KevinMD December 22, 2024
Janet Tamaren, MD

Doctoring in the mountains of Eastern Kentucky, I met Mrs. Snoop, a new patient at the clinic. She is 38 years old. Her chief complaint, according to her husband, is “not wanting to have sex.” He speaks on her behalf, sitting in the corner in grease-spattered overalls and heavy work boots.

On examination, Mrs. Snoop appears markedly older than 38. Her skin is puffy and coarse, she is overweight, and her speech is slow. Upon further questioning, it emerges that she used to be on Synthroid, a detail offered by her husband. The patient herself is a woman of few words.

She took Synthroid last year after being diagnosed with low thyroid hormone. Her husband tells me, “She felt better...

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