Dear Dr. Donohue: While reading the paper, I noticed my husband staring at me. He doesn't do that often. I asked him what he was looking at, and he said my neck - it was getting bigger. I dropped the paper and went to a mirror. He was right. I made an appointment with my family doctor, who said I had a goiter, and he sent me to an endocrine doctor. That doctor determined that I have Hashimoto's thyroiditis and has me on Synthroid. Will I take medicine for life? When should I take it?
R.A.
Most likely, you will take Synthroid for life. The best time to take it is half an hour to an hour before breakfast.
The late Dr. Hashimoto discovered the microscopic picture of the thyroid gland illness that bears his name. Since the original description by Dr. Hashimoto, others have learned that this malady is the result of an attack by the immune system on the gland. Antibodies, the grenades of the immune system, inactivate the gland. Little to no thyroid hormone is produced - hypothyroidism. In addition to antibodies, lymphocytes - another arm of the immune system - invade the gland. The gland enlarges.
Without thyroid hormone, the body's metabolism slows. Affected people gain weight without taking in more calories than they normally do. They're chronically tired and feel uncomfortably cold when others are quite warm. The heartbeat slows. Skin becomes pale and cold. Constipation is common. Hair often begins to fall out.
All of these signs and symptoms come about from too little thyroid hormone. Treatment is straightforward; take the missing hormone in pill form. It might be four or more weeks before you notice your symptoms leaving. And it can take as long as three to six months before there's a complete correction.
Dear Dr. Donohue: I'd like to know what the daily salt limit is. Should everyone be on a low-salt diet?
J.B.
For healthy people, the daily salt limit is 2,300 mg of sodium, the amount of salt in one teaspoon of salt. You'll say that you don't eat a teaspoon of salt in a week. You're right. Most people don't. However, it's not the amount of salt that you add to your food that is the main source of salt; it's the salt that comes in foods like soups, frozen dinners, sausages, hot dogs, luncheon meats, snack foods and baked goods. More than 80 per cent of the salt we take in comes from these foods. If you're interested in the salt content of foods, you can find that information on labels.
Some people are not sensitive to the blood pressure-raising properties of salt. Those people do not have to pay attention to salt restriction. The rest of us do.
For people who have high blood pressure, the daily sodium limit is 1,500 mg.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him at P.O. Box 536475, Orlando, FL 32853-6475
