Corner Clinic

 

By UC San Diego Experts   |   August 31, 2017

​Our experts discuss safe alcohol consumption for seniors, symptoms of a thyroid problem and when too much exercise becomes dangerous.

 

  1. What are safe limits for alcohol consumption for seniors?
  2. What are symptoms of a thyroid problem?
  3. Is too much exercise dangerous?
Alison Moore

What are safe limits for alcohol consumption for older men and women?
Alison Moore, MD, MPH, primary care physician, UC San Diego Health


The risks and potential benefits of alcohol consumption on healthy aging depend on the amount and frequency of alcohol consumption, as well as one’s age and gender, risk for alcoholism, existing medical and psychiatric conditions and medications taken. 

The National Institute on Alcohol Abuse and Alcoholism defines low-risk drinking for women of all ages and men age 65 and older as no more than three drinks on any one day and no more than seven drinks per week. For men younger than 65, the limits are higher — no more than four drinks on any one day and no more than 14 drinks per week.

Safe drinking limits vary with gender and age for several reasons. Women have lower tolerance to alcohol than men because of a smaller body size and lower levels of an enzyme that metabolizes alcohol. Older adults have lower limits than younger adults because of age-related changes in body composition that result in a higher blood alcohol level per amount of alcohol consumed.

In addition, if one has a personal or family history of alcoholism, drinking any amount of alcohol may be risky. Certain medical and psychiatric conditions are also made worse or caused by alcohol. For example, any amount of alcohol can cause a gout flare and three drinks a day can worsen high blood pressure and depression. Many medications are made less effective or have harmful side effects when taken with alcohol (for example, medicine for ulcers or reflux, and sedatives). More research needs to be done, but drinking one standard drink daily has been associated with reduced risk for cardiovascular disease, particularly among older adults with risk factors for cardiovascular disease (diabetes, a prior heart attack or high blood pressure).

In general, I tell individuals who are drinking in the low-risk range and have no contraindications, such as taking a medication that may negatively interact with alcohol, that their drinking does not appear to be harmful. I also tell people who do not drink alcohol, but who have risk factors for cardiovascular disease, that there is still not enough evidence to recommend starting to drink to reduce their risk.

Heather Hofflich

What are symptoms of a thyroid problem?
Heather L. Hofflich, DO, endocrinologist and internist, UC San Diego Health


The thyroid gland is butterfly shaped and located in the lower front of the neck. The thyroid controls the body’s metabolism by producing a hormone. The most common thyroid problems are a result of abnormal hormone production.  

Hypothyroidism: This means that the thyroid gland is not producing enough thyroid hormone. The most common symptoms are: fatigue, dry skin, weight gain and constipation. You may notice that you are feeing colder than normal. Forgetfulness and depression can also be signs of low thyroid production. Women often have more frequent menstrual cycles. Hair loss can also be another sign. Hypothyroidism can have many subtle symptoms, which could also be due to other diseases. It is always important to discuss symptoms with your doctor. The only true way to know for sure if you have hypothyroid disease is to have your physician perform a TSH test.

Hyperthyroidism: Hyperthyroidism means that the thyroid gland is producing too much thyroid hormone and is overactive. Symptoms include heart palpitations, increased anxiety, loose/more frequent bowel movement or diarrhea and weight loss. Menstrual cycles are often lighter and less frequent. Fatigue and hair loss are often common as your body is functioning at a higher rate. Tremors in your hands and muscle weakness in your thighs and arms can occur as well. In a form of hyperthyroidism called Grave’s disease, your eyes may enlarge or bulge and your thyroid gland may enlarge. If you feel you have any of these symptoms please contact your doctor to have your TSH checked. Other diseases may cause similar symptoms.

Kenneth Vitale

Is too much exercise dangerous?
Kenneth Vitale, MD, physical medicine and rehabilitation specialist, UC San Diego Health


The best advice for any athlete, young or old, is to avoid too much, too fast, too soon. High-intensity workouts, particularly those involving new or novel exercise, can cause exertional rhabdomyoloysis, also known as “rhabdo.” 

Though usually not life-threatening, rhabdo can lead to being hospitalized for several days. Famous cases of rhabdo “outbreaks” have occurred when overly aggressive coaches push athletes to perform stressful exercise, even basic leg squats or pushups. Younger athletes and students who feel pressured may not listen to their bodies and are often highly driven to succeed in sport. These cases are higher risk.

There are also rare cases of fatal exercise collapse with exertional rhabdo. For an individual with sickle-cell trait, exertional rhabdomyolysis can be potentially fatal. Genetic workup for myopathies, such as McArdle’s disease or muscle enzyme deficiencies may also be appropriate in unexplained rhabdo cases.

Exercise is healthy, and most of us don’t get enough daily exercise. But, if you are prone to “overdoing it,” I recommend taking time to become acclimatized to new exercises or high-intensity, long-duration exercise. Also, avoid taking any kind of stimulants, as they are very risky and lead to uncontrolled exercise.


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