DEAR PEOPLE’S PHARMACY: I have trouble sleeping more than two hours before having to get up to urinate every night. Is there a remedy? Melatonin pills don’t help, nor does soft music.
Is there a patch that would help me sleep through the entire night instead of getting up every two hours?
A. Sleeping pills or patches may not solve your problem. Getting up every two hours to go to the bathroom suggests a medical condition called nocturia. This condition can be caused by several factors. You will need to consult a physician for a clear diagnosis.
One possibility is “nocturnal polyuria,” an overproduction of urine at night. A health care professional will also need to test for a urinary tract infection, diabetes, or heart or kidney problems. You may be asked to monitor urine output over 24 hours. If you are over age 65 and nighttime production is greater than 33% of your daily urine output, that could signal nocturnal polyuria.
One possible treatment for this medical problem is the drug desmopressin (Central European Journal of Urology, Nov. 2, 2020). When dissolved under the tongue an hour before bedtime, this hormone-like medication (Nocdurna) may be helpful. Your doctor will need to monitor your sodium levels very carefully and make sure your kidney function is normal.
Q. I had angular cheilitis for years. Then I was diagnosed with celiac disease, an inability to tolerate gluten.
Once I went gluten-free, the angular cheilitis went away. Angular cheilitis can be one of the many symptoms of celiac disease.
A. Angular cheilitis is a common irritation of the skin at the corners of the mouth. It may have many triggers and, as you point out, celiac disease is among them.
Q. I’ve been treated for hypothyroidism for close to 40 years. Surprisingly, even now I’m learning new things about it.
After several years of trial and error along with a long series of ultrasensitive TSH tests and avoiding certain foods, my thyroid hormone levels have stabilized. We no longer have to increase my dose of Synthroid on a regular basis.
My doctor suggested leaving a four-hour window before and after taking Synthroid when consuming calcium or soy. Otherwise, they might affect levothyroxine absorption. Lesser known are the effects of grapefruit and walnuts, which should be avoided.
I take my pill when I get up during the night to go to the bathroom. This disrupts my sleep, but it means fewer problems with my diet.
A. You might be able to sleep better if you took your Synthroid pill at bedtime. Studies have shown that the results are similar to taking the medicine first thing in the morning, half an hour before coffee and breakfast (Expert Review of Clinical Pharmacology, March 2024). Although you did not mention it, coffee and tea can both interfere with levothyroxine (Synthroid) absorption (Pharmaceuticals, March 2, 2021; Frontiers in Endocrinology, Sept. 12, 2022).
The only reference we could find to walnuts is very old (Endocrinology, March 1970). These researchers consider it a goitrogen, similar to cabbage, collards and broccoli. Excessive amounts of goitrogens interfere with thyroid hormone function.
You can learn more about foods and supplements that may interfere with levothyroxine absorption in our “eGuide to Thyroid Hormones.” This online resource is located under the Health eGuides tab at www.PeoplesPharmacy.com.
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In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”
(c) 2024 King Features Syndicate, Inc.
