Desiccated thyroid is not the best choice for most people, but there are three groups for whom it is still prescribed: those who have been on it for a long time without ill effects and don’t want to switch, those who have unacceptable side effects or allergies to levothyroxine but can tolerate desiccated thyroid, and those who are insistent on “more natural” methods of thyroid management. I can’t say which group Clinton may fall in, but it’s not exactly bloodletting. It’s an unfashionable, less used option, but it’s still an option.
And if Pinsky doesn’t think warfarin/coumadin is used anymore, I invite him to take over calling my patients, their doctors, and the phlebotomists who come to their homes monthly to test their levels, and the pharmacy every time I’m supposed to change their dose by half a milligram and only have 5 milligram pills in the house. 'Cause that shit takes up way too much of my time for something that isn’t done anymore.
On the blood pressure debate, I’d be mildly concerned if a man of Trump’s age, weight and complexion had a 110/65 blood pressure. Not enough to call the doctor (I have to call the doctor below 100 systolic or below 60 diastolic) but enough to watch him pretty closely and ask him carefully if he had any symptoms like dizziness, fatigue, shortness of breath, or weakness. In my nursing experience with hundreds of men of his age and physique on antihypertensives, I’d expect to see 130s/70s, not be alarmed in the 140s/70s, and be delighted if we were able to maintain him around 124/64. (How can you tell a nurse who listens to her patients’ bps with a stethoscope and manual cuff? Her numbers are always even. No odd numbers on a manual gauge. )
Not sure if it’s mentioned yet but let’s remember that there are believable allegations that Trump used to take prescription amphetamines like stimulants for years, both by statements from ex-staffers of his and that he’s known to have visited a Doctor notorious for handing them out like candy. From his irrational behaviour it’s at least reasonable to suspect that he might still be taking them in order to keep up the campaign schedule.
I’ll let someone with more medical expertise than me speculate on the likely effects on his future health from that.
I’ve been on warfarin for about five years now. I go to my doctor’s office every six weeks for an INR check which has been very stable. Plus it is cheap, unlike the new stuff. I’ve also been on the same dose for at least four years. You’re going to have to pry my warfarin out of my cold dead fingers.
Yeah if it wasn’t bad enough that he’s running a Nancy Grace type tv show, that quote ““Certainly a presidential candidate would get one of the newer anti-coagulants,” Pinsky opined.” is just nuts.
Any asshole on a blood thinner would know there’s reasons to use or not use warfarin over say Xarelto, and anyone opining on it should know there’s no approved anti-agent for Xarelto and in fact an anti-agent that’s proven to work actually got a CRL from the FDA about a week ago because of a management fuckup.
Call me picky, but I’d prefer if we could find three. I’d even donate a pen if it would help ensure his restful stay toward recuperation, but thats only because he is such a dear man.
There’s a new Facebook meme that has a picture of Trump’s “doctor”, and it says, “He looks like the kind of doctor who will write your weed prescription without even hearing your bullshit excuse.” I KNEW he looked like something but couldn’t articulate it until I saw that. :smack:
Desiccated thyroid is also recommended for people who have serious allergies to dyes, because it is dye-free.
MHO: Xarelto is fine for people who need short-term anticoagulation, but long term? Use Coumadin, unless there are other contraindications. Yes, it has to be monitored, but it WORKS.
(When I worked at the grocery store, I had several customers who would request refills on their rat poison , because that’s what Coumadin is also used for.
Oddly enough (because I really do not see it often) today I admitted a patient on Armour Thyroid. Of course I thought about this thread. I asked if there was a reason she wasn’t on Synthroid (they’d already said no allergies, but sometimes people forget until a question like that) and yeah, she’s allergic to dyes AND she’s been on it forever with good thyroid control, so why switch?
My husband is still on warfarin/coumadin after nearly 25 years. And yes, every so often, usually because I’ve gotten him to eat a little better, they need to adjust his dose. Monthly monitoring is kind of annoying, but it’s really not a huge deal. And he’s got a belly full of hernias and a complicated cardiac history. At any moment, one of those hernias might strangulate, or he might need angioplasty, or who knows what. So the most important thing for us is that he be on something reliably reversible in case of emergency surgery.
They tried to switch him to Pradaxa when the reversal agent for that got approval last year…but my rule of thumb is that I don’t want him to take any new drug in the first 10 years on the market unless there is no other option. Let the Phase IV aftermarket trials find the adverse events first, thanks. His doctor (first year Resident) argued, but his pharmacist told me I was absolutely correct, and talked to the doctor and shut him up.
The WARF stands for Wisconsin Alumni Research Foundation, which funded the research.
My wife, who writes about drugs for on-line encyclopedias, never lets me forget the origin of this drug.
)
, because that’s what Coumadin is also used for.