Frank is a 72-year-old man from Jamaica who moved to the United States 2 years ago. He has been diagnosed with hypothyroidism this past year. He comes to your clinic with his medicine and traditional folk remedies, including Synthroid, garlic, and chamomile. His diet history indicates daily use of chicken, rice, celery, dandelion, green pepper, mango, and papaya. He states that he has been very tired lately, has little energy, and has constipation. His hormone levels on his last medical report were thyroxine (T4): 1.7, triiodothyronine (T3): 75, and thyroid-stimulating hormone (TSH): 15, indicative that his hypothyroidism is still not well controlled.
Nutrition Diagnostic Statement
Food-drug interaction related to mixing Synthroid with foods and herbs that aggravate thyroid function as evidenced by fatigue, constipation, high TSH, and low serum T3 and T4.
Nutrition Care Questions
1. What other information do you need for a more thorough assessment?
2. What advice would you offer Frank about his diet?
3. What foods and herbs conflict with Synthroid?
4. Because traditional folk remedies are commonly used, how do you plan to discuss these issues with Frank?