Q. What can you tell me about a compulsion to chew ice? I once read that it signals some deficiency, but I can’t remember what.
Someone close to me eats ice cubes every day, all day long. She’s 32 years old and the mother of four. She carries a bag of ice cubes with her wherever she goes. Though it sounds harmless, the unease she exhibits when she is without ice is alarming. What could be wrong?
A. She should be tested for both iron and zinc deficiencies. Lack of either mineral may trigger a compulsion to eat ice or other unusual items. Readers have reported cravings for orange peel, laundry starch, popcorn, tomatoes, carrots or clay.
One woman reported, “Several years ago I developed a strong craving to crunch on ice. I would always have a cup of crushed ice to eat until I read that craving ice could be a sign of iron deficiency. My doctor suggested iron pills, and in two months my craving for ice disappeared.”
Q. I was diagnosed with hypothyroidism more than twenty years ago. My family physician put me on Armour thyroid, and it worked like a charm.
Three years ago my new doctor prescribed first Synthroid, then Levoxyl. Despite the medicine, I have symptoms such as low energy levels, weight gain, high cholesterol, depression, trouble concentrating, dry skin, brittle nails and hair loss. The doctor just keeps telling me the lab results are normal.
Recently, I read an article on the use of Cytomel combined with Levoxyl. My doctor says Cytomel is dangerous. Can you send me any information on this?
A. The symptoms you mention are classic for hypothyroidism. There is a growing suspicion that lab results may not always tell the whole story.
Cytomel is a synthetic form of the thyroid hormone T3. Levothyroxine (Levoxyl, Synthroid) is T4. A healthy thyroid gland makes both forms of thyroid hormone, but some people may not convert T4 to T3 efficiently. That is why some doctors prescribe either dried thyroid gland (Armour thyroid), which contains both, or a combination of Cytomel with levothyroxine.
We are sending you our Guide to Thyroid Hormones, which provides more details about balancing T3 and T4 and describes how to interpret lab values. Anyone who would like a copy, please send $3 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. T-4, P. O. Box 52027, Durham, NC 27717-2027.
Too much T3 can cause heart palpitations and wide fluctuation in hormone levels. Careful dosing is necessary to optimize treatment.
Q. I think I saw on TV that acetaminophen might counteract the benefit of aspirin used for heart protection. I rely on Celebrex for pain relief and wonder if it falls into the same class of drugs as acetaminophen.
A. Acetaminophen is not like Celebrex, nor does it appear to interfere with the heart protective benefits of aspirin. A new study published in Circulation (Sept. 9, 2003), however, suggests that pain relievers like ibuprofen may pose a risk.
Physicians taking aspirin who also used such pain relievers more than 60 days a year had a higher risk of heart attack. Intermittent use (less than 60 days a year) did not appear to be a problem.
Celebrex and Vioxx have come under scrutiny, but more research is needed to determine if they increase the risk of heart attack or stroke.