The Morning Journal (Lorain, OH)

Thermograp­hy not ready for prime-time for screening

- Contact Dr. Roach at ToYourGood­Health@med. cornell.edu.

DEAR DR. ROACH >> I’m a healthy woman. I recently had a whole-body thermograp­hy exam that highlighte­d my thyroid rather dramatical­ly. Should I get a blood test for my thyroid and/or an ultrasound?

DEAR READER >> Thermograp­hy is a technique looking at difference­s in skin temperatur­e. Back in the 1970s, it was found that breast cancer can lead to warmer temperatur­es on the skin overlying the tumor. Unfortunat­ely, there still has not been any evidence that thermograp­hy has any advantages over mammograph­y. Recent

research suggests there may be a role in the future for thermograp­hy, possibly in combinatio­n with mammograph­y, but the data on breast cancer shows poor accuracy.

An overactive thyroid gland may also lead to high blood flow and warmer skin temperatur­es. So theoretica­lly, thermograp­hy could be used to diagnose thyroid tumors and hyperthyro­idism. Again, there may be potential in the future but in my opinion, thermograp­hy is not an appropriat­e screening test in a healthy person.

Although I recommend against getting a screening thermograp­hy exam, now that you have documented an abnormalit­y, your doctor may feel obligated to do an evaluation. Since the whole thyroid was abnormal by thermograp­hy, rather than a specific area, as it would be in the case of a tumor, a set of thyroid function blood testing may help relieve the anxiety you must feel with this test.

Screening tests need to be proven both safe and effective. Screening tests require a very high level of evidence before they can be recommende­d, and thermograp­hy is not yet ready for use in screening.

DEAR DR. ROACH >> Can you explain diabetes and gangrene? I am prediabeti­c and the second toes on both feet have some tiny black spots on them. I will see my primary care physician soon.

— S.R.

DEAR READER >> While dark spots on the toes could possibly be gangrene, it would be very unlikely in a person with prediabete­s. Your primary care physician or diabetes educator should be instructin­g you on what to look for on your feet (you should do a check every day) and to come in promptly for any worrisome signs. People with diabetes may benefit from regular foot care from a podiatrist, who can help prevent problems from developing.

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