People's Pharmacy

February 02, 2007|By Joe Graedon and Teresa Graedon | Joe Graedon and Teresa Graedon,

As a physician, I want to offer my perspective on the "sticker shock" problem in the pharmacy. I am very conscious of the fact that my patients may not be able to afford medications I prescribe.

Almost all medications have alternatives, and I wish I knew which would be cheapest when I am writing the prescription. Patients with drug coverage could save a lot of time and money if they brought the list of drugs covered by their insurance to every doctor visit.

We appreciate your thoughtful approach. A recent study showed that many doctors don't discuss the cost of prescriptions with their patients (American Journal of Managed Care, November). If more patients brought their insurance company's drug list to their office visits, it would facilitate these discussions.

I know that eating grapefruit can interfere with how the body metabolizes certain medications. I am wondering whether the tangelo, a cross between a grapefruit and an orange, would have the same effect?

One study showed that tangelos don't contain enough of the compound that causes the grapefruit effect to pose a problem (Journal of Food Science, August 2005).

I am a 65-year-old woman and just got back my cholesterol test results: Total 235, HDL 109, LDL 118, triglycerides 39. I believe some of the results are good, but I'm concerned about the cholesterol and LDL numbers. Among other supplements, I take glucosamine and chondroitin for my stiff joints. I read these may elevate cholesterol. Is that true? How can I get these numbers down?

Unless you already have heart disease or other risk factors such as smoking, diabetes, high blood pressure or a family history of heart problems, you may not need to worry about your cholesterol reading. Your ratio of total to good HDL cholesterol is excellent. That might be a better indicator of risk than total cholesterol.

Many readers have reported that their cholesterol went up while they were taking glucosamine and chondroitin and went down after they stopped the supplements. There are no studies that indicate these supplements raise cholesterol levels, however.

I read your column about reflux medication and hip fractures. I take three Tums a day. Are antacids as likely to affect bones as more powerful acid-suppressing drugs such as Aciphex and Prilosec?

In the study that raised this concern, less-potent acid suppressors such as Tagamet or Zantac were not associated with an increase in hip fractures. Antacids such as Tums provide calcium and are more likely to be good for bones than to cause problems.

You receive many letters about nail fungus, and I wanted to share my experience. Our young daughter contracted a foot fungus while swimming at a local club. We tried a lot of different anti-fungal products, but I didn't want to give her oral medicine.

The podiatrist suggested a mixture of half white vinegar and half Listerine. I dab it on her toes every morning with a cotton ball. Finally, her toenails are pink and healthy-looking. It works, but it takes a very long time.

We first wrote about using a mixture of white vinegar and Listerine for nail fungus in the spring of 2005 after hearing about its potential from one reader. Some people dab it on their nails, while others soak their feet in the solution. (It can be reused several times.)

The herbal oils in Listerine have anti-fungal activity, as does the alcohol. Vinegar makes the toes acidic, which discourages the spread of fungus. Perhaps they provide more power together than individually.

I have high cholesterol, and I prefer not to take any medication. Some of my friends have experienced serious side effects with these drugs. What can I eat to help bring it down?

A diet with plenty of soluble fiber from oat bran or vegetables such as eggplant and okra can help quite a bit. Adding psyllium, another source of soluble fiber, is also useful. Fish oil, pomegranate juice, walnuts, almonds and even a little dark chocolate can be part of a cholesterol-lowering diet.

I want to thank you for writing about turmeric for treating psoriasis. I developed this condition two years ago, and it made my skin very itchy and sensitive, as well as unsightly.

I saw three different dermatologists who all prescribed creams and ointments, but none worked.

After I read your article on turmeric, I tried it. Within one month, I was better. After three months, every sore was gone. They have not returned even though I stopped taking the turmeric nearly a year ago.

Turmeric is the yellow spice in curry and mustard. It contains a compound, curcumin, that has anti-inflammatory activity.

Several readers have reported that taking turmeric capsules or putting turmeric on food is helpful against psoriasis. It was used for digestive problems in traditional Chinese medicine, and one reader has found it helpful for irritable bowel syndrome.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or e-mail them via their Web site:

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