March 11, 2004

Q :Can being on a low-salt diet cause thyroid disease, since the ingestion of iodine is greatly reduced?

A :Not so long ago, there were places on Earth called goiter belts. These places had inordinate numbers of people with enlarged thyroid glands. An enlarged thyroid gland is a goiter. The swollen gland is very obvious even to a casual observer. It’s in the lower neck.

The reason why people in those locations came down with goiters was a deficiency of iodine in the soil, with a resulting deficiency of iodine in foods grown in that soil.

Without iodine, the thyroid gland cannot make the thyroid hormone. When there is a short supply of iodine, the gland enlarges in a heroic attempt to extract every atom of iodine it can from food. It is a futile maneouver by the thyroid gland. It gets larger without producing any more thyroid hormone. In North America, the region bordering the Great Lakes was a goiter belt.

In 1922, iodine was added to salt. Salt was the food chosen to bolster the iodine supply because of its universal use. Since the addition of iodine to salt, the incidence of goiter has plummeted.

The recommended dietary allowance of iodine for adult men and women is 150 micrograms a day. 150 micrograms is an amount so tiny, you would have difficulty seeing it with a magnifying glass.

The typical low-salt diet still provides enough iodine to furnish the daily need. Furthermore, we live in an age when foods come from distant places, so even people living in iodine-deficient locales still get much iodine in food transported to them from places where the soil has an abundance of iodine. Good food sources of iodine are dairy products and seafood.

The thyroid gland is a mystery for many people, yet a good number have thyroid problems.

Q :I believe I drink too much, and I want to get a handle on it, but can’t seem to do so. Where can I get help to control my alcohol use?

A :Begin with the family doctor, who can either offer you treatment or refer you to a professional therapist/counsellor skilled in handling alcohol abuse. Medicines help some people abstain when they begin a programme of living life without alcohol.

Antabuse, a drug with a long history of helping people overcome their desire to drink, makes users sick if they drink alcohol while taking the drug. Naltrexone is a drug that lessens the craving for alcohol.

Some doctors have found that ondansetron, a drug whose primary purpose is control of the nausea that often comes with chemotherapy, is useful in freeing a person from alcohol abuse.

Drugs are not the sole answer. Most people need the helping hand of a professional to win the battle over alcohol’s tyranny. Don’t hesitate to seek that help.

Q :How does Alzheimer’s disease kill a person?

A :As the disease progresses, people become less active. They lose their desire to eat. They often spend much time in bed or in a chair.

All of the above weaken the immune system. Many Alzheimer’s patients, therefore, die of infections such as pneumonia, infections that would not be lethal to a more active person.

The average number of years from the onset of Alzheimer’s to a patient’s death is about nine years.

Dr Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write to him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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