cold

Too hot, too cold? Do you have hypothyroidism?

Posted on by Michelle Fritsch, Pharm.D.

Thyroid glandThere can be several reasons you are cold or hot more than the people around you. One of those reasons can be your thyroid.  If your thyroid is underactive, you could have hypothyroidism.

Normally, your body has this ingenious feedback loop that keeps your thyroid hormone levels just right. The two key hormones produced in your thyroid are triiodothyronine (T3) and thyroxine (T4). When these are at the correct levels, your thyroid stimulating hormone (TSH) controls their production. When more is needed, it stimulates more. When no more is needed, it does not stimulate more.

Hypothyroidism

The most common thyroid medical condition is hypothyroidism, or an underactive thyroid. In this case, the TSH keeps going up and up but the needed amounts of extra T3 and T4 are not produced.

Some of the common symptoms of hypothyroidism are:

  • feeling cold all the time
  • feeling sluggish or tired
  • brittle nails and hair
  • weight gain

The most common and very effective treatment for hypothyroidism is levothyroxine. A common brand name is Synthroid. It is T4 that is given to replace the T4 your thyroid is no longer producing. Giving T4 in this form is enough to bring your TSH back to normal levels. It is not necessary to take both T4 and T3; several studies have now demonstrated this. Each dose has a different color. This helps you and your prescriber keep track of exactly what dose you are taking.

When you are first started on levothyroxine, your prescriber will probably have you get blood drawn to check your TSH about 2 months after you start therapy, every 3-6 months until your dose has your TSH right in the goal range, then it will be checked at least yearly. It is common for your dose to change several times, in the first year especially, until the correct dose is identified to keep your TSH at the target level.

When you take levothyroxine, you should take it either first thing in the morning about an hour before breakfast or at the last part of your day at least 3 hours after your last meal. There are several foods and other medications that can interact with levothyroxine. Keeping it separated from your other medicines and meals helps to avoid these interactions.

Note, you especially to do not want to take it near milk or other dairy products, vitamins, or some cholesterol medicines. Taking levothyroxine too close to some of these foods and medicines can make the levothyroxine less effective.

A common question is about brand versus generic when taking levothyroxine. Either is truly fine. What you don’t want to do is switch back and forth. There can be a very tiny variance (2.5%) between medicine made by different manufacturers. For most medicines that makes no difference. Levothyroxine is a ‘narrow therapeutic index’ medication. This means the range from too little to too much is very small. So, the tiny variation between products can make a difference. I recommend generic, but ask your pharmacist to always give you the generic from the same manufacturer.

If you suspect you might be hypothyroid, please talk with your doctor. The most common age to be diagnosed with hypothyroidism is in your 40’s and 50’s, but it can be identified at younger or older ages.

For more information about your thyroid and medications to treat thyroid conditions, contact us at www.medsmash.com.

BIBLICAL APPLICATION

We just read about the amazing feedback loop of the thyroid gland. It is a perfectly designed system that keeps itself in constant check. (Unless it is harmed by disease or other outside influences).

This makes me think of a feedback loop described by Paul. It is not necessarily a comfortable feedback loop, but I know I have seen the truth of it in my own life. And, when I look at those people that have been big spiritual mentors to me, I can definitely see the realities of this feedback loop in their lives. I have yet to find a spiritually mature person who hasn’t experienced this feedback loop more than once.

So, what is the loop?

Romans 5:3-5 ESV

More than that, we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope, and hope does not put us to shame, because God’s love has been poured into our hearts through the Holy Spirit who has been given to us.

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The part that we sometimes miss is that this is a continuous loop. It’s just each time you go through it, the better you are able to ‘REJOICE’ in the suffering knowing that the love is continuous. The loop always involves suffering – something bad is happening to you. But, the more you embrace the love that is yours no matter what, the braver and more joyful you can be with each time around the loop.

So buckle up. The next round is coming! Experience it with the joy that God’s love never fails.

Blessings,

Michelle

Image Source:  National Library of Medicine; National Institutes of Health; U.S. Department of Health and Human Services

Flu or Cold – What do you take with high blood pressure?

Posted on by Michelle Fritsch, Pharm.D.

‘Tis the season of flu, cough, and colds. I’ll be surprised if you don’t know someone with one of these right now. There are many products lining the shelves of the pharmacies and grocery stores ready to treat your symptoms.

If you have high blood pressure or a heart condition

Does it matter which product you choose to treat your symptoms if you have high blood pressure, heart failure, have had a heart attack, or you have some other heart condition? Actually, it does. Most of the products used to treat your cold or flu contain two main ingredients: decongestant and antihistamine.

Decongestants decrease the swelling of the lining of your nose. When these swell, you feel stuffy and have trouble breathing through your nose. Taking one while you have a cold or flu can help you breath better and relieve that stuffed-up feeling. Decongestants can be found in tablets, capsules, nasal sprays, nose drops, and liquids. They are often found in combination with other medicines for fever, headache, cough, sore throat, and mucous.

Decongestants work by increasing your sympathetic system. This is the part of your system that kicks in to gear when you are angry or afraid. It is called the ‘fight or flight’ response. It also causes your heart to beat harder and faster.   Your veins and arteries get tighter. Your blood pressure goes up.

If you have high blood pressure or heart disease, this is not helpful. It puts you at risk of worse heart disease or even heart attack or stroke.

Antihistamines block histamine. This helps to dry up a runny nose, tearing of your eyes, sneezing, and itching in your nose and eyes. They are helpful with these symptoms for allergies or for colds/flu. They come in tablets, capsules, liquid, eye drops, and nasal spray. Some of the antihistamines (first generation) cause you to be sleepy and slow your thinking. The newer, second generation versions have fewer of these side effects, but they can still make you sleepy. Be very careful if you must drive while taking these.

Antihistamines should also be taken with caution with people in high blood pressure or heart disease.

The cold and flu medicines on the market for people with high blood pressure leave out the decongestant. They have the antihistamine and usually acetaminophen for fever. So, still be careful using these if you have high blood pressure. Check your blood pressure while you are taking them. Let your doctor know what you are taking for your cold and flu.

So, if most of the cough and cold and flu medicines on the market are not good for your heart or blood pressure, what should you do?

What can you do without taking cold and flu medicines?

For your fever, take acetaminophen. Medicines like ibuprofen (brand names Motrin, Advil) or naproxen (brand name Aleve) can raise your blood pressure and increase your risk of heart disease.

For your congestion, try a humidifier. Moist, warm or cool air can help break up the mucous and ease your swollen nasal passages.

Get plenty of rest so your body’s immune system can fight the virus. Drink plenty of fluid.

With or without a decongestant or antihistamine your cold or flu is likely to last about 5-7days.

Wash your hands, especially after being out in public. When you are in public or haven’t washed your hands recently, avoid touching your face (mouth, nose, eyes). And finally, please get your flu shot each year!

For more information about managing a cold or the flu with high blood pressure, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

When you have high blood pressure or a heart condition, your treatment options for a cold or the flu are limited. To avoid letting your blood pressure get even higher, you need to carefully select a treatment that is best for you and your specific medical conditions.

Similarly, in your faith walk, what is best for you might not be best for someone else.

Paul mentioned this in at least two of his letters. After Christ came to reconcile us with God, the rules of the past changed. But, this was easier to accept for some people than for others. In particular, new believers found this transition to be confusing sometimes.

So Paul encouraged all believers to consider their friends and neighbors when making decisions. If something would cause confusion for someone else, then Paul encourages us to not do that thing.

Romans 14:13 ESV

Therefore let us not pass judgment on one another any longer, but rather decide never to put a stumbling block or hindrance in the way of a brother.

1 Corinthians 8:13 ESV

Therefore, if food makes my brother stumble, I will never eat meat, lest I make my brother stumble.

1 Corinthians 8:9 ESV

But take care that this right of yours does not somehow become a stumbling block to the weak.

These verses make even more sense in context, so I encourage you to read them within their chapter.

Remember those around you when making decisions. It is easy to get caught up in your own life and not even think about how your actions impact others. Even when you are making ‘good’ decisions, realize other people younger in their faith might not understand your freedoms and reasons for exercising those freedoms.

Blessings,

Michelle