Healthoughts

Healthoughts compiled by Monika Guttman and Kathleen O'Neil

Illustrations by Diane Bigda.

thyroid thoughts

Many people expect they will feel tired, gain weight and have minor joint pain as they age. Those expectations are partially to blame for thyroid disease going undetected in about one out of 10 people. Since thyroid disease affects about 15 million Americans, that adds up to a significant number of people who could be feeling better.

“The similarities between the symptoms of thyroid disease and aging is why my colleagues and I developed a recommendation for all women over age 40 to be tested regularly for thyroid disease,” says Peter Singer, M.D., professor of endocrinology at the Keck School of Medicine and a past president of the American Thyroid Association.

The thyroid is a butterfly-shaped gland located at the front of the neck, and the hormones it produces control metabolism and other essential functions.

Two recent surveys of older American men and women have shown the frequency of thyroid disease is higher than previously thought, due to under-diagnosis. The chance of developing hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid) increases with age and is more common in women. By age 50, about 8 percent of women have thyroid disease, and by age 70, it is about 15 percent.

While it can have a big impact on a person’s health, hypothyroidism is relatively easy to diagnose with a blood test and, in most cases, easy to treat.

“Hypothyroidism is a one-test, one-pill treatment,” Singer says. People suffering from hypothyroidism may experience fatigue, loss of appetite, dry skin, brittle hair or nails, hair loss, frequently feeling cold and muscle cramps.

Treatment for the less-common hyperthyroidism is a little more difficult. Physicians have to shut down thyroid production using medication or radioactive iodine. In rare cases, surgery is necessary. Symptoms of hyperthyroidism include weight loss, anxiety, a racing heart, difficulty sleeping, brittle hair, muscle weakness in the arms and, in some cases, bulging eyes and visual disturbances.

Singer stresses the importance of diagnosis of thyroid disorders since chronically lowered levels of thyroid hormones, in addition to the associated symptoms, also increase the risk of developing heart disease. And elevated levels can cause an irregular heartbeat and a possible increased risk of death, particularly in older men, as well as an increase in bone loss in postmenopausal women.

 

on the right foot

The band has stopped playing, the waiters are stacking chairs and the valet has your car waiting—and your feet are suffering the stiletto heel sting.

Fortunately, says Timothy Charlton, M.D., assistant professor of orthopaedic surgery at the Keck School of Medicine, there are exercises to make feet stronger to outlast the dance or hike the mall.

The first exercise is eccentric contractions that stretch and strengthen the all-important Achilles tendon that connects the calf muscle to the heel bone. Rise up on the tips of the toes of both feet while placing your hands on a wall for balance. Once you are all the way up, lower yourself using only the foot with the most pain. “This exercise is lengthening the muscle while contracting it,” says Charlton, who has worked with the American Ballet Theater dancers on preventing foot and ankle injuries. “This helps to gently stretch the part of the foot that is most stressed in high heels.”

The second exercise, toe crunches, “strengthen and define many of the muscles on the bottom of the foot that support the foot,” he says. For toe crunches, place a pillowcase flat on the floor, about 18 inches in front of you. Put your foot on the closest end of the pillowcase, then curl your toes and “grab” the pillowcase and slide it toward you. Unflex your toes and repeat. Slowly draw the entire pillow case toward you, using only your toes.

If foot pain does not go away, Charlton says, definitely consult a physician. But, he says, much of the time, “the proper exercise can help a great deal.”

 

vaccination stagnation

State laws requiring vaccines for children have made once common debilitating infections, such as polio, almost non-existent in the United States.

California requires all children entering kindergarten to receive vaccinations against nine diseases, most recently adding hepatitis B and chicken pox.

But young children are not the only ones who need protection. The public health community’s new campaign is about disease prevention through a lifetime of vaccines.

“Vaccinations are the most important tool we have for preventing outbreaks of contagious diseases,” says Jeffery Goad, Pharm.D., M.P.H., assistant professor at the USC School of Pharmacy and a public health specialist at the Keck School of Medicine.

For example, the Centers for Disease Control and Prevention (CDC) recommends a vaccine for bacterial meningitis for high school freshmen and first-year college students. Bacterial meningitis is spread easily through sneezing, coughing, kissing and sharing utensils. While the overall risk for bacterial meningitis is low, students are at higher risk for the infection, particularly those who live in dorms or are in close quarters with their peers. The infection can lead to life-threatening complications.

Also on the CDC list is for adults to keep track of their tetnus-diptheria vaccination history to make sure it is updated every 10 years. The CDC also recommends a yearly influenza vaccine for all adults age 50 and older.

Like other tools used to prevent disease—dental check-ups, exercise programs—Goad says vaccinations should be a part of health protection for every age.

 

toothbrush tech

When it comes to keeping teeth clean and healthy, studies have shown that proper use of a power-assisted brush—formerly known as an electric toothbrush—is more effective at eliminating bacteria and plaque than a manual toothbrush. In fact, brushing with a power toothbrush for two minutes removes more plaque than a manual brush used for six minutes.

“Studies have shown that the power toothbrush removes more of the bacterial biofilm or plaque because of the continuous motion, and people use it more often than a manual brush,” says Diane Melrose, B.S.D.H., USC School of Dentistry professor and chair of the USC Dental Hygiene Program. The faster motion also makes the power brush more effective at removing stains caused by coffee, tea and tobacco.

There are many varieties of power toothbrushes—some vibrate, rotate or even use sonic waves. All are effective and, if you do not have teeth problems or gum sensitivity, any one of them will work fine, Melrose says. For people with sensitive gums or gum recession she recommends a brush with a slower speed setting to prevent more gum damage, and to use it once a day. For other teeth cleaning during the day, use a manual brush.

Another variation is the brush’s head size—people with small mouths should select a small, round-headed brush to easily reach back teeth.

The recommended time for using a power brush is two minutes total—30 seconds on each section of the mouth, Melrose says. Any less time does not remove enough of the plaque, but more time may be harmful to the gums.

Manual brushes are still effective when used properly, Melrose says, but a manual toothbrush is no match against the cleaning power of 40,000 oscillations a minute.