People’s pharmacy

Q: My husband recently had to switch testosterone gels due to a change in insurance coverage. The new product was a generic testosterone.

After he used it just one day, our whole house smelled like floral-scented dryer sheets. It took me a day to figure out that the culprit was the chemical pentadecalactone.

I’m asthmatic, and the smell emanating from my husband’s body was overwhelming. Everything he touched stank: the bedclothes, his clothes, the furniture, even my clothes that he folded!

My eyes, nose and throat have been severely irritated from the smell. He stopped using it immediately, and after three days the smell is finally dissipating. Have you ever heard of such a thing?

A: Pentadecalactone is sometimes used in cosmetics as a fragrance because its aroma resembles that of musk. Not everyone finds this scent offensive. Some people seem to like it, and describe it as a sweet, woodsy, powdery fragrance. Surprisingly, almost 10 percent can’t smell it at all (Chemical Senses, December 1977).

Your husband will want to ask the pharmacist whether this ingredient is included in any other testosterone gel he might use to boost his hormone levels.

Q: About three years ago, I woke up to find that I had lost some muscle control in my right leg. When I walked, my foot would flop.

My doctor did blood tests and diagnosed a vitamin B-12 deficiency. After weekly B-12 shots and daily B complex pills, my symptoms went away. It took about three months. I still take monthly B-12 shots.

Why don’t you ever stress the importance of this vitamin for vegetarians? You cannot get B-12 from vegetables.

A: Vegetarians, especially vegans who get no eggs or dairy products, may need to take vitamin B-12 to prevent deficiency. You are correct that vegetables and other plant foods do not contain vitamin B-12.

Anyone taking metformin for diabetes or an acid-suppressing drug for reflux also should be alert for this danger. People with celiac disease, an intolerance for gluten found in wheat, barley and rye, also are at risk.

Vitamin B-12 deficiency can cause nerve damage, confusion, depression irritability and poor muscle control. Detecting a deficiency may require a test for methylmalonic acid (MMA) as well as for vitamin B-12.

Q: I am 56 years old and suffer from hypothyroidism. I’ve been taking a hormone replacement (levothyroxine) for about 20 years. I also am taking a daily low dosage of Lexapro.

Yesterday, my thyroid blood work came back with T3 in the normal range and TSH high. My doctor LOWERED my Synthroid dose.

I’m confused. Shouldn’t my dose have been raised if my TSH is high?

A: You are absolutely right. When TSH (thyroid-stimulating hormone) is high, the body is trying to get the thyroid gland to make more hormone because the brain has detected a shortfall. We don’t understand your doctor’s rationale.

The changes in your thyroid test results may be due to the antidepressant escitalopram (Lexapro) that you take. A case report of hypothyroidism triggered by escitalopram showed normal levels of free T3 and free T4 with elevated TSH (Hormones, January-March 2012).

The Guide to Thyroid Hormones that we are sending you explains how to interpret the tests used to assess thyroid status and also discusses interactions. It is available online at www.PeoplesPharmacy.com. You may want to show the guide to another physician for a second opinion.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them via their website at www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”