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From: (Steven B. Harris )
Subject: Re: Hoshimoto or Addison disease Synthroid question
Date: 18 Jul 1995

In <3uf4ig$> (Zeda Ass'n
[Ralph Burr]) writes:
>In <3ucgmf$> Jim Greene
><> writes:
>>A relative of mine has been diagnosed with Hoshimoto's (not sure
>>of spelling) disease (it is a shut-down of the thryoid) and possibly
>>Addison's disease as well.
>>They are on Synthroid for the Hoshimoto's.
>>Does anyone know the side-effects of synthroid or symptoms of the
>Hashimotos is a cause of hypothyroidism. It is an immune system
>disease. So is Addisons. Synthroid (L-Thyroxin) treats Hashimotos and
>corticosteroids treat Addisons. Both affect the endocrine system.
>No side effects (usually) from Synthroid. If the body adequately
>converts T-4 to T-3, he'll have plenty of Triiodothyronine as shown
>by his TSH readings (demand for T-4). If I remember, the test for
>Addisons is ACTH response; with Addisons you run a surplus of ACTH.
>And, your immune system lacks full power to resist invasive events.
>Steroids have the usual side effects with prolonged use.
>Maybe an M.D. will step in and give a better explanation than I can!
>                                         Burr - Zeda Ass'n

I will add that there are no side effects from steroids at replacement
doses, either (it's just two more pills a day, added to the synthroid).
 A person with Addison's also needs additional steroids when they are
infected or injured (to make up for the body's normal increased
production at these times), but this is easily administered.  All such
persons should have an Addison's medic-alert bracelet reminding the ER
doc to push 100 mg IV hydrocortisol stat, in case of accident.  The
same routine JFK got, in other words, but which (of course) had no
chance to help him, given his non-survivable injuries.

                                                Steve Harris, M.D.

From: (Steven B. Harris )
Subject: Re: prednisone vs. anabolics
Date: 10 Sep 1995

In <> LC <> writes:

>Could someone please explain the difference in these two steroids, prednisone
>(and similar types) and anabolics like weightlifters use.
>thank you,

Well, one class of steroids (glucocorticoids) controls immune response,
and has many important metabolic regulatory functions, such as effects
on glucose use by the body, and free water excretion from the kidneys.
Prednisone and cortisone are representative of this class, and are not
DEA controlled substances (although you do need a doctor's prescription
to get them in pill form).  These hormones are normally made in the
outer part of the adrenal gland.  If this is destroyed, a very
unhealthy condition results, called Addison's disease.  Its most famous
sufferer (until he got artificial hormones) was JFK.

   The other class of steroid hormones (androgenic or anabolic
steroids) are made in the gonads of both men and women (mostly), and
affect primarily muscle, bone, blood, larynx, sex organs, facial hair,
and so on-- like testosterone.   They do to you what a boy's hormones
do to him to make him a man.  They are the ones illegally used (or
abused, depending on point of view) by atheletes.  They are controlled
substances, and require a federal licence to possess.  They are used
medically as hormone replacements, and occasionally to treat disorders
involving anemia and body wasting (as in dialysis patients).

                                           Steve Harris, M.D.

From: B. Harris)
Subject: Re: You've cancer! How would you like to be told?
Date: Thu, 21 Aug 1997

In <> "Paul I. Roda, M.D., F.A.C.P."
<> writes:

>Don C Royal DC wrote:
>> Paul I. Roda, M.D., F.A.C.P. wrote:
>> > given in adequate dosages, opioids should relieve the pain in >95% of
>> > the
>>   And this is appropriate IMHO.  After all shouldn't we each have a
>> say in our own destiny?? If a person wishes not to be in pain then they
>> shouldn't be in pain. I am however curious about another approach. An
>> internist with whom I am inderectly acquainted chose to control his
>> pain with steroids. Of course we know the outcome; on the other hand he
>> was comfortable without sacrificing mental accuity. He may not have
>> lived quite as long as he would have otherwise but - the life he had
>> would, I believe, be preferred by the majority were it made available.
>> Comments??
>Steroids are a useful adjunct to opioids, particularly when the pain is
>do to edema of a nerve; but steroids by themselves are lousy

   I dunno-- except in really acute injury, pain is generally due to
inflammation in some way or other.  Cancer included (where bone met
pain has a big inflammatory component).  Steroids are a useful adjunct
to this anytime, except of course that that they have tremendous long
term side-effects.   If your problem's only going to last a few weeks
or a few months, and you don't care about long term side effects, and
don't care about healing (eg, terminal bone or brain cancer), big doses
of steroids work very well.

   Understand-- I'm not saying that they are expected to be a total
replacement for narcotics (though they might be), or that someone
should be expected to use them so.  I'm merely saying that for a
terminal cancer patient on the way out, perhaps much larger doses of
corticosteroids are a paliative option not utilized often enough.  I've
seen a few terminal people on big steroid doses who it seemed to work
very well for.  Perhaps some hospice people can speak to this.

                                            Steve Harris, M.D.

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