DEAR DR. DONOHUE: I have taught fourth grade for 20 years. This year I couldn’t wait for the summer break. I was feeling fine at the beginning of the year, but as the months passed, I could hardly make it through the day. I had no energy.

My husband insisted I see a doctor. I did. The first doctor told me I was depressed. The second one took a longer time with me and ordered a batch of blood tests. My thyroid gland isn’t working. I have a condition with a foreign-sounding name. Do you know what I’m talking about? Will you expand on it for me? — T.Y.

ANSWER: I’m sure you’re referring to Hashimoto’s thyroiditis. The Hashimoto name is not recognized by most people. It is, however, in our part of the world, the most common cause of hypothyroidism — a nonworking thyroid gland.

The thyroid gland is located in the lower part of the neck. Thyroid hormone keeps all body cells and organs working at their peak efficiency. In Hashimoto’s thyroiditis, the immune system has attacked the gland for reasons that are not clear. It’s yet another example of an autoimmune disease, one where the immune system turns on its own body.

Signs of a lack of thyroid hormone come on gradually. Fatigue and weakness make it a heroic feat to get through the day. Hair might fall out. Skin becomes dry. Affected people feel cold when others are comfortably warm. Constipation is a common complaint. Menstrual cycles are erratic. Weight is gained in spite of a poor appetite and a decreased intake of calories.

In addition to these signs, the gland often enlarges — becomes a goiter.

Although Hashimoto’s thyroiditis and the resulting hypothyroidism are serious conditions, treatment is straightforward: Supply the missing thyroid hormone. Once on the pill form of the hormone, signs and symptoms disappear. It takes time, however, before a person notices big changes for the better.

The booklet on thyroid disorders discusses conditions of both under-and overactive thyroid glands in detail. Readers can obtain a copy by writing: Dr. Donohue — No. 401, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am 66. I had been a heavy smoker, and I had a brother who died of an abdominal aneurysm. My doctor insisted I have an ultrasound of my abdomen to find out if I had one. (He thought he felt one.) It turns out that I don’t have an aneurysm. I do have a porcelain gallbladder. The doctor wants me to have surgery right away. I have no pain. I feel good. He says it’s a cancer threat. Is this so? — M.Z.

ANSWER: It is so. A porcelain gallbladder must be removed because of the high risk of cancer.

This kind of gallbladder got its name because calcium infiltrates its wall. The wall is inflamed, and gallstones are often the cause of the inflammation. Even though you might have no gallstones and even though you have no pain, you need to have the gallbladder taken out, so great is the threat of cancer developing.

DEAR DR. DONOHUE: My grandparents never took vitamins and never talked about them. They both lived into their late 90s. Everyone I know takes vitamins, including me. Why? — C.N.

ANSWER: Vitamins are nutrients essential to body health and body chemistry. They’re needed only in minute amounts. No vitamin is made by the body except for vitamin D. We must get them from foods. Although the body does make vitamin D, many older people and quite a few younger ones are deficient in this vitamin. Your grandparents got their vitamins from eating a well-balanced diet. We could do the same.

Vitamin-taking is a new wrinkle in human history. It does assure people that they’re getting the recommended daily intake of vitamins. Is it absolutely necessary? Probably not, but most do not get their daily dose of all vitamins through foods.

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. Readers may also order health newsletters from www.rbmamall.com.

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