DEAR DR. DONOHUE: Can being on a low-salt diet cause thyroid disease, since the ingestion of iodine is greatly reduced? – D.C.

ANSWER: Not so long ago, there were places on Earth called goiter belts. Those places had inordinate numbers of people with enlarged thyroid glands. An enlarged thyroid gland is a goiter. The swollen gland is very obvious even to a casual observer. It’s in the lower neck.

The reason why people in those locations came down with goiters was a deficiency of iodine in the soil, with a resulting deficiency of iodine in foods grown in that soil.

Without iodine, the thyroid gland cannot make thyroid hormone. When there is a short supply of iodine, the gland enlarges in a heroic attempt to extract every atom of iodine it can from food. It is a futile maneuver by the thyroid gland. It gets larger without producing any more thyroid hormone.

In North America, the region bordering the Great Lakes was a goiter belt.

In 1922, iodine was added to salt. Salt was the food chosen to bolster the iodine supply because of its universal use. Since the addition of iodine to salt, the incidence of goiter has plummeted.

The recommended dietary allowance of iodine for adult men and women is 150 micrograms a day. One hundred and fifty micrograms is an amount so tiny, you would have difficulty seeing it with a magnifying glass.

The typical low-salt diet still provides enough iodine to furnish the daily need. Furthermore, we live in an age where foods come from distant places, so even people living in iodine-deficient locales still get much iodine in food transported to them from places where the soil has an abundance of iodine.

Good food sources of iodine are dairy products and seafood.

The thyroid gland is a mystery for many people, yet a good number have thyroid problems. The thyroid pamphlet covers most of those problems. Readers can order a copy by writing: Dr. Donohue – No. 401, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I believe I drink too much, and I want to get a handle on it but can’t seem to do so. I’ve called AA and gone to meetings. The AA method has no appeal for me. Where can I get help to control my alcohol use? – D.M.

ANSWER: Begin with the family doctor, who can either offer you treatment or refer you to a professional therapist skilled in handling alcohol abuse.

Medicines help some people abstain when they begin a program of living life without alcohol. Antabuse, a drug with a long history of helping people overcome their desire to drink, makes users sick if they drink alcohol while taking the drug.

Naltrexone is a drug that lessens the craving for alcohol. Some doctors have found that ondansetron, a drug whose primary purpose is control of the nausea that often comes with chemotherapy, is useful in freeing a person from alcohol abuse.

Drugs are not the sole answer. Most people need the helping hand of a professional to win the battle over alcohol’s tyranny. Don’t hesitate to seek that help.

The National Drug and Alcohol Treatment Referral Routing Service is an agency that can supply you with information on conquering an alcohol problem. The number is (800) 662-HELP.

DEAR DR. DONOHUE: How does Alzheimer’s disease kill a person? -Q.T.

ANSWER: As the disease progresses, people become less active. They lose their desire to eat. They often spend much time in bed or in a chair.

All of the above weaken the immune system. Many Alzheimer’s patients, therefore, die of infections such as pneumonia, infections that would not be lethal to a more active person.

The average number of years from the onset of Alzheimer’s to a patient’s death is about nine.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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