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Medication stew causes nightmares

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DEAR DR. GOTT: Six months ago, I was diagnosed with hypothyroidism, for which I have been on Synthroid. My biggest concern is hair thinning, to the point of having to use a hairpiece and wig at times. Further, I have nightmares and want to know when they will stop.

I am on a diuretic and timolol for my glaucoma, Zocor for high cholesterol and Ativan for sleep. I'm also on a daily multi-vitamin, kelp, two fish-oil tablets, a 400 IU cod-liver-oil tablet, four calcium with vitamin D pills, magnesium, an 81-milligram aspirin, 1,000 milligrams niacin and echinacea. My doctor doesn't endorse vitamins, but I've taken them for 60 years. I'm told I look 55 and attribute that to good genes.

DEAR READER: Hypothyroidism presents when a person has an underactive thyroid gland. Most cases are caused by the gland itself; however, certain diseases and some medications can decrease thyroid function.

Symptoms vary, but hair loss and thinning are common. Weight gain, cold intolerance, fatigue, brittle nails, elevated cholesterol levels, depression, a slowed heart rate and swelling around the eyes are often reported.

Now, let's take a look at a few of your medications. Timolol can cause depression, glaucoma, cold hands and feet, cardiac arrhythmias and nightmares. Synthroid therapy can be responsible for hair loss early on, but the loss ordinarily levels off once the system adjusts to the medication. Adverse reactions include headache, insomnia, palpitations, decreased bone-mineral density, weight loss, anxiety and more. I believe your timolol is directly related to your nightmares. And, if we can pinpoint Synthroid for your hair loss, we have that answer, as well.

I appreciate your 60-year devotion to supplements; however, if you eat properly and exercise regularly, one supplement that contains the recommended daily allowance for most vitamins is all that is necessary. I must side with your physician on this count.

DEAR DR. GOTT: About once a month, I get esophageal spasms, diagnosed as such by my doctor. The pain actually mimics that of a heart attack, with pain across my chest and back. It lasts about 20 minutes.

Can you tell me what causes the spasms, how they could be prevented and what to do when they occur? I know there is a pill I could take, but I am not anxious to add another pill to my regimen. I would appreciate any information you can provide on this ongoing problem.

DEAR READER: Spasms of the esophagus are muscle contractions that prevent food from passing in a normal manner from the esophagus into the stomach.

Symptoms resemble those of gastroesophageal reflux disease (GERD) and can include heartburn, chest pain and more. Contractions can be quite painful, intermittent and vary in intensity, with chest pain mimicking angina. Women are more commonly affected by the condition than are men, and the probability of developing the condition increases as a person ages.

There are a number of steps a person can take to control symptoms. Diet modification can help. Eliminate or reduce your intake of acidic, greasy/fatty and spicy foods. Try eating four or five smaller meals rather than two or three large ones. You should also avoid foods that are extremely hot or cold, as they can trigger an attack.

Short-term treatment may involve an over-the-counter or prescription medication to relax the muscles of the esophagus. Long-term treatment can include the use of additional medications and determining possible underlying health conditions.

Testing by a physician for diagnosis might include the coordination of a barium swallow, esophageal motility test, esophageal computed tomography (CT) scanning or esophagogastroduodenoscopy. Your physician or gastroenterologist is your best resource to determine which procedure is appropriate to determine if any blockages are present and reach a diagnosis.