For her and millions of other Americans, that’s the most common cause of hypothyroidism, a condition in which the thyroid, a butterfly-shaped gland in the neck, doesn’t produce enough of the hormones needed for the body to regulate metabolism.

There’s no cure for Hashimoto’s or hypothyroidism. But VanOrden, who lives in Athens, Texas, started taking levothyroxine, a much-prescribed synthetic thyroid hormone used to treat common symptoms, like fatigue, weight gain, hair loss, and sensitivity to cold.

Most patients do well on levothyroxine and their symptoms resolve. Yet for others, like VanOrden, the drug is not as effective.

For her, that meant floating from doctor to doctor, test to test, and treatment to treatment, spending about $5,000 a year.

“I look and act like a pretty energetic person,” said VanOrden, 38, explaining that her symptoms are not visible. “But there is a hole in my gas tank,” she said. And “stress makes the hole bigger.”

Autoimmune diseases occur when the immune system mistakenly attacks and damages healthy cells and tissues. Other common examples include rheumatoid arthritis, lupus, celiac disease, and inflammatory bowel disease. There are more than 80 such diseases, affecting up to an estimated 50 million Americans, disproportionately women. Overall, the cost of treating autoimmune diseases is estimated at more than $100 billion annually in the U.S.

Despite their frequency, finding help for many autoimmune diseases can prove frustrating and expensive. Getting diagnosed can be a major hurdle because the range of symptoms looks a lot like those of other medical conditions, and there are often no definitive identifying tests, said Sam Lim, clinical director of the Division of Rheumatology at Emory University School of Medicine in Atlanta. In addition, some patients feel they have to fight to be believed, even by a clinician. And after a diagnosis, many autoimmune patients rack up big bills as they explore treatment options.

“They’re often upset. Patients feel dismissed,” Elizabeth McAninch, an endocrinologist and thyroid expert at Stanford University, said of some patients who come to her for help.

Insufficient medical education and lack of investment in new research are two factors that hinder overall understanding of hypothyroidism, according to Antonio Bianco, a University of Chicago endocrinologist and leading expert on the condition.

Some patients become angry when their symptoms don’t respond to standard treatments, either levothyroxine or that drug in combination with another hormone, said Douglas Ross, an endocrinologist at Massachusetts General Hospital in Boston. “We will have to remain open to the possibility that we’re missing something here,” he said.

Jennifer Ryan, 42, said she has spent “thousands of dollars out-of-pocket” looking for answers. Doctors did not recommend thyroid hormone medication for the Huntsville, Alabama, resident — diagnosed with Hashimoto’s after years of fatigue and weight gain — because her levels appeared normal. She recently switched doctors and hopes for the best.

“You don’t walk around hurting all day long and have nothing wrong,” Ryan said.

And health insurers typically deny coverage of novel hypothyroidism treatments, said Brittany Henderson, an endocrinologist and founder of the Charleston Thyroid Center in South Carolina, which sees patients from all 50 states. “Insurance companies want you to use the generics even though many patients don’t do well with these treatments,” she said.

Meanwhile, the extent of Americans’ thyroid problems can be seen in drug sales. Levothyroxine is among the five most prescribed medications in the U.S. every year. Yet research points to some overprescribing of the drug for those with mild hypothyroidism.

A recent study, paid for by AbbVie — maker of Synthroid, a brand-name version of levothyroxine — said a medical and pharmacy claims database showed that the prevalence of hypothyroidism, including milder forms, rose from 9.5% of Americans in 2012 to 11.7% in 2019.

The number of people diagnosed will rise as the population ages, said McAninch. Endocrine disruptors — natural or synthetic chemicals that can affect hormones — could account for some of that increase, she said.

In their search for answers, patients sometimes connect on social media, where they ask questions and describe their thyroid hormone levels, drug regimens, and symptoms. Some online platforms offer information that’s dubious at best, but overall, social media outlets have increased patients’ understanding of hard-to-resolve symptoms, Bianco said.

They also offer one another encouragement.

VanOrden, who has been active on Reddit, has this advice for other patients: “Don’t give up. Continue to advocate for yourself. Somewhere out there is a doctor who will listen to you.” She has started an alternative treatment — desiccated thyroid medication, an option not approved by the FDA — plus a low dose of the addiction drug naltrexone, though the data is limited. She’s feeling better now.

Research of autoimmune thyroid disease gets little funding, so the underlying causes of immune dysfunction are not well studied, Henderson said. The medical establishment hasn’t fully recognized hard-to-treat hypothyroid patients, but increased acknowledgment of them and their symptoms would help fund research, Bianco said.

“I would like a very clear, solid acknowledgment that these patients exist,” he said. “These people are real.”

For an illustrated version of this article, click here.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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There will be no fogging on Independence Day, Thursday, November 30.

However, several districts in St Philip and St Michael will be targeted when the Vector Control Unit of the Ministry of Health and Wellness carries out its fogging exercise, this week.

On Monday, November 27, the team will be in St Philip in the following areas: Eastbourne #1, Mill Road, Well House, Casuarina Estate and the environs.

The next day, Tuesday, November 28, emphasis will be on the St Michael districts of Lower Burney, Cutting Road, Mount Friendship Road and the environs.

Fogging will occur again in St Michael on Wednesday, November 29. The areas to be sprayed are: Henry Durant Road, Friendship Terrace, Lowland Drive, Mahaica, Storey Gap and the environs.

The exercise will conclude for the week on Friday, December 1, in the St Michael areas of Butlers Avenue, Paradise Road, Chapel Gap, Pioneer Road, Lower Civilian Road, Bush Hall Yard Gap, Ellis Road, Stadium Road and the environs.

Fogging takes place from 4:30 to 8:30 p.m., daily. Householders are reminded to open their windows and doors to allow the spray to enter. Persons with respiratory problems are asked to protect themselves from inhaling the spray.

Pedestrians and motorists should proceed with caution when encountering fogging operations on the street and parents are instructed to prohibit children from playing in the fog or running behind the fogging machine.

Members of the public are advised that the completion of scheduled fogging activities may be affected by events beyond the Unit’s control. In such circumstances, the Unit will return to affected communities as soon as possible.

(PR)

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IF you've beaten strep throat once, you certainly don't want to deal with it again.

Yet, if you or your child are among those who develop recurring strep throat, know these five things:

• Strep throat is a highly infectious disease.

• Children are more susceptible to strep throat, which strikes millions of people, young and old, worldwide each year.

• Science researchers are making discoveries about what causes the condition.

• Treatment methods are available to prevent your strep throat from developing into a more serious condition.

• You can take steps to help prevent strep throat or to soothe your irritated throat.

What is strep throat?

As the Centres for Disease Control and Prevention (CDC) explains, strep throat is named after the bacteria responsible for the illness: group A Streptococcus (GAS). These bacteria live in the throat and nose tissues. They can easily spread between people through talking, coughing, sneezing, kissing, and other airborne and saliva-sharing ways.

While a sore throat that comes on quickly is a common sign of strep throat, be aware of these other symptoms:

• Painful swallowing

• Inflamed or swollen tonsils (sometimes dotted with white pus-filled spots)

• Swollen neck glands

• Small red dots on the roof of your mouth

• Fever

• Headaches

• Aching muscles

• Rash

• Nausea or vomiting

• Stomach pain

Additionally, infants with strep throat might develop a pus-like discharge from their noses and refuse nourishment.

Your sore throat might be a virus, not strep, if it's accompanied by a runny nose, cough, hoarseness, or pink eye. But it's always best to have your doctor conduct a GAS bacteria test to determine if it's strep throat or just a sore throat.

It's important to know that some people who aren't suffering from strep throat might still test positively for GAS. This can occur if a person is a GAS carrier.

Who gets recurring

Children most commonly develop strep throat, but it can affect people of all ages. The bacteria can spread through settings in which infected and healthy people are in close quarters, such as schools and day care centres.

If you or your child get strep throat and undergo a successful treatment plan, unfortunately, you're not immune to the GAS infection. And even if you avoid people with strep throat symptoms, you could be exposed to a GAS carrier. This is a person who's asymptomatic but can still infect you.

But why are some people more susceptible to recurring bouts of strep throat than others? Researchers found factors that, if working together, can lead to recurrent strep throat: genetics, certain cells going haywire, and an inability to produce the necessary antibodies to build strong immunity.

Treating recurring

Though the research noting the cause of recurring strep throat might be the first step towards a vaccine, a cure is well in the future.

For now, a course of antibiotics is usually an effective treatment for strep throat.

A physician or paediatrician might recommend a long-term course of antibiotics to prevent recurrent infections until the end of the school year.

The important thing is getting treatment ASAP as untreated strep throat can develop into more serious conditions. And it's essential to tell your doctor if your strep throat symptoms don't improve after taking all the antibiotics prescribed.

Soothing your throat at home

While at-home remedies should not replace professional treatment from your doctor, you can try some things to help soothe pain or inflammation caused by strep throat.

Some helpful ideas that are also good for a non-strep sore throat:

• Get plenty of rest. Sleep is a wonder drug.

• Drink chicken soup or warm tea with honey or lemon.

• Suck on ice pops or drink iced beverages.

• Dissolve 1/2 teaspoon salt or baking soda in 1 cup warm water, then gargle every few hours.

• Use a humidifier to moisten your living-space air, take a hot shower and breathe in the humidity.

• Take over-the-counter pain medication per package directions.

• Adults only: Suck on throat lozenges or hard candies.

• Avoid dehydrating and irritating items, such as caffeine, alcohol, and smoke.

Preventing strep throat

Good hygiene practices can help prevent strep throat infections and other infectious diseases. These practices include:

• Washing your hands frequently (and for 20 seconds each time) with soap and water, especially before preparing meals or eating. Carry around an antibacterial hand rub that's alcohol-based just in case you're nowhere near soap and water.

• If you sneeze or cough, covering your mouth and nose with a tissue and then putting the tissue in the trash. If you don't have a tissue handy, sneeze into your upper arm or inner elbow — not your hands.

• When caring for someone suffering from strep throat, washing their used utensils, plates, and glasses thoroughly.

If you recognise strep throat symptoms in your child or yourself, please see your doctor right away despite following prevention methods.

However, if any member of your family gets strep throat time and time again, have a heart-to-heart with your doctor about the best course of action for recurring strep throat.

Dr Sharon Robinson, DDS, has offices at Dental Place Cosmetix Spa, located at shop #5, Winchester Business Centre, 15 Hope Road, Kingston 10. Dr Robinson is an adjunct lecturer at the University of Technology, Jamaica, School of Oral Health Sciences. She may be contacted at 876-630-4710. Like their Facebook page, Dental Place Cosmetix Spa.

Many individuals with hypertension remain untreated or inadequately treated. Only about 20 per cent of hypertensives are controlled on medications. Despite widescale availability of effective and well-tolerated medications for hypertension, up to 80 per cent of hypertensive individuals have uncontrolled or poorly controlled hypertension.

Uncontrolled hypertension is a leading cause of death and disability, especially in low- and middle-income countries. Controlling or treating hypertension to target can potentially save many lives and reduce the economic burden associated with hypertension and its many complications. A major reason for inadequate or poor hypertension control is medication non-compliance. Community surveys show that only 50 per cent of patients continue to take anti-hypertensive drugs after one year. It is reasonable to presume that improving compliance in the treatment of hypertension would lead to better control of hypertension and reduction in cardiovascular risks.

There is evidence that increasing the number of patients effectively treated for hypertension to levels observed in high-performing countries could prevent 76 million deaths, 120 million strokes, 79 million heart attacks, and 17 million cases of heart failure globally over the next 25 years.

Finding a sustainable and effective treatment with high level of compliance has been a major quest for doctors treating patients with hypertension. An exciting new research work suggests that we may be getting closer to achieving this objective. In a recently concluded study, a single injection of the investigational anti-hypertensive agent Zilebesiran (Alnylam Pharmaceuticals) effectively lowered blood pressure in adults with mild to moderate hypertension for up to six months. The findings of the KARDIA-1 study were presented this month at the American Heart Association Annual Scientific Sessions held in Philadelphia, USA. The study demonstrated that either quarterly or biannual doses of Zilebesiran effectively and safely reduced blood pressure in patients with hypertension and suggest that Zilebesiran could potentially improve compliance in patients with hypertension and could ultimately improve outcomes.

Zilebesiran is a subcutaneous RNA interference therapeutic that binds to a hepatic receptor, leading to an interruption of pro-hypertensive processes. The KARDIA-1 trial investigated the safety and efficacy of different doses of Zilebesiran in 394 patients with mild to moderate hypertension over a six-month follow-up period. (56 per cent men, 44 per cent women, 25 per cent black).

Ambulatory systolic blood pressure measured over 24 hours was significantly decreased with Zilebesiran. This effect was seen in both daytime and night-time measurements. Furthermore, patients receiving Zilebesiran were more likely to achieve 24-hour average systolic blood pressure measurements ≤ 130 mm Hg at six months.

These findings are very encouraging and suggest that, in the future, we may have an alternative strategy to treat hypertension with an injectable drug that can achieve robust and sustained blood pressure lowering for up to six months, which should improve compliance, increase efficacy, and protect against complications. There is hope that further investigations and refinements would lead to intermittent subcutaneous dosing and administration at home as a desired possibility in the future.

Dr Ernest Madu, MD, FACC and Dr Paul Edwards, MD, FACC are consultant cardiologists for the Heart Institute of the Caribbean (HIC) and HIC Heart Hospital. HIC is the regional centre of excellence for cardiovascular care in the English-speaking Caribbean and has pioneered a transformation in the way cardiovascular care is delivered in the region. HIC Heart Hospital is registered by the Ministry of Health and Wellness and is the only heart hospital in Jamaica. Send correspondence to info@caribbeanheart.com or call 876-906-2107.

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The upfront payment will be expensed by Merck in the fourth quarter of 2023 and included in non-GAAP results.

“Caraway’s multidisciplinary approach has yielded important progress in evaluating novel mechanisms of modulation of lysosomal function with potential for the treatment of progressive neurodegenerative diseases,” said George Addona, senior vice president, discovery, preclinical development and translational medicine, Merck Research Laboratories. “We look forward to applying our expertise to build upon this work with the goal of developing much needed disease-modifying therapies for these conditions.”

Caraway is a preclinical biopharmaceutical company pursuing innovative approaches for the treatment of genetically defined neurodegenerative and rare diseases. The company has built a pipeline of novel, small-molecule therapeutics for the treatment of genetically defined neurodegenerative and rare diseases.

“This important milestone is a testament to the hard work and dedication of the Caraway team and our mission to develop therapeutics with the potential to alter the progression of devasting neurodegenerative diseases and help patients,” said Martin D. Williams, chief executive officer, Caraway Therapeutics. “This acquisition leverages Merck’s industry-leading research and development capabilities to help further advance our discovery and preclinical programs. We thank and appreciate our investors, including SV Health Investors and its Dementia Discovery Fund, AbbVie Ventures, Amgen Ventures, Eisai Innovation and MRL Ventures Fund for their support.”

Under the terms of the agreement, Merck, through a subsidiary, will acquire all outstanding shares of Caraway with earnout milestones associated with the development of certain pipeline candidates. The Board of Directors of Caraway Therapeutics has approved the transaction. Merck, through its MRL Ventures Fund, has been a shareholder of Caraway Therapeutics since 2018.

Read also: Merck gets positive EMA Committee opinion for Keytruda plus Gemcitabine, Cisplatin for Biliary Tract Cancer

As Guyanese police on Wednesday said reported two serious cases of domestic violence, the Pan American Health Organisation (PAHO) announced that it would next week take a major step to improve the way the health sector in the Americas address violence against females. “To enable the health sector to play this important role, it is ...

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