💉 Dr. Friedman: COVID-19 November 2020 update

 

Update November 22, 2020

I have not updated my patients on the COVID-19 pandemic since March. Since the last update and as of today’s date, 12.2 million Americans have been infected with COVID-19 and 256,000 Americans have died. Several of Dr. Friedman’s patients have been infected with COVID-19. Many businesses have closed and there have been major economic loses. The response to the pandemic has unfortunately been politicized and I say unfortunately because the virus doesn’t distinguish based on victim’s political party. Please see Dr. Friedman’s Letter in the Los Angeles Jewish Journal https://jewishjournal.com/letters_to_the_editor/316110/letters-lockdown-vs-no-lockdown/.

Dr. Friedman completely supports efforts to limit the spread of the virus, including wearing masks, social distancing, handwashing and staying at home. Listening to government officials including the CDC is crucial. Dr. Friedman agrees with data showing gatherings are much safer outside and encourages his patients to err on the side of safety and caution. Dr. Friedman is spearheading efforts at Charles R. Drew University to be a site for a vaccine study and after some delays, it looks like his University will be a site for the Sanofi vaccine in December 2020. Dr. Friedman is very excited about the promising results from the Moderna and Pfizer trials and thinks vaccines along with mask-wearing and social distancing will curtail the pandemic, hopefully in the latter half of 2021. He does think that COVID-19 will be with us for a long time. Dr. Friedman anticipates that changes due to COVID-19, including telemedicine and working from home will remain with us after the pandemic subsides.

As mentioned in the March update, patients with endocrine problems such as Cushing’s syndrome, Addison’s Disease, hypopituitarism and diabetes have slightly impaired immune systems, making them potentially susceptible for a more severe infection by COVID-19. He would recommend those patients to be especially vigilant about mask-wearing/social distancing and to get a vaccine when it comes out.

He advises his patients the following:

  • Wear masks, social distancing, handwashing and staying at home as much as possible
  • Use delivery services for groceries, food and medications.
  • Wash hands frequently for 20 seconds and/or use hand sanitizer several times a day
  • Avoid air travel, public gatherings and other public places as guided by local officials
  • Quarantine if sick or exposed.
  • Labcorp and Quest both introduced testing for COVID-19 using nasal swabs. Several other laboratories are also performing tests. Dr. Friedman recommends PCR testing and not rapid antigen testing. For those with symptoms of Coronavirus, he recommends seeing your primary care doctor for testing. Dr. Friedman is unable to provide requisitions or swabs for this testing that should be done by their primary doctor.
  • While Dr. Friedman was initially enthusiastic about antibody testing, he is concerned about the quality of the tests and no longer recommends it.
  • Labcorp and Quest are both still open and Quest has a new Peace of Mind program for lab services not related to COVID-19 and for patients who are 60 years of age or older, or have other conditions that put them at greater risk for COVID-19, in which patients can come to their nearby Quest location during the first hour of each day for VIP care.
  • Dr. Friedman encourages people to get their hormone testing done and make their followup appointments.
  • Many patients have requested extra supply of their medications. However, most insurances do not allow this and carefully monitor medication use. Dr. Friedman recommends patients to use a mail-order pharmacy and sign up for auto-refills so that they get a consistent supply of their medications.
  • Except for patients sick with COVID-19, patients should not up-dose hydrocortisone
  • Dr. Friedman has restarted in person visits on the last Tuesday of each month and continues to see patients via telemedicine on the other Tuesday nights. Please visit goodhormonehealth.com for more information or to schedule an appointment.
  • Dr. Friedman’s staff will still be doing in person growth hormone stimulation tests on Tuesday night in an isolated and sanitized clinic setting.
  • Dr. Friedman especially encourages patients to eat healthy and exercise (especially being outside) including walking, hiking, biking, aerobic videos yoga or pilates at home, during this stressful period.
  • Dr. Friedman encourages patients to get their flu vaccine and the COVID-19 vaccine when available.
  • Everyone should pray that the pandemic ends soon.

Dr. Friedman wishes everyone to stay healthy

📰 WP Thyroid and Nature-Throid recall-August 2020

Dr. Friedman prescribes various thyroid hormone preparations to his patients with hypothyroidism. This includes natural desiccated thyroid (NDT) of which two preparations are WP Thyroid and Nature-Throid, both made by RLC Labs. On August 25, 2020, RLC Labs announced a voluntary, consumer-level recall of all lots of Nature-Throid and WP Thyroid tablets because somel ots contain less than the required 90% of the active ingredient as determined by the FDA. The RLC spokesperson said to Dr. Friedman that one lot of WP Thyroid and 5 lots of Nature-Throid contained between 87% and 90% of the labeled amount of levothyroxine (T4) or liothyronine (T3). The recall did not disclose which of the lots were affected and all lots are recalled, not just the affected lots. According to the recall, if a patient receives a sub-potent tablet, hypothyroid symptoms may not be controlled. To date, there have been no reports of adverse events related to this recall. Patients who have had an adverse event should contact RLC Labs.

RLC Labs advised that patients should talk to their healthcare professional before they stop taking their Nature-Throid and WP Thyroid medicine. Consumers with questions about the recall can email RLC at recall@rlclabs.com or RLC Customer Service  (877) 797-7997. Patients may return unexpired Nature-Throid and WP Thyroid tablets to their pharmacy who are legally required to refund the cost of the tablets. Currently no lots of Nature-Throid and WP Thyroid tablets are commercially available, so a replacement with the same product is not an option. It is unknown how long it will be before Nature-Throid and WP Thyroid become commercially available.

Dr. Friedman has several comments about this recall. This is the second recall of desiccated thyroid as some lots of NP thyroid were recalled in May 2020. Dr. Friedman sees this as unfortunate, but still believes desiccated thyroid is a good option for patients with hypothyroidism. Secondly, the “subpotent” Nature-Throid and WP Thyroid pills are only slightly less potent than stated in that only a few lots are between 87% and 90% of the T4 and T3 levels. For most patients, they will not have symptoms from these subpotent pills and if they are taking a lot that is subpotent, the dose can be adjusted based on laboratory levels at your next appointment with Dr. Friedman.

According to Dr. Friedman, patients taking Nature-Throid and WP Thyroid have three options: 1) they can continue taking Nature-Throid and WP Thyroid knowing they may have a subpotent lot and knowing that they may not be able to get a refill at least temporarily. 2) patients can be switched to Armour thyroid, NP thyroid or have a compounding pharmacy compound the equivalent dose using USP grade porcine powder. Please let Dr. Friedman’s office know if you would like to go on a different desiccated thyroid product (and which one) and what pharmacy you would like to use, 3) Dr. Friedman has a small supply of desiccated thyroid that is available at his clinic for those in Los Angeles on the last Tuesday night of each month. He will not be able to mail desiccated thyroid. Please contact his office about this option.

Patients do not need to contact Dr. Friedman, but if you have any questions or need to schedule an appointment with Dr. Friedman, please email us at mail@goodhormonehealth.com or schedule an appointment on his website at goodhormonehealth.com.

📞 Webinar: Growth Hormone Deficiency, PCOS or Cushing’s: How do You Tell Them Apart?

Dr. Theodore Friedman (The Wiz) will host a webinar on Growth Hormone Deficiency, PCOS or Cushing’s: How do You Tell Them Apart?

Dr. Friedman will discuss topics including:

  • Signs and Symptoms of Cushing’s Syndrome
  • Testing for Cushing’s
  • Signs and Symptoms of Growth Hormone Deficiency
  • Testing for Growth Hormone Deficiency
  • Signs and Symptoms of PCOS
  • Testing for PCOS
  • How do you tell them apart?

Sunday • August 2 • 6 PM PDT
Click here on start your meeting or
https://axisconciergemeetings.webex.com/axisconciergemeetings/j.php?MTID=m4eda0c468071bd2daf33e6189aca3489
OR
Join by phone: (855) 797-9485

Meeting Number (Access Code): 133 727 0164 Your phone/computer will be muted on entry.
Slides will be available on the day of the talk here
There will be plenty of time for questions using the chat button. Meeting Password: pcos
For more information, email us at mail@goodhormonehealth.com

📞 Dr. Theodore Friedman (The Wiz) will host a webinar on “How to improve quality of life for those with no adrenals (BLA and Addison’s)”

 

Dr. Friedman will discuss topics including:

  1. Who should get an adrenalectomy?
  2. How do you optimally replace adrenal hormones?
  3. What laboratory tests are needed to monitor replacement?
  4. When and how do you stress dose?
  5. What about subcut cortisol versus cortisol pumps?
  6. Patient Melissa will lead a Q and A

Sunday • May 17 • 6 PM PST
Click here on start your meeting or
https://axisconciergemeetings.webex.com/axisconciergemeetings/j.php?MTID=mb896b9ec88bc4e1163cf4194c55b248f

OR
Join by phone: (855) 797-9485

Meeting Number (Access Code): 802 841 537 Your phone/computer will be muted on entry.
Slides will be available on the day of the talk here
There will be plenty of time for questions using the chat button. Meeting Password: addison
For more information, email us at mail@goodhormonehealth.com

🎤 Archived Interview: JenS discussed Bilateral Adrenalectomy (BLA)

 

Jen had Pituitary surgery by Dr. Shahinian 4/28/04, removed ACTH secreting corticotroph hyperplasia and prolactinoma.

She was diagnosed by Dr. Theodore Friedman as cyclical pituitary Cushings.

Her second Surgery 7/21/04 for infection resulted in neuralgia. She had a BLA in March 2006 as Corticol Hyperplasia returned and she now has possible Nelson’s syndrome. Jen also has Thyroid Issues (Hashimoto’s, multiple nodules and entire thyroid removed 2003) and she is Growth Hormone Deficient (3/2006)

Listen at http://www.blogtalkradio.com/cushingshelp/2008/02/29/jens-discusses-bilateral-adrenalectomy-bla

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📞Dr. Theodore Friedman will host an important Webinar on Coronavirus Information for Endocrine Patients

Dr. Theodore Friedman will host an important webinar on Coronavirus Information for Endocrine Patients

Many patients have asked Dr. Friedman what do during the Coronavirus Pandemic. He will give candid answers from his view as an Endocrinologist. He will also talk about new telehealth opportunities for his patients.

Sunday • April 5 • 6 PM PST
Click here on start your meeting or
https://axisconciergemeetings.webex.com/axisconciergemeetings/j.php?MTID=m505da5a10afe3aeea456e162414c17b9

OR
Join by phone: (855) 797-9485

Meeting Number (Access Code): 807 657 124
Your phone/computer will be muted on entry.
Slides will be available on the day of the talk here
There will be plenty of time for questions using the chat button.

Meeting Password: hormones
For more information, email us at mail@goodhormonehealth.com

📞 Webinar: Approaches for Pituitary Surgery

Dr. Theodore Friedman hosts Gautam Mehta, MD for a fascinating webinar on Approaches for Pituitary Surgery

Dr. Mehta is a neurosurgeon specializing in pituitary surgery at the House Clinic in Los Angeles. He was trained by Ian McCutcheon, MD and Ed Oldfield, MD

Topics to be discussed include:
• How does Dr. Friedman diagnose Cushing’s Disease
• How does Dr. Friedman determine who goes to surgery?
• What type of patients need surgery besides those with Cushing’s Disease?
• How do the neurosurgeon and the Endocrinologist work together?
• How does the neurosurgeon read pituitary MRIs?
• What types of surgical approaches are used for pituitary surgery?
• How long does surgery take and how long will a patient be in the hospital?
• What are the risks of pituitary surgery and how can they be minimized?

Sunday • August 4 • 6 PM PDT

Click here to start your meeting.

or
https://axisconciergemeetings.webex.com/axisconciergemeetings/j.php?MTID=ma1d8d5ef99605e305980e2f7cdfdb7bd
OR
Join by phone: (855) 797-9485
Meeting Number (Access Code): 807 028 597 Your phone/computer will be muted on entry.
Slides will be available on the day of the talk at slides 
There will be plenty of time for questions using the chat button. Meeting Password: hormones
For more information, email us at mail@goodhormonehealth.com

📞Theodore Friedman Webinar on Treatments for Insomnia

Dr. Theodore Friedman hosts Jay Khorsandi, DDS and Barbara Burggraaff, MD from Snore Experts for an important webinar on insomnia

Topics to be discussed include:
• What are the causes of insomnia?
• How do hormone imbalances lead to insomnia?
• What lifestyle changes can you do to help with insomnia?
• What supplements are helpful for insomnia?
• What medicines are helpful for insomnia?

Sunday • June 2nd • 6 PM PST

Click here on start your meeting.or
https://axisconciergemeetings.webex.com/axisconciergemeetings/j.php?MTID=m2f7d9547a80ec47e43869517ef006f34
OR
Join by phone: (855) 797-9485

Meeting Number (Access Code): 807 924 444
Meeting Password: hormones

Your phone/computer will be muted on entry. There will be plenty of time for questions using the chat button.

For more information, email us at mail@goodhormonehealth.com

📞Theodore Friedman Webinar on Treatments for Insomnia, June 2, 2019

Dr. Theodore Friedman hosts Jay Khorsandi, DDS and Barbara Burggraaff, MD from Snore Experts for an important webinar on insomnia

Topics to be discussed include:
• What are the causes of insomnia?
• How do hormone imbalances lead to insomnia?
• What lifestyle changes can you do to help with insomnia?
• What supplements are helpful for insomnia?
• What medicines are helpful for insomnia?

Sunday • June 2nd • 6 PM PST

Click here on start your meeting.or
https://axisconciergemeetings.webex.com/axisconciergemeetings/j.php?MTID=m2f7d9547a80ec47e43869517ef006f34
OR
Join by phone: (855) 797-9485

Meeting Number (Access Code): 807 924 444
Meeting Password: hormones

Your phone/computer will be muted on entry. There will be plenty of time for questions using the chat button.

For more information, email us at mail@goodhormonehealth.com

🎤Archived Interview: Terry G, pituitary patient

Terry (Terry) is a long time pituitary Cushing’s survivor.

Terry had a pituitary surgery (in LA) in October of 2003 which did not cure her Cushing’s Disease. Then, Dec 13th, 2003 she had her BLA in a Wisconsin hospital. She also had an infection in her sphenoid sinus. It originated at the site of her pituitary surgery from October 2003. She had to be on a lot of antibiotics and narcotic pain relievers.

In Sept 2005 the surgeon removed the infection from one area, making another area clear…..

Listen at http://www.blogtalkradio.com/cushingshelp/2008/04/17/interview-with-terry-g-pituitary-patient

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