just read Karen's post and thought about you with the pneumonia for months and how you stopped taking T3...glad you jumped in to tell your story. T3 can be really good, but it too is not the perfect drug for everyone. Wishing I could try it...boo hoo hoo...~Linda

Ashley, welcome to ThyroidFitness. Glad you came to check us out. I am behind on all my posts so not sure if I will be duplicating what others have told you, but here goes.

#1, let me put it bluntly...your doctor is full of sh#t - pardon my language but it really steams me when a doctor doesn't listen to a patient...obviously by your asking if there are alternatives he got his "I am the doctor and you will do what I say" and "don't tell me how to do my job" attitude...it makes me feel like the Incredible Hulk! (Don't make me angry! You won't like me when I'm angry!)

I too am having trouble with my period, being like 3 weeks out of 5 weeks, almost constant, couple days spotting, 5 days regular, couple days spotting, nothing 1 day then a day of spotting followed by another 3 to 6 days of period...and of course - yet another couple days of spotting. Not a whole lot of cramping though...on months I have more cramping I have less days. Why? My gyno could care less about finding the source, so I have resorted to puttin on my thinking cap and came up with these 2 scenario's...

1.) I am 2 months off of 20 consistant months of oral Prednisone, a steroid, and now my own body is deciding how much cortisol to be making...PLUS once every 4 to 6 weeks I go in for shots of steroid into my eye socket - major blasts of 40mg into each eye. The cortisol imbalance makes a lot of sense that my ovaries are working constantly and keep discharging eggs, etc. (Thank You God that I had a tubal ligation! I couldn't deal with multiple babies - 2 in 10 months is ENOUGH!)

2.) The amount of T3 is too high and telling my other hormones that I am in constant fertility mode. I am not completely certain it would be the T3 is too high, but it makes sense in my own head.

3.) One last thought, my immune system could be thinking I have endometriosis again and the bleeding just won't stop.

4.) I was wrong...THIS will be my last thought on the subject of long periods...my SIL had bleeding for 3 months and they discovered she had polyps in her uterus so had to balloon her uterus with hot water bottle like thing to stop the bleeding then lasered the polyps off. A long period that doesn't slow down too often could be a sign of uterine trouble, but I wouldn't treat with BCP if I were a doc, I would do an ultrasound to make sure there isn't anything inside.

And my friend, we totally understand your frustration and pain and hurt and anger about what is happening to your body and that your doc isn't listening to your needs. This is a great place to vent, ask questions, hey - if you find other thyroid and/or fitness articles on the net when doing your own research, feel free to post them. We are an open group of women, with a few men too, who aren't shy about any topic and if you want to post Off Topic discussions, simply put OT at the beginning of the subject title. Keep us up to date on how you are doing, best of luck to you! OH! And don't get anemic with those long periods, be sure to have your hemoglobin checked every couple months to make sure you have enough iron...the last thing a thyroid patient needs is anemia too...right Bee?

~ Linda Williams/Pooshabi

(Snippage to article posted by Bee)

My Dearest Bee, thank you for finally finding someone to substantiate what I have been complaining about. While I did not have "surgery" per say...the RAI was a removing kind of treatment - removal of function of the gland. For those new to our group, I have been complaining for about a year that whenever I get sick with a cold or flu or sinus infection or asthma, etc...I lose my voice - I suffer laryngitis about every other month. I had been thinking that since my gland is in essence DAMAGED, each time I get sick that area is attacked by the virus/bacteria. Perhaps when I get sick one of those chord's is too strained? It isn't a permanent problem but it happens EVERY SINGLE TIME I get sick. This article helped me think that I am NOT crazy...in THIS idea anyway! lol

~ Linda

[INLINE]
Jewish World Review May 23, 2003 / 21 Iyar, 5763

Peter H. Gott, M.D.

Gott

The issue of chronic fatigue; hoarse after cyst removal

DEAR DR. GOTT: Since having a cyst removed from my thyroid gland, I have been hoarse. Will the problem reverse itself?

DEAR READER: During thyroid surgery, the nerves to the vocal cords can be inadvertently damaged. This results in hoarseness that is usually permanent. I advise you to be examined by an ear-nose-and-throat expert who can verify the cause of your problem and suggest methods of improving your voice.

For instance, if one of your two vocal cords has been paralyzed from a surgical injury, you may be helped by a further operation or by an injection of Teflon into the cord, which will stiffen and strengthen it. [INLINE]

Sorry, I found a typo after I sent the message...I believe they decided on TSI's (Thyroid Stimulating Immunoglobulin's) and the TBG's.

And I should add that I am not TOTALLY against the prized M. Shomon...I just get peeved that so many listen to her when there are even better people out there to listen to...like BEE!!!!! (wink and smile)

~ Linda

Thanks for the information Angel. I put the TRH test, from the article you posted, into WebMD.com's browser and came to the following article. This article is a very basic description of the process dx'ing hypothyroidism.

http://my.webmd.com/content/healthwise/17/4121.htm?lastselectedguid={5FE84E90-BC77-4056-A91C-9531713CA348}

Today I took Brennan to Children's Hospital for the lab draw to see if he has Chromosome and/or Fragile X Syndrom. The Behavioral Pediatrician had also ordered "Thyroid Antibodies" test. The lab tech called to see which tests specifically he wanted and I believe they decided on something like TSA's and also a test called TBG (A thyroxine-binding globulin (TBG) test. TBG is an important protein in the blood that carries the thyroid hormones T3 and T4. TBG testing is rarely needed and is done only after more commonly used thyroid tests produce abnormal results. PER WEBMD SITE). I tried convincing the lab tech to ask the doc for a TSIg also, because drawing blood on Brennan is as painful for him as murder would be - he is only 3 and terrible behavior problems. Doc wouldn't go for it so I suppose if he comes back Graves' positive we will need more bloodwork. Poor Brennan...it took 3 nurses and me to hold him down and get the 3 tubes of blood. Mind you...my little guy is
between 28 and 30 pounds...not like he is a giant or anything. Hell, he weighs less than my damn leg...so you can see how freaked out he gets drawing blood if it takes 4 of us to get the job done. I am rediscovering labs names and their importance. If anyone else has a good site for thyroid review, an educational site - not one chock full of opinions such as the "esteemed" Mary Shomon's...pass the site names over...I really need the refresher.

~ Linda

Your TSH isn't bad, your free T4 is very good, but your FT3 is low
enough that it would give ME: muscle aches and pains, very great
depression, and a sense of not feeling well. But.....if you feel ok,
than take some selenium every day (200mcg's ) if you don't already.

I got my results back from my blood draw yesterday. Am I fine?
Laboratory Results
Test Code Description Result Range U