Q. I have hypothyroidism and take 125 mcg of levothyroxine per day. For the past year I have constantly felt exhausted and fall asleep every time I sit down. I tried taking vitamins without success. Checkups show that my thyroid levels are normal.
Alina Moraru, Manchester.
Dr Martin Scurr responds: Your experience (when blood tests show that thyroid hormone levels have corrected, but you continue to feel tired) is not uncommon.
Hypothyroidism is usually caused by the immune system attacking the thyroid, which is a gland located in the lower part of the neck. As a result, the patient produces very little thyroxine hormone.
Hypothyroidism is usually caused by the immune system attacking the thyroid (a butterfly-shaped gland in the lower part of the neck). As a result, the patient produces very little of the hormone thyroxine, and taking an artificial form, levothyroxine, is supposed to make him feel better.
But most of the time it is not like that. We would then look at your levels of thyroid-stimulating hormone (TSH), which is secreted by the pituitary gland to prompt the thyroid to release hormones, including thyroxine.
High TSH levels are a sign of an underactive thyroid or, in patients already diagnosed with hypothyroidism, that the dose of their medication is too low.
Conversely, very low TSH levels suggest that thyroxine levels are too high or that the patient is taking too high a dose.
But this doesn’t seem to apply to you, so there may be another cause of your fatigue.
You don’t give your age, but if you’re in your 40s, a possible cause could be a natural drop in estrogen levels. I would suggest raising this possibility with your doctor: the right combination of hormone replacement therapy (HRT) could provide relief from your fatigue symptoms in as little as three months.
Q. I’ve been told I’ll have a pacemaker in three weeks. But I heard that I can’t have an induction cooktop because I have a small kitchen and can’t maintain the necessary two feet of distance. Is this correct?
Marian Lazell, by email.
Dr Martin Scurr responds: Thank you for this fascinating question about something that will affect more and more people as they are implanted with pacemakers or cardiac defibrillators.
An induction cooktop consists of a glass or ceramic plate over an electromagnetic coil. If an iron or steel pan is placed on top, it becomes hot.
An induction hob consists of a glass or ceramic plate over an electromagnetic coil, one for each burner; The electricity passing through the coil generates a magnetic field.
If an iron or steel saucepan is placed on top, it heats up, a process known as induction. (This will not happen if the pan is made of copper, aluminum or glass, as these do not have magnetic properties.)
The apparent concern for patients with pacemakers (used to treat heart rhythm problems) is that the plate’s magnetic field will affect their function.
However, a pacemaker does not contain iron. And the magnetic field is localized; After all, it’s not like utensils or other iron objects fly around the room when using an induction cooktop.
A slightly different issue from the magnetic field is the electric current itself.
There is a possibility of electrical current leakage, for example due to poor insulators. And this could be a problem with an older type of pacemaker with a single lead (they have two or three these days).
This is because in this case the “circuit” is formed by the heart tissues, if the pacemaker is implanted in the left side of the chest and the cook grasps the metal handle of a saucepan or other utensil on the induction hob. , the current could interfere with the operation of the pacemaker. However, advances in pacemaker and induction technology mean things have changed.
So why are patients still being warned about induction hobs? It’s not clear, but I think it’s based on a lack of understanding of physics and is an instruction from manufacturers who fear litigation. Another possibility is that it reflects the fact that a pacemaker can be affected by exposure to a magnetic field applied very close to the chest; That’s why hair dryers and electric toothbrushes, for example, should be placed at least 6 inches (16 cm) from the chest. , as advised by the British Heart Foundation.
I tested it with my own induction cooktop and I think it’s entirely possible to cook and stay 2 feet from the cooktop. I recommend following your cardiologist’s recommendations.
Don’t hesitate to get headphones.
Only one in five people with significant hearing loss uses a hearing aid regularly. This seems strange considering that very few people with poor vision in middle age do not wear reading glasses.
Some people are too sensitive to be seen with such important evidence of their age, even though the latest technology means that AIDS is almost invisible.
Another complaint is that when you first use headphones, your own voice resonates loudly in your head; or if you only use them in company or in a restaurant, there is an influx of loud and overwhelming background sounds.
But with regular use you become acclimated to both, audiologists say.
And since poor hearing is linked to the risk of dementia, my advice would be to wear hearing aids constantly, just like any nearsighted person wears their glasses.
