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Beware the Zombie Thyroid!!

Dr. G. Pepper — Sat, 29 May 2010 14:32:59 +0000

Beware the Zombie Thyroid!!

Periodically, I update metabolism.com with interesting problems from my medical practice. Last week I was reminded of a particular thyroid disease which is little known and deserves more attention. In my patient’s case, she had an inactive thyroid (hypothyroid) due to Hashimoto’s thyroiditis for several years which, on its own switched to become an over-active thyroid (hyperthyroid). I call this event a “Zombie Thyroid”. Don’t bother trying to look this term up since ‘Zombie Thyroid’ is my own terminology. A Zombie Thyroid is, of course, one which returns from the dead. Most times when the thyroid is destroyed by either natural forces or by human intervention, the destruction is complete and irreversible. Rarely however, a thyroid which ceased function for years resumes producing thyroid hormone and may even becoming “hyper” or over-functioning. Such was the case of my patient last week. Confusion may result because the newly risen thyroid begins adding thyroid hormone to the blood of someone already taking thyroid hormone replacement for hypothyroidism (under-functioning thyroid). Recognizing the Zombie Thyroid can take months or years due to the rarity of the condition and the subtlety of the changes that occur on blood testing.

The Zombie Thyroid occurs in the setting of either autoimmune thyroid disease such as Hashimoto’s thyroiditis or a structural thyroid disease, multinodular goiter. Hashimoto’s is the most common cause of naturally occurring hypothyroidism in women under the age of 60 years. Hashimoto’s occurs when the body creates an antibody to the thyroid, resulting in destruction or impairment of the thyroid tissue. It is thought that the thyroid can ‘return from the dead’ if the body begins to produce more of another type of antibody that results in stimulation of the thyroid tissue. The switch from under active to over-active can take months or years. During this time the combination of taking thyroid hormone pills for Hashimoto’s plus the new supply of the body’s own thyroid hormone production can result in disturbing and seemingly unexplainable high thyroid levels. Once it is clear that the thyroid is producing thyroid hormone again it is possible to make appropriate adjustments in medication to return the situation back to normal.

Another situation involving the Zombie Thyroid is seen in elderly people who have had an enlarged and lumpy (nodular) thyroid for years. Some of these “multinodular goiters” produce adequate amounts of thyroid hormone but others can be associated with thyroid hormone deficiency (hypothyroid). When the multinodular goiter causes hypothyroidism, the patient will be treated with thyroid hormone replacement just like the Hashimoto’s patient. Over time the nodules may slowly begin to wake up and begin producing thyroid hormone. If the patient is already taking thyroid hormone due to the previous diagnosis of hypothyroidism, the combination of the two sources of thyroid hormone can result in excess or “hyper” thyroidism. In the elderly the doctor may suspect the elevated thyroid hormone levels are the result of a medication error perhaps due to the patient’s forgetfulness. If no action is taken serious complications of hyperthyroidism can develop such as irregular heart beat, congestive heart failure, excessive fatigue, and mental or mood impairment. Some elderly patients become withdrawn and lose weight mimicking depression, a situation known as “apathetic hyperthyroidism”. Recognition of the Zombie Thyroid is essential to restoring the thyroid levels and the patient’s clinical status back to normal.

Don’t let yourself or loved one become a victim of this ‘back from the dead’ thyroid. Alertness is the key to recognizing and treating the Zombie Thyroid. Ask your own physician for advice if you suspect this condition.

This article is for educational purposes only and is not meant as medical advice. The disclaimer of metabolism.com applies to this and all my blogs.

Gary Pepper, M.D., Editor-in-Chief, metabolism.com

Dr. Oz, What Exactly Don’t You Know?

Dr. G. Pepper — Sun, 07 Mar 2010 15:28:09 +0000

For a relatively small South Florida town, Jupiter has attracted a few national news stories. Recently there was the disturbed man who gunned down 4 members of his own family, and Tiger Woods is building his mother a house here. Bringing Dr. Oz to Jupiter is the recently confirmed pediatric brain tumor cluster just West of here. This has stirred up a lot of media attention and later this week Dr. Oz is doing a special on the cancer cluster.

What type of doctor is Dr. Oz? He is a heart surgeon. His training is in using a knife to cut the chest open and in sewing arteries together to heal the diseased heart. Why is he talking to the nation about a brain cancer cluster in South Florida? Why does he have a show where he lectures on everything from swine flu to diarrhea? This situation reminds me of a soap opera where the show’s doctor delivers a baby, removes someone’s brain cancer, and treats someone else for AIDS, all in the same episode. Sorry folks….that’s not the way the real world of medicine works.

O.K…so call me jealous. That doesn’t change the fact that our nation deserves real experts dealing out the facts, not some handsome Oprah pet doc pretending to be G-d’s gift to the medical world.

Operating on the heart requires constant practice and intense focus on only what lies underneath that knife. It shouldn’t come as a surprise therefore, that the last cardiac surgeon I would want operating on my heart is Dr. Oz.

Dr. Gary Pepper, Editor-in-Chief, Metabolism.com

Marion Touts New Adkins Diet for Weight Loss for Ex-Smokers

Dr. G. Pepper — Tue, 16 Feb 2010 13:21:31 +0000

Marion brings us up to date on her progress after stopping smoking, gaining and then losing weight. Thank you Marion for sharing your experience with metabolism.com members!

Marion writes:

Just wanted to give you an update, quit smoking 8 months ago and have gained exactly 20 pounds, seems like the weight gain has finally slacked off. Last Monday a week ago I started Atkins, lost 9 lbs in 7 days, must be alot of fluid. Just the effects of being on Atkins, I feel so much better, but the best part is it forcing your body to burn fat and increases your metabolism. Try it its not as hard as you think. The NEW Atkins is alot more flexible and easy to learn than the old version. Basically the same with a few easier ways of understanding it. Good Luch I hope it works. Thanks, my goal is to wear a bikini this summer, not in public of course just at home in my pool, lol.

LA Falls Through a Crack in Our Health Care System and Finds Armour Shortage Crisis

Dr. G. Pepper — Wed, 04 Nov 2009 13:40:52 +0000

LA lives in rural America and has no health insurance. After 30 years of effective therapy with Armour Thyroid she is unable to obtain this medication any longer. Her story is a sad reminder of just how far we need to go to provide meaningful health care to the citizens of this country.

LA tells her story like it is:

I knew nothing about this problem of non-availability of Armour Thyroid. I have been on Armour since 1978 and it has worked just fine. I had my annual prescription renewal in June and because I do not have insurance, I was able to get 200 pills at a time for a price break. I take 3 60 mg tablets a day and have been on this dosage for about 6 years, up from a previous dosage of 2 60 mg tablets. Today, 4 Nov 09, I went to pick up a refill that I called in a week ago. I was informed at the pharmacy that Armour Thyroid is no longer being made. Period. I took my last pills on 2 November so I have no medication at all. I have a call in to my doctor but he has not yet returned that call. We contemplated a switch to Synthroid a couple of years ago (for a variety of reasons, none of which are relevant here) but the doctor said it could be a very slow process of finding out exactly what dosage of synthetic hormone would adequately replace the natural Armour. At that time I had insurance that would have covered the lab tests required to determine the proper dosage. I am now without insurance due to the death of my spouse, and because of the hypothyroidism I am unable to obtain health insurance that is even remotely affordable. Therefore I can’t afford all the tests, all the doctor visits, all the rest of the hoopla that woudl go with switching medication. I’ve been fortunate so far that I’ve been able to keep my same doctor, and that he gives me a bit of a break paying cash for my once-a-year-visit, but he’s 60 miles away and I can’t even afford the trips back and forth if I have to start “nudging” a new medication. It’s bad enough to be without the medication for a while, but to think that it will never be available again? I honestly don’t know what to do.

Mele is Out of Armour and Out of Options

Dr. G. Pepper — Mon, 07 Sep 2009 15:28:55 +0000

Below, Mele describes her plight struggling to adjust to the disappearance of Armour from U.S. pharmacies. She discovered what was explained in my post, “Behind the Disappearance of Armour”. Forest Pharmaceuticals and Medicare are both responding in their own ways to the FDA decree that Armour Thyroid submit an application (NDA) as if it were any new drug seeking to come to market now. The FDA is charged with the responsibility to assure all prescription drugs in the U.S. demonstrate minimum levels of safety and efficacy. As a bureaucracy the FDA is unable (unwilling) to find a way to use the 50+ years of unblemished clinical experience unique to Armour, to satisfy this requirement. Rather than correct its own deficiency the FDA is forcing many thousands of hypothyroid patients on dessicated thyroid products to go through the difficult and potentially dangerous process of finding alternative thyroid hormone therapies. I am guessing that the FDA is receiving support for this policy from companies making synthetic t4 products and from medical organizations and their officers who receive funds from these same companies. Let’s not forget that Forest itself markets a generic t4 product, Levothroid, which will absorb some of the business lost by the withdrawal of Armour.

Mele submits her story to metabolism.com:

I’m just devastated. I could only get a seven day supply yesterday of Armour at Wal-Mart. They have no idea what the problem is and told me to come in Tuesday and they would have some again. I had no idea there was a problem again (last year’s nightmare made me assume everything would be ok after Forrest redid their manufacturinging plant) until I googled today.

I am 66 years old and have been on Armour Thyroid since I was 15 years old when I had a subtotal thyroidectomy for carcinoma. The only time I ever tried Synthroid was about 20 years ago when an endocrinologist convinced me that I was going to get osteoporosis if I continued using Armour. I only took it for two months, and when I walked into my family doctor’s office at the end of the two months, he took haveone look me and said “whWt is wrong? You are not you”. I wasn’t me anymore (and the blood tests he ordered confirmed that I was very low on T3 and barely in the normal range for T4). That was probably the most terrifying experience I have ever had. I had no idea how totally entwined my personality, and feelings of well being, are dependent on Armour. I still find it scary that “me” is a product of a drug I take and when I take a different brand, I am no longer me. I felt like a stranger in my own skin…weak, no sparkly, dramatic personality… instead dull feeling, acting and cobwebs in my brain. My family doctor said that he was putting me back on Armour immediately and slowly I began to feel like me again.

I’m terrified now. I am in the middle of trying to prepare for a very complicated (nothing is ever simple or easy medically for me) cataract surgery in another city that I have fly to repeatedly for the presurgical appointments. If I have to go on Synthyroid again…how can I deal with this other upcoming surgery? It can’t be put off as I can barely see to drive now.

Anyhow, I agree with others here that we have to organize and fight this. I find it very difficult to believe this is simply a shortage of the thyroid powder that Forrest is claiming is the problem. This is the FDA meddling, yet again, with patients very lives. I think I know an organization that will help us as they have fought bloody battles with the FDA for many years and have been victorious to a large extent. I am speaking of the Life Extension Foundation. I’ll be contacting them.

Two other things. For what it is worth, I have noticed no problems with the change in Armour but for the first time in many years, I have not done thyroid blood levels in two years. But I feel fine so I guess I don’t have the absorbtion problem some mention with the new formula. I have had hair breakage though which I have puzzled over and that could well be due to the formula change.

As for Medicare and Armour, I have had Medicare since a drunk driver hit me many years ago so I have had Medicare long before I turned 65. When Medicare Part D first appeared Armour was on the Medicare forumulary. That was in mid 2006. Armour was on the Medicare formulary in 2007 also. Beginning Jan 2008, Armour was removed from the Medicare formulary. My physician I did a lot of research, calling, letter writing, etc. about it. My drug plan was and still is from AARP/United Health Care. United Health Care is angry about the Armour situation. However, they cannot make a special exception to cover it when a physician asks them to do so (as mine did) because their hands are tied. They are required by law to allow ONLY drugs that are approved and on the Medicare formulary.

AARP/United Health Care covers ALL drugs on the Medicare formulary and by law cannot cover any that are banned from the Medicare formulary. Armour was banned in 2008. I called Forest about it and was extremely puzzled by their lacksidasical response. My physician wrote Forrest also and they sent back a reply that had nothing to do with the question about Armour being removed from the Medicare formulary. My physician learned later that his, and my, suspicions were correct. It was removed because the FDA told Medicare that they could not cover a drug that had not gone through the NDA I believe it is called…where a new drug has to undergo extensive clinical trials as per FDA regulations. We learned that the FDA was requiring Forrest to do this if they wanted Medicare coverage for Armour. Well, that is not possible. Forrest charges very little for Armour. Where are they supposed to get the money for the many years of clinical trials that the FDA has demanded? The FDA knew that demanding this would effectively kill Armour and that was their intent.

So, since Jan 2008, I have had to pay for a Medicare Part D plan that I can’t use because the only drug I take (unless I need an antibiotic or something short term) is Armour. Wat is worse, most health insurance companies follow the Medicare formulary so if Medicare no longer covers Armour then most insurance plans will not cover it either.

Why we binge eat

Red Apple Yoga — Thu, 28 May 2009 03:28:18 +0000

Over eating and emotional eating is just another sign that you are in fact human.

knowing why is more than half the battle

You’ll see a lot of articles about how to fight the occasional eat-fest, in fact I dare you to find one woman’s or man’s magazine near the holidays and at the beginning of summer that doesn’t address this issue.

In these magazines, and even on weight loss forums all over the net, you’ll see suggestions with how to beat it: eat this food, don’t eat that food. Go for a walk, take a bath. But let’s be honest, if these things worked, we’d all be prunes from taking all of those bubble baths and ben and jerry’s would be out of business….well, okay, they’d have to at least sell the summer home in Buenos Aires.

So here’s some more practical advice on discovering your reasons for binging and how to heal from them:

There are only 2 possibilities for eating past hunger:

1) you’re not getting enough nutrients from the foods you eat.

If this is true, your cravings will be for very particular food groups and will often come with other health problems like light headedness, cranky moodswings, headaches, muscle cramps, etc.

For example, someone that does not get enough protein or is getting too much protein will crave sugary foods because both proteins and sugars will show up in your blood sugar insulin levels, keeping the right amount of proteins in your diet will keep sugar cravings at bay. If this is you, you may feel fatigued in your workouts, have irregular periods or feel sluggish.

People on over restrictive diets low on calories will crave carbohydrates and sugars because these are the sources more quickly turned into energy in the body.
If you know that you’re not eating well or are on a ___diet (fill the blank in with any one food item and you KNOW it’s a bad idea), this could be your reason. Do you feel hungry constantly, do you have trouble sleeping? These could be signs of imbalanced carbohydrates in your diet.

2)you’re not getting enough emotional outlets in your life.

Look, we’re emotional beings. We eat for hunger, yes, but we also eat because we’re stressed, tired, lonely, bored, celebrating. And we’re not the only ones. I’ve watched my cat eat until she puked (and then eat the puke, and then puke the puked food and eat it again) because she was lonely, so why should we expect more from ourselves? Okay, fine, don’t eat what you’ve puked.

If you know this is why you over eat, I ask you to think of one question: What feeling am I seeking when I eat too much?

This one question will get you a lot more than you may think. If you eat until you feel happy, what happened today or earlier that made you UNhappy? If you eat until you feel calm, what made you irritated? Generally, emotional eating form their own kind of food groups:

Crunchy salty foods = aggravation, irritation.

Sweet, soft doughy,creamy foods = sadness, need for consolation.

Soft, salty foods = boredom, loneliness.

Fatty, fried foods = feeling spacy, ungrounded, unsure.

Now of course there’s no science book that’s going to break down these parallels in what you eat, when and why. You could be ready to punch your boss in the face and reach for ice cream, not chips, but hey, don’t you want someone to console you after you punch him?

In the end, if you can start with knowing why YOU eat too much, that’s more than half the battle.

So I’m not saying the next time you go shopping to distract yourself from the Dorito aisle because it’s “bad”, but just think, what do I want to feel after I eat this? and see if that changes anything.

Kimberly, counselor since 1998 and founder of www.RedAppleYoga.com, holds a Masters in Health & Healing as a Certified Nutritional Counselor, a Masters in Education and is an internationally trained advanced Yoga and Yoga Therapy instructor that has worked and studied in New York, Spain and in Southern India. Her practice is based in New York City. She believes in showing her clients how to combine time-tested ancient theories with modern knowledge to get the best benefits from both worlds.

Follow her blog: www.RedAppleYogaNutrition.blogspot.com

Nature’s Hydroxycut

Red Apple Yoga — Tue, 19 May 2009 23:08:32 +0000

another secret from nature

Yes you read it right, hydroxycitric acid (HCA, or “hydroxycut” used in many diet formulas that are otherwise dangerous to the body, bad bad bad) has a natural safe original source:

the Hibiscus Flower!

Hydroxycitric acid (HCA) is effective in weightloss because it helps to stop the conversion of carbs in food to body fat. It fights appetite and encourages weight loss not by increasing your energy, but by limiting how much we convert the carbs we eat. HCA is not a good idea on low carb dieting (which is a crap idea anyhow) but it does help weight loss when used with a healthy program of general calorie restriction reducing consumption of carbs, protein, and fats equally.

Hibiscus tea affects how we absorb fats and carbohydrates because it contains phaseolamin, a powerful enzyme inhibitor that blocks amylase, the enzyme responsible for breaking down fats and carbohydrates. This enzyme inhibitor acts in the same way as the drugstore-pill versions, but remains in its natural, unadulterated form and is much safer and more beneficial for the body than laboratory-produced concoctions. (This can be said for almost all things, if it comes in nature, why make it in a lab?) By the way, the same form of amylase inhibitors is present in kidney beans and other hard-to-digest legumes, so eat your beans!

In addition to blocking the absorption of sugars, this traditional tea has cleansing and anti-bloating properties, helping the body rid of excess fluids and therefore further contributing to weight loss, especially in premenstrual and menopausal women. It’s especially good for women as it balances our Yin (female) and Yang (male) energies when our hormones are changing.

Hibiscus tea is caffeine-free and has a high vitamin C content, it has a bright red color and a tart cranberry-like flavor, it’s like natures Kool-aide but way way better for you. Hibiscus tea is also known to lower cholesterol and blood pressure. In folk medicine, they are used to prevent and treat heart and liver diseases. I dare you to get those benefits out of a crappy diet pill or kiddie drink!

You can find dried loose flowers in most nature stores, and some brands even market hibiscus tea bags. It’s inexpensive (no more than $20 per pound here in NY, and a full pound will last eaons) and can also be added to loose green or black tea for an added flavor.

HOW TO MAKE IT:

Steep 3-4 dried flowers in about 16oz of freshly boiled water for 5 minutes. It’s so great in the summer as a refreshing afternoon drink, but to use it medicinally for cholesterol or weight loss management, I suggest you have 3 cups a day, 1 hour after each meal.

Follow her blog: www.RedAppleYogaNutrition.blogspot.com

Cardamom, small spice with huge benefits

Red Apple Yoga — Wed, 13 May 2009 01:22:12 +0000

Did you know that Cardamom, that secret spice in many Indian and Mediterranean dishes is nature’s Ricola and Pepto bismal all in one?

small pods with huge potential

Ever taste the earthy vanilla undertones in Chai or that gloopy Indian milk dessert and wonder what that special flavor is? Most likely it’s cardamom. In the traditional Indian medicine, Ayurveda,

cardamom seeds are also used as lozenges to suck on after meals to help digestion. I’ve tried it, its a little minty, sorty like licorice but pleasant.

Indian medicine says that the acid from teas and coffee and spicy foods irritate the intestines, leading to an increase of gassy gassiness that make the other foods we eat (namely milk, cheese, wheat) more difficult to digest. Cardamom in your diet can help the body to better digest all the other possibly irritating foods we eat because they are natural carminatives which reduce gas. I recently learned that the word “carminative” comes from the latin word that means to “card” as in carding wool…so it helps to remove gas from the intestinal wall as you would remove knots from wool. See, didn’t you always want to know that?

Cardamom is also used in the Middle east as an additional flavor to ground coffee, making coffee brewed with these little pods less acidic on the body and actually helps regulate how we absorb the caffeine. You’ll still get the buzz without the possible gas or irritated stomach. And besides, it can make any coffee, especially bargain brand coffee taste like something that rhymes with Barbucks.

If you want to try it out, buy the bottled powder stuff and use it with cinnamon…over toast, oatmeal, in a cookie recipe, even in tea with milk and cheat your way to better digestion.

Best Benefits of Cardamom:

Detox the body of caffeine
Cleanses kidneys and bladder
Stimulates digestion and reduces gas
Improves circulation to lungs, helping asthma and bronchitis
Cures bad breath, even the official “halitosis” bad breath

Follow her blog: www.RedAppleYogaNutrition.blogspot.com

Cold sore cures

Red Apple Yoga — Tue, 05 May 2009 16:00:27 +0000

Yup, cold sores. Here at metabolism.com, we have the unique opportunity to discuss a range of health concerns, and I thought why not discuss something many people experience but few want to discuss: the cold sore!

One of the best euphemisms ever for the “gift that keeps on giving” if you ask me. But! Cold sores are just as easy to prevent and heal in a natural way as they are to freak out about!

One of the easiest ways to treat an existing breakout:

Avoid acidic situations: spicy foods, tomato products, hardcore toothpaste/mouthwash, coffee, alcohol, processed sugars. Now I’m not saying to stay away from these forever, but just as you’re healing.

dancing raisin

Rub a raisin in your mouth: at the end of your day, after brushing your teeth gently, rinse your mouth completely with warm sea salt water (1/2 tsp per 80z). Then rub a raisin around in your fingers until it’s soft. Now split the raisin and apply the open side to the sore for 15-20 minutes. This can be repeated for 2-3 nights until it’s gone.

This is of course easiest on a cold sore that’s on the inside of the mouth, but you can apply a bit of the raisin mush to a band-aid or use like a lip balm for an external sore. I know I know, NOT the hottest look, but please, you’re embarrassed already, why not?

Raisins have a high iron and potassium content which balances out the acidic environment that cold sores love.

Preventing more breakouts:

Discover L-lysine:

cold sore

The amino acid l-lysine, one of the key essential amino acids (meaning we have to get it from our diet) to fight, minimize and prevent viral herpes (sorry, that’s the real name for cold sores!) is a nutrient you can easily find in supplement form. It also comes naturally in foods, but brewer’s yeast is a unique food with a high lysine content. (sorta like vegan powdered cheese…sorta)

If you’re taking the supplement form, make sure to take at least 1250mg per day when you feel it coming on, and then back down to lower levels once you’ve been breakout free for a while. Also remember to consume plenty of Vitamin C, Zinc and Bioflavinoids (from a good multi-vitamin or better from dark leafy veggies) when taking this supplement to support it’s benefits.

Hydroxycut Banned-It’s About Time

Brian RD — Sun, 03 May 2009 18:58:35 +0000

As you may have read in the news, Hydroxycut, the wildly popular weight loss supplement, has finally been banned. The FDA has cited serious liver damage and even death in certain users.

It’s about time the FDA stepped up to the supplement companies who produce and market supplements without regulation. The multi-billion dollar supplement industry has influenced federal regulators to give them a “free ride” when it comes to producing supplements. Currently, supplements in the market don’t have to prove that they are safe or effective-or even whether they contain the ingredients they claim. mayo clinic diet

In case you don’t know the story of how supplement companies have literally getting way with murder since 1994, here is the quick and dirty version:

Orinn Hatch, the Utah senator, with huge backing from the supplement industry (which is largely based in Utah), fought against forcing supplement manufacturers to prove that their produtcs were safe. It’s bad enough to put the bottom line of corporations in your state in front of the health of the entire country. What’s even worse was that Senator Hatch’s son was a lobbyist for these same supplement companies at the same time that this law was put into effect. Can you say conflict of interest?

The situation is so out of control that even though the FDA has banned Hydroxycut, it doesn’t even know what ingredient may be causing the problem. This is due the fact that the supplement manufacturer isn’t obligated to provide the ingredient list.

Large scale, pharmactical grade safety regulations aren’t needed for supplements-which are generally safe. But to let the supplement makers get away with putting contaminated products and misleading claims on the shelves without an ounce of liability is downright criminal.

Brian Dean MS, RD is a registered dietitian and researcher. After years of research, Brian has set his sights on helping those with lower back pain. He serves on the Medical Nutrition Committee for The American Society for Nutrition and is a professional member of numerous research organizations including the International Association for The Study of Pain, American Chronic Pain Society, and The American Dietetic Association. He recently created a research-based lower back pain treatment program , ‘The Back Pain Diet’ which is available from his website Stop Lower Back Pain.