General Medical issues thread

[ellen10]

I have bursitis in my hip, very painful to sit, sleep etc. I am trying to manage it and take nurofen at night. I have been recommended cortisone injection but most people I have spoken to say they didn't think it worked. So I am just hoping it goes away.

 

[Pushka]

I have bursitis in my hip, very painful to sit, sleep etc. I am trying to manage it and take nurofen at night. I have been recommended cortisone injection but most people I have spoken to say they didn't think it worked. So I am just hoping it goes away.

If it was bursitis then we will know whether it worked in a week or so. He had it under guided ultrasound so maybe that is the difference? And telling bursitis apart from other bone/ligament etc issues is very difficult.

 

[ellen10]

Yes @Pushka my procedure would be under guided ultrasound also. I will be interested to hear how Mr P goes.

 

[RooFlyer]

If it was bursitis

Did he do the test where he lifted his outstretched arm sideways and up? Pain at a certain point in the upswing was diagnostic ( or nearly so) for me.

Had the injection guided by ultrasound and had a poor night’s sleep ( they told me to expect that). Made a difference in 3 days and no return after 3 months - I was diligent in doing the exercises they recommended.

 

[drron]

And a little more general discussion.There is a good deal of activity in genetics and precision medicine which may make diagnosis but also preventative medicine much more accurate.

All of Us: Partnering Together for the Future of Precision Medicine

Over the past year, it’s been so inspiring to watch tens of thousands of people across the country selflessly step forward for vaccine trials and other research studies to combat COVID-19. And they…

directorsblog.nih.gov

And some good news in a global context.

This is How Close We Are to Eliminating Malaria – 7.6 Million Deaths Averted in 20 Years, Thanks to Generous Nations

The World Health Organization reported that malaria deaths fell last year to the lowest level ever recorded.

www.goodnewsnetwork.org

 

[rogerkambah]

Recently had a CT scan after 3 months of Pazopanib. Unfortunately the growth on my adrenal has not responded, so need to continue medication. Have also lost 6kg in that time, and have now gone off the drug for 4 weeks as the side effects had become quite onerous.
In addition have developed hypothyroidism so have to take eutroxsig for that.
Interestingly many of the side effects of hypothyroidism are the same as those attributed to Pazopanib. I wonder whether it is the hypothyroidism that is really producing these, rather than the Pazopanib.

 

[Pushka]

Recently had a CT scan after 3 months of Pazopanib. Unfortunately the growth on my adrenal has not responded, so need to continue medication. Have also lost 6kg in that time, and have now gone off the drug for 4 weeks as the side effects had become quite onerous.
In addition have developed hypothyroidism so have to take eutroxsig for that.
Interestingly many of the side effects of hypothyroidism are the same as those attributed to Pazopanib. I wonder whether it is the hypothyroidism that is really producing these, rather than the Pazopanib.

Interesting. I’ve been hypothyroid now for gulp, forty years! Instead of dose going down as I age it’s increased every few years. Have gone from 50mcg a day to currently 225mcg. I don’t know what not being hypothyroid feels like. Have also had ultrasound and last week CT scan for kidney stuff as I have something flakey happening too. Just hoping it’s not lupus nephritis.

 

[rogerkambah]

Interesting. I’ve been hypothyroid now for gulp, forty years! Instead of dose going down as I age it’s increased every few years. Have gone from 50mcg a day to currently 225mcg. I don’t know what not being hypothyroid feels like. Have also had ultrasound and last week CT scan for kidney stuff as I have something flakey happening too. Just hoping it’s not lupus nephritis.

My dose is 50mcg, but expected to rise to 100mcg shortly following another TFT.
My TSH was reported as being 47 while T3 and T4 were both low.

 

[Pushka]

My dose is 50mcg, but expected to rise to 100mcg shortly following another TFT.
My TSH was reported as being 47 while T3 and T4 were both low.

Yeah. 47 is really up there. They like it under 5 or less. Indeed expect a dose increase and another test.

 

[love_the_life]

Recently had a CT scan after 3 months of Pazopanib. Unfortunately the growth on my adrenal has not responded, so need to continue medication. Have also lost 6kg in that time, and have now gone off the drug for 4 weeks as the side effects had become quite onerous.
In addition have developed hypothyroidism so have to take eutroxsig for that.
Interestingly many of the side effects of hypothyroidism are the same as those attributed to Pazopanib. I wonder whether it is the hypothyroidism that is really producing these, rather than the Pazopanib.

Bummer RK. Hope the break allows you to get on top of the unwanted possible or not side effects. From memory you didn’t have a lot of weight anyway so 6kg will have been a lot.

 

[prozac]

Seems my TSH (thyroid) level is a bit low at 0.35. Has been dropping past 12 months or so. No-one seems to be acting on it yet and my cardio is suggesting I ask a bit louder (he says it is not his position to suggest anything to my GP). I think with everything else I've had going on it has been pushed to the back-burner.
Question for our medico members;
1. Is it an issue
2. My diet past few years is almost devoid of added salt. Should I perhaps be using a little iodised-salt on my eggs for instance or would this have little effect?

 

[drron]

A low TSH means an overactive thyroid so you don't need iodised salt.
Hyperthyroidism is definitely a problem for any one with heart disease.it speeds up heart rate increasing the hearts oxygen needs therefore more prone to angina.
The other risk is arrhythmia particularly atrial fibrillation.
So at the very least ask your doctor to measure T3 and T4 as well as the TSH.
A TSH at 0.35 is not in the overactive range but some certainly can be at that level and the worry is it is dropping.

 

[Quickstatus]

TSH (thyroid)

The Thyroid hormones are T3 and T4. These are under several layers of control within the body. The most common way of hormormal control is the negative feedback mechanism

TSH is Thyroid stimulating hormone. This is produced in the pituitary gland in the brain.
The pituitary gland detects low T3/T4 levels and releases TSH - resulting in higher levels of TSH which in turn stimulates the Thyroid to release T3/T4. The pituitary pick up the increased T3/T4 and moderates the TSH release.

So Hypothyroid is low T3/T4 and hyperthyroid is high T3/T4 but the TSH is important in that treatment and management of the proble,m.

TSH high + normal T3/T4 = mild hypothyroid
TSH high + low T4 and low/normal T3 = hypothyroid

TSH high + high T3/T4 = pituitary tumor secreting excess TSH + hyperthyroid

TSH low + normal T3/T4 = mild hyperthyroid
TSH low + high T3/T4 = hyperthyroid
TSH low + low T3/T4 = illness or pituitary problem secreting not enough TSH

So someone with hypothyroid would generally be High TSH + low or normal T3/T4.
Treatment with thyroxine aims to generally cause the TSH to return (reduce) to a normal level, not just to normalise T3/T4

 

[prozac]

A low TSH means an overactive thyroid so you don't need iodised salt.
Hyperthyroidism is definitely a problem for any one with heart disease.it speeds up heart rate increasing the hearts oxygen needs therefore more prone to angina.
The other risk is arrhythmia particularly atrial fibrillation.
So at the very least ask your doctor to measure T3 and T4 as well as the TSH.
A TSH at 0.35 is not in the overactive range but some certainly can be at that level and the worry is it is dropping.

Thanks drron. I better ease off on the iodised salt then. ... don't tell Mrs prozac.
Thought I was onto something.

 

[Quickstatus]

I better ease off on the iodised salt

Iodised salt is not the only source of dietary iodine

Milk, cheese, eggs, saltwater shellfish (oysters), seaweed, saltwater fish (tuna, salmon),
And dont forget Bread. Most bread has been been laced with all kinds of stuff - folate, vitamins, and iodine via iodised salt.

Looks like no cheese or bread
No oysters or lobsters
And watch out for the sushi and sashimi

Im told a Big mac is OK

Other than that Merry Christmas!

PS: Champagne OK

 

[cove]

Thanks quickstatus we are doing some champagne tonight because we can.

 

[Pushka]

Seems my TSH (thyroid) level is a bit low at 0.35. Has been dropping past 12 months or so. No-one seems to be acting on it yet and my cardio is suggesting I ask a bit louder (he says it is not his position to suggest anything to my GP). I think with everything else I've had going on it has been pushed to the back-burner.
Question for our medico members;
1. Is it an issue
2. My diet past few years is almost devoid of added salt. Should I perhaps be using a little iodised-salt on my eggs for instance or would this have little effect?

What are your T3 and T4 levels? Low T3 TSH is hyperthyroid.

 

[Quickstatus]

Low T3 is hyperthyroid.

Hypothyroid, but also require a T4 for that diagnosis. T4 could be normal. In which case look at TSH. If TSH high then subclinical hypothyroid.
T3/T4,TSH is all done together anyway in the one test.

T3 just means a thyroid hormone with 3 Iodine stuck on it
T4 = 4 iodine molecules stuck on it.

Note that despite my previous note about dietary iodine. Exessive iodine can lead to hypothyroid
This is getting complicated for this forum

 

[Pushka]

Hypothyroid, but also require a T4 for that diagnosis. T4 could be normal. In which case look at TSH. If TSH high then subclinical hypothyroid.
T3/T4,TSH is all done together anyway in the one test.

Note that despite my previous note about dietary iodine. Exessive iodine can lead to hypothyroid
This is getting complicagted for this forum

DOH. I meant to say low TSH. I’ve corrected. Blame baby sitting fatigue. I do know about it all, I’m hypo and have recorded a TSH in the forties.

 

[prozac]

Iodised salt is not the only source of dietary iodine

Milk, cheese, eggs, saltwater shellfish (oysters), seaweed, saltwater fish (tuna, salmon),
And dont forget Bread. Most bread has been been laced with all kinds of stuff - folate, vitamins, and iodine via iodised salt.

Looks like no cheese or bread
No oysters or lobsters
And watch out for the sushi and sashimi

Im told a Big mac is OK

Other than that Merry Christmas!

PS: Champagne OKDon't eat

Don't eat store bought bread. Bake sourdough.
Oysters are up there for me but don't eat them often.
Sushi, sushimi. meh. Different if I was in Japan.
Don't eat fast food.
I sound dull ...
Cheese.....like, but my cholesterol is 2.8 and LDL 1.1, now tell me why my stents block in 6 weeks. Lipids professor and haematologist don't know.

I'd drink more champers if it didn't go down like lolly water. Too easy to drink so I give it a miss mostly.

Don't have my current T3, T4 levels.

EDIT: Sounds tricky. Thought it might have been easier. Thanks everyone.