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DRUG REQUIREMENT CAN CHANGE AS PATIENT AGES, GAINS WEIGHT

DEAR DR. DONOHUE: I had my thyroid gland removed completely 10 years ago. I have taken the supplement, Synthroid, since then. This year, when I had blood work done they found my thyroid hormone level had gone up. I don't understand how this could happen, and I got no satisfactory answer from the doctor. I am 46 and weigh 117 pounds. - S.G.

ANSWER: As we age, our body alters the way it handles drugs. A dose of thyroid hormone perfectly acceptable for you when you were 36 might be far too much today.Age is only one consideration in altering drug dosages. A person who has put on a lot of weight may actually need more of a drug to accommodate the greater body bulk. Conversely, losing large amounts of weight has the reverse effect, requiring lesser dosage.

Some people have to adjust drug dosages to reflect the presence of other drugs being prescribed for other illnesses. If this has happened to you in the past 10 years, that could explain the high hormone level and the need to adjust dosage of the supplement. Your other thyroid-related questions are answered in the material you ask for. Others may order the Thyroid pamphlet by writing Dr. Donohue/No.32, Box 19669, Irvine, CA 92713-0660, enclosing a long, stamped, self-addressed envelope and $2.

DEAR DR. DONOHUE: Recently, a neighbor told me he had seen a segment on TV that proclaimed a great advance in cataract surgery. A tiny incision is made and a small plastic lens inserted. This would allay some of my concerns regarding cataract surgery. Is this lens transplant surgery available at present, or is it only a vision for the future? - H.K.

ANSWER: Lens replacement surgery is a reality today. In many cataract operations today, incisions of a tenth to a third of an inch are made, through which the old natural eye lenses are removed and the new plastic type inserted. Usually, the patient goes home the same day. While no one can guarantee 100 percent success or total vision restoration, mail from my readers on this subject usually includes glowing praise for the procedure.

A related item:

DEAR DR. DONOHUE: I am 63 and have glaucoma. I take eye drops for it. Today, my doctor said I had a tiny cataract, but not to worry. Yet, I am worried. Will this cataract cause my glaucoma eye pressure to go up further? Should this small cataract be removed? - E.W.

ANSWER: Most 63-year-old people have small cataracts, probably quite like yours. Most cataracts grow very slowly, and most never reach the point of surgery (lens removal). Your glaucoma eye pressure will not rise because of the cataract.

Aside from forgetting these concerns, there are things you can do to deter cataract formation and growth. Wear sunglasses to filter out ultraviolet light. Don't smoke. It is beginning to look as though cataract formation is one of the more destructive results of smoking.

DEAR DR. DONOHUE: My question is about the anti-gallstone drug, ursodiol. Could there be any side effects? - J.C.

ANSWER: Just about every medicine has some undesirable side effect for some users. It's well nigh impossible to say beforehand who will have which and to what degree.

Sure, ursodiol, the stone-dissolving drug, can have side effects. It nauseates some and a few get diarrhea. But in general it is well tolerated by most.

Others have written about this stone-dissolving treatment and wonder why it is not being used for their stones. For one thing, it may not work on the type or size of stones a person happens to have. Secondly, it requires long-term use, sometimes for as long as a year. Thirdly, there are times when the stones re-form after you finish taking the medicine. Fourthly, sometimes it doesn't work at all. The various stone removal techniques are discussed in detail in the new gallbladder report. To order, write Dr. Donohue/No.40, Box 19660, Irvine, CA 92713-0660, enclosing a long, stamped, self-addressed envelope and $2.

FOR B.H. - Shingles is rare in children. Yes, your 9-year-old daughter must have had chicken pox earlier, an absolute prerequisite for getting shingles. Yes, it's possible to be exposed to the pox virus in the uterus with no signs occurring. But the fact that impresses me is that her twin sister had chicken pox earlier. She almost certainly got her chicken pox from that exposure. Chickenpox is highly contagious. No, the chance of her getting shingles again is remote.