RX for Readers: Check your thermostat

The only common medical problem that can explain generally feeling cold is hypothyroidism.

I am 66 years old and have never really understood why some people – like me – feel the cold temperatures in winter much more than others. Is it due to some inner metabolism? Is there anyone one can do about this?

    – A.L., Rishon Lezion
Prof. Mark Clarfield, chief of geriatrics at Soroka University Medical Center in Beersheba, comments:
It is difficult to know why some people feel more cold and others feel less so in the same environment. Like all other things, there is much variation in humanity. I myself try to turn down the thermostat, while my wife raises it.
The only common medical problem that can explain a general feeling cold is a low-functioning thyroid gland (hypothyroidism). Among the symptoms are fatigue; exhaustion; feeling run down and sluggish; depression; difficulty concentrating; unexplained or excessive weight gain; dry, coarse and/or itchy skin or hair; feeling cold, especially in the extremities; constipation; muscle cramps; infertility in women; and increased menstrual flow, more frequent periods or miscarriage. These symptoms, however, can be caused by other conditions as well.
Fortunately, hypothyroidism is diagnosed with a simple blood test (TSH) and treated relatively easily with one oral pill of thyroid hormone replacement per day.
I am an 83-year-old man. Whenever I wash my dishes, my left hand trembles. I am afraid of accidentally dropping dishes into the sink. My rheumatologist has twice given me shots in the left arm, but to no avail. I have also rubbed venoruton cream onto the left arm numerous times, but with no results. Is there an effective treatment?

    – H.L., Jerusalem
Prof. Clarfield answers this question as well.
Shaking of limbs can be caused by many different conditions. You should see your family physician, who will assess all medications that you are taking (as some can indeed cause tremor) and give you a good general examination with special attention to the neurological system. From what you have written, it seems less likely that this is a rheumatological (muscles and joints) problem. Sometimes Parkinson’s disease starts in this manner, but in this condition, there are usually other signs and symptoms as well. Another possibility is what is called “essential tremor,” the cause of which is unknown. It usually starts earlier in life but gets worse as we age. Oddly, it seems to be relieved by alcohol, but I would not recommend this as a treatment. There are medications that can reduce the symptoms of both Parkinson’s disease and essential tremor. If your family doctor can’t find anything, the next step would be a referral to a neurologist.
My four-year-old grandson is getting bitten by something at night. The skin bites swell up, and he scratches them. In summer, his parents thought they were due to mosquitoes, but it’s happening now in the winter. When one looks close up, they definitely seem to be bite marks. Even if his two brothers who sleep in the same room are being bitten by the same thing, they do not react like this. What expert should he be taken to? Could the problem be bedbugs?

    – D.S., Jerusalem
Dr. Kosta Mumcuoglu, a senior parasitologist at the Kuvin Center for the Study of Infectious and Tropical Diseases at the Hebrew University Faculty of Medicine, replies:
At this time of the year and according to what I could grasp from what you describe, it seems as the cause of the problem is bites of either fleas or bedbugs. In this case, it would be not enough to treat only the patient (surely not with scabicides) but rather the environment with insecticides. Even before his parents take him to a dermatologist, they could treat the bite areas with an antipruritic medication such as Fenistil gel. I would also recommend that a parasitologist see the patient and determine the bite areas on the body, duration of the infestation and whether the bite marks appeared all at once or over a period of time. I would be glad to see him at my office in Jerusalem.
Rx for Readers welcomes queries fromreaders about medical problems. Experts will answer those we find mostinteresting. Write Rx for Readers, The Jerusalem Post, POB 81,Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02)538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, ageand residence.