Know Your Diagnosis before Treating Your Symptoms

OPRAH SHINES A LIGHT ON THYROID DISEASE:  After Oprah shared last week her recent diagnosis of a “burned out thyroid” after suffering months of undiagnosed low fatigue and energy, I have heard from so many women complaining that they too have been misdiagnosed before finally learning what was wrong with them.  I plan to write much more about thyroid disease in the future, what causes it, how to diagnose it, how to best treat it.  But for now I think the most important message we can take away from Oprah’s revelation is that if we feel something is just not right – believe it – and act on it to get the most accurate diagnosis possible and the best treatment possible.  Find a doctor or practitioner who takes your concerns seriously and be sure that you get the necessary tests to get to the bottom of what is going on.  Don’t just assume stress is the cause of your symptoms without first exploring the possibility that an underlying medical condition that requires specific treatment exists - such as Oprah Winfrey’s hypoactive thyroid or Leslie Stahl’s iron deficiency Read my interview “Women Must Take Charge of Their Own Thyroid Health” with thyroid expert and patient advocate Mary Shomon at About.com to learn more about thyroid disease and how to work with your doctor.

I spoke to Diane Sawyer on Good Morning America last Thursday about a common sense approach to low energy and fatigue and emphasized the importance of getting a comprehensive blood workup before attributing your symptoms to stress.  I also responded to her questions about iron deficiency when a brief interview with Leslie Stahl of 60 Minutes admitted she had a dramatic response recently to taking iron. “HEALTH SECRETS FOR WOMEN”, Good Morning America and ABC News Audio

For those of you who didn’t see the segment on Good Morning America last Thursday, Leslie Stahl described her recent discovery of low iron and low-grade anemia and her dramatic response to taking iron boosting her energy within two weeks!  I applaud her for sharing this information with us – but I would also add that before taking iron tablets to treat anemia or low energy, make sure you really are iron deficient first and then find out exactly WHY!!!  

Most postmenopausal women (and men for that matter) who are iron deficient likely have a hidden source of bleeding in the bowel such as colon cancer causing the iron loss.  Iron is normally recycled or reused in the body when red blood cells are destroyed from old age so to suddenly become low in iron suggests your body is actually losing iron; not recycling it.  So if you learn you are iron deficient, ask why and be sure you undergo testing to look for the underlying cause.  Taking iron can give a dramatic response to your low energy but it will simply mask the underlying the problem.  And taking too much iron is not a good idea either.  Iron is a heavy metal, and although our stomach and intestines will only absorb a small amount at a time, some people have the undiagnosed condition hemochromatosis that can lead to excess accumulation of iron and cause permanent damage to our liver and other organs.  So you can see why I believe so strongly that people need to be as informed as possible about their conditions and know that every thing you put in your mouth including vitamins and minerals should be considered “medicine”.

My book, HOW TO SAVE YOUR OWN LIFE (Warner Books, Inc. 2000) is a good resource to help you learn more about to expect during a physical examination and what tests you need to get the most accurate diagnosis.  It also shows you how to collect, read and organize your medical records. 

THE HPV TEST IS MORE EFFECTIVE THAN PAP TEST

I have been talking about the importance of The HPV Test for women 30 and over for some time.  I answer frequently asked questions about HPV and provide a lot of other important information about HPV at my website at http://www.drsavard.com/cancer/cancer_home.html.

This week THE HPV TEST made headline news.  The first randomized, controlled study in North America of HPV testing as screening test concluded that it is almost 40 percent more accurate than traditional cytology (the Pap smear) in identifying women with advanced cervical disease, according to a report published in The New England Journal of Medicine

The study, which involved more than 10,000 Canadian women age 30-69, found that the HPV test’s sensitivity – its ability to accurately identify women with pre-cancerous cervical cells or cancer – was 94.6 percent, compared to 55.4 percent for the Pap.  In this study, the conventional “dry Pap” test was used – the cells smeared onto a microscope slide and sprayed with a fixative. Recent studies have found that the newer “liquid-based” Pap test – the cells placed in a liquid solution - is not that much better.

Another study in the same journal found that when using the HPV test to screen for cervical cancer, the interval between screening tests could extend to every 3 or more years if your HPV test and Pap test are both normal.

The best and most effective approach to cervical cancer prevention combines 1) HPV vaccines for girls and young women with 2) screening with the HPV test (women 30 and over) and the Pap test for ALL women.  Girls and young women who receive the HPV vaccine also need to have regular screening tests because the vaccine only assures protection against the 2 most common or serious strains of HPV.

As always, I welcome your questions and comments.

Warm regards,

Dr. Marie


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