About….The Doctor Is In!

2344790148.jpgThis page will help me answer questions regarding your health or other matters regarding health issues like doctor referrals, tests to do, questions on the medications and other health matters you want to clarify or issues you want me to address in the blog.

This page will not be used to consult or diagnose a case since proper history with physical examination are needed to get to the right diagnosis. No appointment schedules will also be entertained here. Please see the page About…The Medical Clinic for appointment schedules.

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445 Responses to “About….The Doctor Is In!”

  1. Jocelyn Pepito Says:

    I have GERD or suffer from heartburn. Is okra good for hyperacidity or does it aggravate this condition? What fruits can we eat that will not cause hyperacidity?

  2. Doc Gerry Says:

    Helo Jocelyn… Here are some home remedies you can try if you develop hyperacidity. Of course, these suggestions are not subsitute to doctor’s work up and advise because again proper history and physical examinations are key tpo p[roper diagnosis and treatment.

    If you have almonds in the house, chew them at any first sign of hyperacidity. Some advocate taking ginger root with honey taken after meal as effective for treating heartburn. Fruits like apple, watermelon and banana are acceptable to take if you have the symptoms. Likewise try to avoid spicy or fried foods. Again these are home remedies while awaiting your doctor’s appointment.

    I have no knowledge of okra…but again we recommend vegetables even with hyperacidity. If okra has special properties to treat hyperacidity, no studies so far have been done yet unless anybody can quote a source for me which is reliable to the medical community.

  3. jessica Gabriel Says:

    GOOD DAY TO U DR. GERRY, I JUST READ ABOUT U ON THIS WEBSITE AND I DO REALLY APPRECIATE UR EXPERTIES BEING AN ENDOCRINOLOGIST HERE IN OUR COUNTRY.
    DOC, I JUST WOULD LIKE TO KNOW IF A PERSON WHO HAD UNDERGONE THYROID SURGERY SOME 15 YRS AGO, CAN STILL UNDERGO ANOTHER SURGERY THIS TIME ? HER THROID SEEM TO ENLARGE AGAIN NOW AND SHES AFRAID BOUT IT.PLS DO HELP US DOC. GOD BLESS!

  4. Doc Gerry Says:

    Hi Jessica… I transferred your comment on this site because this is the page where my readers can ask questions.

    The problem with thyroid problems in the past is that majority of the cases were done by surgeons from the diagnosis to the management. Now with us endocrinologists on board… we see thryoid cases in a different perspective.

    The majority of thyroid problems require total thyroidectomy to avoid a similar case as you’re presenting… to suffer again because of recurrence. That’s the true nature of nodular goiters. However, total thyroidectomy requires expertise. The onset of postop complications depends on the surgeons skills. That’s why I only trust 2 surgeons to do my thyroidectomies without any compications of hoarsenss or loss of voice, etc.

    To answer your question:
    1. The remaining thyroid gland left after the surgery may have not produced enough thyroid hormone to supply the body’s daily needs. As a result, her Thyroid Stimulating Hormone or TSH will increase which will stimulate the residual gland to grow. If this is the case, only medication replacement will solve the enlargement.
    2. If her TSH is normal and the nodular recurrence is large, I would recommend a repeat surgery for cosemtic reasons and it should be okay as long as done by an expert surgeon.
    I hope this helps you decide what to do.

  5. Susan Montecillo Says:

    Hi Dr Gerry,

    First of all, I would like to thank you for making a difference in this world. Not many doctors do clinics very early. People would go all the way as waitng for you at 4:00 AM so they can get a chance to see you so you can do your magic and, make a difference in their lives. What impressed me the most is that you’re not a snob! Even if the lines are long, you give your patients your time, to hear them out and give your most honest opinion. ( as others would hurriedly finish so th next patient can go in). Thank you again.

    Secondly, Question time. hehe. Four years ago, I was diagnosed with PCOS. took metformin and got pregnant, gave birth. Four years later, now, doing the same but not getting pregnant. Don’t know if you still remember us/me coz it is my mom who is your patient and we just accompanied her. Anyway, you told me to take Actos instead of the usual metformin. I’m presently very happy in taking Actos coz i am not experiencing any of the discomforts. (which is also why i was not taking metforminn diligently the second time around). My concern is, I read over the internet that Actos (or same generic) can cause liver damage and I should monitor my liver and do liver tests every 3 months? Is that necessary? As per your advise, I am now waiting for my period to come before I see my OB. I am hoping that you will be able to answer my question before that time comes. and also hopefully, the reason why I am going to see my OB is because I am already pregnant. :)

    Lastly, Kudos to your website. Very informative, comprehensible and I see that you update it often ( I last viewed it 2nd week of Feb). Will visit your website whenever I can. Good luck and thank you for touching our lives. :) You dont know how much it means to us.

    P.S. Will leave a note again if I DO GET Pregnant. :)

  6. Doc Gerry Says:

    Hi Susan… thanks for the complement.

    The recommendation to check liver enzymes every 3 months is true to every durg you take that passes to the liver to be metabolized. Pioglitazone ( Actos or Piozone) or Rosiglitazone ( Avandia) are both newer generation PPARS which are devoid of the usual liver toxicity associated with the old PPAR family. In fact these two drugs are safe to us for fatty livers as they have been shown to reduce elevated liver enzymes long term.

    I think I advised you to take that drug in passing… Just make sure your liver function tests are normal before taking it. I like this drug better for PCOS than metformin. We treat PCOs as a case of Insulin Resistance state. As you said it is devoid of any untoward gastrointestinal side effect. Now to get you pregnant… make sure you get your ovulation kit ready all the time and your husband ready to jump and take action whenever the ovulation kit says so!

    Be sure to name him Gerry if he’s a boy! Good Luck. Please spread the news re my website for others to benefit too.

  7. Dati Mong Kilala Says:

    Dear Dr. Gerry,

    As your website dictates, I took the liberty of writing.

    First of all good day to you and let me extend my warmest greetings to your lovely wife & kids. Likewise, receive also my sincere congratulations for fulfilling your dreams (i.e. as a very successful Doctor & a Father). I knew since the beginning that you will be one of the great people. Ano ba ang magagawa sa mga hindrances if you have the riches, brain, desire & most of all having with God — of course you will be on top of your career. Don’t be flattered, dahil factual ito at hindi rin ako mambobola dahil sa katangian ko. In fact inferior pa rin ako ngayon since the last time you saw me in Hi-school.

    You might be thrilled or amazed who am I?

    I found your sites through a search engine. Before that, I’d heard already about you. I was hesitant to write but nilakasan ko lang ang loob — hindi ka naman siguro nagbago kahit nasa top ka na. At wala naman siguro sa katangian ng mga doctor yan w/c is visible through your medical advocacy (unusual net services – for free ikanga)

    Your website is professionally organized, very helpful, informative, full of medical documentaries and amusement (he, he, he — pictures nyo sa mga ibang bansa. Para na ring nakapunta ako while browsing your clippings).

    Well, hindi ko na pahabain pa ito. Please find below my med-history:

    B.P.  140 – 150 / 100-110 (corrected to 120 – 130 / 90 through daily medication – codiovan 80/12.5 + Norvasc 5mg)

    Uric Acid  7.3 mg/dl —- corrected by taking Zyloric, but I stopped with his permission (by force). Lalo kaseng sumakit ang mga joints ko w/c was not before although meron sa mga ibang katawan like muscle related pain.

    Cholesterol  T. Chol. 214 mg/dl ; Triglycerides 267 mg/dl; HDL 32 mg/dl; LDL 144 mg/dl  with medication but stopped dahil sobrang-sobra ang sakit ng katawan ko. Doctor found out that sudden increase in enzymes. Final advice was to do exercise, have diet & minimize eating with red meat & oily foods instead of giving an alternative prescription.

    The above test properties did not give me worries. What I was worried about is my present diagnosis – mild hydronephresis (i.e. from having a 1.2 cm. length of stone at mid-ureter  by CT Scan). I went 2x already to a doctor in separate occasions. The last one was in emergency case. The 1st time, some med examinations were made (ultrasound, blood & urine then CT scan as confirmation).

    Recently (in emergency case), another ultrasound & blood tests carried out (difft. Doctor). The nature of attack (pain) was that parang punong-puno ang bladder ko na walang iihi at sakit ang hips ko extending downward to upper limbs. The urine contained threads of blood cells, but after sometime ( 3 hrs. of drinking water), it became clear. I was given an injection to relieve the pain. Afterwards, with all the test results (1.8 cm stone at same position at wala naman daw signs of infection), binigyan pa rin ako ng antibiotics. I was scheduled to see a specialist (Urologist) pero matagal pa.

    Right now, I feel pain sometimes like a busisaw/matatae at sakit ang hips & upper limbs. During a sleep-night, I feel hot on both lower hips & sometimes on legs. I observed that when I pressed my glands (sa bulog), medyo ma relieve ang sakit (parang ngulngul at anglay).

    Matagal pa kase ang appointment ko sa Urologist kaya I took the opportunity of consulting to you as a 2nd opinion.

    I hope hindi ka nahabaan sa sulat ko.

    By the way ako pala si Marciano (classmate mo). So long for this, ‘till next e-mail na lang.

    God bless,

    marsh

  8. Doc Gerry Says:

    Marsh thanks for the kind words. I was not able to write back right away because I just came back from Butuan yesterdy after giving a lecture on Diabetes to medical doctors in Caraga region. I took 2 days off from my clinic to again educate anotehr side of my advocacy and this time the professionals who need more informations to treat diabetes. I find it fulfilling even if am away from my family.

    Going back to your case….this is a simple case of kidney stone causing you the trouble. Am not sure where you’re located now but this should not be a big deal. We now have a way to break down these stones without surgery called lithotripsy which we do in Cebu Doctors’. Feel free to see me anytime so I can refer you to a good nephrologist not a urologist. At the same time we can talk more about your other problems especially cholesterol and hypertension. I am afraid you are developing metabolic syndrome and watch out for your sugar becuase it may be the next to go up.

    Just a last note: for Hypertnesion, Cholesterol and Suagr problems… take your meds daily to prevent long term complications like heart disease and stroke. They are treatable diseases but NOT Curable meaning you have to take these meds long term.

    Nice to hear from you.

  9. Marvi Says:

    Grace and Peace…
    Dr Gerry,
    I want to thank you for accomodating me last tues, feb 20.I know you were tired then but you still managed to see me as your last patient.Am glad you are not a snob. I was able to go home that night and be with my 8mos old baby on the following day..
    Anyways, regarding the 100mg levothyroxine sodium you prescribed.Took it for the 1st time last feb 21 and at 11pm i noticed my bp raised to 140/100mmHg. Took aldomet and my bp was stabilized.I thought what caused it raised was some problems at home,i didn’t associate it with the drug then. Took it again on the following day but still, i have an elevated bp and palpitations. What I read at MIMS regarding the drug made me decide to call your office on saturday but your answering machine says you will recieved calls monday to friday.. :-) I stop taking that drug for the meantime and noticed i dont have palpitations and raised bp anymore.What other medication are you going to prescribe me? :-) Nag pa Lipid profile and FBS ako last sat also and the results are in normal range..
    FNA result says I have benign colloid nodule. What are the foods i will avoid (you said cabbage, young corn, camote,cassava… what else??) and the foods recommended? I’m into singing..will it affect the nodule?cause it to enlarge futher?
    Thank you also that you have a website like this, so informative… and for your effort in taking time to read and answer questions… What a generous doctor you are, a rare one…I Thank God for you..
    May the good Lord Jesus Christ bless you and your family.

  10. Doc Gerry Says:

    Marvi, try reducing the dose to 50 ug. If you persist to have palpiations then the best recourse is surgery. No other medications can be given unfortunately based on your FNA biopsy. By the way, singing does not increase your nodule size and just stick to the NO NO foods that I mentioned to you.

  11. sol Says:

    Good day Doc Gerry!

    This is sol here…i just want to thank you for being an inspiration to every student, resident, and doctors alike! I admire very much your dedication to educate ever since i was still in training… and i believe you have influenced me to become an endocrinologist myself. Thank you again doctor and more power to you. Hats off!!!

    Sol

  12. Shelly Says:

    I stumbled across this website by accident! I love it! Very informative! I am emailing all the way from sunny Port Moresby , the capital of Papua New Guinea in the South Pacific just above Australia.
    Keep up the good work doc.

    I might have some questions later.

    Cheers,
    shelly

  13. Tina Says:

    Dear Doc Gerry,
    I am a regular visitor to your blog and obviously the word “impressed” does not quite express the value of your work to me.
    But enough complements have been said (and quite a lot more unsaid I am sure) so I will skip straight to my question. My mother is a diabetic, she takes insulin shots twice a day. I get a thorough annual PE courtesy of the benefits I get from the company I work for so for the past 6 years I know that my sugar has been well within the limits. My cholesterol has always been below 200 (only in one year did it reach 213). BUT my current weight is 212 lbs ( I am 5 feet 5 inches tall ).
    I had hyperthyroidism from 2001 to 2003 and last year my THyroid panel came back with increased TSH which meant I had hypothyroidism. I was on medication for a while but after getting my lab results that came back normal I failed to go back to my doctor.
    I am still awaiting for my results for this year to come back so I decided to ask you questions before setting my appointment. – So the big question is : considering that with my history and obesity – I may be called prediabetic, plus the problems I am having to bring my weight down, is it reasonable to expect that your clinic will be able to help me avoid becoming a diabetic? Is weight management a natural result of being under your care? Thank you for taking the time to read my post doc and I shall be checking back to get your response. God Bless you.
    Tina

  14. Leila Says:

    Hi Dr. Jerry. I am Leila, daughter of your patient from Surigao. My mother has been taking Euthyrox as prescribed. Just yesterday, she called me and told me she felt slight pain in her thyroid gland/throat. Does it mean something serious that we have to worry about? She is scheduled to visit you again this coming May 19 but if it is something serious then we would visit you as soon as possible. I know how busy you are but I would really appreciate your immediate response. Thank you so much! God bless.

  15. Doc Gerry Says:

    Hello Shelly, Tina and Leila…
    Sorry but I just came back form my trip in Kyoto. Check out what Kyoto has to offer soon in my thet health rules travelogue blog.

    To Shelly… thanks for the comments and keep reading…..
    To Tina… very big chance that you will become a diabetic if you dont lose weight especially with a strong family history. We can talk about the process of avoiding becoming a diabetic and we have ways to do that already. Make sure you have you thyroid check to be sure you are taking the right dose.
    To Leila… slight pain in a nodule may mean there is bleeding especailly after lifting a heavy object. Ask her for now to avoid lifting heavy object until her next visit…okay?

  16. Leila Says:

    Thanks a lot, Doc! You’re the coolest doctor I’ve ever known. My Aunt will also visit you soon regarding a small lump in her throat. There’s a big possibility it’s a goiter. God bless!

  17. Teresa Says:

    Hi, doc!
    i’d like to ask what’s the “time-frame” between taking humulin 70/30 to eating time? I know that it’s supposed to be you eat 30 min. after taking the insulin shot to be effective…but sometimes, my ma forgets the time she injected the humulin, so she sometimes eat after 45min. or an hour…does this affect the effect of the insulin?

  18. Doc Gerry Says:

    The latest you can eat after injection is 45 mintues. But we now have a new Hum 7/3 that you can injext immediately before a meal. Well talk about it when you get your next appointment.

  19. Teresa Says:

    Thanks for the reply, doc! Will ask you about the new hum7/3 on our next visit. :-)

  20. Donnabel Says:

    Good day! I aws diagnosed to have multinodular goiter. I want to ask you doc if mine was Hypothyroidism or hyperthyroidism or it is just as multinodular goiter? If it is,can it lead to some problems like concieving,pregnancy and giving birth? By the way doc you prescribed me euthyrox 100. Is it ok if I take another brand like thyrax 100? Sometimes the drugstore I went to doesnt have euthyrox but instead they have thyrax. I do hope you could reply with this msg doc. Thank you very much. I really liked your website,it’s so informative. I’m so thankful you choose to serve your own country where in fact your a great doctor who had a lot of opportunity in other countries. More power!God bless.

  21. Doc Gerry Says:

    If you have a multinodular goiter and is placed on euthyrox…then you should have a benign colloid goiter that is functioning normally. The probem with multinodular goiter is when it becomes toxic and develop a state called Plummers disease…then this state can lead to problems of conceiving. But as long as you are clinically euthyroid then you are well okay in terms of fertility. You may elect to take thyrax if you want.

    Please do continue to read and visit my website and do write comment or suggestion on the posts so I know you’re reading them haha.

  22. Marsh Says:

    Dear Doc Jerry,

    Sorry for I was not able to visit your clinic. I setlled here in Imus, Cavite & busy talaga. Thanks for the advice. I was about to have my operation in Manila, but the insurance will not shoulder the expenses unless it is in emergency case on which St. Luke did not agree with my suggestion na ireport lang that I was in EC.

    I am scheduled for operation this 10th April At Al-Noor Medical Hospital, Abu Dhabi. The doctor told me that a tube insert (capable of locating the stone & breaking into fragments) from the penis to the ureter is to be carried out.

    My question : How reliable this procedure is?

    By the way I got a VCO (virgin coco oil). I feel comfortable with it as my BP is going normal. As I observed, this is better than my daily medication (Norvasc & Co-Diovan). Walang side-effects pa. Any comment on this?

    Marsh C.

  23. teresa Says:

    Hi, doc!
    You’re probably on vacation with your dear family at this moment. Anyway, i just want to ask if accupuncture is ok for stage 2 diabetic patients? Do we have reliable people here in Cebu who could do accupuncture?

  24. Doc Gerry Says:

    Hi Marsh… I guess you’re talking about lithotripsy. It should be a safe and simple procedure that can be done well in your place. With regard to VCO… unfortunately, I can’t accept it as a replacement to your antihypertensive medications. Please check my post on VCO.

    To Teresa… Please contact me in my office re the address and name of the doctor who performs the accupuncture.

  25. lenin Says:

    hi. i have a hyperthyroid for about a year and 4 months now. my doctor wants me to undergo radioiodine therapy. my in laws said it will be difficult for me that kind of treatment. so where seeking some options. my husband said ill just go for a surgery. the question is… what is the differences of radioiodine therapy and surgery. what is the best options i will have? my goiter is getting bigger although im taking anti thyroid meds. help!

  26. Doc Gerry Says:

    Hello Lin…just came from Seattle thus I havent answered some querries. There are many kinds of hyperthyroid state and we have to determine if your kind requires RAI or surgery. Not all hyperthyroid conditions will be better off with RAI, some kinds requrie surgery. Your goiter will definitely get bigger if you are taking too much dose of the antithyroid agents so better check your thyroid function tests and have your dose adjusted accordingly. Check with your local endocrinologist to get a better discussion of your case.

  27. eva c. malbas Says:

    dear doc gerry,
    pls comment on this article i received from an email…

    Subject: Fwd: SWEET, BUT POISON – A MUST READ
    Date: Mon, 26 Feb 2007 16:51:40 +0000

    >
    > [ SWEET, BUT POISON – A MUST READ
    >
    >
    > In October of 2001, my sister started getting very
    > sick. She had stomach spasms and she was having a
    > hard time getting around. Walking was a major chore.
    > It took everything she had just to get out of bed;
    > she was in so much pain.
    >
    > By March 2002, she had undergone several tissue and
    > muscle biopsies and was on 24 various prescription
    > medications. The doctors could not determine what
    > was wrong with her. She was in so much pain, and so
    > sick.she just knew she was dying. She put her hous e,
    > bank accounts, life insurance, etc., in her oldest
    > daughter’s name, and made sure that her younger
    > children were to be taken care of. She also wanted
    > her last hooray, so she planned a trip to Florida
    > (basically in a wheelchair) for March 22nd.
    >
    > On March 19 I called her to ask how her most recent
    > tests went, and she said they didn’t find anything
    > on the test, but they believe she had MS. I recalled
    > an article a friend of mine e-mailed to me and I
    > asked my sister if she drank diet soda? She told me
    > that she did. As a matter of fact, she was getting
    > ready to crack one open that moment. I told her not
    > to open it, and to stop drinking the diet soda! I
    > e-mailed her the article my friend, a lawyer, had
    > sent.
    >
    > My sister called me within 32 hours after our phone
    > conversation and told me she had stopped drinking
    > t he diet soda AND she could walk! The muscle spasms
    > went away. She said she didn’t feel 100% but she
    > sure felt a lot better. She told me she was going to
    > her doctor with this article and would call me when
    > she got home. Well, she called me, and said her
    > doctor was amazed! He is going to call all of his MS
    > patients to find out if they consumed artificial
    > sweeteners of any kind.
    >
    > In a nutshell, she was being poisoned by the
    > Aspartame in the diet soda… and literally dying a
    > slow and miserable death. When she got to Florida
    > March 22, all she had to take was one pill, and that
    > was a pill for the Aspartame poisoning! She is well
    > on her way to a complete recovery. And she is
    > walking! No wheelchair! This article saved her life.
    >
    > If it says ‘SUGAR FREE’ on the label; DO NOT EVEN
    > THINK ABOUT IT!
    >
    > I have spent several days lecturing at the WORLD
    > ENVIRONMENTAL CONFERENCE on “ASPARTAME,” marketed as
    > ‘NutraSweet,’ ‘Equal,’ and ‘Spoonful.’ In the
    > keynote address by the EPA, it was announced that in
    > the United States in 2001 there is an epidemic of
    > multiple sclerosis and systemic lupus . It was
    > difficult to determine exactly what toxin was
    > causing this to be rampant. I stood up and said that
    > I was there to lecture on exactly that subject.
    >
    > I will explain why Aspartame is so dangerous: When
    > the temperature of this sweetener exceeds 86 degrees
    > F, the wood alcohol in ASPARTAME converts to
    > formaldehyde and then to formic acid, which in turn
    > causes metabolic acidosis. Formic acid is the poison
    > found in the sting of fire ants. The methanol
    > toxicity mimics, among other conditions, multiple
    > sclerosis and systemic lupus.
    >
    > Many people were bei ng diagnosed in error. Although
    > multiple sclerosis is not a death sentence, Methanol
    > toxicity is! Systemic lupus has become almost as
    > rampant as multiple sclerosis, especially with Diet
    > Coke and Diet Pepsi drinkers. The victim usually
    > does not know that the Aspartame is the culprit. He
    > or she continues its use; irritating the lupus to
    > such a degree that it may become a life-threatening
    > condition. We have seen patients with systemic lupus
    > become asymptotic, once taken off diet sodas. In
    > cases of those diagnosed with Multiple Sclerosis,
    > most of the symptoms disappear. We’ve seen many
    > cases where vision loss returned and hearing loss
    > improved markedly. This also applies to cases of
    > tinnitus and fibromyalgia.
    >
    > During a lecture, I said, “If you are using
    > ASPARTAME (NutraSweet, Equal, Spoonful, etc) and you
    > suffer from fibromyalg ia symptoms, spasms, shooting,
    > pains, numbness in your legs, cramps, vertigo,
    > dizziness, headaches, tinnitus, joint pain,
    > unexplainable depression, anxiety attacks, slurred
    > speech, blurred vision, or memory loss.you probably
    > have ASPARTAME poisoning!” People were jumping up
    > during the lecture saying, “I have some of these
    > symptoms.Is it reversible?”
    >
    > Yes! Yes! Yes! STOP drinking diet sodas and be alert
    > for Aspartame on food labels! Many products are
    > fortified with it!
    >
    > This is a serious problem. Dr. Espart (one of my
    > speakers) remarked that so many people seem to be
    > symptomatic for MS and during his recent visit to a
    > hospice, a nurse stated that six of her friends, who
    > were heavy Diet Coke addicts, had all been diagnosed
    > with MS. This is beyond coincidence! Diet soda is
    > NOT a diet product! It is a chemically altered ,
    > multiple SODIUM (salt) and ASPARTAME containing
    > product that actually makes you crave carbohydrates.
    > It is far more likely to make you GAIN weight!
    >
    > These products also contain formaldehyde, which
    > stores in the fat cells, particularly in the hips
    > and thighs. Formaldehyde is an absolute toxin and is
    > used primarily to preserve “tissue specimens.” Many
    > products we use every day contain this chemical but
    > we SHOULD NOT store it IN our body!
    >
    > Dr. H. J. Roberts stated in his lectures that once
    > free of the “diet products” and with no significant
    > increase in exercise; his patients lost an average
    > of 19 pounds over a trial period.
    >
    > Aspartame is especially dangerous for diabetics. We
    > found that some physicians, who believed that they
    > had a patient with retinopathy, in fact, had
    > symptoms caused by Aspartame. The Aspar tame drives
    > the blood sugar out of control. Thus diabetics may
    > suffer acute memory loss due to the fact that
    > aspartic acid and phenylalanine are NEUROTOXIC when
    > taken without the other amino acids necessary for a
    > good balance. Treating diabetes is all about
    > BALANCE.
    >
    > Especially with diabetics, the Aspartame passes the
    > blood/brain barrier and it then deteriorates the
    > neurons of the brain; causing various levels of
    > brain damage, seizures, depression, manic
    > depression, panic attacks, uncontrollable anger and
    > rage.
    >
    > Consumption of Aspartame causes these same symptoms
    > in non-diabetics as well. Documentation and
    > observation also reveal that thousands of children
    > diagnosed with ADD and ADHD have had complete
    > turnarounds in their behavior when these chemicals
    > have been removed from their diet. So called
    > “b ehavior modification prescription drugs” (Ritalin
    > and others) are no longer needed. Truth be told,
    > they were never NEEDED in the first place! Most of
    > these children were being “poisoned” on a daily
    > basis with the very foods that were “better for them
    > than sugar.”
    >
    > It is also suspected that the Aspartame in thousands
    > of pallets of diet Coke and diet Pepsi consumed by
    > men and women fighting in the Gulf War, may be
    > partially to blame for the well-known Gulf War
    > Syndrome.
    >
    > Dr. Roberts warns that it can cause birth defects,
    > i.e. mental retardation, if taken at the time of
    > conception and during early pregnancy. Children are
    > especially at risk for neurological disorders and
    > should NEVER be given artificial sweeteners. There
    > are many different case histories to relate of
    > children suffering grand mal seizures and other
    & gt; neurological disturbances due to the use of
    > NutraSweet.
    >
    > Unfortunately, it is not always easy to convince
    > people that Aspartame is to blame for their child’s
    > illness. Stevia, which is a sweet herb, NOT A
    > MANUFACTURED ADDITIVE, helps in the metabolism of
    > sugar, which would be ideal for diabetics. It has
    > now been approved as a dietary supplement by the
    > FDA. It is known that for many years the FDA
    > outlawed this true sweet food,” due to their loyalty
    > to MONSANTO Chemical Company.”
    >
    > Books on this subject are available:
    >
    > EXCITOTOXINS: THE TASTE THAT KILLS written by Dr.
    > Russell Blaylock (Health Press 1-800-643-2665) AND:
    > DEFENSE AGAINST ALZHEIMER’S DISEASE-written by DR H.
    > J. Roberts, also a diabetic specialist.
    >
    > These two doctors will soon be posting a position
    > page on the Internet with case histories on the
    > deadly effects of Aspartame. According to the
    > Conference of the AmericanCollege of Physicians, “We
    > are talking about a plague of neurological diseases
    > directly caused by the us of this deadly poison.”
    >
    > Herein lies the problem: There were Congressional
    > Hearings when Aspartame was included 100 different
    > products and strong objection was made concerning
    > its use. Since this initial hearing, there have been
    > two subsequent hearings, and still nothing has been
    > done. The drug and chemical lobbies have very deep
    > pockets. Sadly, MONSANTO’S patent on Aspartame has
    > EXPIRED! There are now over 5,000 products on the
    > market that contain this deadly chemical and there
    > will be thousands more introduced. Everybody wants a
    > “piece of the Aspartame pie.” I assure you that
    > MONSANTO, the creator of Aspartame, knows how deadly
    > it is. And i sn’t it ironic that MONSANTO funds,
    > among others, the American Diabetes Association, the
    > American Dietetic Association and the Conference of
    > the American College of Physicians? This has been
    > recently exposed in the New York Times. These
    > [organizations] cannot criticize any additives or
    > convey ! their link to MONSANTO because they take
    > money from the food industry and are required to
    > endorse their products.
    >
    > Senator Howard Metzenbaum wrote and presented a bill
    > that would require label warnings on products
    > containing Aspartame, especially regarding pregnant
    > women, children and infants. The bill would also
    > institute independent studies on the known dangers
    > and the problems existing in the general population
    > regarding seizures, changes in brain chemistry,
    > neurological changes and behavioral symptoms. The
    > bill was killed. It is known that the powerful drug
    > and chemical lobbies are responsible for this,
    > letting loose the hounds of disease and death on an
    > unsuspecting and uninformed public. Well, you’re
    > informed now! YOU HAVE A RIGHT TO KNOW!
    >
    > Please print this out and/or e-mail to your family
    > and friends. They have a right to know too.
    >
    >
    >
    >
    >
    >

  28. Doc Gerry Says:

    No evidence…all anecdotal. No mention of source or scentific study. The internet is a powerful tool for everyone to just write anything they wish to write and people has a tendency to believe and no more time to check the truth. Am happy you sent this to me so people will know the difference… in order for one to say what they are saying is true… there should be case series reports properly written and submitted for publication. This will then be throughly reviewed by experts/specialist in the field to check authenticity or merely a junk! Make sure the source should be published in a reputable peer reviewed journals before we believe in something written. In short…enjoy reading this post as if this is fictional drama….

  29. rebecca tan Says:

    Hello dr tan, my name is Rebecca (hope you still remember me). I am one of your patients, but I stopped seeing you because I’m now residing in california. I was seeing you because my goiter , I think I have hypothyroidism and I was taking euthyrox for it. I had stopped taking the medication for a long time, I couldn’t buy it from the pharmacy because it needs prescription. I was wondering if you could tell me another name for euthyrox or another medication that has the same effect with euthyrox. I think that medication worked for me. Everytime I touch my neck, i’m always concern about what’s gonna happen to me, I really do think that my goiter is getting bigger. Do you think I will need an operation?

    I am planning to visit your clinic as soon as I have my vacation there in the philippines, I’m really worried about my goiter. Say hi to Ivy for me. Thank You!

  30. Leila Says:

    Hi Dr. Gerry! My mother is taking Unasyn as prescribed after her surgery. But the problem is that she’s having loose bowel movement for days now. Her stool has chocolate brown particles in it which I think is blood. I searched in the internet and I found out that Unasyn can cause Pseudomembranous colitis. Is it an alarming condition? Please give me advice on what to do. We are scheduled to visit you but it will still be on May 8. God bless.

  31. Doc Gerry Says:

    Bec… another name for euthyrox in US is Synthroid or Levoxin. Use the same dose and see me when you have the chnace. Well discuss if you need surgery depending on our evaluation when I see you. For now maintain the medication.

    Leila… you get the complication of colitis if youve been on antibiotics for a long time. Doubt its alarming. Just inform your surgeon about the LBM and he may elect to change it to something else which your mom may tolerate better.

  32. rebecca Says:

    dr tan…thank you so much for the info…i was thinking about that too, that synthroid is another name for euthyrox or at least the same effect…it’s also the same with levothyroid, levothyroxine, and levoxyl right?…okay doc, i will take that medication as soon as i get a prescription from the doctor…but, i don’t remember the dose on the euthyrox, is it still in your record?…can you please let me know doc?…

    thank you!

  33. Doc Gerry Says:

    Hi Becky… just missed answering you on your question. Its 100 ug once daily of levothyroxine.

  34. rebecca Says:

    thank you doc…i asked a friend of mine who is a nurse, she said that i have to do some kind of test before the doctor can prescribe the medication…is that true?…

  35. Doc Gerry Says:

    Hi Bec… if you are treated as a case of hypothyroidism, then you need to check your TSH FT4 to determine how much dose you need. But I doubt if the med was given for hypothyroidism since you never had symptoms of hypo since you discontinued the drug. Rather the drug most likely was given to suppress the growth of the nodule… then if this is the case, you can start the meds right away. BUT in the US you need to be seen by an MD before you are given an Rx. Hope this will give you peace of mind. Better still… seek a medical advise there


  36. i had a total thyroidectomy 3 weeks ago and my calcium gland was damaged.i spent 7 days in hospital with a terrible pins and needles in hands arms legs face and nose.i am now told i will have to stay on calcium meds for life as well as thyroxine.i just want to know if the dose of thyroxine is right for me im on 100mcg a day.i weigh 9 stone.i dont want to gain weight if i can help it.I still have an appetite so i think the dose is right but started feeling a little tired

  37. Leila Says:

    Hi Doc Gerry! We totally forgot to ask you important things when we visited you last May 8. You prescribed Evista to my mother before her surgery. Should she still continue taking it now that she had total thyriodectomy? How about Diovan? She already consumed all 30 tablets of Diovan as prescribed. Do we have to buy some more? My mother’s name is Florencia Remo, 59 years old. I hope you don’t mind that I am asking you this here. Thank you and see you on July 8. Thanks!

  38. Nilda A. Gallison Says:

    Hi Doc Gerry, I was diagnosed with a hyperthyroidism in the U. S. and my specialist and I decided to kill my thyroid with Radioactive Iodine in 2004, now I’m hypothyroid currently taking Synthroid 88mcg.

    I’m here in Bogo, Cebu Philippines, living here permanently.
    Doc, I need a endocrinilogist here in Cebu area to check my TSH level and my medication. I hope you can help me.

    Thank You!

  39. Doc Gerry Says:

    Yes you do. Thyroid hormone replacement will change overtime. Your dose may increase with age so yearly TSH FT4 tests are recommended.

  40. Doc Gerry Says:

    This answer is for Dennise… Please make sure you dont have permanent hypoparathyroidism which will not only require calcium but active vitamin D as well. This is one postop complication that we should avoid if possible. This is where the skill of a surgeon counts. But complications like this happen that’s why you need to know the history of the surgeon doing it on you. Just make sure you are on the right dose of your thyroid hormone replacement so as not to gain weight. But dont blame the thyroid all the time if you gain weight especailly if your TSH level is normal.

    To Leila…dont change or stop any meds until I see you both on July 8

  41. Alan Macatangay Says:

    Good Day Doc Gerry!

    I am taking lescol xl, blopress and piozone as you prescribed tome. at the same time am also taking glucovance 2.5 mg. I just want to ask if I can change my glucovance to Metformin hydrochloride ( neoform 500 mg) since I have a lot of these from my in-laws.
    Thank you very much…

  42. Leila Says:

    Hi Doc Gerry! Do you know of any research study saying that frequent drinking of boiled water (as drinking water in replacement of mineral water) is not good to our health?

  43. Doc Gerry Says:

    Hi Alan… Neoform is different from glucovance so if you are doing well on glucovance please dont change it to neoform okay?

    Leila… nope… havent heard of ill effects on boiling water.

  44. Lin Says:

    Dear Doctor Gerry,

    I was told that I have multinodular goiter but that at this point there is nothing to worry about. However, I was also told by my doctor that I should get a scan evey 6 months to monitor the size of the nodules. Can you please tell me, is it ok for someone with multinodular goiter to get pregnant and have children?

  45. Doc Gerry Says:

    The scan may be done to monitor the activity rather than the size of the goiter. There is a risk of a multinodular goiter becoming toxic or hyperactive overtime. Definitely no contraindication to get pregnant and have children

  46. Lin Says:

    Thank you.

  47. lusel sepra Says:

    dear doc.
    So sorry if i have to ask you here but i called your ofc. this morning and no one answer me i would just like to ask if can i meet you tomorrow for my fathers check up cause we got his x-ray yesterday and dr.barba said they have a findings of tubercolocis.. what shall we do? thanks

  48. Joseph Nazareno Says:

    hi Dr Tan,

    Thank you for your very informative articles. Some alarm bells went off after I’ve read your info on diabetes. Do you have a clinic in Metro Manila? If not, I would like to request for referrals to physicians who are specializing on diabetes. preferably in the Quezon City area. Thanks again.

    Joseph

  49. Doc Gerry Says:

    Sorry guys, just cam from Canada to attend the Endocrine Soceity eeting. Just came back yesterday.

    To Lusel… please call my office anytime now since am back to work.

    To Joseph… unfortunately I am only stationed here in Cebu. I have lots of friend in Manila but it’s up to you to make sure they fit your needs because I was not trained here in the Philippines Please go to St Lukes Medical Center and look for Ray Rosales and tell him I refered you to him. If you have a chance to drop by Cebu I will be glad to accomodate you.

  50. Jill Says:

    Hi Doc,

    I bumped into your website when i was searching for thyroidectomy experts here in cebu. My doctor is PVL of cebu docs. his initial diagnosis is toxic goiter and my tsh level is less than normal but my t3 is very high. im taking tapazole for this and im supposed to have my 2nd thyroid panel this friday. yesterday, i felt that my lump is bigger and im really worried. i think i would like to have my throids taken out. but im scared of the lifelong effects of this. can you please be kind enough to give me your thoughts on this doc?
    im planning to call for an appointment but im hoping to catch you with your early morning clinic hours.

  51. marianne Says:

    doc, can metformin help lose weight?

  52. Doc Gerry Says:

    Hi Jill… depends on what kind of toxic goiter you have. Your test results suggest toxic but there are different kinds based on the physical examination of the goiter. They have different ways of treating meaning… Graves Dse may respond to medication or radioactive iodine but Plummers Dse will need surgery.

    To Marrianne… yes it can help but not much. The best it can do is for a diabetic to have a neutral effect on weight meaning your blood sugar gets controlled without havng to gain weight.

  53. Jill Says:

    Hi doc, thank you so much for the reply. I didn’t know that there are different kinds of toxic goiter. i read about graves disease and it seems scary. is there any food that i should avoid to minimize the tendency of my lump getting bigger? do i have to have a specific diet doc? what tests should i have doc to determine what type of toxic goiter i have? thanks doc and looking forward to reading your reply.

  54. Doc Gerry Says:

    Again physical exemination is paramount to determine the diagnosis.. Better see a specialist nearest you because treatment of toxic goiter requires a thorough evaluation and tests.

  55. Jill Says:

    Hi Doc, thanks for the advise. Im based in Cebu so I’ll call your office to set an appointment with you. Hope you can accommodate me. Ill also bring my ultrasound and thyroid panel results, right doc? Thank you for your inputs doc. So sorry I asked a lot of questions…it’s just that all i know is that my family has a history of diabetes and heart problems but not goiter. Hope to see you soon doc for a consult. Thanks again

  56. ricky Says:

    Hi doc, my wife unknowingly bought 20 tablets of codiovan instead of the usual diovan that i take daily for my hypertension. Can i take it temporarily until it rans out? We are unable to return it back cause the reciept is missing. Thanks.

  57. Doc Gerry Says:

    Yes it’s okay

  58. kristine dawn sanchez Says:

    good day doctor, am dawn, 21 years old and was diagnosed to have pcos. the doctor required me to drink metformin for few months but was never satisfied for the result. can you tell me any other more effective drug that i can use to treat my pcos? i really wanted to be pregnant now, am already married for 1 year and really wanted to have a baby…hopefully before these year ends…hoping that you could help me with my problem :)
    thanks and God Bless doctor.

  59. Doc Gerry Says:

    Ask your doctor about trying PPAR drugs like avandia and Pioglitazone. I find it a better option to improve insulin sensitivity for patients with PCOS

  60. Claire Says:

    Hi doctor, I am so glad I got the opportunity to know this website of yours. It’s so informative… I love it. I have learned a lot even though this is my first time to open this website. I was amazed because earlier today me and my colleagues were talking about lack of sleep, over-eating and not doing any exercise. You see, I always sleep late even though there are no works oe deadlines to be done, I just can’t sleep early. And most of the time, I only have 5-6 hours of sleep. At least now I know, there’s still a way to counter the effects of chronic sleep loss.

  61. Claire Says:

    Hi doctor, it’s me again. I made a comment on Too lilttle sleep… Just wanna tell you that your site is really inspiring… and encouraging. I am now convinced to do exercise, really. I have never tried doing any exercise like going to the gym or playing sports because I feel it’s so tiring. Even though my eent told me several times to exercise still i chose not to. I have light weight but I have experienced numbness sometimes, feelings I can’t explain. I have experienced coughing for years now, my eent said it’s because of my rhinosinusitis and still my cough persisted even though i have nasal spray. And lately, i have been so moody and so irritable. Now, i’m more convinced to do exercise… you are right doctor. BEAT THE STRESS, LET’S EXERCISE! I read your category Exercise and Activity Tips. Yes!!! exercise can improve mood and self-esteem and therefore… overall!!! thank you doctor for that encouraging article. God bless!

  62. Doc Gerry Says:

    Thnak you Claire for your inspiring comments

  63. donnabel Says:

    hi doc!i am diagnosed to have multinodular goiter.march this year,was the last time i went to your clinic.you prescribed me euthyrox 100mcg tab OD.I am still taking it up to now.Is it okey,If i will just continue taking euthyrox?Is there a need for me to go back to your clinic?with my busy schedule at work,it’s hard for me to adjust my time.thank you very much for your help.
    More power to you.

  64. Doc Gerry Says:

    A multinodular goiter has a chance to become big inspite of medication… to become toxic or hyperactive overtime and most of all… may eventually require surgery depending on your response to medications. And yes you need a follow up to determine which of the above possibilities your problem will proceed.

  65. Lesley Go-Uy Roa Says:

    hi doc, this is lesley uy. daughter of your patient roberto uy. my mom told me about your web site. i am currently diagnose with hyperthyroidism by my doctor here and possible to be grave’s disease. my TSH is very low (0.005)and my T3 is 12.41 and T4 is 3.19. i had my ultrasound and it was a little bit enlarge. my doctor advised me to have the Radioactive iodine reuptaking scan but i have problems with my insurance right now and i don’t know if its covered or not and i’ve heard that it can be pretty expensive. do i need to have that one done? my doctor told me that it would be best if i get treated with radioactive iodine. thank you doctor.


  66. dear doc gerry,
    i would like to ask you opinion, if i should undergo surgery immediately or if i could still postpone it next year and what complications should i have in case i dont undergo surgery as early as now. my right thyroid lobe measures 5.6 x 3.9 x2.9 while the left 3.8 x 1.9 x 1.7 cm.it exhibits enhomogenous parenchymal echotexture. right lobe is almost entirely occupied by echolucent focus with two small solid masses within measuring 1.3 cm and 0.8 cm respectivvely. tyhe margins of these solid mAsses are irregular with septae connecting to the wall of the cystic mass. left lobe shows a 1.0 x 0.6 cm isoechoic ovoid echolucent focus in its inferior pole, anteriorly. its wall is well defined. impression is ‘” CYSTIC MASS, RIGHT WITH TWO SMALL ISOECHOIC SOLID COMPONENTS, ISOECHOIC NODULE SOLID LEFT. my FNAB shows, no cancers cells found .
    please give me your comment on this since i was looking for a very good response on this since honestly i am afraid to undergo surgery for i may lost my voice or have complications after.
    thank you very much. and i am very much imprressed by the comments i read on ur articles.

  67. Doc Gerry Says:

    To Lesley… I advise radioactive iodine for my Graves Diseases patient especially if the thyroid gland is large meaning around 50-60 gms based on my estimate based on palpation. But smaller goiter may respond with antithyroid drugs especailly Asians and has the chance to undergo remission provided dose adjustments are done properly…this is the key. If dose adjustments are not done well, a recurrecne is expected. However if your hyperthyroid state is due to Plummers disease tor an autonomously functioning nodule, and the sizes are more than 3 cm, surgery is a better option than RAI. Meaning a proper examination and evaluation by your specialist is needed. Please take note that this is my opinion based on what you’ve written wthout me having the benefit to examine you.

    To Cecilia… I dont trust an ultrasound too much. As a sspecialist in endocrinology, I trust my palpation better because of the overinterpretation of the ultrasound findings by the readers. There are cases where an ultrasound s needed. Based on the readings, you haev a multinodular goiter. Again I need to palpate them to give you a decision. With regard to surgery…you shold not fear if your endocrinologist has a trusted surgeon. The skill of the surgeon is KEY to avoid complications. Lucky me, I have two trusted surgeons who have not given me headache meaning, we do TOTAL thyroidectomy to avoid recurrence but zip complications of hoarseness or loss of voice!


  68. dear doc gerry,

    thank you very much for your quick response and i am very amazed that your really took time to answer my questions. are you available if i will see you in your clinic next week before the end of august or first week of september because i am a resident of davao city. again my heartfelt thanks.

  69. Doc Gerry Says:

    Hi Cecil…yup am facing my computer the whole day because my patient files are in my computer. Since I have my internet connection 24 hours a day…I can have access to my website and emails anytime …thus I can answer you back anytime.

    Please call my office 032-4124803 or 032-2535460 for appointment with my secretary. You can always check my website because I update my sidelink: Clinic Schedule per month on my trips and times the office is close.

  70. Ronabec Says:

    Hi doc! What foods should i avoid if i have goiter?
    And foods should i consume..
    Tnx!

  71. Doc Gerry Says:

    Depends on what kind of goiter you have. There is no single prescription either of foods to avoid or drugs to take for all goiters. There are several kinds.

  72. Ronabec Says:

    Hi, doc! thank you for this website…I can well, feel free to ask you …I have this tyroid problem, my question is, can i still take gluthathione like methathione for instance? I heard it has some health benefits to our body like liver, but i prefer to ask this first to you..

    Thanks and God Bless to you.!

  73. Doc Gerry Says:

    Thnaks for visiting. For one, I dont believe and will never recommend glutathione to anyone for any reason. We just dont have enough data to support its claim and enough proofs to say it’s safe! So taking glutathione is taking at your own risk.

    Hope this will help you decide whether to take it or not.

  74. tanya Says:

    Hi doc gerry, new here…
    Lately my doctor asked me to have this test. TSH, FT3 and FT4…here’s the result:

    TSH – 0.2
    FT3 – 2.58
    FT4 – 1.76

    I have thisUltrasound report also:
    The right lobe of the tyroid gland measures 6.36×2.90×4.43 cm (LHW). While the left lobe measures 8.17×3.43×5.44 cm (LHW). Both lobes show heterogenous echotexture. the right lobe shows a 2.94 x 1.55 x 2.45cm complex predominantly solid nodule of the inferior pole. The left lobe shows 3.40 x 2.46 2.76cm hypoechoic nodule of the superior pole and a 2.72 x 1.67 x 2.54 cm complex nodule at the inferior pole. The isthmus mesures 2.86 cm.
    What should i do next doc/ My endoctrinologist now is out of the country..

    I’m so thankful i find a sute like this.

    Thank you also for sharing your knowledge to us.

    GOD BLESS!

    Tanya

  75. Doc Gerry Says:

    Tanya…I am not supposed to give any diagnosis or recommnedation on this site otherwise your endo will kill me. Likewise we need to see pts to clearly define your problem and History and physical exam are very important measures to do before we reach a diagnosis.

    Suffice it to say, your thyroid gland is showing signs of hyperactivity and your endo may require you to do a thyroid scan. If you happen to visit Cebu I;ll be glad to help you.

  76. tanya Says:

    Thank you so much doc, for the reply..
    But i’ll try to see you on dec.,Im here in manila right now.
    I’ve read some articles from internet doc, about hyperactivity, does my thyroid produces more iodine? do i still need to eat those seafoods?
    And about my physical, i do gain wieght but i can control it, and my eyes is normal.

    Hope this info doc will help to answer some of my many question.

    Thank u again,
    God Bless You and Your Family.

  77. tanya Says:

    And doc to add this up.
    My sister also have this thyroid problem. And lucky to her she already undergone TT w/ no changes in her voice.

    Tanx!

  78. Lou Anne Says:

    good day doc gerry! im using insulin for more than a year.my first insulin was humulin n and humulin r my weight increase a lot,that time im still studying and it is inconvinient for me to combine those drugs especially when i have classes at night that’s why my doctor recommend novomix,because it is easy to use, since i used novomix i began to lose weight until i got thinner and thinner.doc does changing the brand of insulin affect me?
    Thank you very much!

  79. francis Says:

    hi dr gerry,
    my wife is already 33 years old and has goiter.her goiter, diabetes, and high blood pressure appeared after giving birth to our child.its been a year and six months already.she is on a maintenance. 3 tabs of ptu and and neoblack but still the inflammation on her neck doesn’t subside even a little bit.please doc can u help me what to do?

    francis

  80. Wena Says:

    Hi Doc Gerry!

    My father is a diabetic person. This morning he had a cut in his toe (big toe) it bled so badly that we brought him to the hospital, he was given anti tetanus and anti biotic injections, my question is, is it necessary for him to have an appointment with his diabetes doctor? or the medical treatment given would suffice? Thanks a lot Doc.

  81. Merlinda( Macazarte)Harlin Says:

    Dear Doc.Tan,
    Hi…Good Greetings to you.

    IM your former patient.Ive been in your clinic last August 2007 and I forgot to mentioned some things during check up.
    My whole thyroid is removed already so I am taking a hormone replacement everyday.As to the result showed from the lab.my TSH is high that means my hormone is so low .What if there are instances that my hormone level is low would I feel fatigue?or what are the symptoms if my hormone is not enough?would it affect my metabolism? and weight too?

    I exercise 45min.-1 hr daily or sometimes I missed once in a week since I like exercise since I was a teenager will it affect the demand of hormone intake? I hear some slight popping sounds not painful but just a sound once I do some procedures of stretching and bending is it normal? IM just kind a curious if my calcium level is fine.Though I dont feel any signs of lack of calcium.Plus I am so careful and watchful of daily needs of nutrients and the particular foods.

    Thank you so much.I will appreciate your attention with this matter.

    Merlinda

  82. Doc Gerry Says:

    Hello… I was not able to answer your questions because I really had no time accessing the internet while in San Antonio for the Postgraduate course in Endocrinology. I am answering all your queries while here in the Northwest Lounge in Detroit as of the moment. Rest assured that when I am home, I will be giving an up to dat replies to all queries.

    To Lou Annee… chnaging one kind of insulin to the other will not make you lose weight! If you are not doing anything different to make you lose weight then make sure you call your doctor because you may be taking too little insulin for the amount of sugar you have in the body. I agree with shifting to Novomix instead of your old regimen. Any diabetic who drastically loses weight without any dietary changes should be worked up and one should look for a reason for the weight loss.

    To Francis… If your wifes thyroid problem started after giving birth.. make sure it is not due to pregnancy which almost always will subside. However if she still has a goiter. then most likely she has a primary thyroid problem which is hyperactive since she is on PTU. If she is still maintaining on PTU of 3 tabs up to now ( 1 year afetrwards), then there is something wrong with the diagnosis or there is a problem with the treamtent regimen. She may have a state called Plummers Disease which tends to be resistant to antithyroid drugs.

    Its now boarding time…I dont want to miss my plane…I will attempt to answer the other querries when I get back home okay?

  83. Doc Gerry Says:

    To Wena… Just make sure his blood sgugar levels are okay wihtin the range that your diabetic doctor recommends to avoid no healing of the wound.

    To Merlinda… yes if ones TSH is high …it means you lack the thyroid hormone…either because you are taking them wrong that is with meals or you are taking it with other drugs that affect its absorption like calcium. If hypothyroid, you feel weak and fatigued and you tend to have a slow metabolic rate which may prevent you from losing weight.

  84. Lou Anne Says:

    THAnks DOC.. do u have any clinic here in manila or in cavite? if none, any doctor u can recommend?im planning to change my doctor thank u very much!!

  85. francis Says:

    Thanks doc…for the comment…but i want to make sure the safety and risk involve about her goiter. doc. gerry, I’m planning to go to Cebu this 3rd week of October or the 2nd week of November for her check up.we ask her aunt to go to your office the other day and today to have my wife on the list for that particular weeks. Is it true that it would take 3 month for reservation alone?can u help us…i dont like my wife to suffer more…

    francis

  86. Doc Gerry Says:

    Lou… what you can do is give me a list of endos close to where you work or live either in Cavite or Manila and Ill tell you who among them I can recommend to you okay?

    Francis… Please try calling my secreatry 2535460 Oct 16 for her to get a schdeule for Nov 16 onwards. My schedulfe from Nov 2 till 15 if alsready booked. We will start booking for Nov 16 to 20 on Oct 16. Okay. See you then… Bring all her labs!

  87. francis Says:

    thanks doc………….

  88. francis Says:

    doc is it ok if we go there as walk in patient on the 3rd week of october if your available because my is having a difficulty of swallowing her food and even her saliva.do u entertain walk in patient for that week doc?

    francis

  89. ivy joan Says:

    hi doc gerry
    i’m ivy from iligan. i will inquire if you have an out of town schedule on the third week of october? im planning to have a check up for that particular week…..hope to see you soon…
    ivy

  90. Wena Says:

    Thank you so much Doc Gerry. More power to you!

  91. Lou Anne Says:

    im from binkayan, kawit, cavite….
    my former doctors’clinic are located at manila and alabang…thank you very much doc..

  92. Lou Anne Says:

    manila medical and asian hospital to be specific..

  93. Doc Gerry Says:

    To Lou Anne: Asian Hospital: see Dr Joy Fontanilla

  94. Lou Anne Says:

    thank you very much doc

  95. Maria Victoria Galang Says:

    Dear Doc.

    I just had thyroidectomy with isthmusectomy last June 19, 2007. I am taking euthyrox 25 mcg. Was there any implication if I also take Glutathione? I heard Glutathione is one of the best antioxidants.

    Maraming salamat po and more power!

  96. Doc Gerry Says:

    that’s totally false advertising. Please dont take glutathione if you are taking any medications for your health. We dont advise our patients any supplements or medications that dont have extensive research studies to prove they work and to prove theyre safe. Dont trust what the salemen or stores or TV tell you!

  97. Maria Victoria Galang Says:

    Dear Doc. Gerry,

    I appreciate your immediate reply, Doc. Gerry. Thank you po.

  98. donnabel Says:

    Hi doc! I had a multinodular goiter,you prescribed me euthyrox 100mcg tab OD. I am two months pregnant. My question doc is,Is there a need for me to continue taking euthyrox,inspite of my pregnacy? Can it affect my baby?By the way doc,my TSH and FT4 results are normal which was taken last week. Thank you very much doc!!Your website is of great help.More power!!

  99. Doc Gerry Says:

    Lets monitor it if it grows while the pregnancy progresses BUT discontinue it now. Then call Ivy for an appointment once you enter the 2nd trimester.

  100. fady Says:

    Dear Doc Gerry,
    Good day to you..
    I was diagnosed as hyperthyroidism and I was operated on the left lobe last 2003.As of now I feel so unhealthy,I would always feel something uncomfortable like gastritis, painful arms and legs then mild palpitations and sometimes I would experience Highblood. Does these unhealthy feelings has to do with my thyroid?I weighed 195 lb,I tried to take XENICAL orlistat but it doesn’t work.can you please tell me doc. what will be the possible blood test i’m going to do.Thank you very much doc.hope to see you.More Power….

    fady

  101. fady Says:

    Dear Doc Gerry,
    Before i forget i am also taking cozarr 50 mg for my high blood maintenance… thanks again doc..
    fady

  102. leonardo m. sabijon Says:

    hello doc, good day. i’m one of your patient. my enquiry s ” is it ok f i take 20mg or 40mg lipitor instead of 40 mg vidastat as prescribe. however f the lipitor tablet are consume i’lll take again the vidastat. my cousin has given me 100 tablets of 40mg lipitor. i highly appreciate your concern for ur patients. thanks

  103. Doc Gerry Says:

    Lipitor and Vidastat belong to the same class. I uaually dont like pts shifting from one drug to another even if they are of the same class becuase efficacy differs. If you like to take the Lipitor…take the 40 then take only 1/2 tab daily. BUT once the stocks given by your relative is consumed…continue the lipitor and buy it locally

  104. miriam Says:

    my husband’s blood sugar is on the high normal. he also has fatty liver. is it safe for him to take metformin? i read somewhere metformin treats fatty liver, is that true? what can you suggest?

  105. Doc Gerry Says:

    The best medication so far based on studies for fatty liver is weight loss and physical activity. Dont rely heavily on drugs right away espeically if you’re telling me..it’s still high normal. If I have to start medications for a fatty liver.. I choose a Glitazone rather than metformin for that specific indication.
    Plus no alcohol!

  106. miriam Says:

    thanks doc for the advice.he doesn’t exercise much (maybe that was the cause of fatty liver. he doesn’t drink alcohol except a few beer when he parties out) he hates exercise because he says he tires more when he exercises. i think it’s his diastolic dysfunction acting up. his diastolic reading shoots up whenever he exercises. he was diagnosed to have a slight hypertrophy of the lower left chamber of the heart. he has a slight hypertension and he’s taking up micardis. it is now under control. however, his uric acid is also high. is that the side effects of the Micardis?

  107. isabel Says:

    I am one of your patient her in Cebu.I am taking a steroids drug as maintenance (euthyrox).Are there any side effects or complication when exposed to lead.God Bless and more power.

    Hope to hear you soon!
    Thanks

  108. Doc Gerry Says:

    Isabel… Euthyrox is not steroid…it is a thyroid hormone pill. It is taken either to suppress the nodule size or as replacement medication for pts with non functioning thyroid gland. It is very safe but we need to be careful when given to elderly because it can accelerate bone loss and cause palpitation.

  109. Ruth Says:

    Dear Dr. Gerry..

    Hi Dr. Gerry…Im Ruth from Cebu Phils. and presently in Abu Dhabi UAE, I hoping that u can help me coz im confused right now..I have a irregular menstration and i go to OB Gyne regularly when im still in Phils and i used to take a tablet named Neoform 500g (Metformin HCI) it helps me a lot unfortunately i dont have it anymore and my menstration havent come yet been 2nd month now and im suffering some pain right now, i want to buy the tablet from here in Abu Dhabi when i inquire in some pharmacy here i dont have Neoform but instead they recommend me same Glucophage (Metformin HCI 500mg), they have the same generic name i just want to ask Dr. Gerry if this two tablet is the same since they have the same generic name. Please help me Dr. Gerry because it would take too much time for me to buy the medicine from my country. Please help me Dr. Gerry, i would appreciate your reply to me. Thank you very much.

  110. Doc Gerry Says:

    Yes Ruth… they’re exactly the same. Neoform is the brand of a local pharma while Glucphage is the brand name of a multinational company called Merck. Meaning you can take Glucophage instead of Neoform.

  111. angela Says:

    is neoform safe if u feel that ur pregnant?

  112. chinchin Says:

    Good day. Doc, is it okey to consumed egg white everyday? tnx.

  113. Doc Gerry Says:

    Chin…absolutely…go ahead and enjoy

  114. jill Says:

    Hi Doc,

    I’m one of your patients however I wasn’t able to go back to show you my lab results since I was forced to go home for a family emergency that dragged on for three months.

    I am planning to schedule another appointment with you soon as I get back to Cebu. However, my primary concern is that the lump on my throat (goiter) has grown significantly bigger over the past two months. It has now occupied the right side of my throat and is inching rapidly to the left side.

    I am really concerned Doc. Is there some medications I can take to hinder the growth? Is there a way for us to remove the lump without causing too much damage to my body?

    Doc, I would appreciate your advise soon as I am really concerned and terribly worried.

  115. Joan Says:

    Hi doc,

    Thank you for this site. I was operated last Nov. 2007 total thyroidectomy. And take my THS last feb 21, 2008. My lab test says about 12 something and the normal level is 0.2-40. Im taking Tyrax now 50mcg 3x a day… Is that ok? well w/ my endo advise of course. But just want to make sure. Im gaining weight right now. Pls help me.

    More Power!
    joan

  116. Doc Gerry Says:

    To Jill and Joan… Please set an appointment or see your doctors because I dont actually do consults in this website. Gaining weight can be due to a lot of factors other than the thyroid.

  117. Angela Moorehead Says:

    Hi, Doc I would like to know if I can drink a beer while taking synthroid after having a total thyrodectomy due to cancer

  118. gastroboy Says:

    Good day doctor!

    I know a patient who is asymptomatic 50 yo female who incidentally found out on chest xray to have minimal PTB with undetermined activity. AFB sputum smear for 3 consecutive mornings were negative. My question is how will u treat this patient? Will you start her on Anti-TB drugs (INH, RIF, PZA) or just give her INH and pyridoxine or no treatment at all? and for how long is the treament?

    Thank you and more power to you.

  119. Doc Gerry Says:

    Angela… you can drink beer but the most 2 bottles only and not more.

    Gastroboy… A lung specialist should review the CXR and hostory. Treating a pt based on the reading of an Xray is tantamount to giving the radiolgist the go signal to diagnose the case. Have the Xrays reviewed by the pulmonoligst. The more likelihood…no treatment will be given.

  120. flordelina l.cabahug Says:

    good day doc
    i’m glad i find your web. Today my 8 yr old daughter was hospitalized due to flu .Last june to august she took thyrax 50mg 1/2 tab given by doc uy . She stoped taking since august because her doctors don’t agree with dr uy prescription even if i showed all the thyroid panel ,scan result. My daughter was always confined. She’s taking anticonvulsants. I could not convinced my doctors that my daughter have slight seizures because of her thyroid problem. She,s a normal child by birth. She got sick when she was 5. She stopped schooling this year hoping she could recover. When she was taking thyrax before , she was very active. I could not afford to bring her back to Dr. Uy because of financial reasons .She,s been in and out of the hospital. Thanks for this space .I’m sure your answer could inspire me to do what right.Is there a pedia-endoc in cagayan de oro .

  121. Doc Gerry Says:

    I cant answer you Flor…your info is lacking. You may check with Dr Nonin Sison or Allan Chang- both adult enodcrinologists there in Cagayan.

  122. Chris Tan Says:

    Hi Doc,

    How are you? I’m writing to inquire about the condition of my girlfriend Anna Melissa Gandionco’s hyperthyroidism…from what I reacall, she was scheduled for surgery last January but it didn’t push through. I was hoping that you could please give me an update as to how she is. Thanks and hoping to hear from you soon.

  123. Doc Gerry Says:

    Hi Chris…no news of her yet.

  124. Chris Tan Says:

    Thanks Doc. Last I heard is that she hasn’t been taking her medicine and she hasn’t been feeling well..I know she gets like that when she’s sad, depressed or upset. I assume she’s not happy with where she is and what her parents are doing to her. Thanks again Doc..please let me know if you hear anything.

  125. michael kiser Says:

    Hello, I so hope you can shed some light on my current condition. about five years ago, my lover and I became Ill after staying in a hotel, not sure if we caught anythint there or if it was perhaps the restarant that we both ate at. anyhow we had sore throats feaver, and just felt awful. after getting back home, he got a shot of pennicillian and got better. I am allergic so I was given a weeks worth of antibiotics, (I dont remember what the first one’s were) I took them for seven days, didnt feel anybetter at all. feverish, extreamly tired, loss of appetite. went to another doctor, they kept me there for five hours running blood tests to no avail, the one thing they did say was that I didnt have strep, which is what the first diagnosis was. I ended up getting two weeks worth of doxycycline and after about three days taking it I felt completly better. I continued the script until it was finished. THEN a few days after finishing the doxycycline, I was struck with pain under my left rib, pain in the middle of my back between my shoulderblades, and a stiff painful neck and shoulders that I had never felt before in my life. all this coupled with an inability to eat ANYTHING without it causing the pain between my shoulders blades and neck to become WORSE.
    I ended up not being able to eat hardly anything but dry rice cakes, and drink water, anything else would come back up. or cause the bad bad back pain, and kill my stomach. I felt very fatigued.
    Prior to all this I had began to get sweaty for no reason out of the blue, this was during the day and was quite embarrasing as I wouldtn have to do anything to cause it.
    During this time I was on testosterone injections every three weeks. taking a min amount of loritab 7.5 mg, about one a day due to a curviture in my spine. and also taking adderall 10 mg twice daily. I also smoked a pack a day ( ive since quit).
    Its been five years since this began, before my initial illness I was in perfect health, I was exercizing five days a week, eating only healthy foods, fish, chicken ect. (smoking was my only vice) the only thing during that time, about a year into my becomming Ill, that they found was that i had H Pylor, they gave me tetracycline triple therapy, pepto ect. to cure it, the drug made my stomach hurt something awful, and I told them this but was told to continue the treetment.
    that was about four years ago, I have had chronic gastritis and horrible acid reflux after finishing the therapy for H Pylor. NOTHING has worked for the reflux, Ive tried a complete life style change and stuck with it. quit smoking years ago. taken every pill on the market for it. I ended up having Nissan surgery for reflux, and even it did not help very much.
    I now have to eat ever two hours or so or my mouth will become very dry and I will feel weak. I still cannot eat ANY thing fried at all, even olive oil will cause me stomach distress. Ive eaten brown rice green beans, and salmon twice daily for over two years. that and a little bran cereal with rice milk for breakfast is about it. I am now lactose intollerent, and hyper acidic, even a half teaspoon of honey will cause me horrible reflux for 24 hours.
    My stomach stays swollen after I eat, it swells to what feels like its going to burst, and I have horrible gas.
    I started taking a pancrease enzyme suppliment and it maby helps just a tad bit after meals, but only just a tad. Ive tried every thing under the sun to help ease my stomach pain. Ive had gastritis now for five years, the doctor says its chronic and probably wont ever go away. I dont understand this, your stomach lineing should replenish and heal itself every 24 hours provided you arnt doing anything to damage it?
    I no longer have the pain between the shoulder blades, but just the swollen painful stomach after i eat, and the bloating becomes worse if i bend over. My weight goes up and down ten to 15 lbs, although my diet stays the same. Ive added bananas to help with gastritis and like everything else, they only help a little bit. Ive also tried drinking aloe gel which again helps only a little. and I drink Only water.
    sorry to write such a long email, Its just hard to leave out anyting and make you understand what ive been thru and still go thru.
    Ive got an extra thyroid gland in my neck under my chin, although my doctor has ran tests and says that my thyroid hormones are within range. I stay tired all the time, I still take the adderall but abut half what I used to take, and always with food. My pain medication I take ocasionally now.
    I have low blood sugar, hypoglycemia i am told. and a slightly high white blood cell count. Ive been tested for all std’s and are neg. I have a slava (submandular gland) under my right jaw that stays hard, it does not hurt and about a month ago it swelled up real big when I got a bad bad cold, I had to get antibiotics to make it go down.
    Ive had the gallbladder tests, the hydascan I believe its called. it came out normal.
    any thought you might have on this medly of symptoms i would greatly appreciate. its hard to explain all this to a doctor in a ten min office visit, and i always leave feeling disapointed.
    Ive recently sort of given up and dont bother persuing any other opinions. Im so hopeing you might be able to help me. YOu can email me at michaelreace@hotmail.com if you would like.
    thanks so much.

    Michael

  126. michael kiser Says:

    one quick thing, I forgot to mention I stay extreamly thirsty all the time drink about twelve glasses of water a day. wake up in the night sometimes to drink water.

  127. Doc Gerry Says:

    Michael…sorry for this late reply. I really dont know how to say this but…as I have mentioned in my website, I dont use this site to get consult and to give my inputs ona diagnosis because I am deprived of one important part of giving a diagnosis and that is Physical examination.

  128. joan Says:

    hi doc!
    its me again… want to ask some things that bothered me since i was TT….can i still be pregnant and normal again?

    Thank you!

  129. Doc Gerry Says:

    YEs and YES! Just make sure you have been taking your thyroid hormone replacement properly and your TSH FT4 are norm,al. Make sure you see me once you get pregnant for further instructions and dont ever stop the replacement meds even once you’re pregnant okAY?

    jUST ARRIVED FROM mALLORCA sPAIN AND AM ANSWERING you here in the lounge. Sorry for the delay.

  130. Jeremy Says:

    Hi Doc!

    I am wondering if you can recommend for me a good endocrinologist in the Chicago, USA area.

    Here is a little background. You may not remember me but I was your patient in Cebu in Aug 2006. I am an american, born in Indiana. I collapsed while visiting Cebu due to critically low sodium levels. I have Diabetes Insipidus. I was so lucky to have you as my doctor!

    I spent most of my life going to doctors who didn’t understand my condition. I believe it started as a child at age 2 as a result of a procedure to remove bone from the back of my skull. I wasn’t diagnosed until I was 9, even though my parents had taken me to countless doctors, most of which thought I had a psychological problem…not a medical problem. But since that diagnosis (from a good doctor who has since retired) I have had a hard time finding a doctor in the US that I can trust to actually consider my overall health. You were the first doctor I have had that actually gave me the advice I needed about regulating my medication. You taught me about my sodium levels and recommended that I be tested every so often. I am so thankful for your help!

    Lately, I have been getting headaches starting from the back of my head, near where I had one piece of the tumors removed as a baby. Sometimes, I think my headaches are due to having too much DDAVP, and as you suggested, I always try to stop taking it for at least one day a week to let it get out of my system, and to make sure my sodium level gets up. This seems to help most of the time, but sometimes it doesn’t. Often it feels more like a migraine.

    So I guess I would like to know, what doctors / specialists you would recommend for me to see, and also what tests do you think I should have done. Other than my head and my DI, I believe that I am in very good health overall.

    Your advice has been priceless to me, and I am healthier now. Your blog is fantastic as well, and I have shared your posts with my entire family.

    – Thanks you!

    Jeremy
    Chicago USA

  131. Doc Gerry Says:

    Hi Jeremy…Yap I remember you well,,,You just had too much fun in the sun and beach in Cebu…am sure you missed all those fun stuff except the day you got admitted,

    Anytime you also get too high a concentration of sodium due to too little water or dehyration, you will also get headache. So make sure first that your headaches are not related to a high sodium rather than a low sodium level.

    Ill try to check my alumni website of the Mayo Clinic. We were trained so well by our gurus there especailly Dr William Young jr that all graduates of the Mayo system are experts in this area. So will email you once I have checked on it.

    Ill be leaving for Orlando tomorrow to attend our AACE convention. We will have our usual alumni meeting and will check.

    Take good care of your health!

  132. Jeremy Says:

    Thank you. Good advice about dehydration causing headache too! I need to find a way to keep things balanced. It’s not easy, as taking the same dose doesn’t always seem to have the same effect on me.

    I will definitely look for your email referral. BTW, two other things I have going on that may or may not be related are high-cholesterol (seems to be hereditary because I eat well) and lately, I have been more tired…feeling groggy and a wanting to sleep longer than usual. I read another article of yours saying that perhaps it would be worth it for me to get my thyroid checked. An endocrinologist should also be the one to check this correct?

    Have fun in Orlando!

    Thanks,

    Jeremy

  133. Bella Says:

    Hi doc Jerry!

    I would like to know if what are the right and best food(s) to give for the loose bowel movement (lbm) patients especially kids 3-6 years of age?

    Thank You po.

  134. Doc Gerry Says:

    Jeremy…so far, no endocrinologist trained at Mayo is practicing in Chicago.

    Yes, also an endocrinoloigst should check your thyroid status.

  135. Doc Gerry Says:

    Bella… better have your kid checked by a pediatric gastroenterologist because LBM shold nto be normal for a 6 yo kid.

  136. Angeli Says:

    hi doc gerry! im angeli from iligan city and would want to have an appointment with you regarding a right thyroid cyst found in my ultrasound. i didnt see your contact numbers posted in this site or i may just have missed it. to whom can i book an appointment w/u? can i go to your office as a walk-in patient? i really want to have this checked asap because it bothering me. hope to hear from you.

    thank you!

  137. Doc Gerry Says:

    Hi Angeli…its 412 4803 or 2535460. Ch3ck the schedule on About…The Medical Clinic Schedule…

  138. Jeremy D Says:

    Hi Doc,

    I am sorry, I was supposed to email you about my visit last week, but I don’t seem to have your email address. Can you please contact me via email if you get a chance to look at my results?

    Thanks,

    Jeremy

  139. Kylee Says:

    hello doc gerry,

    i have been diagnosed with UTI last year and now just recently i have been feeling the same thing again. I am now taking INOFLOX and i am constantly in pain in the bladder area. what can i do with this problem and what diet should i follow? is it true for acid ash diet? what food should be a yes and a no no for UTI

  140. Anthony M. Clark Says:

    Hi again Doc,
    Been to a local family doc here to discuss the lab results from the tests you ordered and he advised not to worry about the low HDL level and slightly elevated Eosinophil (0.14). He is repeating some of the tests next week to see how they are from a Swedish lab and if the A1c is heading down. This week is a bit too soon. Do you want me to email you a copy of the lab test results from HP? Would you be able to recommend an Endocrinologist in Stockholm Sweden by any chance? Thanks again for you help and will be back to Cebu around this time next year for a check up, a wonderful excuse and keeps the wife happy.

  141. Doc Gerry Says:

    Hi Anthony… why dont you just write to me in this website once you have the repeated results there in Sweden and include your HP results as well. I will have to llok for some Mayo alumin who may be wroking already there in Stockholm…Best regards.

  142. Marites Says:

    Good day, doc!
    My husband’s mother is a stage 2 diabetic and his father died of pancreatic cancer. What medical examination would you recommend for him to take before we see you? My husband is 47 years old now. Best regards.

  143. Marites Says:

    btw, doc, i forgot to add, my husband seems to be healthy now but i’m a believer of the saying “an ounce of prevention is better than a pound of cure”.

  144. Doc Gerry Says:

    Yes…you’re right. I am happy you have that philosophy. Executive panel C or Diabetes Panel to be done at Cebu Docotr’s Hosptial and well see what else we can do from there.

  145. marites Says:

    thanks a lot for the reply, doc. We’ll take those examination before we visit you. But would it be ok if we take the examination in Hi-precision instead of Cebu Doc?

  146. marites Says:

    Doc,
    btw, how many hours fasting needed for this test?

  147. Doc Gerry Says:

    12 hours fasting. Yes it would be A OK to have it done at Hi Precision

  148. Anthony C Says:

    Hi again Doc, here are the results you suggested I posted here. they only performed a subset of your tests as most were normal anyway.
    HP June 22 Sweden
    Lab July 21 Units
    Fasting BS 13.21 12.1 mmol/L (Note 1)
    HbA1c 8.4 6.8 (4.0 – 5.3%) (7.5% Nov 2007)
    Creatinine 73.33 74 (<100) umol/L
    SGPT/ALT 35 U/L
    ALAT 0.5 (<1.2) ukat/L
    Cholesterol 3.04 3.9 (3.9 – 7.8) mmol/L
    Triglycerides 1.25 1.9 (0.4 – 2.6) mmol/L
    HDL 0.75 0.85 (0.8 – 2.1)mmol/L
    LDL 1.75 2.2 (2.0 – 5.3) mmol/L
    CHOR/HDL 4.10 4.6 Calculated for Swed.
    LDL/HDL 2.33 2.6 (<6.6) Calculated for Phil.
    MICRAL 30mg/L Note 2

    Notes
    1. Fasting period in Sweden is 10hrs verses 12 in Phils. I also reduced Gliclazide MR by 30mg the day before the test due to 2 hypos the previous week. My daily morning tests have ranged between 6.8mmol and 10mmol, postprandial 4.6mmol – 6.1 mmol the week prior to r
    educing the Gliclazide. Glucose level rose slightly immediately after the reduction in Gl
    iclazide but are now falling again.
    2. Sweden uses Alb/Crea, which I didn’t get checked yet. My last test was August 2007 wh
    ich was normal. Will have it tested this week.
    3. The local doctor is refering me to the Endo clinic at St Gorans Hospital. My meds are
    too unknown to him :)
    4. Current daily meds are now:
    a. Metformin 3 x850mg
    b. Gliclazide 60mg MR
    c. Vildagliptin 50mg
    d. Rosuvastatin 10mg.
    f. Ramipril 10mg.

    I strongly advise people to eat sensibiliy and avoid the joys on NIDD.

  149. lauie Says:

    I already posted this on another page of your website but realized that this is the right page to ask quesions.
    I found this website about a week before I forced my mom to go to cebu for a thyroid check-up. I gave her your contact number and told her to go to Cebu Doctors Hosp. Unfortunately you were out the day she went there with my dad so they went to Chong Hua instead. The endocrinologist who examined her diagnosed her of a hyperthyroid disease (which is what I expected because my mom has been continually losing a lot of weight) and the lab result according to the endocrinologist says that her FT4 level is 70.5 and that the normal should be 22. My mom doesn’t have a lump on her neck and her eyes aren’t bulging either. But anyways she was prescribed of Tapdin and Inderal under a 2-year medication. My question is, is it necessary that my mom takes the Inderal? I’m just worried there might be some danger of taking mixed medications. Thanks for taking time to read and your reply on this would be very appreciated.

  150. Doc Gerry Says:

    Hi Lauie.. sorry to have missed your mom.

    Treating thyroid disorders is not one easy task. You can have normal functioning thyroid with a goiter or a hyperfunctioning or toxic porblem but a non palpable goiter or a big multinodular goiter or a single nodule. It is very important to differentiate what kind of toxic goitr you have to be able to determine if she will respond to medications long term or will require radioactive iodine or surgery.

    For me it would be unfair to a pt to expect a remission or cure after 2 years or more on therapy and to be told later that she requires surgery.

    Inderal is safe to be given with Tapdin. The way one tapers the dose of Tapdin will deteremine the success of the medication.

  151. Lauie Says:

    Thank you very much dr. gerry for the reply. I have one more question though. So my mom was prescribed with Tapdin. I’m just curious whats the difference between Tapdin and Tapazole. I’ve read from different articles on thyroid diseases that hyperthyroidism is treated with either Methimazole or PTU and that the Methimazole’s brand name Tapazole is the one that’s widely used. I didn’t even read anything about Tapdin until my mom said that it was the one prescribed to her and I did some research on it and found out that its also a brand name of Methimazole. I hope I don’t sound like I’m questioning the ability or knowledge of the endocrinologist who examined my mom because I’m not. Like what I said, I just want to know the difference between these 2 Methimazole brand names, like are they prescribed depending on the level of the disease’s severity? For instance, if hyperthyrodism is more severe, one of them would be the better prescription or if the case is mild, the other one is preferred? Or is it just the endocrinologist’s choice to prescribe either Tapdin or Tapazole? Thank you very much doc for taking time to read this. Have a great day!

  152. Doc Gerry Says:

    Same generic- doctor’s preference

  153. Lauie Says:

    Hello doc, im here again for another question. I appreciate your time for entertaining my previous questions. My mom’s white blood count dropped due to the anti-thyroid medication that she’s been taking so the endocrinologist who examined her reduced the dosage and advises her to get WBC after a week to see if her white blood will still continue to drop or not. Next week she’ll see a Hematologist and ask what she can take to get her white blood back to normal. Can my mom take a white blood cell booster medicine while she’s under anti-thyriod medication? Would it be safe for her?

  154. julieanne Says:

    Hi Dr. Gerry,

    I was recently diagnosed of hyperthyroid. I’m taking medicine which is Tapdin. Is this medicine can make me fat. What are the foods to be avoided when you have hyperthyroid?

    Thank you for your reply. More power!

  155. julieanne Says:

    BTW, these are the result of my thyroid panel:

    TSH 100.0 pmo/L 12.00 ~ 22.00

    Thyroid Ultrasound interpretation:
    Both lobes of the thyroid exhibits coarse, hypoechoic echopattern an appears hypervascular on color flow. The left lobe of the thyroid measures 5.0cmx1.6cmx2.2cm. The right lobe measures 5.4cmx1.8cmx2.4cm. The isthmus is not enlarged and measures 3.9mm. No focal mass noted within. No evidence of cystic nor complex nodules seen on both lateral neck areas.

    Conclusion: Bilateral coarse and hypoechoic thyroid lobes, consistent with hyperthyroid disease.

    Thanks a lot for your time reading this.

  156. julieanne Says:

    FT4 result: >100 pmol/L 12.00 ~ 22.00

  157. Maronielangelo Says:

    Dear Doc Gerry,
    Greetings!
    Please help me because I am getting confused. Some say that fasting before an FBS extraction only include food and liquids other than water. Some say that fasting means all food and all liquids including water are not allowed. May I know which is right? Moreover, am I allowed to take my maintenance medicines during the fasting period? If yes, would it not affect the results?

    Thank you very much and I hope you can help me doctor.

    Best regards:-).

  158. Doc Gerry Says:

    To Lauie… yes antithyroid drugs have one very rare side effect of bringin down your WBC to a very low level. Howevere the effect called agranulocytosis cant exactly be predicted by clinical parameters of constsnt follow up. So we always intruct pts to reporst to us and get a CBC immediately with episodes pf fever or sore throat. Yes there is a way for one to increase wbc and the hematologist can explain that to you.

    To Julinne… Tapdin is a good drug. All it does is correct your hypercatabolic state during the time you are toxic. So if you are used to eating too much without gaining weight since you were “toxic”..with meds, all it does is correct the toxicity…so what makes you gain weight? It is your eating habit which has not changed. Now with overeating, you gain weight. Whereas before since you were sick of toxicity frpm a hyperactive thyroid, even of you overeat, you dont gain weight. In short, dont blame the drug.

    To Maronie…I allw water fr my pts that go on fasting. Water should not affect the results. Cont the maintensance drugs as well or might as well take them immediately after the blood extraction

  159. julieanne Says:

    thank you for the reply Dr. Gerry. I smiled when you said, don’t blame the drug.

    they said and I researched in the internet that hyperthyroid is too much exposure of iodine. So it means, I’m not allowed to eat seafoods anymore?

    Thank you again for giving time reading this. Good speed!

  160. Doc Gerry Says:

    You’re right.. Avoid lato, guso clams, shelss which are rich in iodine especially duirng the toxic stage.

  161. Helen of Cagayan de Oro City Says:

    Dear Doc,

    Greetings! After i got diagnosed of a toxic goiter a month ago, i did not stop surfing the internet regarding my disease. And im so happy that i was able to visit this site that entertains querries about our sicknes. I have my t3 and t4 and tsh checked last Sept 30 and the result is normal t3 and t4 but only .01mIU/ml of tsh. My tsh does not change from my first laboratory test a month ago after taking strumazole 30mg, but my t3 and t4 goes normal. Doc i would like to ask if i have a very big chance of getting rid of this hyperthyroidism. Presently i am taking strumazole 30mg for 15 days but will be reduced to 15mg after 15 days for a period of 1 month and after it i have another t3t4tsh check up again. Doc i would like to ask what are the food (fruits/veggies) to eat in order to increase my battle against toxic goiter? Also, what are the vitamins i have to take? i am presently taking vit e, c and calcium. IS it OK? I would also like to ask if i can take glutathione capsules as these are known antioxidants. Does taking glutathione can help me recover from Toxic Goiter rapidly?

    thank you very much doc and hope to hear from you.
    God bless you doc.

  162. Maronielangelo Says:

    Dear Doc Gerry,

    Thank you very much for responding to my email. It’s so nice of you to give attention to my inquiry.

    I heard a lot of good things about you. Wish I live in Cebu but I live in Pampanga.

    Hope I can meet an endocrinologist here who is as kind as you.

    Best regards:-). God bless.

  163. Maronielangelo Says:

    Dear Doc Gerry,

    May I again ask for your opinion. Which is a better test for the success of total thyroidectomy connected with papillary carcinoma- a total body scan or the results of a serum thyroglobulin test? If the value for the serum thyroglobulin test (taken six months after the total thyroidectomy) is less than 0.20, would you still recommend a total body scan or the serum thyroglobulin test would suffice to declare a patient as already cancer free? How often would you recommend a serum thyroglobulin test or a total body scan?

    Thanks again, Doc Gerry and God bless you always :-).

  164. Doc Gerry Says:

    Hi Marobie… are you a physician practicing endocriology. Your questioning on thyroid cancer is intriguing. You know how controversial management of papillary cancer is, I do MACIS scoring on all pts to prognosticate their risk of mortality. If considered low risk I dont do RAI as therapy since no proof exists it can alter the low mortality rate. I do check thyroglobulin in 6 months on T4 suppression and I use a cutoff of 0.1 on the ultrasensitive assay. Meet me in one endocrine conventions and lets talk more in detail.

  165. Denise Says:

    Hi Dr. Tan,

    I have just been back to the country and wanted to find out if you happen to know of any top Endocrinologist in Metro Manila.

    I have a Thyroid condition and would prefer to go to the best in the area. I would have wanted to go to you, but unfortunately, you are not based in Manila.

    Any information you could extend would be deeply appreciated. Thank you.

    Denise

  166. Doc Gerry Says:

    Hi Denise… go to the website of the Philippine Society of Endocrinology and Metabolism (PSEM) for alist of endocrinologist in Manila.

  167. Lea Says:

    hi doc, i’m diagnosed with hyperthyroidsm. it’s been a month now that i’ve been taking PTU med. i was advised to take 12 tabs a day and have my blood tested again (TSH, T3 and T4) after a month. my doc said this is to monitor if i have improved with PTU. i just got my result today and TSH level is exactly the same as before (very low; <0.005); there’s no improvement. doc gave me another med, Neomercazole. and have to check TSH again after 2 months. he also gave me an option to go thru Radioactive Iodine treatment. my plan is to actually check the effect of Neomercazole first. if there is no improvement still, then i would think of RAI. is this ok? or is RAI a must in my case now? is a month of taking PTU significant to the expected effect? or is this normal? my first endocrinologist said there’s really no need for RAI since i am improving clinically, no fatigue and excessive sweating anymore, less tremors, gained 10 pounds in 2 weeks…my ultrasound shows a slight enlargement of thyroid but she said it’s not something to worry about. but my TSH level is still the same. what would you recommend at this stage?

  168. Doc Gerry Says:

    Lea… if you can pease see another endocrinologist for another opinion. I need to check your thyroid gland in person to tell you what I will do next. I dont want to give an opinion based on what is written.

  169. Lea Says:

    hi doc, thanks for the time. i actually had another blood test in another hospital to make sure of the results. and yes, checked with another endoc. T3 is within the normal range, T4 and TSH have improved. 4 days lang po gap from the previous result. i’m actually here manila. but i’m planning to go thru RAI, if it is needed, in Cebu since it’s nearer Cag de Oro (my hometown). my latest endoc also gave me the same option, she said it’s my choice if i wanted to go thru RAI. will continue with PTU as advised and have to test T3 and T4 again after a month (late Nov). my question really doc is, how will i know that RAI is a must or needed? i mean in what case and how worse? or does it really matter? i’ve been reading about RAI and it seems like it’s an OK procedure. at first i’m a bit hestitant because of the isolation needed. but reading its effect and its ‘faster’ way, i’m considering the idea. i just wanted to know if it’s really needed. anyway doc, i will try to go there Cebu this Nov, hope you don’t mind me waiting for you in Cebu Doc. :) Thanks so much and God Bless!

  170. Doc Gerry Says:

    This is for Helen of Cagayan…Unfortunately I missed your question and forgot to answer. My answer would be similar to Lea:

    Toxic goiter is a clinical disgnosis and I need to examine the neck properly to give you my opinion. I do recommend antithyroid durgs or if recurrence occurs or the the goiter is diffusely enlarged to more than 50 gms then I recommend RAI BUT if the pt is young and has toxic multinodular goiter or Plummers Dse then I recommend surgery. I will be glad to explain my options to both of you anytime.

  171. beky Says:

    Can you tell me my tsh is 0.011mIU/L and doctor give me euthyrox 200 is that ok or I need to drink smoler euthyrox because my tsh is falling down and he gives me every time more euthyrox.best regards

  172. Doc Gerry Says:

    I need more history. I am not sure why you’re on euthyrox in the first place. But if the TSH is low it means you’re taking too much. So the usual option is to lower your dose. See an endocrinologist in your area.

  173. beky Says:

    YES I SEE him but I am not sure if this dose is ok for my tsh.Before 14 years i have an operation of parotid gland(Op:Thyreoidectomia totalis)medullary C-cell carcinoma of the thyroid.My last 3 diagnosis of blood was:02.02.07. T3=1,7nmol/L T4=160nmol/L TSH=3,04mIU/L dose euthy. 125
    17.10.2007. T3=1,6 T4=160 TSH=0,031 dose euthy:150-175
    10.10.2008. T3=1,8 T4=168 TSH=0,011 dose euthy:200.
    So what you think about my dose?

  174. Maronielangelo Says:

    Dear Doc Gerry,

    Greetings!

    I am so humbled by your reply to my query about the serum thyroglobulin test and the total body scan.

    Actually, Doc Gerry, I am not a doctor by profession. I am a “frustrated doctor” or a doctor wannabe but family finances didn’t allow me to fulfill that dream.. Please allow me to state my case…

    I had total thyroidectomy last 6 December 2007 due to papillary carcinoma stage 1 I think it was NOD or something.I have to check through my numerous blood tests and etc :-). Suffice to say, the cancer cells didn’t invade my lymph nodes and there is no sign of metastasis. I had RAI last 4 January 2008. I was told by my doctors that I had to undergo another body scan after six months but due to financial constraints I read literatures, websites and medical journals to search if there is a better and cheaper alternative to that test. Not to mention that it’s not best for my condition since I have scoliosis and GERD. Lying flat on my back for an hour surely is very gruelling for me. Then I saw the article on serum thyroglobulin which was not given as an option to me. So I asked one of my doctors about it and I was told that it’s a very good indicator for the recurrence, if any, of papillary CA. I asked opinions from several doctors and some are conflicting. Thus, after several prayers and financial considerations, I went on with the serum thyroglobulin test and I deferred having the total body scan. My result was less than 0.2. That’s why I asked your opinion, Doc. Gerry. From what I have been reading here you have excellent experience on endocrinology. My conversations with several doctors made me still skeptical as to the total reliability of the total body scan which costs a few thousand pesos. I more inclined to the serum thyroglobulin test. But I am not a doctor by profession so I am very much concerned because I read in some medical websites that ideally for someone who had total thyroidectomy the serum thyroglobulin test should be nil. But mine is less than 0.2. My TSH value rose to above 100 when I stopped my eltroxin dose for just two weeks. Since June 2008, after resuming my intake of a daily dosage of 100 micrograms of eltroxin, my TSH is still above 40.0. I take my eltroxin 30 mins before breakfast. To make sure that my body’s absorption of eltroxin won’t be “dampened”, I take my calcium supplement four hours after I take my eltroxin. Now I am starting on a daily 200microgram dose of eltroxin. Some of my doctors say that this is a good indicator that indeed there are no thyroid tissues left because I am still suffering from hypothyroidism inspite of my daily intake of eltroxin. Doc Gerry, may I ask for your opinion on my condition? Should I still be concerned that my serum thyroglobulin, although below normal levels, is still not nil? The test was done by one of the most reputable hospitals in the Philippines. But I am not aware what method was used, if RIA or IMA. I am due for another body scan this December but I am more inclined to the serum thyroglobulin test. But I was told by one of my doctors that it should be done once every year. So now I am at a loss, should I have the body scan this December or should I have the serum thyroglobulin test on June 2009? Is my decision to just go on with the serum thyroglobulin and forget the total body scan a reasonable choice?

    Thank you and please forgive me for my long query. Best regards to you.

  175. enjell Says:

    Dear Doctor Gerry,

    hav a blez day!!!
    I hav sumting 2 ask u regarding my thyroid gland…i hav already my check up but though im scared if the medicine i’ve taken is really good for this kind of disease…as the result of my check up it say’s that i hav a colloid goiter which is nonmalignant disease..the Doctor prescribed me a medicine called THYRAX 250mg..is it good?…

    Plz help me…i need your opinion

    Your’s Truly;
    Evangeline Garcia Dag-uman

    “GOD BLESS”

  176. Doc Gerry Says:

    Guys… I just came back from Brazil for a convention and am replying here in Amsterdam on my way home. Sorry for the delay in my reply to your querries…

    Becky…your endo is trying to purposely suppressed your TSH to prevent spread of cancer. I think he needs to explain to you more why hes doing it :)

    To Doctor Michaelangelo…
    you sound more of a doctor than your doctros hehehe…
    My mentors at the Mayo Clinic…Drs Hossein Gharib, Dr Ian Hay , Dr Rebecca Bahn DR John Morris and few more are world renowned. I was blessed to be able to learn from the experts. And here’s my opinion of whatever its worth for you:

    We use MACIS scoring to prognosticate a case of paillay cancer. MACIS based the prognosis on size, the presence or absence of spread, age and completeness of surgery. If we deemed you are at low risk with a score of <6 which I think you are- then there’s really no need for RAI since it has not beend shown to affect mortality. ONly high risk pts are given RAI. Unfortunately a lot of doctors give RAI left and right without reagrd of the prognosis and cost. I then use thryoglobulin level determination every 6 months and neck ultrasound yearly on a suppressed TSH: I want it to be less than 1 or 0.1 preferably.

    If the thyroglobulin is higher then I follow it closely if it continues to go up…if it does, it is really a sign of recurrence then RAI is an option. OK? I hope I am not making you an endocrinologist and make you argue your case with your physician.

    Just like doing things in life… different person make it different and approaches differ depending where he or she is trained. If you have doubts with your Doctor then better seek another opinion….

    Good Luck Michael… papillary cancer is a good cancer and does not in itself shorten your life span.

    Enjell… the dose is pretty high and can give you toxic symptoms. Whether you will respond to the drug or not depends on the size of the tumor. Likewise if you are menopausal already, then the drug can cause harm to your bones and cause osteoporosis. Weighing the pros and cons should have been made before the drug was given to you.

  177. kc Says:

    hi doc..i will be seeing you in december but i have a biG concern at ds tym! i hav palpated a some sort of a lump on my neck particularly on my right carotid pulse area.. i think ds is enlarged lymph node but am not really sUre! am a bit scared and starting to worry it now..huhuhu :( wiLL ds prompt me to have an imediate chek-up on you or wait tiL december??? another thing also doc,iv noticed dt i experienced numbness associated wd tingling sensation (binhud) on my extremities once i dont moved it often lyk when am sleeping at nyt,i usualy placed my arm above my head.. does it has something to do wd my replacements (euthyrox and ca carbonate) doc?? or am just being paranoid?? hehehehe.. i hope ds issues of mine arent so serious :]]

  178. Doc Gerry Says:

    if in doubt…see me earlier that would be fine. JUst call Ivy for scheduling

  179. Mimi Says:

    Hi Doc. I am so impressed and happy with the way you explained everything. I chanced upon this site when I googled about hyperthyroidism in relation to pregnancy… Am taking Tapdin and Therabloc and after reading your answers, am assured that my baby and I will be safe. More power to you.

  180. Doc Gerry Says:

    Thanks Mimi for leaving a comment

  181. ruben valdez Says:

    Dear Doctor,
    I am new to your site and I’m glad I found it. Four years ago my cholesterol reached 279. I took vidastat 20mgs for one month and it went down to 160. Now, it seems my choleserol has risen again because my bp is 140/100 as it was 4 years ago. I started taking vidastat again a week ago and also lozartan lifezar 50 mgs.
    How long I should take vidastat for cholesterol?

  182. ruben valdez Says:

    I am new to your site and I am glad I found it. 4 years ago my cholesterol level rose to 279. I took vidastat 40 mgs for a wmonth and it went down to 160. Now it seems my colestero is high again because my bp is 140/100. I started taking vidastat 20mgs a week. How long should I take vidastat? A month or two or more?

  183. ruben valdez Says:

    Dear Doctor,
    I am new to your site and I am glad I found it. 4 years ago my cholesterol level rose to 279. I was prescribed vidastat 40 mgs which I took for a month and it went down to 160. Now my cholesterol level is high again I am sure because my bp is always 140/100. I started taking vidastat again a week ago. How long should I take vidastat? I am also taking lozartan lifesar 50 mgs for my bp. Thank you.

  184. kc Says:

    hi doc, am just somehow curious about the use of activated charcoal?? is it safe and beneficial to one’s health??

  185. Maronielangelo Says:

    Dear Doc Gerry,

    Thank you very much for your response regarding my query on the serum thyroglobulin test and etc. I deeply appreciate your concern for us. I also tried looking at the website for Mayo Clinic and am online sites about MACIS scoring :-). I learn a lot from your responses.

    I think I will not go ahead with the total body scan. Even though my nuclear radiologist assured me that it is safe, the thought that a radioactive substance will again invade my body made me wary for possible complications how remotely possible they may be… By God’s grace, I will ask my endocrinologist for a repeat of the serum thyroglobulin test this December :-). (Thank God for HMO’s.) She wanted me to have it one year after my first thyroglobulin test but I would like to have it as you said on a 6-month period. December 6 is my 1st anniversary . I also had a neck ultrasound last June and ultrasound results noted the absence of the thyroid gland but I have simple lymphanenopathy. I asked for an ultrasound because I felt lumps. But my doctor gave me azithromycin and the lumps faded away. I am already allergic to lumps. Last year around October a month before I was diagnosed with papillary carcinoma, I had a CT Scan of the lungs to rule out bronchiectasis. I was cleared of any lung disease. Last month, I had a Chest PA xray and I was cleared by the radiologist. Doc Gerry, I hope and pray that my body is giving an indication that I don’t need to worry anymore about having a recurrence of papillary CA. I just thank God that the CA that I experienced is, as my endocrinologist put it , a “kind CA”.

    By the way Doc, I don’t know if this is still under your specialization… May I know your opinion for an ASO Titer value equal to 200 for an eleven year old girl?

    Thank you and God bless!

  186. Doc Gerry Says:

    Hi Ruben… high cholesterolproblem and high BP are red falgs for you to develop diabetes. These conditions are metabolic in nature meaning they are chronic diseases that require chronic treatment meaning…once you take the meds, the conditions are controlled…once you stop the meds, conditions recur! I wish you doctor has explained this to you but unfortunately most just dont have the time to explain.

    Hi KC.. the only use I cna see for activated charcoal is as a treatment for poisoning and overdose of oral meds. Other than that…I am not sure if they have any proven medical benefit

    To Michaelangelo…lets stick to papillary cancer! :)


  187. I just found this link and i was wandering if you could help me. I’m 26yrs old and soon be migrating in US with my hubby so i just want to prepare myself to have a baby because i don’t want to give birth when i reach the age of 29. I am taking THYRAX 50mg to prevent hypothyriodism as my maintenance, I undergo NUCLEAR MEDICINE almost 3yrs ago. I am seeking for your expertise if its possible for me to conceive even though i’m taking this drug and i have a regular menstrual cycle and my husband is 2yrs younger than me and he is very healthy. what do i need to do for me to conceive a baby in just less than a yr.
    thank you in advance!! GOD BLESS

  188. Doc Gerry Says:

    Definitely. No problem and good luck. The med will not harm the baby

  189. Helen of Cagayan de Oro City Says:

    hi doc gerry!

    thank u very much for ur reply. Anyway, i had my another t3t4tsh test again and its amazing , after 2.5 months of taking strumazole my tsh was now in a normal level .7mIU/ml from .01mIU/ml of tsh. With that result the doctor stopped my medications, however after 15 days of stopping medications, im now sweating again. i dont know, i sweat too much, even if im just walking a bit, or the worst even after im taking a bath. Before i was diagnosed w/ toxic goiter i also feel the same feeling. Is excessive sweating really associated w/ hyperthyroidism? As a result my face has darkened. Im really so confused. Please help.

    thank you doc and God bless and Merry Christmas!

  190. Sarah Says:

    hello Doc,

    i need some advices regarding my cyst below my ear. it’s been 8 years since ive noticed this. I am afraid to under go a surgery due to fear of facial tissue/nerve damages. the doctor said it is a parotid cyst. I hope you can recommend some good surgeons in cebu because I am afraid of big scars. I already had one when I meet an accident. I really do not know of an expert of this type of cyst… thank you in advance!

  191. Doc Gerry Says:

    Helen… theres a way to stop the medication for toxic goitr… there’s a technique to avoid recurrence. You just dnt stop it immediately just because its normal..I am sure you are now having a recurrence. Please check with your local endocrinologist

    Sarsah…kindly call my secretary so we can answer you on this one.

  192. Diane del Rosario Says:

    Good evening doc. I actually posted this on the clinic schedule and i think i should post it here. anyway,

    I was diagnosed with thyroiditis and I am showing no symptoms at all of hyperthyroidsm except occasional palpitations. my doctor asked me to took therabloc 25mg once a day for the palpitation. is that safe to take? i think therabloc is for patients with high blood pressure?

    thanks in advance

  193. CONCEPCION ANNIE LUA ANG Says:

    Hi Doc! I am scheduled to see you on Feb 2009 yet, but I was wondering if I should see you sooner. After religiously taking Euthyrox 100mg for 2 months or more, I have observed that I have been heat intolerant and am sweating excessively. Because of this, I opted to have a thyroid panel done. My TS

  194. Doc Gerry Says:

    Dianne… therabloc is used also to control palpitation so it is okay.

    Ann… call me when I get back Jan 5

  195. Connie Says:

    Hi Doc Gerry. My aunt was diagnosed with hyperthyroidism and unfortunately she is diabetic as well. She is taking Tapdin now but lately we’ve noticed that her eyes are becoming yellowish and she itches a lot. Are these expected side effects of Tapdin? Also, is it safe to take asthma medicines while she is under medication? Many thanks!

  196. maronielangelo Says:

    Hello Doc. Gerry. Happy New Year to you! May God give you much more blessings this coming year.

    I just had my second test of serum thyroglobulin. I prodded my doctors about it because I have lymphadenopathies on my neck. My endocrinologist has not seen the result yet but she saw the ultrasound. She suspects a recurrence of my papillary so she said that I might have another RAI.She suspects that the lymphadenopathies ( no matter how small as she described them) are metastases from my papillary.My ENT said that she will observe first if zithromax will resolve my problem. She said I just might have infections other than the CA because I already had RAI after total thyroidectomy. If not, she will contemplate on another operation. :-(

    My serum thyroglobulin test is less than 0.2. The same as last June’s result. I was hypothyroid (TSH=more than 40 ) from June to November which was corrected (?) last December when I became hyperthyroid (TSH = 0.1). Do you agree that I might have had a recurrence of papillary? I am not a doctor but I am a little skeptical about it because despite of my being hypothyroid for a long time the serum test result was unchanged. As much as possible, I don’t want to undergo another RAI. I already had one after a total thyroidectomy. When I heard that I might have another RAI, I became really perflexed.

    I hope you can give me another valuable advice. Thanks a lot :-).

    • Doc Gerry Says:

      Maronie… I am so concerned giving you advises over the internet without the privilege of seeing the actual results, what assays are used and without PE. Do seek another opinion with another endocrinologist in your area. I definitely have a different opinion if my thinking and assessment of your results are right but I have questions. Unofrtunately it is best resolved if you are seen in person.

  197. cute Says:

    hi sir would like to ask how much would it take for a 42 yrs. old woman to take thyroidectomy. Consider the lowest price you can give sir. She lives at San Miguel, Zamboanga del Sur and I would give her the money needed for this operation. I take this opportunity to help my wife for her mother inspite of limited income from mine. I’m thankful if you can help. Salamat.

  198. Maronielangelo Says:

    Dear Doc.Gerry,

    I deeply appreciate your concern. I think I have an idea what your opinion might be. May I know if you can refer me to someone here in Angeles City, Pampanga? I can’t go to Manila due to other health reasons :-). My body can’t stand the pollution in Manila although I grew up and lived in Manila until I was assigned here in Pampanga. I would like to visit your clinic in Cebu but it’s not cost effective for me. Hope you can refer me to an endocrinologist whom you personally know.

    Best regards to you:-)

  199. Anthony C Says:

    Hi Doc, A short update on my progress with Galvus, all cases include metformin 850mg x3 daily:
    Oct A1c 6.7 Galvus 50mg + Gliclazide SR 60mg + weight gain 2 – 3 kgs
    Nov A1c 6.8 Galvus 100mg, weight stable.
    Currently Better morning levels 6.5mml – 8.5mml, Galvus 100mg + Glimepride 2mg + weight gain. Put on 4 – 5 kgs since I saw you in June. The Endo here is starting to talk about swapping to Exenatide, not an option I like much.

    Meals are a problem, Cebuano wife only really eats meat/fish + rice, small breakfast and snacks or skips lunch forcing a large evening meal. Wont listen to reason! :) I have tried to be creative with vegetable dishes but she wont even try them. Even Filipino vegetable dishes. The best I have done so far, is to get her to eat potato and tomato once in a while. She complains when I only take a few spoons of rice even though she is well aware I need to control carbohydrate input.

    Will be back in Cebu sometime between April and June. Will see you then.
    All the very best.

  200. mercheille parson Says:

    hi doc! very very noble site! :) i read from your previous thread that thyrax is safe even for pregnant women? that it will not affect the baby? thanks!

  201. Christine Says:

    Hello, I hope you can help me. I was recently diagnosed as suffering from hypothryroidism (mild) and was prescribed Euthyrox 50mcg. After about a month on the medication I started experiencing insomnia and generally a “wired” feeling. I stopped the medication but the insomnia is still plaguing me 3 weeks later. Is it normal to take a while for these symptoms to hopefully dissipate? How long should it take? I’m sooooo tired from lack of sleep, two nights now I have not slept at all. Thank you for reading this.

  202. Christine Says:

    Hi doctor and thanks very much for your reply. Yes, I’m going to see a doctor but not the endo who prescribed the medication. I called her for advice when my symptoms began and she said she didn’t think it was the meds and to just go off them for a week and see what happens. She wasn’t concerned at all that I had several nights insomnia in a row. Have any of your patients had similar problems when taking Euthyrox? Just trying to make sure that ‘m not going crazy here imagining things! I’ve read up on the internet about this drug that a possible side effect is insomnia, but my doctor never told me this and I don’t know how common this reaction is. Thanks again for this informaiton service you provide. I wish all doctors were as concerned about their patients as you are.

  203. maronielangelo Says:

    Dear Doc Gerry,

    Thanks for your concern. Big problem doc. I can’t say who my endo is because there are only two endos here who are accredited with my HMO. If they are the only two endos around, I am wary of telling you publicly who my endo is.. But is there a way for me to tell you privately …? I am willing to make a long distance call or something just to be able to get the right advice. I haven’t visited my endo yet. I am flying to Iloilo this last week of February. I looked for fares going to Cebu and I still have no budget for that. Wish I can get more funds to get to visit your clinic!

    Dear Ms. Christine,

    Wise decision! Glad for you that you have other choices for endo. Had the same experience with my endo. Believe it or not, I almost went critical if I didn’t unilaterally decide to stop one medication prescribed to me. Then I showed my endo the results after being off the medication for three weeks. Guess what my endo told me, I didn’t really need that medication because I wasn’t inflicted with that ailment at all! I told my endo that I had previously insisted that I don’t have that ailment but still I was “pressured” to take it. To give my endo credit, though, sometimes I was given free synthrax(?) tablets..I don’t know with some doctors they just brush off how patients feel although if they would read thoroughly (if they didn’t) the literatures about the drug they are prescribing they would understand better the cases of their patients. After what had happened to me, it has been my principle: Ask as much as I can, all that I want with my doctors no matter how trivial the question might be for as long as I will get satisfied and everything is clear with me as to what is happening to me…. Best regards to you, Ms. Christine. Hope you will feel better soon!

    • Doc Gerry Says:

      Christin and Maron you can become great friends hehehe…. Yes… you just need to ask questions to your doctors especially if they seem in ahurry to finish things… or just been busy. Thyroid hormone pills can actually cause palpitations, tremors, insomnia and therefore I always ask pts to see me back if these symptoms occur. People can differ in how they feel with drugs. Some are so sensitive to it even with minimal dose.
      Maron.. you will find a doctor soon that can help you. Be patient and am sure the endos in your area are just as qualified to help you. Good luck to both

  204. Lose Fat Says:

    Great article. I’ll definitely be back. Thanks again, Kayden

  205. delsa minster Says:

    Hello Doctor Gerry,

    My father was diagnosed of liver cancer 2months ago. He is 70 year old, he is not doing any chemotherapy treatment or radiation because of the fear of the side effects and we want him to have a quality of life. He is been taking pain reliever for his pain but recently the medecine doesn’t seem helping his pain. He is taking utram HCL 50 mg bid. I was thinking to send him for acupuncture might help his pain. He continue complaining of severe right lower back pain. Any suggestion I can get is greatly appreciated. Thank you very much.
    Sincerely yours,

    Delsa Minster

  206. maita sheila academia Says:

    good evening doc Gerry,

    i am sheila, i was diagnosed of hyperthyroidsm last year.. my reasults were way up like three times higher from the normal range.
    Since my hometown is quite far from my doctor in cdo, at the moment i am experiencing severe headache and hard cough. The last time i consulted Dr. Sison, she told me i can only use mucosolvan syrup. Since i have a nebulizer at home, i tried to use combivent nebule for me to sleep well at night since in 1week time, i haven’t slept well. is combivent nebule ok while i am taking tapdin20mg and cardiosel 50mg?

    Thank you and God bless…

    Sheila

    • Doc Gerry Says:

      I suggest you really have to talk to DR Sison. I am sure you have her phone number. Again this site is not to replace proper consultation of diseases. I am here to give some opinions but not to replace proper evaluation based on hisotry and physical exam.

  207. Lisa Says:

    Dear Doc Gerry, I think it’s by the grace of our Lord that I stumbled across your website. I stay in Johannesburg, South Africa. My question… I had a total thyroidectomy on 17 February 2009 (last week). The specimen of my thyroid came back saying that I had Lymphocytic Thyroiditis (ps – I was hyperthyroid with many horrible symptoms). What is Lymphocytic Thyroiditis. As I’m now headed for the hypo route, I find myself anxious and nervous, not knowing what to expect. I just need to know that my TT was not done too hastily because right now it feels like I’ve lost a part of myself when in fact if I carried on taking my neomercazole for long enough it may have solved my problem in the long-term (it wasn’t working for me in the beginning – I was on the highest dosage, 60mg per day for approximately 6 weeks, my levels only started to drop on the 6th week). Please answer? Your advice will be absolutely invaluable to my mental well-being.

    • Doc Gerry Says:

      Hi Lisa… it means you had an autoimmune thyroid disease that caused you to become hyperthyroid. Dont worry….it is better that way since it is easier to treat a hypothyroid pt than hyper. You only need a replacement dose and then fine tuning of the dose and you will be well. You just need to trust your doctor.

  208. Lisa Says:

    Dear Doc Gerry, thank you for your response. Is there any chance that your thyroid could grow back after a total thyroidectomy? Last question for now, promise!! But I’m sure I’ll try to contact you later again – WHAT AN ABSOLUTELY AWESOME WEBSITE with a doctor so willing to share his knowledge. Wow! :-)

  209. Pippa Says:

    Hi Doc:
    After years of not being taken seriously by my GP, I finally found, of all things, a Rheumatologist, who has taken me seriously and has ordered a gamut of tests and has begun referring me out to specialists based on the findings. Most curiously to me, apparently I was born without the left lobe of my thyroid. My thyroid scan came back abnormal, so they did an ultrasound, where it was determined that in the right lobe, I have multiple tiny colloid cysts and a small heterogeneous nodule at the inferiour pole with a small cystic nodule also at the inferior pole. The cystic nodule measures 4mm and the heterogeneous nodule slightly more medial and inferior measures approx. 6mm. The isthmus appears to be unremarkable with a tiny cystic nodule. I do have an appointment coming up with an ENT, but what does all this mean, in layman’s terms? I’m trying to think happy thoughts…. I also have a few lymph nodes in my neck that are firm (I’ve had them for years, they haven’t grown any more). Any comments? Should I be scared?

    • Doc Gerry Says:

      Pippa…I need more history to help you but with what I have… the best option is to do a biopsy and then go from there. The only time one gets scared if one will die from a disease…and for sure…you will not!

  210. Kerrie Says:

    HI

    Can you tell me if taking Wheatgrass can affect the absorption of Eltroxin? I am currently on 100mcg, and I usually take it first thing in the morning. Also what vitamins are recommended and can it be taken right after Eltroxin? Or even an hour or two?

    • Doc Gerry Says:

      Any food taken together with eltroxin can affect its absorption so take it on an empty stomach. Vitamins? I dont recommend any except calcium for your bones

  211. jing gonzal Says:

    doc gerry, mayroon akong toxic goiter pls. help me in my situation my mother is deseem sick with my mother. i confined last 4 years but i stop for a treatement.ngayon bumalik ang mga sign like malakas ang kutob ng heart beat ko at laging hirap kahit walang ginagawa.at ang pinaka worst ko ay ang di makalakad lagi akong lumpo walang lakas ang mga binti ko kaya i take daptin 5mg 3 times aday at therablock 3times a day din. walang resita galing sa doc for searching thru internet lang. kaya na search ko sa internet yung docgerrytan.com kaya ako nag try by texting thru computer.kaya po doc tanong ko land po ano po yung treatement para sa lumpo walang lakas ang mga binti or paa pls. doc help me walang wala po ako sa ngayon i ask your opinion, im worried talaga.

    • Doc Gerry Says:

      JIng… you have what we call as hypokalemic periodic paralysis due to to toxic goiter. Please see a specialist para ma treat ang toxic goiter mo. You cant take it for granted dahil you will have long term complications if that is not treated well. Dont worry mawala yang lumpo once matreat ka na sa toxic okay?

  212. Lisa Says:

    Dear Dr Gerry, Lisa again from South Africa. Doc, granted I only had my total thyroidectomy on 17 February and only started taking Eltroxin on 26 February (50mg – I think, I’m on the lowest dosage). My question is… I still feel very groggy in my head – how long does it take for one to feel normal again – is it correct that it could take the Eltroxin 2 weeks to get yours levels up again? Am also extremely depressed, obviously by this. I have extreme wind in my large intestine which makes me short of breath at times. Is there anything one can take for this? Also, I’ve always been a social drinker. Is it safe to have one or two whiskys or glasses of wine whilst taking Eltroxin? Sorry for all the questions, you seem to be the only Doctor out there willing to help anyone. :-( Lisa

    • Doc Gerry Says:

      it takes 6 weeks for the medication to achieve a steady state. But if total thyroidecotomy was done. depending on your weight, your dose maybe too low for your weight. So please have a repeat blood tests in 6 weeks and have your dose reassessed.

  213. Helen of Cagayan de Oro City Says:

    hi doc.. thanks for your reply… after being examined to have a normal tsh level .. i now feel better , no more sweating and fast heartbeat.. however when i indulge myself into a badminton activity, after a few minutes of playing (in a moderate level) i almost lost my breath.. my heartbeat turns so fast that my back is aching.. i immediately stopped the activity and rested..
    doc is playing badminton or any physical exercise bad for those who had history of hyperthyroidism? please help me. i want to exercise or play badminton in order to be in good shape.. what physical activities is good for me?

    thank you very much doc and hope to hear from you.. God bless!

  214. Helen of Cagayan de Oro City Says:

    hi doc..

    just an addition to my previous msg.. actually i played badminton for the 2nd time.. and i was amazed that during my second time im no longer have fast breathing problem and i love the feeling..does it mean im totally healed from toxic goiter?
    thanks and God bless doc

  215. charlienfat Says:

    hi doc gud day!this is charlien Fat Caparida ur patient.Ask lang ta ko doc ba kon ok ra ba ang tapazole 5 mg.15mg a day,kay nana man gud ko sa canada doc nya wala man silay tapdin 5 diri tapazole man ila gihaatg nko.Nya kon moinom ko sa ptapazole ug 15 mg mohuot man ako dughan nya makutasan ko unsaon man kuni siya doc?please help me!Thank You!!God Bless…

    • Doc Gerry Says:

      Please have yourself checked there in Canada again for follow up if you have symptoms. Mao nay problema diha kay socialized medicine biya so you cant choose your own doctor unya am sure you are only being seen by a family doctor instead of a specialist. Continue with tapazole for now.

  216. maroniel Says:

    Dear Doc Gerry,
    How are you? Hope you remember me :-) one of the many readers of your wonderful site who sometimes ask a lot of questions:-D.

    Anyway, I followed your advice and I changed endocrinologists and I am so glad I did. I was recently hospitalized due to hypocalcemia and stroke due to hypothyroidism. I am I changed endos because now I feel better. Didn’t know that I can suffer stroke if I have severe hypothyroidism. Previously it was a hit and miss dosage for eltroxin. Now I feel much better. Had Tg and anti-Tg (which was never suggested to me before and was the answer to my unanswered question for more than a year. By God’s grace my doctor said I am now thyroid cancer free. He only need to check my TSH and my Tg will now just be a yearly exam just to make sure I am ok. He changed my simvastatin to Ezetrol because he said that the medicines I’ve been taking has affected my liver. Thanks for your advice, Doc Gerry. Now I have two less doctors :-).. not to mention, more peaceful nights, less worries… hopefully I won’t suffer stroke again.

    Take care and best regards to you!!!!!!!!!!

    • Doc Gerry Says:

      Maroiel….Happy to be of help. My suggestion is for a twice a year thyroglobulin instead of yearly and a yearly neck ultrasound to check for lymph nodes. Good luck!

  217. Lisa Says:

    Dear Dr Gerry, after my total thyroidectomy on 17 Feb 2009 I had bloods taken on 12 March 2009. My TSH was 0.38 and my T4 12.4. I had bloods taken again yesterday, 15 April 2009 – my TSH is now 11.93 and my T4 13.2. My endocrinologist says I have nothing to worry about and has told me that I should have bloods taken again in 6 weeks. Do you agree with this? I am currency taking 0.05 [mg] of Eltroxin. She has told me to stay on the same dosage for the next 6 weeks. Please will you let me know your thoughts because I am extremely anxious about all this? Lisa :-(

  218. Diana del Rosario Says:

    Hi doc,

    It’s me again. I’m a little worried. Last night while I was sleeping, my boyfriend saw my neck was moving involuntarily in a rhytmic manner like the pulse (gumagalaw daw po leeg ko). What could it be?

    Thank you very much.

    Diana

  219. HANS QUIJANO Says:

    HELLO DOC GERRY,
    I DIAGNOSE FOR HYPERTHYROID LAST 5 YEARS. I WANT TO CONFIRM TO YOU THAT BASKETBALL IS A GOOD EXERCISE FOR A HYPERTHYROID ILLNES? WHAT IS EXCERCISE GOOD FOR HYPERTHYROID SICKNESS,SOMETIMES I SING IN VIDEO K IT IS GOOD FOR ME TO SING 2 TIME A WEEK PLEASE DOC FOR ME TO ADVICE THISTHANKS AND MORE POWER TO YOUR ABILITY AS A DOCTORS….

    RESPECTFULLY,
    HANS

    • Doc Gerry Says:

      Hi Hans… any exercise is good for a “cured” hyperthyroid. Just make sure you are already euthyroid or the tests are back to nromal before engaging in any activity


  220. dati mataas akin colesterol trylicerite pwd b ako inom ulit ng vidastat kahi wala me k check up

  221. nadia kasab Says:

    hello dr.Gerry
    i’m so lucky to find ur website
    because i’ taking eltroxin daily is it safe to take xenical weight loss? i’m female 50 years.
    thank u

  222. kat Says:

    hello po doc. doc na diagnosed po ako na may toxic goiter. bale binigyan pko ng endoc ko ng tapdin 20mg 3 tablets once a day po prescribe po nya inumin ko po yung 3 tabs sabay sabay po. kya lang po doc last 2 weeks po na notice ko nawalan pko ng panlasa. saka may time po na sobra bitter po ng panlasa ko. side effect po ba to ng tapdin? diagnosed din pko ng GERD.
    pinapapili rin poko ng doc ko kung RAI po o Thyroidectomy po. ano po kya ang mas ok na procedure sa may mga toxic goiter po. thanks po doc GodBless po!

  223. paris anatoli Says:

    hi doc,

    i would like to thank you for helping my dad. he has been your patient for almost 2 years. his blood sugar is normal or close to normal, either way he has been feeling better.

    i have a question doc,is it possible to have a low blood sugar level (hypoglycemia) problem? like the opposite of diabetes?any measures to help manage it?and is it permanent?

    thanks doc

    • Doc Gerry Says:

      Paris…Hypoglycemia is exepected at least 2-3 x a month esp in a pt who is well controlled. It is very easy to manage and is treatable. I should have instructed your father what to do. If he forgot … to please ask me again when he comes for follow up.

  224. April Says:

    I just want to ask opinion on 3rd thyroidectomy. i has underwent 2 thyroidectomy operationns: ist in 1986 and 2nd in 2007. latest test showed remnants in my right thyroid and i am scheduled for operation this month. i am so apprehensive that my right vocal fold will be damaged. my left is already damaged and i have a weak voice now. i am just thinking that i forego this operation because of the high risk of losing my voice.

    april

    • Doc Gerry Says:

      April…I am not sure whats happening. There is something missing in your history. Please make sure you see an endo first before undergoing surgery. And maKE YOU HAVE a good surgeron that will follow what is recommende by your endo. The only time we have a reoperation due to recurrence is when we are dealing with thyroid cancer …other than that… one surgery should CURE the pt as long as it is done the way I want it done!

  225. Sharon Says:

    I am interested in finding a website on Dietary guidelines for ghanians (or other cultures)that immigrate to the United States for heart health. I think it is great that we have wonderful website for american diets and how to integrate a healthier lifestyle with interactive online tools(www.health.gov from the US Dept of HHS is one) is there such an online site available to help people from other cultures? I am wanting to recommend such a website to a family as an educational tool to improve their cardiovascular health.

  226. Belen Lagumen Salas Says:

    Hi Doc,

    Good day!

    I just want to ask you on what to do.2008 was my last visit in your clinic and you recommended for thyroid operation.Im planning to go there this month if not within this year, as soon as i have money for operation.I’m from bohol doc.

    1.) Should i call your clinic for appointment month before i go there? or is it ok if i’ll just show up as soon as i have money?

    You gave me a laboratory exam request note for HP hi-precision diagnostic.

    2) Do i need to take this lab exam 1st before i go to your clinic?

    3.)How much the operation cost if admit in ward room? private room?

    Doc, I hope you still have time to answer my questions and thank you very much.

    More Power to you,
    Bel

  227. mary troie felipe Says:

    hi doc! i’m so happy that you have this site which is so helpful to many people. you treated my father for his diabetes about 13 years ago, you and dr. marlon co were his doctors. my father was bert luna. anyway he died last february 14 2009 due to a stroke, and i would just like to thank you for helping him prolong his life. he was on dialysis for 11 years.

    anyway doc, my prob now is with my husband. 3 years ago he had a high SGPT of 84 and high total cholesterol of 249. he was given reducil and neobloc bec he also had high bp. for his sgpt he was given liveraide. after 2 months on that treatment it became normal. after that he went back eating up to 5 cups of rice per meal, and he eats lots of fatty food. we had his labs done on a routine check up and we found that he has an SGPT of 137 and his cholesterol level is 249.50 and his LDL is quite high. his bp is 130/90. his doctor did not give him any meds for the bp bec he said the liver problem has to be treated first. he was prescribed with godex, 2 caps for 3x a day. it’s very expensive doc so after a week of godex we tried milk thistle or silymarin with low carb, low fat diet plus exercise. is this enough to replace the godex doc? and is 130/90 bp alright? should i give him neobloc?

    also doc my son has flu like symptoms. how do i know if its H1n1 or just ordinary flu? my son is 10 years old. what should i give him. he is not weak though and is eating fine. his fever reached 39 degrees and i gave him biogesic. now its just cough and runny nose. also he vommited last night. he is still very active and is not showing any signs of weakness. he said he doesnt have headache and the fever has subsided.

    • Doc Gerry Says:

      Hi Mary… for now there are no studies to prove drugs like liveraide or godex work for fatty liver. No concrete date to support their claims so I would not recommend you taking them. Better for your husn=band to seek the opinion of a specialist because I am sure he is next in line to become a diabetic. Hope you’r son is now better

  228. mary troie felipe Says:

    p.s. thank you doc and i hope to hear from you soon! God bless!

  229. Bel Says:

    Hi doc,

    Good pm!

    thanks you!

    bel

  230. mary troie felipe Says:

    thanks doc! my son is now okay. he was given josamycin by his doctor. my husbands sugar is actually quite lower than average. his fbs is only 66. is there still a chance for him to become diabetic doc? i read that milk thistle and diet with exercise works better also doc for fatty liver. and doc, if we should see a specialist, can you recommend any in particular?

  231. kai Says:

    doc,

    my father is your patient. and he is complaining right now of numbness in his right lower leg. he is a diabetic. any advise on this?thanks doc

  232. allison Says:

    hi doc what is the best contraceptive method to be used for hypertensive women? I had pre eclampsia on my last pregnancy 3 yrs ago. and is it ok to be pregnant again if you are hypertensive? I am taking concore as my maintenance medication.

  233. Debbie Says:

    Hi Doc Gerry.

    I was your patient last year and I perfectly remembered u asked me to come back after 3 months but i wasnt able to do so since i was studying medicine. Now i keep drinking your prescribed 20g tapdin once a day but i also drink pearl white as diet pill but ive noticed im still gaining weight. Is it because of the medicine im taking? Is there any other way to take meds and not gain weight? Im back in cebu now and im planning to go to your office next week. When is the best time? I talked to Ma’am Nancy btw andwhat a small world, hadnt arlene mentioned about you being her husband i wouldnt have known, truly a small world. Akai has been one of my clients for your corrugated materials.

    Please help me doc.

    Thanks

    • Doc Gerry Says:

      Debiie…STOP Pearl white! Taking tapdin 20 mg for long time is also not good because you may be having an overdose of the drug. Please call my secretary for appointment

  234. Vissia Says:

    Hi Dr. Gerry Tan,

    I’ve been browsing online on where to go in Cebu. My mom is your patient from Dumaguete who had recent two major surgeries on the neck (thyroid cancer, papillary type) and a metastasis to the lung (Right). I don’t know if you told her to have a Radioactive Thyroid Iodine Treatment or Dr. Tan (the Surgeon). Anyway, she was hospitalized again in Dumaguete days after she got back from Cebu. She had two episodes of what my Papa and my niece described to me appeared to be Altered Level of Consciousness where they could hardly awaken her. I was thinking when the first time they told me that it could have been hypoglycemia since you started her on glimeperide. Many patients don’t tolerate that medicine too well but with my mom, her poor appetite aggravated it. Anyway, they managed to bring her back. Then it happened again after two or three days and this that time they checked her blood sugar and I was right. She had a FSBS of 38. I was on the phone instructing them on what to do. They managed to raise her BS to 57 then I told them to take her to the hospital where she stayed for 3 days.
    Anyway, the endocrinologist questioned your suggestion of a Radioactive iodine treatment in three months. He recommended it end of this month and my mom has been off her thyroid meds since July 25. He recommended Dr. Varela at Chong Hua. I was thinking it would be wise to go back to you and concur with you about it since you know her case better. But since she’s off her medication now, we don’t have a choice but to go ahead with the treatment but who would you recommend to handle the treatment? (Again with discount as I have become empoverished now since my mom’s illness. This is probably a shameful thing to say but it’s true). Thank you so much!

  235. Vissia Says:

    Dr. Tan,

    My mom’s name by the way is Rosalita Edria. If you have further instructions for my mom for her preparation for thyroid iodine treatment, please let me know. Again, she’s been off her meds thyroid meds since July 25 and she’s trying to stay on a low iodine diet. They can’t find a non-sea salt- which reminds me that she had a very low sodium level on top of hypoglycemia- a very good combination to make ALOC. Thanks for this site too. I just bumped on this and I’m glad I did so Iget to know my mom’s doctor.

    • Doc Gerry Says:

      Vissia..hello. Unfortunately your mom has not followed up with me since April of this year. I am not sure who recommended the RAI and I dont ask them to wait for three months off the meds before an RAI. She may have sought another opinion for that matter. I base the recommendation on RAI treatment post surgery on her MACIS score and that not all pts with Thyroid cancer require RAI fpr that matter. I am sure she sought further follow up in Dumaguete and her endo in Dgte is the one suggesting the RAI.

  236. Maria Giles Says:

    G’day Dr Gerry.
    I am so pleased to have found your site.
    After 2 years of discomfort in swallowing I underwent an Iodine test and told I have a multinodular Goitre but told i would not need any treatment as it is small. I am concerned as I have an iron and folate def. and have been experiencing vertigo and the lump in throat sensation seems strangling. I am on waiting list for endoscopy but due to have a growth removed on uterus next week but so concerned as they have to put pipe dow the throat and worried there maybe compliations. Do you think I should cancel surgery until I sort out the lump feeling in my throat that often takes my breath away. Also concerned with swine flu at same hospital. Thank you. Maria – Australia

  237. Liezl Bucad Says:

    Dear Dr. Gerry,

    My mother has a severe inflammation on her left hand and foot. She has a high uric acid. My questions are: Does having a high uric acid affects the memory? And how to avoid it..Please reply soon. Thank you very much.

    Reply

    • Doc Gerry Says:

      Hi Liezel, high uric acid as a cause of gout: Yes but affecting the emory…other factor defiiniely copme into play. Age, Diabetes, High blood presure na dcholesterol do aggravte memory deficits esp if not well controlled.

  238. liezl bucad Says:

    Dr. Gerry,

    Thank you for the reply. Here’s some details about my mother’s condition: She is 73 yrs old. The inflammation started two moths ago. She’s taking allopurinol now. But what worries me now, bihira na siya magsaloita. When Im talking to her and asking her, she will just nod, but she can still talk kasi ginulat ko siya two days ago and she reacted and utterred: A-ah ginulat mo naman ako. And most of the time now, she’s always sleeping. Hindi lo pa po siya napapacheck up coz of financial reason and im all alone taking care of her. Dr. Gerry she cannot move her left arm and hand pero pag ginalaw ko po at binuka ko yun kamay niya, nasasaktan po siya. Sabi po nag kapitbahay namin baka nag uulyanin na daw po at baka na mild-stroke pero minomonitor ko naman po ang BP niya, meron po kami pang-BP. Regular din po ang inom niya ng Versant XR. So pag tumataas pa rin po, binbigyan ko siya ng Pineapple juice. Posible po ba na namild stroke siya without my knowing? She also cannot walk now and it started three weeks ago and i thought maybe because of the severe inflammation on her left leg and foot. Please help me to understand my mother’s condition Doc Gerry.

    reply

  239. uwingabire aurelie Says:

    warmer greetings to you,i really try to read some questions and its answer to this web really a saw how kind u you are,but for me i want just to ask how the throid stimulating homes be related to reproductive hormones such as progestrone,eostrogen,follicle stimulating hormone,prolactin and others thanks a lot am waiting the answer good day

  240. charlotte roughan Says:

    Hi Dr Gerry..
    Ive just found out im 6 weeks pregnant but my husband had radio iodine treatment 4 months ago and was told NOT to father a child for a year..We both got a big shock as we’ve been very careful..We are both very nervous,stressed and affraid of what we could be facing..Could you give me some advise please..look forward to hearing from you..Kind Regards..Charlotte

    • Doc Gerry Says:

      Chrlotte… I dont like to give my comment thru the web becuase I may give a different recommendation than your MD. Suffice it to say. DONT WORRY….both you and your child will be okay!!!! Enjoy your pregnancy.

  241. yan Says:

    hi doc,

    mu father is a diabetic and his bp is usually 110/70 – 120/80. lately, his bp readings are 130/80 – 150/90 and it has been almost a week now. any advice on this?should we give prompt attention to this right away?
    thanks doc

  242. Candz Says:

    Hi Doc Gerry,

    I’m 23 y.o. and I was diagnosed with PCOS last year by Dr. X (one of our ob-gynes in CDUH). Dr. X prescribed me BCPs (birth control pills) to regulate my cycle. Yes, it lessened unwanted hairs and acne, and I had a regular cycle. 3 months ago, I decided to stop taking BCPs, thinking that I might return to ‘normal’. Now, my unwanted hairs are growing faster, my pimples are popping out again, I’m having a heavy flow, and I’m starting to have problems in my weight. Dr. X told me that PCOS has no cure unless I want to get pregnant, is that true? I’m so determined to have it cured so I searched the web for any possible cures. I found a few sites stating that with the help of proper diet and exercise, plus taking natural progesterone will cure PCOS, in cream or in capsule form. I found this site informative: http://jeffreydach.com/2008/02/13/understanding-pcos-the-hidden-epidemic-by-jeffrey-dach-md.aspx. What do you think about natural progesterone? Can we have my hormones tested? I’m starting to get frustrated about this PCOS.

    Candz

    • Doc Gerry Says:

      Candz… PCOS is due to insulin resistance state. I agree that its is diffcult to cure but we have ways to prevent its problems from manifesting. Likewise there are ways to make you pregnant with meds to reduce the IR state. Dont be fooled by creams or supplements. We strongly advise against them.

  243. Candz Says:

    By the way, Doc, your website is nice..very informative as well :)

    Hope to hear from you soon.

  244. Divya Says:

    hello.. my sister while joining her new work place was asked to submit her medical certificate. as said, she 1st underwent her chest x-ray and then when she went for her abdominal check up, only then she got to know that she was pregnant. the doctor said it is very risky to undergo x-ray when in pregnancy and that its better she terminates her pregnancy. thats really heart-breaking and hurting doctor. it was all our deepest desire and now that she had concieved aftr 4yrs of her married life and this unusual has happened.. so i pls request you to reply and suggest something that must be followed to keep both the mother and feotus to be healthy and safe during the pregnancy period as well as aftr the delivery.. looking forward for your reply doctor.. pls pls pls do reply to my id.. divya_tud2005@yahoo.co.in
    thanku..

  245. Helen of CDO Says:

    hi doc gerry. good day!

    im helen from cagayan de oro, i was diagnosed to have a hyperthyroidism last sept 2008 and after medication for 3 months my tsh has raised to normal level and my doctor stopped my medication. I was feeling fine during those times (from november 2008 where my tsh showed normal level) up to october 2009 when i felt fast heartbeat, i went to my doctor again and have my t3ft4 and tsh checked.. sad to say that my tsh had dropped to .008 hence im toxic again. i was advised by the endoc to have a radioactive iodine as soon as possible, im not yet ready to do that thing but i wanted to get rid of this disease, pls advise me should RAI be alright for me. I need your help. pls doc gerry, enlighten me on having RAI.

    thank u very much and im waitng for ur reply on this. God bless Doc Gerry!

  246. Yan Says:

    Hi there Dr Gerry

    This is the 1st time i log in to this website and finding some answer for my question. Im 23yr old and i just went for tyroid operation, soon i will be going for radioactive iodine for thyroid then i will be taking Euthyrox for my lifetime. I would like to know will it affect my pregnant it the future..

    I hope that you will reply me as soon as possbile, because this question keep bothering me and it will affect my lifetime decision as well.

    Thanks

    • Doc Gerry Says:

      Hi Yan… Nope…Levothyroixine is safe and should not in any way prevent you from becoming preggy. Hope if your case is cancer..your MDs did prognostication first before deciding whetehr you need RAI or not. Good luck.

  247. Lance Cervantes Says:

    good dsy dr gerry! i have PCOS for about 3 years already but it was only about a month a go that i started to take metformin and later will be changed to galvusmet..i was also recently diagnosed with HPN and was taking losartan 50mg daily.. is it ok if i take liver aide, vit c and e along with my other meds? when i take galvusmet, my doc said to take it before meals, is there a specific time frame or like minutes before meals that i should follow to make it more effective? thank you so much and more power!

  248. Mary Says:

    hello doc,i will just be brief and go straight to the point.its about this vibrating and ringing like the strings of a guitar or voilin sound that is happening in my mothers ear.it has been going on like this for about 5 years now.though after series of scan and prescribed medicines from my doctor the ringing sound has reduced but just a little bit.pls help my mom out what do u think

    • Doc Gerry Says:

      Mary… tinnitus is the most likely problem your mother has. The best specialist would be a good EENT. Try asking friends which among the EENT guys in your area they would recommend

  249. Sandy Mel Says:

    You mention only two surgeons you can recommend for thyroid surgery. Can you give me their names? My friend has a very large benign thyroid nodule and surgery has been recommended.

  250. Deb Says:

    Hey Doc Gerry!

    I want to visit you on Monday but my appointment should have been scheduled on september this year, unfortunately, I wasnt able to come. Are you available Monday doc?

    Thanks

  251. gerlee Says:

    my mom skin and eye color turns to yellow after taking the antithyroid med called tapdin…is it a side effect or is there any reason why her color changed?pls hepl me

  252. imelda Says:

    Hi Doc! Just want to know if you’ll be having a clinic this coming Dec. 28-29, 2009. I have a cousin who is diagnosed as having capillary carcinoma and wants a second opinion. I tried to call the clinic but then it’s on answering machine. Hope to hear from you soonest possible. Thanks & Merry Christmas!

  253. Joel Cruz Says:

    Hi, Dr. Tan. I admire your website very much. I am currently seeking a new endocrinologist for my mother who has a hyperthyroid condition but I am sad that you are based in Cebu.

    Sorry to write to you at Christmas Eve but I wanted to seek some thoughts on my mother’s condition. The endo she’s been seeing has been prescribing her Tapdin on and off for the past few years at 3 month intervals (her periods for TSH tests). Around middle of this year, instead of the usual 3-mo. period of taking Tapdin he asked her to take it for another 3 mos. Making it around 6 mos. in total. Around the 5th month, my mom was complaining of vertigo, discomfort, etc. She somehow equated this to the Tapdin and she says the symptoms stopped when she stopped taking the med.

    She reported this to her endo and he just agreed and anyway put her back to her 3 mo. cycle of Tapdin. Just this month, she was required though to take 30mg. Tapdin for 1 wk and then 20mg maintenance in preparation for an endoscopy and CT Scan in relation to stomach pains she has been having recently. Just today, her vertigo and nausea came back and she related it to the medication again.

    THe endo explains that no such side effects are related to taking the medication. My mom is also a bit of worrier and she is high strung. I am inclined to believe the endo that it may be psychosomatic but I also just want to make sure, that’s why I want to seek a 2nd opinion from a new endo. What are your thoughts on this, doc? I would really appreciate your thoughts since she is scheduled for endoscopy on the 30th already and if she potentially gets scared to continue the medication the sched for the procedure will of course be affected. On the other hand, I also want the endoscopy and CT scan to proceed since her stomach pains are also another problem to investigate. Thanks again and Merry Christmas!

    • Doc Gerry Says:

      Hi Joel… tough question regarding a possible side effect without the advantage of examining her. Just like any repair to any defective machines, there ar several ways to repair and depending on which wkind of repair can do the trick. My opinion on your case can only be made if I have the privilege to examine her neck.

  254. karlimae Says:

    Hi Doc! I’m currently in abu dhabi and I was just diagnosed by a doctor here that I have tennis elbow. I was given a cortisone injection on my first visit last dec 26. Then the doctor prescribed kotoprofen gel(applied in the elbow in the morning and everning) and etoricoxib (taken after breakfast). I forgot to mention to him that I’m taking thyrax for my hypothyroidism. My question to you is, would there be a problem when I take this medicines? I take thyrax in the morning after waking up then I take the etoricoxib after breakfast. Please advise. Thanks.

  255. Rick Chong Says:

    Hello Doc,
    I did a threadmill test [twice] withing a one month period and the overall impression was a positive stress test typical of ischaemia. I was advise for coronory angiogram to find out out if if i had significant underlying disease as mentioned.

    Question here is that:

    [1] is there any significant risk involved if i continue with my jogging knowing of the above?

    thanks & regards,

    Rick

    • Doc Gerry Says:

      Hi Rick… ETT is a good screening test to determine if there is a a blockage to your vessels from whatever risk factors you have. Typically a positive stress tes requires angiogram and I would recommend that you proceed with the imaging prior to continuing your exercise regimen.


  256. Very nice article I enjoy your website keep up the great blog posts

  257. Movie Pig Says:

    Very nice article I love your website keep up the amazing articles

  258. Melody Says:

    Hello Doc, I’ve just browse our blog and im so amaze in your website. Is it possible ba doc na i can be pregnant? Im taking metformin (neofrom) and folic acid. im 2 yrs married. wala po bang side effect ang pag take ng metformin? is there another best medicine for me to get pregnant?

    thankz & God Bless

  259. Mark Says:

    Gudday

    Hi doc gerry, thanks for this site……..

    Doc, my concern is…….

    On July 2008, accrdng to my 1st ENT doc I have a hypothyroidism stage base on my bloodtest lab. result(tsh,t3 & t4). He prescribed me to take euthyrox 50mcg for 3months and afterthat im going back again to him together my bloodtest result n found out that my bloodtest lab. result back to normal.But my goiter size didn’t decrease so he again prescribed me to take synthroid 75mcg for 3 months trying to shrink my goiter and that time im always had a hard breathing, loosing weight, unconfortable to my health and etc.Due to my worrying on my Health I decided to look another doc.

    On Jan. 2009, I found my 2nd surgeon doc. and i told him about the case of my 1st doc. and also i shows all my previous bloodtest lab. result. He again advice me to undergo bloodtest lab.(tsh,t3&t4) and ultrasound test. Afterthat i go back to him together w/ the bloodtest lab result and 1st ultrasound result.He said to me that my bloodtest lab result was normal and i have two thyroid nodules left and right, let say the sizes was like the size of a diameter of a 25cents coin.He prescribed me again euthyrox 50mcg for 6months to take together w/ the aphebone multivit. for 3months to try to shrink the size of my nodules. And goodnews i felt comfortable to my health and i have gained weight from 52kgs to 57kgs.After 6months of taking the medicine I come back again to him last aug. 2009 together w/ my bloodtest lab. result and my 2nd ultrasound test result.He again said to me that my bloodtest lab. result was normal but on the other hand my 2nd ultrasound result unfortunately my nodules was increasing the size let say X2 increased of the previous size. And He advice me to undergo surgical on my neck. Due to financially problem I agin look another doc.

    On Oct. 2009 I have found again my 3rd ENT doc.
    I discussed again about my previous medication and also all the lab result. and he gave me metroidazole 500mg and cloxacillen 500mg for 2x a day good for ten days and advice to maintain diet such as eating of fiber foods and not to eat foods that have monosodium or delicious food, only fruits and veg. i have to eat. After 10 days I again come back to him and he told me to continue my diet of what he said before to see if will shrink my nodules and prescribed me to take multivit.And again he told me to come back to him on dec. 2009.But I felt there’s nothing positive change to my neck and continuing to become bigger the size let say as of now like the size of my adam’s apple and Im worrying because its visible.
    And as of now im taking Herbal Medicine like First Vita Plus Herbal juice drink trying cure my neck problem.

    Doc base on my history that i presented to you there’s a chance to shrink my nodules or nedd to undergo surgery?

    I highly appreciated your feedback on me…..thank you for this site very helpfull ang informative.

    Goodbless doc.

  260. Amy Says:

    Hi Doc! I would just like to get a second opinion… I had a partial thyroidectomy in 2003 and have been on thyrax eversince. I also had GDM during my pregnancy in 2006, so I am definitely a candidate for diabetes.

    Recently, my dr. diagnosed me to have impaired fasting glucose, so prescribed 500mg of metformin. then i came across an article on the internet that metformin suppresses thyroid medication. is this true? is it ok to tell my dr about it?

    Thanks, Doc! You are a blessing!

  261. sheryl ladot Says:

    Dear Doctor Gerry,

    last year i was diagnosed for having a toxic goiter. and now my doctor advised me to take methimazole tapdin, 20mg before meal in the morning and half of that in evening before meal also. First, it was 15 mg in 1 day. Since i take that medicine, there are times that i find it hard to breathe like there,s not enough air. and i often feel that my heart beats faster. and i had lost lot of weight also.
    my friend told me that she has a friend that also have toxic goiter, and that her was being injected by some kind of medicine once a month.
    should i continue taking up methimazole tapdin or is it better if i just choose injected medicine?
    what other option can you suggest doc? thanks in advance.

  262. ava cariquez Says:

    Doc Gerry,
    Gud pm. I am greatly thankful for your compassion in helping thru online. Thanks Doc. I just want to know if its ok if I take gluthatione med with my other meds like liverpro, allopurinol and ziac? Please advice Doc. God bless.

  263. Kara Says:

    Hello Doc i stumbled on this website while surfing about total thyroidectomy. I had a TT Jan 7 2010 due to papillary Ca, and RAI last feb 15. I gained 4 lbs since the surgery i am now 100.5 lbs, 5’3″. Im used to having a fast metabolism and i hardly gain a lb even if i over indulge in food but now i have to restrain myself because of unexplained weight gain..im taking 125ug thyrax and will have my tsh t4 drawn on 2nd week of march..Doc what is the right dose to prevent weight gain? im just getting really impatient and worried i might balloon up. Also its been a month and 3 weeks post op and my Calcium level is still not normal, is this bad? thanks a lot..

  264. Sam Says:

    I have been looking through your site and understand that you are keen in responding to all. Here I need an important information. I came across in some Canadian literature that 6 patients receiving Rosiglitazone reported with Parotid swellings. I need to know as Vildagliptin too has similar actions and reactions, can patients present with Parotid swellings almost mimicking MUMPS? Hope to hear from you.
    Sam

  265. alex Says:

    hello doc gerry! my doctor prescribed me Godex for the aid of my liver..According to him, there is a portion on my liver na “nangangapal”..Someone told me that METhatione is originally a liver aid as well..can i replaced “Godex” with MET? I still have stock of MET here and planning to use it instead of buying Godex..please advise thanks.

  266. burberry Says:

    hello doc gerry!doc i hve pcos!i did everything doc to get pregnant but nothing happen jud doc!ni undergo ko ug iui with dr.marivic tan pero wa jud ko ma pregnant doc kay w man mu rapture akung mga eggs!but last year doc i got pg naturally pero na ectopic pregnancy man!doc pls help me!!thnx

  267. rea Says:

    Hi doc, m already 1 yr married and until now m not yet pregnant. Recently we decided to consult to an OB gyne and we found out that m not ovulating and the doctor advise me to take neoform 500 to loose weight and control sugar. doc, just want to ask if i have a big possibilities that m get pregnant while taking neoform 500. thanks and looking forward to read your replies to my letter

  268. kara Says:

    Hello doc, I wrote earlier and im still waiting for your reply :) anyways, i had RAI therapy for papillary cancer feb 15 2010 and two days after taking the rai until now which is more than a month ive been having constant joint pains. My doctor says im her only patient who has this symptom but after researching about this in the net there were some people who experienced joint pains as well after rai..this is so uncomfortable, would you care to enlighten me about this post rai side effect? tnx alot

    • Doc Gerry Says:

      Hi Kara… Rai as a cause of joint pain is not heard of as a common complication. I am not sure where your joint pains are coming from form the limited info you gave. You need to be evaluated further by a specialist like a rheumatologist.

  269. raven Says:

    hi doc, It was good to know that you created a website like this…
    doc, you see i have a aunt that opetd for a dialysis. the first reason is that they dont have enough financial resources for the dialysis. going for a dialysis is too costly right?? but what must she do as an alternative way since she decided no to undergo Dialysis.
    when she was admitted last wed morning.the doctor said her heart is already enlarge and she wasn’t able to urinate until she went out to the hospital a few hours ago. She is also a diabetic patient.
    they signed against medical advise and right now she is at their home she still wasn’t able to urinate and has an oxygen for breathing.
    what do think doc is her chances??
    hope to her from you doc..kindly answer my question in my email.. loking forward for you’re reply..

    • Doc Gerry Says:

      Hi Raven… not good…dialysis acts like an artificial kidney since her kidneys are not functioning anymore. WE need the kidneys to get rid of waste products in out body…so if these waste accumulate, the patient suffers. Noalternative to dialysis execpt kidney transplant.

  270. armie Says:

    hi doc, i found this very informative and helpful, thanks for sharing ur knowledge to us. I was diagnosed w/d toxic thyroid/graves d, last feb. My FT4 was 74, and TSH < 0.06. My endoc gave me 15 mg strumazole last feb 14, for 2 weeks. Then made it 30mg a day, in march 2. But aftr 2 weeks (mar 14), I was rushed in the ER, due to very low wbc . My dktr ordered me to stop strumazole and gave prednisone for my wbc to go up. She told me i could not go back to anti thyroid drug anymore since my wbc got too low. Only RAI or surgery, but she said that to perform surgery, my thyroid hormone should be at least 20, otherwise surgery cant be possible. She gave me 200mg PTU, for my t hormone to get low, and ask me to decide which option i prefer. My right eye is slightly protruded and sometimes painful. Doc, in my case, what could be my best option, so that i will not or have minimal side effects, what could be best for my eyes not to have complication. Ur least advice could be very helpful for me in deciding. Pls help me doc, im so confuse right now. My doc gave me only 2 weeks to decide. Do i have to find another doctor for second opinion? Can you recommend someone from PGH? Im from dasma cavite and sorry for this very long message. May God continue to bless you and your advocacy to help others!

    • Doc Gerry Says:

      Hi armie… you may elect to seek a second opinion…no harm in doing so. Again in any thyroid case, it is best to palpate the neck before we give our opinions or diagnosis.

  271. armie Says:

    hi doc, my doctor also gave me propranolol, 40 mg, 3x a day! I felt great since my palpitations, pounding heart, and nervousness went away. But how long can i take it? Thanks a lot doc!

  272. Mark Says:

    Gudday

    Hi doc gerry, thanks for this site……..

    Doc, my concern is…….

    On July 2008, accrdng to my 1st ENT doc I have a hypothyroidism stage base on my bloodtest lab. result(tsh,t3 & t4). He prescribed me to take euthyrox 50mcg for 3months and afterthat im going back again to him together my bloodtest result n found out that my bloodtest lab. result back to normal.But my goiter size didn’t decrease so he again prescribed me to take synthroid 75mcg for 3 months trying to shrink my goiter and that time im always had a hard breathing, loosing weight, unconfortable to my health and etc.Due to my worrying on my Health I decided to look another doc.

    On Jan. 2009, I found my 2nd surgeon doc. and i told him about the case of my 1st doc. and also i shows all my previous bloodtest lab. result. He again advice me to undergo bloodtest lab.(tsh,t3&t4) and ultrasound test. Afterthat i go back to him together w/ the bloodtest lab result and 1st ultrasound result.He said to me that my bloodtest lab result was normal and i have two thyroid nodules left and right, let say the sizes was like the size of a diameter of a 25cents coin.He prescribed me again euthyrox 50mcg for 6months to take together w/ the aphebone multivit. for 3months to try to shrink the size of my nodules. And goodnews i felt comfortable to my health and i have gained weight from 52kgs to 57kgs.After 6months of taking the medicine I come back again to him last aug. 2009 together w/ my bloodtest lab. result and my 2nd ultrasound test result.He again said to me that my bloodtest lab. result was normal but on the other hand my 2nd ultrasound result unfortunately my nodules was increasing the size let say X2 increased of the previous size. And He advice me to undergo surgical on my neck. Due to financially problem I agin look another doc.

    On Oct. 2009 I have found again my 3rd ENT doc.
    I discussed again about my previous medication and also all the lab result. and he gave me metroidazole 500mg and cloxacillen 500mg for 2x a day good for ten days and advice to maintain diet such as eating of fiber foods and not to eat foods that have monosodium or delicious food, only fruits and veg. i have to eat. After 10 days I again come back to him and he told me to continue my diet of what he said before to see if will shrink my nodules and prescribed me to take multivit.And again he told me to come back to him on dec. 2009.But I felt there’s nothing positive change to my neck and continuing to become bigger the size let say as of now like the size of my adam’s apple and Im worrying because its visible.
    And as of now im taking Herbal Medicine like First Vita Plus Herbal juice drink trying cure my neck problem.

    Doc base on my history that i presented to you there’s a chance to shrink my nodules or nedd to undergo surgery?

    I highly appreciated your feedback on me…..thank you for this site very helpfull ang informative.

    Goodbless doc.

    • Doc Gerry Says:

      Hi Mark…better still you see an endocrinologist. Diiscuss with him your history and it is very important for us to feel your neck and palpate your thyroid gland. By then I can give you my opinion.

  273. grace Says:

    hello doctor gerry:)im glad i saw this site cz there are plenty of questions about my brother’s medications i would like to ask..my brother is taking an antipsychotic drug called zyprexa and his doctor prescribed him to take zithromax for his 1 week cough.actually this has been newly prescribed by his doctor after amoxiclav cause there was no improvemtn in his cough,so he decided to give him zithromax,i was wondering, will zyprexa affect the effects of zithromax and will vidastat also affect it?

  274. jtm Says:

    gud day doc gerry!

    I would like to inquire something. i am taking 150ug of thyroxin as you prescribed, now i’m here in Libya and i’m almost out of my daily supplement, they only have one brand, 50 and 100ug of levothyroxine in the pharmacies here, but these tablets are big unlike the 150ug thyroxin you prescribed me back in the philippines which are considerably small. Is it ok to change my medication from 150ug to this new brand. hoping for your reply. thanks and more power doc!

  275. hazel Says:

    hi! i just want to ask if it’s okay to bring metformin neoform outside our country without the prescription? i lost the prescription my ob gyne gave me and she’s in the US right now.thanks!!

  276. Gia Villar Says:

    Hello Doc, Gia here from Pasig City. I currently have hyperthyroidism. I am taking meds already and my blood test is due next month. Having a complete thyroidectomy in case I would need one doesn’t worry me, BUT I only have one kid up to this time. I’m still planning to have 2 more kids. If my thyroids are completely removed, can I still get pregnant?


  277. Hi Doc,
    I’ve been trying to call your secretary in your clinic almost everyday. Your phone is always busy the other phone is ringing but no one answered. I would like to have my appointment for my semi-annual checkup hopefully by May 28, 2010.
    Thank you and best regards.

  278. Carmen Tan Says:

    Good day doc gerry! I am now learning to use my laptop in my own slow pace. Surfing the net has become an enjoyable chore day to day.Your website is a delight to read PLUS the pics of places you shared to your readers. Doc 1 question lang> Is Splenda , a no calorie sweetener safe to use? This product is not the same as Equal

    Good day doc gerry. I am now learning to use my laptop on my own slow pace. Surfing the net has become an enjoyable day to day chore. Your website is very informative plus a delight to see the views of places you have visited.
    Doc Gerry please advise if SPLENDA, a no calorie sweetener is safe to use. Is this not the same product as EQUAL?
    tHANK YOU DOC AND HAVE A NICE DAY.

  279. tin tin Says:

    hi doc,

    i had hyperthyroidism 2-3 years ago, got pregnant,gave birth with no complications. My medication was lowered as my T$ is normal until my medication was totally stopped after giving birth.It been 2 years now with out meds and my t4 is normal according to my check up tests every 6 months.My left eye is also getting small ( it was big before)due to grave’s disease. Doctor did not gave me meds for my eye…just told me that it will heal slowly.I wanted to know if there’s a medicine for my eye to make the healing a little bit faster?it’s not painful at all… and i can say its healing…thanks doc….just curios

    • Doc Gerry Says:

      Chritine…no supplement can make the eys heal faster. Just make sure that you dont get a recurrence of your toxic goiter. Recurrnce is determeined by how well you were titrated downwards with your antithyroid meds.

      • tin tin Says:

        Dear doc,

        thank you… i am having my t4 tested every 5-6 months to ensure that my t4 is normal…since 2008 up to present my t4 has been normal…with visible improvement n my left eye….is this t4 test enough to ensure that my hyperthyroidism is under control?

      • Doc Gerry Says:

        Christine…definitely not…get a TSH and a FT4

  280. au herradura Says:

    hi doc gerry,pls advice me of what other way i can do coz my husband failed to urinate dis past two days,he is on dialysis 2x a week.,although i supposed to be 3x but because of financial reason we cant accomadate it.i have heard and read of bioenzyme and i want to try it for him..it was last dec that he was diagnosed of kidney failure..pls rply and thank you..god bless you and your family…

    • Doc Gerry Says:

      Again…Au this question is out of my confort zone. But definitely he needs a dialysis and once you are ona dialysis then dont worry of he no longer urinates just amke sure he goes thru his weekly dialysis as scheduled by your doctor

  281. candice Says:

    me nd my bf are tryin to concieve nd have been tryin for 2 yrs nd havent yet wut advice or supplements can u give or reccomend

    • Doc Gerry Says:

      Candice tough question to answer because again i dont believe in supplements. Your just need a workup to make sure all the systems for reprodcution are up and running

  282. Pat Gigliotti Says:

    Hi Doc
    What is the healthy amount of eggs one should consume per week? My Grandson is eating at least two eggs a day, sometimes 3. Is this a healthy amount? When he is at home he rarely eats an egg. While vacationing with me he has eggs everyday. He is now itchy, at times, on his neck and back etc. Is this a result of eggs?

    • Dora Says:

      Doc Gerry hasn’t replied for a while. I guess he’s busy. But if I may help, we consulted a nutritionist a couple of months back since my father has really high cholesterol. The nutritionist said that it is safe to eat 2-3 eggs per week. But the nutritionist did warn that eggs have really high cholesterol and recommended that my father refrain from eating more than 3 per week. But since you mentioned that he’s your grandson, I’m not sure about the recommended serving for growing children though. To be on the safe side, I believe that moderation is the key. I hope this helps. I just needed to reply to this post since it’s timely. We did see a nutritionist a couple of months back and I’m just sharing what she told us.

      • Doc Gerry Says:

        Thanks Dora… you are abosulutely right… been extra busy with something else both transferring to our new and better medical office and transferring all the files, computers, etc was so much hassle! Plus making sure that new cabinets are made in time for our transfer etc.

    • Doc Gerry Says:

      Hi Pat…for a growing kid… it should be fine especially that he only indulges when hes on vacation. Itchinees due to eggs? doubt it as the culprit

  283. Malou alo Says:

    Hi, Doc just came across this U.S. supplement that provides energy to our mitochondria in our cells bec. provides polysaccharide and polypeptide. They have clinical studies here in the Philippines that eventually helped people with diabetes, cancer, heart diseases and even women who have concerns were able to conceived. Can you please evaluate this functional food product called Alfa PXP Plus, this is BFAD approved.

    • Doc Gerry Says:

      Malou…please dont associate or mistake the word BFAD approved as a sign that it is based on evidence or scientific data. BFAD approved means they have met the requirements set by BFAD as a supplement meaning no therapeutic claims meaning no sicnetific evidence meaning : YOU TAKE THEM AT YOUR OWN RISK!… in short…a supplement is a supplement and nothing more. You are taking a chemical that you dont know how it works what the outcome would be and what the side effects are because they have NOT been thoroughly studied! Selling supplement is a business and that business needs a good marketing arm to convince you to take them.

  284. An Says:

    Dear Doc Gerry,

    I would like to ask about chemotherapy. My friend was diagnose with chronic leukemia and he was in treatment for 4-6 months for 5 days every month. He said to me its stage 1 but how the chemotherapy is 5 days for every month? I ask some friends who done chemo here in Phils but its one day every month not 5 days. I think his illness is worst coz his chemo is 5days every month. What do you think?

  285. Dora Says:

    Hi there Doc Gerry. I was supposed to go to you for consultation but it would seem that you’re out of the country a lot. I’ve heard that you’re a very good endocrinologist. Anyway, I’m diagnosed with hyperthyroidism and was told to take Tapdin. However, there’s a really bad side-effect– I now suffer from acne and it’s really getting worse. I can really say that it’s the medication that’s doing this because before I took the medication, I had clear skin and would get pimples rarely. Right now, the pimples are really bad which prompted my doctor to switch to PTU which made it even worse. I had to stop taking the medication since my acne is getting really bad. Is there a way that I can take goiter medication without the side-effects? My dermatologist said that she sees patients with similar problems. She said that the worse is PTU since it causes acne. What should I do? And how can I stop the acne? I know I need to take the goiter medication but I just have to stop because my acne is really out of control. Hope to hear a reply soon. Thank you so much!

    • Doc Gerry Says:

      Hi Dora… I need to see you because again a diagnosis of toxic goiter requires me to have a feel on your neck. Base don my clinical impression then I can give you my opinion of meds are for you or not

  286. Ella Bejemil Says:

    Hi Doc, I’m new here so I really don’t know how your blog works. My friend told me about your blog. I hope you could help me.

    I am 20 years old and has been suffering from hyperthyroidism for 2 years now. I’ve stopped taking methimazole for more than 5 months now. and now, here comes the problem. I am really having a hard time coping up with my routines. I’m a student so sometimes it’s such a burden not to be able to sleep at night. My symptoms are getting worser each day and my goiter is becoming visible. I’d like to ask if there are medications that can stop or can make the growth of my goiter more slow. It’s really hard keeping up at school when I keep on hiding my neck from people especially since I’m a student nurse. The “poto” thing is the worst thing that happens when I’m on duty. Nagiging visible ang neck. grr.

    It has been 2 years. I’m in my fourth year now and next year would be the board exams. I really dont want to stop schooling. By the way, do you know any hospitals in Cagayan that offers RAI therapy? How much would it cost me? and for how many days will I be staying at the hospital.

    Thanks Doc! It would really mean a lot to em if you could reply. thanks!

    this is the worst dilemma that I am in.

    • Doc Gerry Says:

      Hyperthyroidism isvery easy to treat…you just need to trust your endo and his preferred treament of choice… I believeCDO already has RAI facilities.

  287. josie Says:

    Doc, I’ve been to 3 endocs,(one after the other) been taking medicines, since 2000-2009. There was no change at all-mean the size of the nodule .I got tired of taking medicines, I stopped and didnt go to my latest endoc. My last doc was a homeopath. she said stress caused the problem in my thyroid gland. Now I noticed, it is more visible. I want to take natural med. I heard VCO is also good. What do you think thanks and God Bless

  288. mhilz Says:

    good day…doc i have a history of grave’s disease and post RAI 1999 in Manila.now my Endo doctor told me that i have no longer hyperthyroidism but i still maintain taking thyrax 125mcg daily.my concern now is that i want to take gluthathione orally,is it safe for me doc having a maintenance drug which is thyrax?i’ll wait your reply doc….thnx and more power…

  289. Aileen Says:

    I have a 7 year old daughter whose growth increment is very low. In fact, she is currently at a very low percentile on the weight and height chart. I would like for her to be seen by a pedia-endocrinologist or an endocrinologist. Anybody you can recommend here in Manila?
    Thanks.

  290. Emilie Nuguid Says:

    Dear Doc Gerry,
    My husband has been sick for the last 3 weeks. His right foot became swollen then it got better. I am suspecting that he is positive for diabetes. I had his blood tested using the blood glucose monitoring system kit and it registered 340. I am encouraging him to see a doctor and have further test to confirm whether he is positive or not with diabetes but he refuses to do so. He said he will be just be careful with his diet and he does not like to submit himself for testing because it might also discover other diseases like heart disease or kidney problem or prostate cancer. I am so worried about his health. There are occasions that he wakes me up in the middle of the night saying that he has chest pain or he feels dizzy or simple not good. Please give me some pieces of advise how i can convince him to see a doctor. Thanks.

    • Doc Gerry Says:

      Emelie…typical male patient hehe. Well tell him diabetes is a treatable disease but can cause disability in the long run if not treated properly. Tell him if he considers his body his own house…he wants it clean so he can live in that house comfortably and easy. If he does not take care of it and gets dusty and dirty then one feels sick all the time. Its the same with his body, if he does not take care of it now and get rid of the excess sugar circulating then eventually his heart will fail, his kidneys will fail and dirt will accumulate in this body and therefore he will feel miserable evryday of his life. Now that we dont like. we want to enjoy and feel good all the time. And treating diabetes is easy and with a purpose…to prevent one from feeling ill , to prevent one from suffering, from getting sick or complication like blindness or stroke which can really make life miserable for him and his family! Good luck I hpe thisshort explanation can do the trick!

  291. jade castro Says:

    hi doc im jade……ultra sound result

  292. jade castro Says:

    ULTRA SOUND RESULTS

    the right lobe is normal in size with a homogeneous echo pattern. ther is no mass seen

    the left lobe is inlarge with a complex mass at the lower 2/3 measuring around 7.5×3.2×7.78cms (LHW) with extension of the mass to the isthmus. the wall is smooth. there is minimal vascular flow within the solid portion of the mass. the mass extends to the isthmus.

    impression:

    complex mass,left lobe 2/3 with extension to the isthmus normal right lobe…

    hi doc please help me give some advice for this im done olso biopsy resul is colloid goiter negative for malignant….pls doc…..im so worried.thnx god bless.

  293. jade castro Says:

    hi doc im jade
    ihave my ultrasound result:
    the left lobe is enlarged with a complex mass at the lower 2/3 measuring around 7.5×3.2×7.78cms (LHW) with extension of the mass to isthmus.the wall is smooth.there is minimal vascular flow within the solid portion of the mass

    impression:

    complex mass,left lobe lower 2/3 with extention to the isthmus
    normal right lobe:

    im done olso biopsy my result is negative for malignant,colloid goiter left side.pls help doc give me some advice.thns.god bless.

    living in cdo.

  294. jade castro Says:

    hi doc…….can u tell me status of my thyroid some surgery ned of this…..please help me doc im so2x2x woried of my thyroid problem….

    jade castro..

  295. jade castro Says:

    hi doc jade castro again.

    doc please till me the status of my tyhroid problem ultra sound is done…i have plan 2 visit in cebu by dec and 2 met u personaly..

    please help me doc…give some advice.

  296. Nexiq Says:

    Thanks for all the great health articles. I visit often to read them.

  297. jade castro Says:

    hi doc jerry…

    regarding my messge about my ultrasound sound result…and till now no rply regrding some avice…i knw u can help me most…..till now waiting for the adse some surgery in my case or medicine….please help me doc……

    regrds & god bless 2 ur family.

  298. hon Says:

    hi doc gerry,

  299. hon Says:

    hi dic gerry,
    i jst wnt to ask if thyrax or synthroid levothyroxine could possibly damage my kidneys? coz when i read on “how to take care of your kidney”, one of the advice is that dont take drugs with hormones, and too much sodium could damage your kidneys….pls answer my concern doc…and thank you so much!

  300. jade castro Says:

    hi doc im jade
    ihave my ultrasound result:
    the left lobe is enlarged with a complex mass at the lower 2/3 measuring around 7.5×3.2×7.78cms (LHW) with extension of the mass to isthmus.the wall is smooth.there is minimal vascular flow within the solid portion of the mass

    impression:

    complex mass,left lobe lower 2/3 with extention to the isthmus
    normal right lobe:

    im done olso biopsy my result is negative for malignant,colloid goiter left side.pls help doc give me some advice.thns.god bless.

    living in cdo.

  301. Junalyn Says:

    Hi doc. I have a couple of questions to ask which i know wud help me a lot.

    I underwent total thyroidectomy last May 2010 and Im now taking euthyrox or thyrax daily? I was prescribed 100mg but I was gaining weight so I took 150mg for 1 month now. Is there any side effect of taking more than my dosage?

    Also, I read in one website that Gluthatione is good for people with thyroid problem so I want to try. I am still waiting for my scheduled check-up to ask my endo yet I wanted to change my endo because she seems not accommodating to my questions. Can I try it as an antioxidant and to boost my immune system?

    thanks a lot for answering my questions. God bless you po!

  302. analie Says:

    is it safe to take liveraide and glutathione at the same time?tnx po

  303. Kh.Sanjeev Kumar Singh Says:

    Sir,
    My mother had undergone total thyroidectomy surgery after she was diagnosed with papillary carcinoma of thyroid on January 2010. She had also undergone radio-active iodine therapy on March 2010 at the TATA Radiation Centre , Mumbai, India, and the next follow up date given by the doctors was November 2011.But few weeks ago her thyoglobulin level was very high.Doctors suggested to have Radiocative Iodine Thyroid scan done very urgently. Sir , What should we do now ? Is papillary carcinoma of thyroid not completely curable ? I’ am very much worried . Please give your valuable advice…. Thanking you.. Regards..

  304. blessie Says:

    Happy Holidays, Doc Gerry!
    I was one of your early morning patients who were not able to see you last june (supposedly my 3rd visit) of this year due to the limited time of consultaion for you had a visitor to attend to. I could not find another schedule since I was scheduled to be here in the US last August. I have been finding ways on how to reach you. Finally, I found this blog site. I was diagnosed with multinodular goiter and have been taking 100mcg of levothyroxine since January 2010 until now that I am on my 12th week of pregnancy. My concern is, would it still be safe for the baby? Should I continue or stop taking the med?

    • gay Says:

      Hi Dr. Gerry,

      I have a similar situation as blessie’s (December 18, 2010 post). I have been on 150 mcg of levothyroxine sodium since September 2010 for the treatment of a single cystic nodule. I am now on my 8th week of pregnancy.

      And like blessie, I am concern if taking levothyroxine sodium will be safe for the baby. And if so, is the 150 mcg dose all right? or is it considered high?

      Thank you…

    • Doc Gerry Says:

      Hi Blessie..please stop the drug..it is safer this way and well jst recheck your status after delivery

  305. jeanielly Says:

    Hi Dr. Gerry,

    Im jeany from Butuan City.i just wanna share to you my health problem. hoping to enlighten my mind. I discover that i have a goiter since june 2008.it started to a small one but in dec. 2009 i get pregnant. and it become bigger and bigger until i deliver my child on Aug. 2010. Now im worry if it will be cure by medicine or it need an operation.

    Im planing to go in Cebu to have my check up..What hospital could cater my needs?

    hoping for your answer..

    thank you

  306. marjon Says:

    Dear doc gerry,
    My wife diagnosed to have a thyroid nodule. Accdg. to her endo, she is not hypo nor hyperthyroid bec. the result of her UTSH & FT4 is normal while her biopsy is benign.
    Result Ref. Values
    UTSH (Elecsys) -1.77 0.27-4.20
    FT4 (Elecsys) -19.57 12.00-22.00
    According to her endo, the nodule is small and there is no urgency for an operation. He suggested that every after 8 months, she has to undergo for an ultrasound to monitor the size of the nodule. But he did not prescribe any medicine to take bec. accdg. to him, it would make my wife’s goiter toxic. That’s the thing I want to ask you doc Gerry.. I want to know if there are medicines that would suppress or prevent the growth of my wife’s thyroid nodule. If there is no medicine for that case, is it ok if she will undergo a surgery? Although, the size of the nodule at present is not a problem to her since it does not affect her physically still she is worried because the nodule might grow bigger at the time goes by specially when she will again give birth. What can you advice on this matter doc. Thanks doc, your advices will be a great help for us..

    • Doc Gerry Says:

      Hi Marjon… you know questions on goiter is difficult for me to answer because I hate giving advises on something I havent seen or feel. To treat a goiter is to make sure you felt the goiter..the size, the consistency, etc. Surgery is definitely an option but make sure you discuss with your endo that it should be a procedure that will assure you that it will never come back…and make sure you get a good surgeon.. a surgeon that your endo can vouch as having the best postop experience in terms of postop complications.

  307. kc Says:

    hi doc.. i just want to ask maybe you have a personal knowledge on the matter.. ahm, is there any scientific basis on taking (not chewing) “sili” for treating hemorrhoids??

  308. Ida Says:

    Hello doc, glad to come accross this site of yours. I regularly check my TSH, FT3, FT4 becoz i am prone to hyperthyroidism. My latest result is:

    TSH 0.069 mlU/l,
    FT3 5.37 pmol/L
    FT4 19.99 pmol/L

    And my neck is slowly getting bigger, my symptoms are back, hyper & nervousness, depression, memory loss, short attention span, fatigue…

    I want to stop my neck from getting any bigger without surgery, pls. kindly help me. I am in the middle east. God bless & thanks in advance…

  309. joli Says:

    dear doc. gerry:
    i would like to thank you for your valuble information..i found this website accedently, and i like to ask you if it is possible to take glutathione pills 500g/day with vit.c 1000gm, as i heard that they have lightning effect on the skin, i’m totally lost, what brand should i buy?, is it safe?…i am 28 yrs old, spanish, healthy, woman, regardless some digestion problems,in addition, i live in the uk.looking forward to hearing from you…thank you…

    • Doc Gerry Says:

      Hi Jolie… unfortunatley… whatever the effects of glutathione is… no medical therapuetic experts will claim them as based on evidence. So Please be cautious in taking supplemetns for vanity…they may cause you more harm long term.

  310. anjimartinez Says:

    hi doc! i am a Lupus patient SLE. i just want to ask if there is big possibility that i can have a goiter? if yes what would be the necessary precautions?,if i need to have biopsy?..please,answer..thank you!!

    • Doc Gerry Says:

      Hi anji… you amy develop autoimmune thyroid disorder but the risk is not high. no need to be too anxious about it because goiters are very easy to treat and are not life threatening

  311. Sarah Jane Says:

    Dear Doc Gerry,
    I’m from Bacolod City…I would like to ask if I could get away with therabloc as my maintenance..I was diagnosed with hypertension…and im taking therabloc 25mg…i feel fine everyday and check my bp daily and it is it has been stable 110/70..with diet and exercise… another thing doc…i had dermatitis just this week and i already asked my dermatologist about it she gave me creams and oral medicine like prednisone 15mg…i forgot to tell her that i’m on therabloc 25….Does it have any side effects if i take these medicines in one time? the prednisone is only for 7 days..

    Hoping to hear from you
    thanks again doc

  312. Gwazie Says:

    Dear Dr. Gerry,

    Good day!

    I’m from Cagayan de Oro. This tuesday we will be going there in Cebu to look for endocrinologist and manage my mother RAI therapy. She was diagnosed last Feb. 18, 2011 in St. Luke’s Hospital of having Cytomorphologic Findings Suspicious of a neoplasm of follicular cell origin with poor differentiation. Thus, she underwent surgical intervention; total thyroidectomy. Her surgical pathology diagnosis follicular carcinoma with anaplastic transformation, left lobe, tumor size 9cm with blood vessel invasion, lymphocytic thyroiditis, right lobe @ nonlesional left lobe surgical margins clear.Immunohistochemical stain results:
    calcintonin – negative
    synaptophysin – negative
    chromogranin a – negative

    I hope we can see you there.

    Yours sincerely,

    Gwazie

  313. may kalalang Says:

    hi Doc!

    i wish for you with your expertise and capacity to check on a product, which profile description i can send you. i don’t have any access with your email add but mine is ssmayk@yahoo.com

    thanks and God bless your big big heart

  314. anna reyes Says:

    hi dr.gerry,

    my mother is 69 yrs. old..she takes medicines for high cholesterol, diabetes, high blood. last week she was having a headache and was vomiting a little which she says was like acid. her stomach was also in pain. her family doctor said it was high uris acid. she was prescribed losec. is it high uric acid that caused this? she has been drinking iced tea for the last two months because of the heat and then she started feeling like that.


  315. doc gud am, i was dianosed last week that i have a goiter my doc gave me tapdin 2o mg. all my resuls are high.. iwll go to cebu dis mon. pls gve me your number in clinic 4 schedule . thank you

  316. Nicole Says:

    Hi Doc,

    Good Day!

    I’m sufferingToxic Goiter and the medicine that my Doctor gave me are Carbimazole and Propranolol tablet.What is the best medication for me?What are also the foods that are good and not good for me?

    Thank You.

    Respectfully yours,

    Nicole

  317. Rose Says:

    Hi doc, im 9w and 3days pregnant w pcos. Last yr, I was diagnosed w blighted ovum and underwent dnc. After this,ob advised me to take metformin 3x a day. By God’s grace I got pregnant again after taking met for 8mos. My question, is it safe to take met all throughout my pregnancy? Or until what trimester? Thank you very much and more power and blessings to you!

  318. oobie Says:

    I was diagnosed with hashimoto’s thyroiditis 3 years ago and doctors looked at my levels and told me I was fine – I felt like I was dying slowly.

    Fastforward to three years later and a really stressful time, I could not stand it anymore so I switched to a different endo – this one listened and she put me in Thyrax with the dosage being upped slowly. After a month and 3 weeks I started on 50 mcg and it seems I am back to square one. I am always cold, I have this nasty headache, and I feel just as tired. What is going on?

    Is armour available in the Philippines? I thought I’d be better by now.

    Any thoughts apart from “See you doc”? – I tried but she had an emergency. I will try to see her again in a few days.

    I Want this headache and heavy fatigue to just go away. I miss being energetic :( i feel so useless, can’t even drive now.

  319. Noel Miller Says:

    Hi Doc Gerry,

    Is it safe to combine Euthyrox with Glumet (Metformin)? If so, how should the dosage schedule go? And what are the indications if I take both?

    Thanks much! Hope to hear from you soon.

    Noel

  320. Lhai Jimenez Says:

    Hi Doc. is RAi always recommended if a patient has a papillary Ca? I undergo total thyrodectomy last july 21. What next treatement do you recommend? Thank you in advance :)

  321. Boracay Says:

    Its like you read my mind! You appear to know so much about this, like you wrote the book in it or something. I think that you can do with some pics to drive the message home a bit, but instead of that, this is magnificent blog. A fantastic read. I’ll definitely be back.

  322. Kareen Berol Says:

    Hi doc! I would like to know the names of the 2 trusted surgeons you recommend for thyroidectomy here in Cebu.

  323. joy Says:

    good morning, hi! doc……i just had my D&C last monday july 25, why is it still have blood? is it started my monthly period? how to get pregnant fast? how many months i can go back mt daily routine exercise?

  324. Jesz Says:

    hi Doc Gerry, just find out ’bout your website and thank u so much for doing this for us. May God bless you!!
    A month ago,I have a swollen thyroid nodules on the right side of my neck. I did an ultrasound test ~ well defined isodense nodule. I was prescribed euthyrox 50 for that before my blood result come out.
    Then, when my blood result came out, he just said that it was normal and i am fit for the operation.He does not say if i was diagnosed with any disease.
    Feeling a bit confuse, i met the other doctor, the second doctor said that my blood result is okay and normal, everthing is within normal range and he advised me to stop taking the euthyrox. he suggested that my thyroid nodule is acting up.
    Now, i thorn.. i don’t know what to do…what if i stop taking euthyrox, what ‘ll happen to my body hormone and thyroid ~ will it do more damage.

    Please help me doctor, i really do not know who to believe.

  325. Silvy Says:

    Hi Doc, Good morning.. I am seraching for thyroid specialists in the philippines and I am so glad that I have found this page. My boyfriend was diagnosed with hyperthyroidism last February. I want him to be checked in your clinic, can i have po your clinic address and contact number? Please Doc..

    God bless you more. Thank you.


  326. Hi Doc, Good Day! I was diagnosed of hypothyroidism 4 years ago, since then i was taking a medication “thyrax 50mg”. But now i stopped seeing my doctor and i was diagnosed again of hypertension. My querry doc is , is it safe for me to continue my medication while taking medicine for my hypertension? Please help me doc…

    More power to you and GOD BLESS…


  327. Hi Doc, Good Day! I was diagnosed of hypothyroidism 4 years ago, since then i was taking a medication “thyrax 50mg”. But now i stopped seeing my doctor and i also stopped taking my medicine because was diagnosed again of hypertension. My question doc is , is it safe for me to continue my medication while taking medicine for my hypertension? iis it also possible doc that hypothyroidism is one of the cause of my hypertension? Please help me doc…

    More power to you and GOD BLESS…

  328. dewei Says:

    hello doc just want to ask if you can treat a gynecomastia without any surgery? and if surgery is necessary how much would it be? are you still the surgeon?

  329. ryly Says:

    dear doc,
    hi! good day. i am 31 years old who wants to become pregnant. i am taking euthyrox 50 mcg30 mins before breakfast and another 50 mcg 30 mins before dinner. i i have hypothyroidism. can euthyrox affect my wish of becoming pregnant? can u help me or give me some advices so that i can be pregnant. please help me. thank you. more power to you.

  330. Mariam Says:

    Dear doc
    hi, how are u, im 16 years old and i have thyirod problems i’ve done my surjey one year ago and i removed the whole thyriod im im taking medine “thyroxin : 125″ tablt each moring.
    my last test was in june 20-2011 and im having the other on tomorrow 27-9-2011
    i’ve been taking “Xenical Orlistat” tablets one month ago but nt regruly.
    im scared that i’ll show in my blood test results … i want your answer pls
    im waiting, my blood test is tomorrow morning
    thank you.

  331. Litlyn Says:

    Hi doc gerry,

    I heard many good things about you. I have a thyroid problem. I was still 12 when i had it, then i had it checked with a doctor in chonghua hospital–i don’t know if it is okay to mention the name..

    Anyway, im already 23 now and i still have it. I did not undergo surgery. I took different medicine but it did not work. I gave birth normally last september 2010 because my thyroid problem is not hypo..

    All of the doctors i spoke advised me to undergo surgery but i was and still hesitant because im scared of having voice problem—-im a freelance now internet marketer, business consultant and i make calls USA (telemarketing my own service) so my voice is very very important. I was also managing the whole operations of BPO that is why i did not have confidence to have it removed coz i dont want to risk of losing my voice.

    My goiter looks bad, the width is big. It looks like lisay2X…If anything, i wish i could meet you personally.. i will call your office to get a schedule..

    Litlyn


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  333. biswajita Says:

    hello
    My thiroid gland is enlarged with regular shape. With the advice of doctor I did FNAC test and the diagnosis was colloid goiter. My TFT test is normal and every one year I am doing TFT . I want to know what precautions I I have to take Which food to avoid which food to take.

    • Doc Gerry Says:

      Hi biswajita… I can’t comment on your case because it is best that you see a specialist and physical examination is very important.Please make sure you have a good follow up with your doctor.

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  339. Amaranth Says:

    Hi Doc Tan,
    I was diagnosed for hyperthyroidism last year in August. I was regularly visiting my doctor. I have undergone my test and from my first THS result of 0.03 to now 6.353. My question is if I really need to undergo a surgery as I was advised to do asap. Is there any other option other than surgery. Thanks in advance.

  340. carla_mariveles@yahoo.com Says:

    hi doc pago lang po ako d2 ask ko lang about sa beer plus biogesic and beer plus raw egg
    nag ta take ng biogesic ang friend ko every time na may inuman para hindi daw po xa malasing, hindi po ba masama un? ano po ang mga side effect?
    ako po nag ta take po ako ng raw egg bago mag beer, ang sabi po sa akin beer plus raw egg ay nakakataba daw po, sa province daw raw egg plus soft drinks ang ginagamit pang pataba ng cow, totoo po ba yon?

  341. soundarya Says:

    i ate eltroxin tablet 10 unwantedly what will happen to me

  342. soundarya Says:

    gve me reply

  343. JTM Says:

    Good day Doc Jerry!

    I was your patient before (May 2009). I am now working here in Libya and I hope you can help me with my case. You diagnosed me with papillary carcinoma when I was 21 and I have already undergone total thyroidectomy. I am taking levothyroxine daily 100mcg. Recently, i’ve undergone blood tests and the results are:

    Third Generation TSH 2.26 (Normal- 0.400-4.00)
    Thyroglobulin 1.49 (Normal- 0.20-55.0)

    The libyan doctor said that the TSH should be suppressed. Even though the thyroglobulin is normal, I might need to undergo radiation which is contrary to your advice as there were no metastasis and I am at my early age. Now, I am already 24 years old . I hope you can enlighten me regarding this matter. Thanks a lot
    Doc Jerry.

    Sincerely,

    JTM

  344. mae Says:

    i am a diabetic for 11 yrs and taking twice a shots of novomix everyday 26 morning n 16 in the evening. how can i get in touch with u doc? where is ur clinic? im in san fernando, pamp. thanks n more power. Godbless

  345. remmy Says:

    1. i used to have pain in the center of my chest… whenever i lift something or if i give some stress it pains… this pain comes once or twice in a week…and iam 26 years old… what could be the problem? is it so serious?
    2. i have bruises at the back of my head for about 6months .. i dint consult any doc since i dint take it seriously… whats the reason for this?? is it serious??

    worried youth.. please let me know the reason asap

  346. Ahye Says:

    I just want to ask if thyrax can cause hyperacidity? I’m taking it everyday and after eating breakfast that’s when I experience hyperacidity. My dosage is 75mcg. Thank you.

  347. annie zamora Says:

    hi Doc Gerry,

    Doc my niece just got thyroidectomy yesterday and she was advised to under Radioa active iodine. How much will it cost her for radioactive iodine if done in cagayan de oro. and What hospital in Cagayan de Oro has this procedure?

    thanks.

  348. prisca Says:

    Hie doctor I am a 22 year old african lady and I have a problem of always craving to eat soil I know I can replace it with iron tablets as craving soil has been assosiated with iron deficiency .. In africa women consume tones of soil per yer and it is sold anywhere .is there any food that I can eat 2 stop this crave??


  349. Hi Doc Gerry,
    I found your website very interesting and very helpful i read all the people whos writting you and the most i like is they get the solution or advice from you, godbless you Doc.

    Doc i have thyroid problem it was diagnos last 2007 in UST and advice to make radio active the problem doc i was not able to stay long in Philippines im just on my vacation 1 moths the doctor said i have to stay for 3 months but i cant so i did not undergo radio active when i came back here in Kuwait i was suffering too much lack of oxygen at night i cannot sleep afraid cannot breath many times i go hospital, i cannot sleep because of that and my chest is paining thought i have problem to my heart but nothing if i undergo ECG. Last May im on my vacation then i find Dr. Ramon Caceres for my thyroid i was on medication 1st months he gave me 25 mcg of Euthyrox then 50 mcg till Sept 24 because i suppose to take emergency before the date but my company not allow so till October. My question Doc i can continue my medicine till October? without any problem? Please help me Doc. And i have skin allergy it is cause of the medicine because before i never had this since birth,

    Im 36 years old 45 kls only i want to gain but whatever i eat i never gain is this because of my thyroid and dringking of this euthyrox i will not be pregnant?

    Hoping for your kind reply…Thanks in advance doc.

    Jasmin D. Pilar
    Kuwait

    • Doc Gerry Says:

      hi Pilar…
      its really difficult to diagnose a disease without the proper history and proper examination.
      I WOULD RECOMMEND that a TSH FT4 be taken first before any diagnosis or medication is given
      hether you should continue to tak your meds? I am not sure what you have in the first place.
      Your symptoms points to a hyperactive thyroid but you are on a thyroid pill…so I cant say what you have nor advice until I know more information and I can properly examine you.

  350. victoria a. Says:

    hello doc..

    i was in your clinic last week but i forgot some questions..im taking eltroxin 100mcg also. akong problem ky if weekends and gabie after work around 8pm ako baby mo bf man jud siya. ang advised doc bf before inom sa med in the morning. ako sched 7am. malooy man sad ko molutas oi, pwede kaha ni? basin naa effect sa baby ang eltroxin..

    thanks doc

  351. rizzadelc Says:

    Hi Doc! Just a quick question…how risky is pregnancy post-total thyroidectomy? I had mine in 2010 and my husband and I would like to try to have a child now. I’ve read horror stories in internet forums about chemical pregnancies; some babies don’t make it past the first trimester. I am scared that this will happen to me. This will be ou first pregnancy. What would you recommend? What precautions should we take before moving forward?s Thanks and I hope to hear from you soon!

  352. Noreen Says:

    Hi Doc,
    My name is Noreen. I’m 33 years old from General Santos City. Im taking tapdin for a month now and my mild hyperthyroidism have subsided a bit. My t4 is now normal and t3 is just slightly above normal. There is no nodule found on my thyroid per ultrasound report. And my thyroid is not enlarged, its just toxic. After taking tapdin for a month my endo recommended to take cardiosel-od for my fast heart rate. My heart rate at rest is 97 bpm. Do i need to take this med? How long will i take this med? My endo recommended 3 tablets only once a day. Or will my heart rate go back to normal by itself if the thyroid problem is fixed. May i also ask what will happen to my heart because of the increased heart rate for a long period of time. Will it be damaged? I’m afraid to take cardiosel due to its side effects and that my condition could get worse if i stop taking it abrubptly. I hope you can help me on this. Thank you and more power…

    D

    • Doc Gerry Says:

      Hi Noreen… it would be best if your questions are directed to your endo . Just like a barber,the way one cuts may be different form the way others do theirs. my treatment may differ from others. It does not mean I am better… but I may treat your disease feaster or make you feel better… the patients will attest to where they will believe more. The bottom line is we tend to treat our pts the best we believe we can. So please call your endo and ask the questions you have in mind. Otherwise… you can see me anytime.


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  354. maria febra patangan Says:

    Good day….
    Iam Maria Febra patangan,iam your patient for almost 2 yrs now.i visited your offfice your clinic last apr 29,2013 and was given xelevia 50,arbloc 50, Uthyrox 100 and novostat..i bought all my medicines in cebu doc pharmacy except for novostat because Its out of stock,so i went to mercury and still theres no stock,so my last option was rose pharmacy..fortunately i was able to buy 50 pcs.of novostat.my problem now Is im almost out of stock for my novostat and it is not available here In our place (dipolog).and im asking for your help on what to take in replacement of my novostat..my schedule for My Next check up Is on august.
    Thank you and god bless……


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    Thank you

  356. maye Says:

    Hi doc good day, I’m new here and would like to share my case as well, perhaps I could get significant infos like others with your very helpful advises. I gone through total thyroidectomy last May 4, 2013 in Bacolod City due to papillary carcinoma. They got this thing from me in 3cm already and my doctor advised was to go RAI after a month. I followed my doctor’s instruction and went to a radiologist in Chung Hua Hospital last June 4, a month after my operation since no available rai in Bacolod City yet. My problem now is when I learned about the cost of the rai, I was totally surprised, very pricey and I don’t know if I could generate the amount within 3mos.as given by my radiologist. I was given prescription, thydin (levothyroxine) but the brand is not available in my place so I opted to replace it with euthyrox 50mcg 2 tabs daily 30mins.before breakfast. I don’t know if I’m doing the right thing since I was no longer able to go back to Cebu to ask my doctor if it’s ok to replace the brand. I’m start taking this meds last June 4 and as advised I’ll stop my intake at the end of July since I will be starting if I’d be able to push through my rai, I’d start my no seafood/low iodine diet on August 1. Anyway Doc Gerry, my really concern is that what if I can’t produce the amount for my rai procedure till my health card get renewed April of next year, what will happen to my condition doc? I’m getting worried about my health condition, and I hate the idea of just bcoz I have no enough money to proceed for rai I’m already feeling as if I’m going to die and this gives me so many sleepless nights. Doc, I hope you could give me idea and other options about my case. Looking forward to hearing from you Doc. Thank you..

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  358. christine Says:

    Hi Doc! can i take methathione supplement if i am on aspirin 81 mg OD? Thanks!!!
    -christine

  359. melou jane taran Says:

    hi doc, i would like to have an appointment schedule. thanks..
    –jane

  360. Richie Says:

    Hi Doc Gerry,

    Good day!
    I am Richie of Molave Zamboanga del Sur. I would like to ask for your professional opinion with regards to the health of my father. He is suffering for a diabetes and according to him, since he was just 33 years old. We hadn’t had the chance to seek for his medication due to a financial reason and because of that his illness has dramatically worsen. He is now 54 years old, and his health is really deteriorating. Over time, he has developed some conditions which, according to my research in the internet, are: neuropathy, nephropathy, and retinopathy. I have been so concerned on how he spends time in a bathroom urinating for about 10 to 15 minutes and also on his ability to walk which really has changed. Adding to that, i am also deeply concerned with his lack of strength and the numbness of his whole body.

    Doc, is there a chance that his health would get better? I know that it’s already too late since his illness had begun long time ago and there was no proper treatment done. I have been carrying this burden on my own since I am there only child. 2 years ago, my mother underwent a surgical operation at the Chong Hua Hospital in Cebu City due to a Bile Duct tumor. There was no biopsy done, so we have no idea if it was a cancer or not. She then developed an anemia twice, firstly was due to her peptic ulcer and secondly for an unknown reason. Anyhow, the condition of my mother has been carefully watched by her doctor. My only concern right now is the deteriorating health of my father who is really suffering for a diabetes.

    Doc, are you available sometime around 1st until 15th of March 2014? And can I ask for your clinic address/time in Cebu City or perhaps a clinic somewhere in Cagayan de Oro doc or anywhere in Misamis Occ/Orriental where it is nearer to us? We’d really like to visit you doc or anyone of your fellows specializing in diabetes whom you can recommend to us.

    Looking forward for your response doc.
    Thank you.

    Sincerely,
    Richie


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  362. Am not feeling fine,i have terrible fever,my body is always hot,i experience weakness of the body,always sleeping,feeling body pain,lost of appetit,what kind of drugs will you prescribe for me?

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  366. cecile Says:

    hi Doc Gerry! i’m cecile 35 years old. i’m a hyperthyroid pt. i’m taking carbimazole 20mg BID, my T3 and T4 is within normal range already but my TSH still <0.005. i'm a bit concerned already. is there anyway that my T3-T4 will decrease but still my TSH is low? is there any problem if I take glutathione caps? there will be any side effects? thank you very much and God bless!

  367. Lindsay Says:

    Excellent article. I certainly appreciate this site. Keep it up!


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