Stopping herb may have saved a life

JOE and TERESA GRAEDON

King Features Syndicate


You recently wrote about a link between black cohosh and liver problems. I have a friend who has had hepatitis C for 23 years. She had been taking black cohosh for menopausal hot flashes, but her liver enzymes were high, at 600. When I read your column I e-mailed her, and she quit taking the herb.

Today she phoned to tell me her liver enzymes are now down to 60. She credits quitting the black cohosh for this dramatic improvement. We both thank you for perhaps saving her life.

We are delighted to learn that your friend had such a positive outcome. As far as we can tell, this reaction to black cohosh is quite rare. Nonetheless, it is so serious that women taking black cohosh might wish to have their liver function monitored.

For many years I suffered from heartburn and had to take Alka-Seltzer four or five days a week at bedtime. I had been advised to avoid fatty foods, so I ate a very low-fat diet with lots of rice, pasta and beans. I ate nothing fried.

Then last year I made a New Year's resolution to lose weight, and I tried the Atkins diet. I worried that eating greasy food like sausage, eggs and hard cheese would aggravate my heartburn, but decided to try the diet anyway. (I could no longer button my jeans.)

I managed to lose 25 pounds in 10 weeks and have kept it off for 15 months. I also lost my heartburn, even before the weight came off. I no longer need to take any antacid. Have others reported this benefit?

We have heard from some people that the Atkins diet helps relieve symptoms of heartburn and acid reflux. There is even a preliminary report in the medical literature documenting five cases of patients whose acid reflux disappeared when they adopted a carbohydrate-restricted diet (Alternative Therapies in Health and Medicine, November-December 2001).

Do decaffeinated green and black tea have the same antioxidant content as regular green and black tea? We have read about the benefits but want to avoid the caffeine.

Jeffrey Blumberg, Ph.D., chief of the Antioxidants Research Laboratory at Tufts University, has assured us that decaffeinated tea contains a similar amount of antioxidants.

I have trouble with insomnia and would like a natural remedy instead of a prescription sleeping pill. I take metoprolol and hydrochlorothiazide for high blood pressure, and sometimes I am awakened by a nightmare and cannot get back to sleep.

My doctor says I can take melatonin, but my pharmacist says there isn't any good research. Is this harmful, or is melatonin a safe sleeping aid?

Recent research from the Netherlands (Hypertension, February 2004) suggests that taking melatonin an hour before bed for three weeks can help control blood pressure in men with hypertension. Data suggest melatonin can be effective against insomnia but longer-term studies are needed to answer your question about safety.

We list drugs that can contribute to insomnia (such as metoprolol) and discuss the use of melatonin and nondrug approaches in our Guide to Getting a Good Night's Sleep. Anyone who would like a copy, please send $2 in check or money order with a long (No. 10), stamped (60 cents), self-addressed envelope to: Graedons' People's Pharmacy, No. I-70, P.O. Box 52027, Durham, NC 27717-2027. Metoprolol should never be stopped without medical supervision.

For about six months, I took ibuprofen on a regular basis to prevent muscle aches from my exercise program. During this time, I had many blank thoughts and feared I might be in the early stage of Alzheimer's disease.

Then I checked my nurses' drug manual and found that ibuprofen can have cognitive effects. Stopping the medication improved my mental status. I know the medication is effective for many people, but I would like to alert others to this possibility.

Millions take nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin IB), naproxen (Aleve) or prescription pain relievers with no problems. In fact, there is some data to suggest that such drugs might help lower the risk of Alzheimer's disease.

Unfortunately, some people are very sensitive to digestive tract irritation. It is estimated that more than 100,000 people are hospitalized each year as a consequence of NSAID-induced ulcers. More than 15,000 die from complications.

Psychiatric reactions are much less common, but there are reports of dizziness, drowsiness, headache and confusion brought on by NSAIDs. Why some are vulnerable to this effect and others appear resistant remains mysterious.

I had dandruff for 26 years and tried all sorts of medicated shampoos with no success. About two years ago I got a fungus under the nail of my big toe. My podiatrist put me on Lamisil, one pill a day for three months.

While taking it, my dandruff cleared up and quit itching. I swear I am totally cured, although the Lamisil did not get rid of my nail fungus.

We're not surprised to learn that the antifungal medicine you took for your nail infection cleared up your dandruff. Dermatologists believe that bad dandruff might be caused in part by a yeast (Pityrosporum ovale). Antifungal medicines could well eliminate the yeast, which is a type of fungus.

I've read that walnuts can reduce cholesterol. What I would like to know is what portion to eat each day.

The Food and Drug Administration will allow labeling on walnuts suggesting that 1.5 ounces daily might reduce the risk of heart disease. That comes to about one-third cup of walnuts.

My wife has just been placed on Coumadin for atrial fibrillation. Could you tell us what foods affect Coumadin? Do you have any information about potential interactions with over-the-counter medicines? She has been told to avoid aspirin.

Coumadin (warfarin) prevents dangerous blood clots by countering vitamin K. In general, people on Coumadin do best if they get roughly the same amount of vitamin K daily so the drug dose can be adjusted accordingly. This vitamin is found in dark green vegetables such as spinach and broccoli.

Many medicines, including aspirin, ibuprofen and naproxen, don't combine well with Coumadin. Even regular use of acetaminophen (Tylenol) might pose problems.

We would like to send you our Guides to Food, Drug and Coumadin Interactions, with lists of food sources of vitamin K and medicines that might interact with Coumadin. Anyone who would like copies, please send $3 in check or money order with a long (No. 10), stamped (60 cents), self-addressed envelope to: Graedons' People's Pharmacy, No. FD-195, P.O. Box 52027, Durham, NC 27717-2027.

British experts warn patients on Coumadin to avoid cranberry juice, since the combination might lead to excessive bleeding.


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Joe Graedon is a pharmacologist. Teresa Graedon is a medical anthropologist and nutrition expert. Write to them in care of King Features Syndicate, 888 Seventh Ave., New York, NY 10019, or e-mail to PHARMACY~mindspring.com