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Treatment Options for Hypothyroidism

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There is no one-size-fits-all treatment for hypothyroidism. It may take a few trips to the doctor to get the right remedy, and over time, your prescribed medication may change. Heres a brief look at the possibilities:

Synthetic hormones.
Most people with hypothyroidism first receive a synthetic thyroid hormone known as levothyroxine; the brand names are Synthroid, Levoxyl, Unithroid, and Levothroid. This medication often gets you back to normal within weeks. And youll take it for the rest of your life. But it doesnt work for everyone.

“About 80 percent of patients who test positive for hypothyroidism get a prescription for levothyroxine and feel better,” says endocrinologist Theodore Friedman, MD, PhD, an associate professor of medicine at Charles R. Drew University of Medicine and Science and the University of California, Los Angeles. “For the other 20 percent, we need to be flexible. I get the patients who tell me conventional treatment isnt working. And I believe them.”

Combination therapy.
Your thyroid produces two hormones, but synthetic levothyroxine replaces only one, known as T4. The biochemistry can get complicated, but basically your body has to convert T4 into yet another hormone called T3 for your thyroid to work well.

Experts like Friedman and Baylor Universitys Ridha Arem, MD, a nationally known endocrinologist, believe T4 treatment alone doesnt do the job for some patients. For them, Friedman also prescribes a small amount of supplemental T3 (brand name Cytomel), so-called combination therapy.

Other animal-based hormones.
Some experts may even reject this approach in favor of animal-based hormone treatment (the most common brand is Armour). Manufactured in the United States for more than 100 years, this medication is made from the desiccated thyroid tissue of pigs.

The major thyroid organizations consider it outdated, but some specialists swear by it. “I clearly have patients who do better on Armour,” Friedman says. Even its strongest advocates arent sure why Armour would be more effective. But it contains both T3 and T4, as well as lesser-known hormones called T1 and T2 and other substances.

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Diagnosing and Treating Hypothyroidism

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If you suspect you have hypothyroidism, see if your symptoms match any on the list below. Then talk over the following action plan with your doctor.

If you feel . . .

Fatigued or exhausted

Lethargic

Depressed or anxious

Moody or irritable

Uninterested in sex

Constipated

Forgetful

Cold even when others dont

Achy or crampy

Nauseous or queasy

 

Or if you have . . .

 

Sleeping problems

Unexplained weight gain despite watching your diet

Thinning hair or hair loss

Dry skin and hair

High cholesterol

High blood pressure

Periods heavier or longer than normal, and increased cramping

A low, throaty voice

Trouble getting pregnant

 

 

 

 

 

 

 

Next Page: Try this action plan

[ pagebreak ]. . . Try this action plan
1. List your symptoms.
Write down that you cant get through the day without a nap, or that youve gained 20 pounds despite walking five times a week and doing the South Beach Diet.

2. Ask about your family.
Hypothyroidism tends to run in families. Talk to siblings, parents, aunts, uncles, cousins, and grandparents. They might have been told they had a “glandular disorder.” Ask if theyve ever taken a supplemental thyroid hormone.

3. Ask your primary-care doctor for a TSH test.
Its an inexpensive blood test (covered by insurers) that checks for levels of thyroid stimulating hormone (TSH); high levels indicate low thyroid. Find out your exact level, not just whether its in the “normal” range. Some experts, including groups like the American Association of Clinical Endocrinologists, now say a normal score is between 0.3 and 3. That means a TSH above 3 would indicate hypothyroidism. But many labs havent adopted the new guidelines, so a result of 4 or even 5 wont necessarily be flagged as high.

4. Get retested in 3 months.
You might also ask for a low-dose trial of thyroid medication to see if it helps before being tested again. Some doctors are amenable to doing that.

5. Ask for the Anti-TPO thyroid antibody test.
If your TSH test is normal but you dont feel right, the antibody test can help determine whether you have hypothyroidism.

6. Ask for additional hormone tests.
Doctors can also screen levels of T3, T4, Free T3, and Free T4 hormones, which can provide a more accurate picture of how your thyroid is functioning. If the results are out of whack, you may need treatment.

Can Thongs Cause UTIs and Yeast Infections?

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In theory, since your thong is just touching your body, you won't catch anything you don't already have. In fact, studies have never been able to find a link between thongs and infections. But some women do notice an increase in UTIs and yeast infections when they wear these undies, so you'll have to decide if it's worth the risk to avoid visible panty lines.

The potential problem with these undergarments is that fecal bacteria can move more easily from the rectum to your vagina, and then work their way into your urinary tract, possibly causing a UTI. Also, tight thongs may irritate the vagina and surrounding skin, which opens you up to infection.

No need to switch to granny panties: Just use basic common sense-meaning, good hygiene. Don't wear the same thong for more than a day, and wear them for limited periods of time. If you start to notice any itching or irritation on your outer skin, switch to a loose cotton pair of undies instead. And if you develop a UTI or yeast infection, don't wear a thong until the infection is history.

 

 

 

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Escarole & White Bean Salad with Swordfish

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Escarole & White Bean Salad with Swordfish Recipe
Escarole & White Bean Salad with Swordfish
In this healthy fish recipe, meaty swordfish gets a dusting of herbs before being pan-seared. Then it’s served on top of a healthy escarole and white bean salad with a lemon-Dijon vinaigrette.

5 Sleep Problems Nobody Talks About

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You drift off at night like a newborn baby yet can't recall the last time you woke up truly refreshed. It may not seem that weird: "People tend to assume that because our modern lives are so hectic, nobody feels rested," says Meir Kryger, MD, a professor at the Yale School of Medicine. But the reality is, you might have a sleep disorder and not even know it. There are a handful of problems that can cheat you out of quality slumber, leaving you more tired in the morning than you were when you went to bed. Find out what could be going on between your sheets and how to catch more restorative z's, starting tonight.

Sleep Problem No. 1: You snore like a saw
Those snuffle-snorts mean that your slack tongue and throat muscles are narrowing your airway, possibly due to the shape of your soft palate or any extra weight you're carrying.

Although you're likely to wake up if you get short of breath, it may not be for long enough to remember. Some people wake dozens or even hundreds of times a night—a disorder known as sleep apnea that increases the risk of heart disease, stroke and possibly osteoporosis, according to a new study in the Journal of Bone and Mineral Research. "Those repeated awakenings are as disruptive as someone pinching you every two minutes all night long," says Safwan Badr, MD, chief of the division of pulmonary, critical care and sleep medicine at Wayne State University School of Medicine in Detroit.

Sleep aid: If you rarely wake up feeling bright-eyed, see a specialist to get checked for sleep apnea.(Three to 9 percent of women between the ages of 30 and 70 suffer from it.) If you have the condition, a CPAP machine and mask can help by keeping your pharynx open with a steady stream of air.

To quiet your snore, avoid rolling onto your back—a position that makes your airway more likely to collapse. Rachel Salas, MD, associate professor of neurology at Johns Hopkins University School of Medicine, suggests this little trick: Sew a tennis ball into the pocket of a sweatshirt and wear it backward to bed.

RELATED: 14 Reasons You're Always Tired

Sleep Problem No. 2: You grind your teeth
Do you wake up with a sore jaw or get chronic headaches? If so, you may be gnashing your ivories overnight. All that clenching can cause enough pain to interfere with your shut-eye (not to mention wear down your enamel). Experts believe that teeth grinding, which about 16 percent of us do, is associated with anxiety—though an abnormal bite and antidepressants can also play a role.

Sleep aid: A dentist will fit you with a mouth guard. If you're clamping down because you're overwhelmed and overloaded, find a healthier way to manage stress, urges Michael A. Grandner, PhD, an instructor in psychiatry at the Perelman School of Medicine at the University of Pennsylvania. "It's also crucial to spend plenty of time winding down before bed so you drift off in a calm, relaxed state," he adds.

RELATED: 11 Signs You're Sleep Deprived

 

 

Next Page: Sleep Problem No. 3: Your body clock is off

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Sleep Problem No. 3: Your body clock is off
Not even drowsy until the wee hours? Delayed sleep-phase syndrome (DSPS) is the technical term for this disorder, which afflicts 10 percent of people who seek help for insomnia. It involves a biological glitch that prevents your body from making melatonin (the sleep hormone) until 12 a.m. or later. A prime sign you've got DSPS: You've been a night owl since high school. The syndrome is common among teenagers and sometimes persists into adulthood. If you're not squeezing in at least seven hours of z's a night, you're at greater risk of high blood pressure and diabetes. What's more, a recent study published in Cognitive Therapy and Research found that people who nod off late (and get less sleep as a result) tend to experience more negative thoughts.

Sleep aid: Begin by improving your sleep hygiene. Cut back on caffeine. Avoid tech and television starting 90 minutes before bedtime. Create a soothing wind-down routine. And get some sun first thing in the morning to help reset your body's 24-hour rhythm. "In 80 percent of cases, these strategies lead people to conk out earlier," Dr. Badr says. If they don't do the trick, a specialist may prescribe synthetic melatonin, as well as light therapy with a medical lamp to use in the morning.

RELATED: 20 Things You Shouldn't Do Before Bed

Sleep Problem No. 4: Your legs feel jittery at night
That creepy-crawly feeling—aptly called Restless Legs Syndrome (RLS)—troubles as many as 1 in 10 people and is thought to be linked to a dysfunction in the way the brain processes the neurotransmitter dopamine. However, in some cases it suggests a nutritional deficiency, Dr. Kryger notes: "With people who have low iron, there seems to be overactivity in parts of the brain that results in an urge to move the legs."

Sleep aid: Ice packs, warm packs, massages, a bath—any of these remedies might help, says David N. Neubauer, MD, associate professor of psychiatry at Johns Hopkins University School of Medicine: "Different things seem to work for different people."

Also, talk to a sleep doc about trying an RLS drug. Be sure to mention your current prescriptions because some meds (including certain antidepressants) reduce dopamine activity. Get your iron levels checked, too, Dr. Gardner advises: "Sometimes a supplement is the only treatment necessary."
 

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Sleep Problem No. 5: You sleepwalk—and even sleep eat
For reasons that aren't completely understood, somnambulists are partially aroused in the night—often from the deepest stage of slumber (called slow-wave)—and proceed to wander around the house. The behavior, which may affect up to 4 percent of the population, appears to run in families and is more likely to occur with sleep deprivation. Another trigger: taking zolpidem (one of the most popular sedatives), according to Robert S. Rosenberg, DO, author of Sleep Soundly Every Night; Feel Fantastic Every Day.

Additionally, 1 to 3 percent of people who experience such a zombie-like state actually raid the kitchen. Called sleep-related eating disorder, this condition often strikes women on a diet, who go to bed hungry.

Sleep aid: Benzodiazepines (aka tranquilizers) can sometimes help, and so does getting more sleep. As long as your nocturnal adventures don't involve anything risky (like, for example, baking cookies), you may not need medication, Rosenberg says: "Just make sure you safety-proof your home by clearing out clutter and stowing away sharp objects." If you're a nighttime roamer, let your partner know that the ideal approach is to gently lead you back to bed.

RELATED: Best and Worst Foods for Sleep

 

 

 

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