Q. My sister in England has been suffering from rheumatoid arthritis. The doctors are suggesting a drug containing gold. Have you ever 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 (RA). 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 very 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 2020). 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 or not 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, 2020). However, people taking sertraline might need a higher dose of levothyroxine.

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

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.

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