Q: My husband had been getting testosterone shots every three weeks for many years for Low T. I was concerned that this might be affecting his heart, so he agreed to stop the shots this summer and see how he felt.
Within a few weeks, he began experiencing hot flashes, especially at night, and wasn’t sleeping well. He went back on the shots and now is back to normal. Did stopping the testosterone shots abruptly cause the hot flashes?
A: When men experience a sudden drop in testosterone levels, such as during prostate cancer treatment, they often experience what doctors call vasomotor symptoms. That’s another way of saying hot flashes and sweating.
When your husband stopped getting injections of testosterone, it is quite likely that his hormone levels fell rapidly and triggered the symptoms.
The Food and Drug Administration used to warn physicians and patients that taking testosterone could increase the risk of heart attacks and strokes. The agency reversed course Feb. 28. It removed the previous warning about adverse cardiovascular outcomes linked to supplemental testosterone. Some data even suggests that men with “low T” may have a greater risk of cardiovascular disease and mortality (Annals of Internal Medicine, May 14, 2024).
Q: I was listening to your radio show and heard your thyroid specialist mention that people who are cold all the time might be suffering from low thyroid. He also said that if your eyebrows are disappearing at the ends, that could also be a tipoff.
I have both of these symptoms. How can I find out more about diagnosing thyroid problems?
A: You have described two distinctive characteristics of hypothyroidism. Other symptoms may include fatigue, brain fog, constipation, trouble losing weight, slow pulse and depression. To diagnose a thyroid problem, however, the doctor will want to have a blood test. When TSH (thyroid stimulating hormone) is high, it indicates that the brain is trying to push the thyroid gland to make more hormone. Why? Usually because the hormone level is too low.
Generally, doctors prescribe a replacement hormone called levothyroxine (Levoxyl, Synthroid, etc.) to treat this condition. Adjusting the dose may require a period of trial and error.
Levothyroxine contains only T4, and some people are less efficient than others at converting it to the active hormone T3. They might need a treatment that includes T3 as well.
You can learn more about hypothyroidism diagnosis and treatment in our “eGuide to Thyroid Hormones.” This online resource may be found under the Health eGuides tab at peoplespharmacy.com.
Q: I used to suffer from cracked fingertips and tried multiple remedies with no success. Then I read somewhere that people can be allergic to nickel.
The bottom of my watch contained nickel, so I stopped wearing a watch and haven’t had any fingertip cracks since (over 30 years ago). I received a smartwatch as a gift about three years ago and tried wearing it. The cracks returned within a couple of months. After giving up on the watch, my fingertips returned to normal.
A: As you note, nickel allergy is a fairly common condition (American Family Physician, Aug. 1, 2010). It may cause severe reactions with redness, rash, itching and scaling, while cracks and fissures are more likely to result from chronic exposure. Avoiding contact with nickel, as you have done, is the best way to deal with this problem.
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