Balancing Prevacid, Synthroid

I have suffered from stomach pain and reflux for a long time. I am taking Prevacid, but even after an increase in dose, I am still experiencing gastrointestinal upset.

I also have a thyroid problem. My endocrinologist started me on Synthroid and recently switched me to Levoxyl. Now I am noticing side effects. Should I ask my doctor to put me back on Synthroid?

Substituting one brand of levothyroxine (Levoxyl) for another (Synthroid) may require an adjustment in dose. But first, you and your doctor need to consider your stomach problems. An article in the New England Journal of Medicine (April 27, 2006) shows that people with low stomach acidity do not absorb levothyroxine well and may need a higher dose. The Prevacid you are taking reduces stomach acid.

People infected with a stomach bacterium called Helicobacter pylori also seem to have trouble absorbing thyroid hormone. This bug may be contributing to your gastrointestinal problems.

My husband had hip-replacement surgery in January. For two days after the surgery, he was a bit groggy. By the third day he was hallucinating. We finally figured out it was probably the OxyContin he was given for pain.

OxyContin (timed-release oxycodone) is a very effective pain reliever, but like other narcotics, it may cause hallucinations. Doctors should alert patients about this possibility.

Joe Graedon, a pharmacologist, and Teresa Graedon, an expert in medical anthropology and nutrition, can be reached at www.peoplespharmacy.com or care of this newspaper.