People’s Pharmacy: Gold has a long history as medicine

Q. My sister in England has been suffering from rheumatoid arthritis. The doctors are suggesting a drug containing gold. Have you heard of such a thing? Does it work?

A. Gold therapy (chrysotherapy) was popular during the 1970s and 1980s for the treatment of rheumatoid arthritis. Injections of gold salts were used to slow joint destruction when aspirin alone was inadequate.

An oral gold formulation, auranofin (Ridaura), was approved by the Food and Drug Administration in 1985 for patients with RA. The drug never became popular, though. That was in part because of adverse reactions such as blood disorders, rash, digestive upset, kidney and liver damage.

Auranofin is gaining renewed attention these days because it appears to have antiviral and anti-inflammatory activity against COVID-19 (Virology, August).

There is also preliminary evidence that gold treatment may have potential for treating other infections, neurodegenerative disorders and a number of cancers (Yakugaku Zasshi, Vol. 141, No. 3, 2021).

Q. A few years ago, my doctor prescribed sertraline for depression. I gained 20 pounds, but when I complained, she attributed the weight gain to increased happiness. I do not accept that explanation.

I have been an avid exerciser since my teens, and I watch my weight carefully. Believe me, I was not eating more. In addition, no matter how much I exercised, the weight stayed on.

I believe sertraline altered my metabolism. Could it have interfered with the Synthroid I have been taking for two decades for an underactive thyroid?

A. An underactive thyroid can lead to depression or weight gain on its own. Since you have been taking the same dose of levothyroxine (Synthroid) for a long time, that might not explain your experience. It does suggest that the answer to your question might be complicated, though.

Doctors have been debating for decades whether the antidepressant sertraline interferes with the thyroid hormone levothyroxine (Synthroid). An initial report in the New England Journal of Medicine put up a red flag for this interaction (Oct. 2, 1997).

A recent review found that the evidence for this interaction is inconclusive (Frontiers in Endocrinology, Dec. 22). People taking sertraline might need a higher dose of levothyroxine.

You can learn more about testing and treating thyroid conditions and drugs that might interact with levothyroxine in our eGuide to Thyroid Hormones. This electronic resource is available in the Health eGuides section of peoplespharmacy.com.

Q. I was raised in Florida and discovered as a teenager that when I had a headache and took aspirin, I didn’t burn. Otherwise, my skin could blister in 20 minutes at midday.

I am now retired, and I take a baby aspirin daily on my doctor’s advice. I don’t burn, though I am careful to avoid the sun in the middle of the day. Sunscreens with SPF irritate my skin, so I don’t use them but don’t seem to need them.

A. Your experience has scientific support. There is evidence that aspirin can reduce the damaging effect of the sun’s ultraviolet rays (Journal of Investigative Dermatology, January). There is also research suggesting that people who take aspirin might be less likely to develop skin cancer (Oncology Letters, March 2015).

It still makes sense to use sunscreen and avoid the midday sun. Before taking aspirin regularly, discuss the pros and cons with your health care provider.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”