Dr. David Strobel, M.D.

The normal level of these hormones (called gonadotropins) depends up where you are in your menstrual cycle.

Total T4 is not reliable enough. Free T4 is better with a target level in upper 1/2-1/3 of normal range. However, this is less important than your symptoms. A high total T4 isn’t as important as your symptoms. Unfortunately, most doctors listen to the tests rather than the patient.

Decongestants are probably not a good idea for someone on carvedilol or who has a defibrillator. However, an antihistamine, such as loratadine (Claritin) or a nasal steroid spray (fluticasone or mometasone), all over the counter, would likely be fine. Also consider a neti pot or sinus rinse, which really help.

The pigment in hair is the same as in skin and eyes, brown. It is called melanin. The hue of hair, skin and eyes is simply due to the concentration of this pigment in these areas. The cells that make it can vary from one body location to another. While there is likely some fancy dermatology term for different hair colors in different body areas, I think the best one is “normal human”.

The injury produced tissue bleeding at the thigh that was too deep to see. Aspirin permits the bleeding to continue longer than usual, though seldom dangerously. Simple gravity caused painless bruising to appear distal to injury site. The bruising will resolve. The injury site itself also will most likely resolve, but should be evaluated if pain persists more than a few weeks. If you take aspirin for an important preventive purpose, this not a good reason to stop it.

Sharp chest pain with breathing is called pleuritc. This is because this is the kind of pain that happens with pleuritis, sometimes also called pleurisy, which is inflammation of the pleura. The pleura is a thin, snotty membrane that covers the lungs and lines the chest cavity. It allows the lungs to move freely with breathing. The ending -itis means inflammation
(arthritis, dermatitis, bronchitis, etc.). When it becomes inflamed, usually due to a viral infection, the pleural membranes don't glide like they should and can stick together, causing pain when they move against each other. However, pleuritis is not the only cause of sharp chest pain with breathing. Pleuritic is just the term we doctors use to describe this sort of pain. In your case, with phlegm that has been present for a long time, I wonder about asthma or other chronic (longstanding) lung disease. Getting a COVID-19 test is reasonable, but it is important to remember that these tests can have a lot of false positive results, depending upon the type of test used. That means that it might say you have the infection, but actually have something else going on. The good news is that pleuritic chest pain, while often shocking and uncomfortable, is often due to problems that are not serious. This isn't always true so it's best to be evaluated by a health professional before simply concluding that it is OK.

UTI is an abbreviation that stands for urinary tract infection. Since the urinary tract includes the kidneys and bladder and also the tubes that connect the kidneys to the bladder, called ureters, and the tube that empties the bladder, called the urethra, infection of any of these areas could be called UTI. However, the most common area to be infected is the bladder (called “cystitis“). This is so much more common than other areas of infection that cystitis has become essentially synonymous with UTI, although that is technically not quite correct. As long as the infection is isolated to the bladder, the kidneys are not affected. Kidney infection (called pyelonephritis) does occur, but it’s rare In comparison.

The superficial layer of the intestine is replaced about every week. However inflammation due to dietary elements, such as gluten (among others), occurs in a deeper layer, resolving at a slower rate. Ordinarily, removal of inflammatory diet results in maximum gastrointestinal symptom improvement fairly quickly, within 4 to 8 weeks in the majority of affected people. It is important to remember that this is gradual, meaning that many experience progressive improvement as time goes by. This means that people can experience improvements in shorter periods of time but that maximum improvement takes a longer. In people with non-intestinal manifestations of intestinal inflammation (joint pain, dermatitis, “brain fog“, et c.) symptom improvement can take even longer, but these also can gradually improve as time passes.