With COVID, we have never been more aware of critical shortages of masks, ventilators, hospital beds, etc., all leading to rationing. In this BLOG, Dr Frankel, examines how rationing in our medical care is a much bigger problem than just face masks.
Not long ago, while I was at my desk reviewing charts, it came to my attention that a staff member had uploaded a patient’s recent lab test results. The patient is a 60 year old woman who came in for a consultation, complaining of generalized fatigue combined with weakness in her legs. The weakness was debilitating to the extent that she sometimes had difficulty walking.
She denied any other past medical history of any significance. However, at the time of the exam, I noted a horizontal scar above the thyroid gland in her neck, so I inquired about it.
She told me she’d had her thyroid removed a couple of years ago. Although she’d provided me with a list of her medications, thyroid replacement was NOT on it. Upon examination, I felt no thyroid tissue and her reflexes were quite flat, consistent with a low thyroid state. Her quads and hamstrings were very weak as well, demonstrating at that moment that she did have trouble walking.
I asked her if she had been advised to take thyroid replacement after her surgery, but her response was vague and inconclusive. Her thyroid panel was quite abnormal; her T4 was undetectable and her TSH was 25. (Normal range is 0.4 - 4.0) These indicated a severely low thyroid state (hypothyroidism.) Most patients that come in with fatigue and weak muscles would jump at the chance for simple thyroid replacement, once told their symptoms could be easily remedied. (They might even potentially lose a few pounds.)
I am quite confident that recommending thyroid replacement therapy was indeed appropriate medical advice. Trusting my instincts as a Doctor of Internal Medicine superseded my specialty in Cannabis dosing. In hindsight, I’m glad I did not suggest a Cannabis treatment plan. I’m not implying in any way that this was a brilliant diagnosis, but more on point: being a trained physician is of great benefit when advising dosed Cannabis medicine.
Sadly, many patients are not receiving adequate medical care in general, and even more so when it comes to seeking guidance with Cannabis. Common health issues easily, and often, fall through the cracks. Over the years, I have seen many patients with clear-cut medical explanations for their symptoms, where Cannabis is just not indicated or appropriate.
When addressing any medical condition, it is vital to work with a physician that has a clear understanding and deep knowledge of Cannabis, and at the same time can work with your other physicians and specialists, in order to minimize toxicity, drug interactions and more.
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