Could changes in spinal health cause thyroid problems?
DEAR DR. ROACH: I recently had a full spinal health check done, since I have a history of scoliosis and a few other things I can't pronounce in my spine in my neck. My neck no longer has a 45-degree curve -- it is now straight up and down, and it has my thyroid completely pinched off. Would this cause me to gain weight or lose hair, or have any emotional effects on me? Can a blood test really tell if your thyroid is off in any way, or would my thyroid even be working right since it's completely pinched off? -- Anon.
ANSWER: The normal spine, viewed from the side, makes a soft "S" shape. There is supposed to be a curve in the neck. When that curve is lost, it is called loss of cervical lordosis. It is often caused by degeneration of the cervical disks, but can also be a result of trauma.
This is not at all the same thing as scoliosis, which is an abnormal curve to one side when viewing the spine straight on. It is called hyperkyphosis (or just "kyphosis") when the curvature forward becomes excessive.
Not everyone with loss of cervical lordosis (sometimes called a "military neck") has pain, and studies are mixed about whether people with this condition will go on to develop further problems in the neck. People who have neck pain and loss of cervical lordosis may benefit from physical therapy. Some studies have shown that cervical traction may improve the position of the neck and symptoms. Surgery is considered in cases that do not respond to PT.
I don't think the thyroid has been pinched off. It may feel like it has been, but the body is very good at adapting to changes in the bone structure. A simple blood test of your thyroid function can show you how well the thyroid is doing at making hormone. Changes in thyroid hormone levels can affect weight, hair and emotions. However, chronic pain can cause those symptoms as well, so testing the thyroid will be important as you move forward through treatment.
DEAR DR. ROACH: I'm amazed how often advice on medications or vaccinations say "talk your doctor or pharmacist." How are pharmacists trained, and on what subjects can their advice equal a doctor's? -- T.C.
ANSWER: A doctorate of pharmacy takes, like a medical degree, four years after an undergraduate degree. I would say that the pharmacist and the physician have complementary knowledge.
Pharmacists are expert in the uses, side effects and interactions of medications. Pharmacists also act as a check on physicians, when we make errors. This is particularly true in complex patients, such as patients with cancer or those who are critically ill. Pharmacists need to be expert communicators with both the physicians and the patients.
I often recommend readers consult with their pharmacist. During the course of my writing this column, many readers have presented medication lists where the risk of an adverse drug interaction is very high. Often, multiple physicians are prescribing for the same patient and are unaware of all the medicines a person is taking. An alert pharmacist can be literally life-saving in these situations.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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