Q: Recently I was out in the backyard for about 15 minutes with my grandkids. I ended up with two large, swollen bites that itched and kept me awake for a couple of nights. No one else out there was bitten.
This happens to me every year. I attract mosquitoes, and then I seem to be hypersensitive to the bites. Any advice?
A: Someone like you, who is especially attractive to mosquitoes, should apply repellent before going outside. DEET is effective, but if you prefer something else, oil of lemon eucalyptus and picaridin also work to ward off mosquitoes.
Once bitten, you should try heat. Hot tap water for a second or two can stop itching for a few hours. Some people use a brief application of a metal spoon that has been submerged in hot water. Be careful not to burn your skin.
A third option is a battery-operated device that heats the skin around the bite. We know of two brands, Therapik and Bite Helper. Such gadgets are especially helpful when you are away from home and don’t have ready access to hot water.
Q: I was diagnosed at 16 with hyperthyroidism. My doctor treated it with radioactive iodine, which immediately made me hypothyroid. As I have gotten older, I’ve never been able to get a doctor to adjust my meds to make me feel good. As long as my blood tests are within the normal range, they say everything’s fine. Do you have any information on treating hypothyroidism?
A: There is some controversy about the normal range for TSH (thyroid stimulating hormone). This compound is produced by the brain to regulate thyroid activity. It is used as the primary measure of thyroid function, but it’s not the only way to assess how well the thyroid gland is doing. Some doctors also test for T4, T3 and reverse T3. A test for TPO (thyroid peroxidase) antibodies will reveal if a person has Hashimoto’s, an autoimmune thyroid condition. The patient’s clinical symptoms are also important (BMC Endocrine Disorders, April 18, 2019).
There is even more controversy over treating hypothyroidism. Many people do just fine on the usual prescription, T4 (levothyroxine). But others report feeling better if they also get some T3 (triiodothyronine). This may be especially relevant for people like you who have no functioning thyroid gland (European Thyroid Journal, July 2012).
You can learn more about the diagnosis and treatment of hypo- and hyperthyroidism in our eGuide to Thyroid Hormones. It is available at www.PeoplesPharmacy.com.
Q: I graduated from nursing school in 1994. At that time, we were taught to instruct our patients on Coumadin to be consistent in their intake of vitamin K-containing foods. A couple of years later, I started encountering patients who had been told “no vitamin K-rich food.” Now I read that research has shown people should be eating more green vegetables as long as they get about the same amount of vitamin K from day to day. Is this true?
A: We, too, were fascinated by recent Canadian research demonstrating that people who consume plenty of foods providing vitamin K have more stable levels of warfarin (Coumadin). It is important to keep this anticoagulant within the proper range. Too much can lead to excessive bleeding, while too little puts a person at risk for blood clots. Regular blood tests are needed to monitor clotting activity.