May 23, 2007

Poison Ivy

Summer is coming up, and last year my children got into poison ivy. We had bad rashes to deal with. Any advice?

Poison ivy has the typical three leaves, and slightly reddish stalks. It grows as a weed, and the first thing you should do is teach the children to recognize it.

Our family has a cottage, and early in the spring we inspect for poison ivy. Rather than pulling it up, which gets the oil on gloves and clothing, we have spot sprayed with “Roundup.” By doing this we have eliminated it from our yard.
The burning of poison ivy can be extremely hazardous, because the oil vaporizes and can be inhaled and cause severe pneumonia. The oil in the plant can get on skin, where it causes a delayed hypersensitivity reaction. But it can also get on tools, clothing, pets, and then is secondarily transferred to the skin.
Any items possibly contaminated require cleansing with soap and water. Clothing should be thoroughly washed, and not with a load of uncontaminated clothes. Pets may need shampooing.
Recognized contact allows one to cleanse the skin, perhaps first with alcohol and then with soap and water.
The rash of poison ivy may be localized and itchy, but on occasion it becomes widespread. When large areas are affected, your doctor should be consulted, as medication may be required to suppress the rash and prevent secondary infection.

I was raised an Adventist and have always been health-conscious and avoided harmful foods. So I was totally shocked when my doctor diagnosed a painful swollen foot as gout. He said the condition is not diet-related but hereditary. What is the truth here? Numerous articles on the net seem to indicate that certain foods can cause or at least precipitate an attack.


Gout was first described by Hippocrates approximately 2,500 years ago. It is a disease that has both acute and chronic phases. The well-known acute phase is the acutely swollen, red, and extremely painful joint—classically the large toe, but any joint may be involved. The pain can be
so severe that even the lightest covering (sock or bed sheet) cannot be tolerated by the patient.
Your doctor is correct. Gout is usually a genetically determined disease involving the metabolism of protein-related substances called purines. There is an increase and accumulation of uric acid first in the blood and then in the joints. This occurs either because of increased production or reduced excretion of the uric acid. There are instances in which other conditions cause increased uric acid production with a similar clinical picture to the gout that are genetic or hereditary. This is termed secondary gout. Examples of this include diseases such as leukemia, lymphomas, and psoriasis. Chemotherapy can also result in elevated uric acid because of increased cell destruction.

2007 1515 page14Gout is a disease that affects mainly men and, to a lesser extent, postmenopausal women. The major uric acid production (two thirds plus) arises from the body’s manufacture of purines. Approximately one third of the body’s uric acid is produced from dietary sources. This brings us to another aspect of your question. Since dietary purines account for a relatively small proportion of daily uric acid production, diet is not the primary cause or precipitant of the acute gout attack. Foods that are high in purines include anchovies, sweetbreads, liver, kidneys (organ meats), and leafy vegetables such as spinach. Individual patients can usually identify whether a specific food article precipitates a gout attack. Experience in one rural area revealed an increase in gout attacks during cherry and asparagus seasons respectively. This varies from patient to patient. Anchovies and organ meats are possibly the most consistent culprits. Alcohol should be avoided entirely as it is clinically the most important stimulus for the production of uric acid.

Taking all of these factors into account, your question and concerns regarding lifestyle and gout are well taken. It is all the more important to understand that primary gout, the most common form of this disease, is a genetic disorder. Your healthful Adventist lifestyle has not failed you. We cannot avoid diseases that are, so to speak, “common to man,” because we do not get to choose our genetic makeup. This reminds us of the grace we each need to live our lives in a world that has become so changed from the ideal since the entrance of sin.

I have hypothyroidism and have been taking levothyroxine for almost two years. Blood tests show that my levels are stable/normal with this medication. Otherwise, I am a relatively healthy 50-year-old female, and not taking other medications except a multivitamin. I would like to get off the medicine eventually. Is this possible?


The most common cause of hypothyroidism in adults is Hashimoto’s disease. This is an autoimmune disease that results in the destruction of the thyroid gland. An autoimmune disease is a condition in which the body fails to recognize a part of itself and develops destructive antibodies against itself, in this instance against the thyroid. Other conditions may cause hypothyroidism, including surgical removal, radioactive treatment, and lithium therapy. In parts of the world a lack of iodine is present in the diet, and this can result in hypothyroidism associated with enlargement of the thyroid gland (goiter). The addition of iodine to salt has significantly reduced this problem in many areas.

You are on the appropriate treatment, and your physician is treating you carefully and monitoring your blood levels. The fact that these levels are stable shows that you are on the correct dosage. You are fortunate not to be on any other medications. It is important for you to know that you will have to take thyroid hormone supplementation the rest of your life.
The most important side effects of replacement therapy result from either underdosing or overdosing. Excessive doses will result in weight loss, tremors, intolerance of hot weather, palpitations, and nervousness. Insufficient thyroid hormone results in weight gain, lethargy, tiredness, depressed mental activity, anemia, and elevated cholesterol. With careful follow-up as your physician is currently doing, you can continue your present therapy with peace of mind. You are supplementing that which is essential and needed.
As far as diet and lifestyle are concerned, it is important to have a nutritious and balanced diet (we recommend a lacto-ovo vegetarian diet). Regular exercise at least five days per week is important to enjoy the best health. Be sure to discuss your exercise program with your health-care provider to ensure that your exercise is appropriate for your current health status. You should be able to continue to lead a full and healthy life with your current therapy.
Allan R. Handysides, M.B., Ch.B., FRCPC, FRCSC, FACOG, is director of the General Conference Health Ministries Department; Peter N. Landless, M.B., B.Ch., M.Med., F.C.P.(SA), F.A.C.C., is ICPA executive director and associate director of Health Ministries.

Send your questions to: Ask the Doctors, Adventist Review, 12501 Old Columbia Pike, Silver Spring, Maryland 20904. Or you may send your questions via e-mail to [email protected]. While this column is provided as a service to our readers, Drs. Landless and Handysides unfortunately cannot enter into personal and private communication with our readers. We recommend that you consult with your personal physician on all matters of your health.