DEAR READER: The thyroid gland is situated in the lower neck — below the larynx and above the collarbone. This gland uses iodine to make hormones essential for the proper function of every cell in the body. The pituitary gland and hypothalamus at the base of the brain regulate the rate at which the hormones are produced and released. The TSH to which you refer stimulates hormone production. The normal range for lab work at my local hospital is anything between 0.34 and 5.60. Thus, by these standards, both your readings were normal.

The most common causes of a goiter are from the over- or underproduction of thyroid hormones, nodules that develop within the gland or a lack of iodine in the diet, which, in the United States, is uncommon. A goiter doesn’t necessarily indicate that the thyroid gland is malfunctioning. Even when visibly enlarged, the thyroid may produce sufficient hormones or too much or too little thyroxine (T4) and T3 (which is the most active form of thyroid hormone).

Your ultrasound revealed an abnormality of the right lower lobe without directing the abnormality to a specific lesion within the gland. Your physician has you on Synthroid because you have been diagnosed with hypothyroidism. Your gland does not produce sufficient amounts, and your body requires supplemental medication. My guess is that you have Hashimoto’s thyroiditis (an underactive thyroid), which can be successfully treated with medication.

If questions remain, I suggest you speak with your physician or request a referral to an endocrinologist to obtain additional information on your condition. In the interim, I am sending you a copy of my Health Report “Thyroid Disorders.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order payable to Newsletter. Mail it to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: Levothyroxine is synthetic thyroid-hormone replacement therapy that can be taken successfully by most people, primarily because thyroid hormone occurs naturally in the body. There are no common side effects. However, when side effects do occur, they can include allergic reactions to one or more of the inactive ingredients and symptoms of hyperthyroidism caused by therapeutic overdose. If your physician has your complete medical history and believes you should be on replacement therapy, you can either take his or her word for it or you can request a referral for a second opinion.

To provide related information, I am sending you a copy of my Health Report “Thyroid Disorders.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

He takes synthroid, 175 mcg, once a day. I am wondering and have asked if there is a possibility of him having a reaction to this medication. It falls on deaf ears.

Last night, I called the ambulance, as he was having one of those spells again and could not walk. His speech and thought processes were slow. When the EMTs arrived, he seemed normal. Four hours of observation confirmed that everything was normal. This is not normal for him and never has been. I was questioned why I was wasting precious time calling an ambulance for something like this. I responded I am not a doctor and cannot diagnose what is happening. We have done everything the doctors have required and still want answers as to the cause. I feel they are treating the effects without checking into the possibility of it being a reaction to medication.

DEAR READER: Seizures are commonly brought on by sudden, abnormal electrical activity of the brain. Causes include head injury, drug overdose, brain tumor, accidental poisoning, low blood sugar or sudden lack of oxygen to the brain. They are divided primarily into two categories — focal or partial. Focal seizures occur on both sides of the brain, partial seizures on one side. They may present with muscle spasms, unusual sensations (such as your husband’s taste of burnt beef), loss of consciousness and more. In some cases, the cause is never identified, but the activity doesn’t necessarily represent epilepsy.

I would like to address your husband’s daily use of synthroid. When was he diagnosed as being hypothyroid? Is there a correlation between the time he went on the medication and the time the seizure activity began? The dosage is a rather strong one. Was he begun on a lower amount and increased over time? Has he been tested on a timely basis? The inert ingredients in synthroid include confectioners’ sugar, acacia, lactose monohydrate, magnesium stearate, povidone and talc. The dose also includes FD&C blue No. 1 Aluminum Lake and D&C red Nos. 27 and 30 Aluminum Lake dyes. Perhaps he is responding to the coloring. Were he on a lesser dose, the dyes would vary in intensity.

If he had a CT scan to rule out a brain tumor, didn’t sustain a head injury within the past month or so, hasn’t been accidentally poisoned, and can’t attribute the activity to a recent occurrence, perhaps the medication is the cause of the seizure activity.

I recommend he ask his physician for a little indulgence. If the medication isn’t vital, perhaps they can compromise on a trial without it. He might consider diet modification — include cabbage, Brussels sprouts, lima beans, broccoli, cauliflower, potatoes, bananas, and supplemental vitamins B and C. Fats, sugars, red meats and eggs should be consumed in moderation. And he should exercise 15 to 20 minutes every day unless his doctor says otherwise.

If no improvement is found, request a referral to a new neurologist for a second opinion.

To provide related information, I am sending you a copy of my Health Report “Thyroid Disorders.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.