DR. ROACH WRITES: A while back, I asked readers for suggestions on swallowing pills, and I got many helpful answers. I particularly liked this pharmacist’s advice, since it combines physics and common sense:
“ Because capsules FLOAT and tablets SINK, two ways are helpful. For capsules this works for me: Place the capsule on your tongue, then take a big swallow of water through a straw, keeping your chin neutral. For tablets, put water in your mouth first, then tilt your head back and drop the tablet into your mouth and swallow.”
Using a straw was the most frequent advice I heard. Thicker liquids were the key for other readers, while one reminded me that an inexpensive pill crusher can turn a pill to powder, which can then be mixed into yogurt or applesauce. However, always check with your pharmacist, since some pills, such as long-acting formulations, should not be crushed, and a few should not be mixed with foods. Another person found that swallowing some ice chips for a few minutes prevented the gag reflex that kept her from swallowing medicines.
DEAR DR. ROACH: My father read your recent column pertaining to kidney stones. He recently passed a kidney stone and was wondering if there is a lab that he could send his stone to directly to be analyzed? Unfortunately, he prefers not to visit an internist or urologist. — L.P.
ANSWER: It depends on the state, but most laboratories require a professional’s order to perform testing. I have mixed feelings about this; however, I generally agree, since a physician or other provider should provide individualized recommendations on the appropriate changes in diet, medication and fluid intake, based on the stone type, medications taken, diseases or conditions present and other factors. There are services available on the Internet that will perform laboratory testing without an order (by having a medical director in a given state order the lab), but I don’t recommend it for the reasons above.
DEAR DR. ROACH: I have to take levothyroxine in order to obtain an acceptable TSH number. I have read that some doctors are stating that there is a relationship between hypothyroidism and gluten intolerance, possibly even celiac disease. Is this proven to the point where a patient should alter his or her diet and give up the basic foods of bread and cereal? — R.K.
ANSWER: People with celiac disease have a much higher risk of autoimmune thyroid disease (especially Hashimoto’s, the most common cause of low thyroid) than expected, to the point where everyone with celiac disease should have a blood test to look at thyroid levels. Celiac disease, or intolerance of gluten in general, may have few or subtle symptoms, and it might be worthwhile to consider testing for celiac disease in people with autoimmune thyroid disease. However, I would not recommend a drastic change in diet for people with thyroid disease if there are no symptoms.
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. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803. ©2017 North America Synd.