March 2008

Q. Can Drinking Soda Raise My Risk for Metabolic Syndrome?

A. Regular soda contains sugar, which adds nothing to your diet except calories. Sugary drinks also raise levels of a hormone called insulin, setting off a dangerous chain reaction. Insulin causes you to put on more visceral fat (fat deep inside the abdomen). Too much visceral fat can raise certain blood proteins. And an excess of these proteins leads to metabolic syndrome. When insulin is high, it also increases hunger. That hunger, in turn, may contribute to overeating. You might even reach for another can of soda, thus continuing the cycle. Even diet soda can be a problem. Studies have shown that drinking diet soda on a regular basis can actually lead to weight gain. The exact reason is still unknown. It might be that diet soda itself somehow triggers the insulin response, or it might be that people tend to drink diet soda along with sugary foods that have this effect. Try to cut out or taper off both regular and diet soda from your diet. If you do drink soda, pair it with raw fruits and vegetables. The fiber in these foods can help control the insulin response.

Q. I need your advice on the following please:- I took Trifeme starting from my menstuation bleeding 1 week before marriage, and continued till the first week of marriage, then stopped it suddenly without following correct directions.. 2 days later, i got my periods (it wasn't their due date), and 30days later i got my periods again (my cycle was always 35 days, not 30), I've been married for approx. 2 months, my questions are: 1. Does stopping trifeme suddenly have any side effects? 2. Does it affect falling pregnant? 3. Will my periods cycle go back to normal? how long will that take? 4. What other advice do you give me? Your quick response will be appreciated. Thank you for your time.

A. Please, don't worry. What happened to you was actually quite okay and expected. The body is expected to respond to a sudden stopping of hormones (in your case, the Trifeme low dose birth control pill) by triggering a withdrawal bleed. The fact you had another period just 5 days shorter than usual is not a worry. There is virtually no concern at all that you have caused any problems - you just confused your ovaries and the lining of the uterus briefly. You will not jeopardize your chances of getting pregnant by taking Trifeme incorrectly. If you are planning to delay pregnancy for some time, I would resume the Trifeme just as you did before e.g. the Sunday following your period or whatever regimen your practitioner recommended to you. Hope this information puts your mind at ease.

Q. Here are my symptoms - 51 years old female in the early stages of menopause, fatigue (horrible) brain fog, slower pulse, higher blood pressure (130/90 and on meds for it), hoarse voice at times and feeling of a lump in my throat, feeling "off-balance", sleep disturbances. I am seeing a family practitioner who is now starting to practice "age management" type medicine. He tested me for different hormone levels (saliva test and did routine blood work also). My thyroid levels were in the "normal" range - 1.58 and tests showed adrenal fatigue. He put me on a supplement for low thyroid/adrenal (wants my thyroid levels a little higher) that is made from procine. I had to look that one up to find out it is from pigs. I don't know that they are helping - have new saliva/blood tests on order. DO you think this type of supplement is the right thing for a sluggish thyroid? I had a thyroid ultrasound done by an Endo earlier this year which showed a couple of nodules that she said were probably benign. Doing my own research I feel that my thyroid is not functioning where it should be and I think I should be on something other than "pig" thyroid meds. What do you think?

A. I will try to answer your questions as best I can - but as I know so little about you it will be more general than specific to your unique circumstances. Three concerns for me: 1) you have a multinodular goiter on ultrasound? I presume? is there a dominant nodule? any reason to do a fine needle biopsy? are they palpable on exam? did you have x-ray/radiation exposure when you were younger which would increase your risk of cancer? are they growing? Please keep original copies of all your test results. 2) according to your TSH of 1.58 (that was your TSH and not your T4, correct?) it is hard for me to believe your thyroid is underactive - however if you have muliple nodules, that alone may justify an empiric trial of thyroid to gauge your response. If your thyroid is truly inactive, then treatment should make you feel better. What did your endocrinologist say about thyroid treatment. 3) Porcine thyroid was the very first available thyroid hormone replacement and has been widely and safely used for years. Because it is "natural" although from pigs, it contains both T3 and T4. Most other prescription thyroid contains pure T4 - and there is no question some patients feel better on Armour thyroid (porcine thyroid) rather than synthetic levothyroxine. It sounds like I have more questions for you - and fewer answers.