Q. Heart disease runs in my family. My maternal grandfather died in his 30s of a massive coronary, and my dad has had bypass surgery. He is now on several medications, most of which have dreadful side effects.
Given this history, I am concerned about my own heart. I have heard that there is something new that is better than just a cholesterol test. I believe they call it “high C” but I don’t think I’ve got it exactly right. Could you tell me more about this?
A. The test is for C-reactive protein (CRP). This compound is a marker of inflammation and may be a better predictor of heart disease than standard cholesterol tests. Up to half the people with coronary artery disease do not have elevated cholesterol levels.
Because of your family history, you may want to ask your doctor if you are a candidate for the CRP test. The cost can run anywhere from $10 to over $100.
Q. Milk gives me diarrhea so I no longer drink it. Where else can I get vitamin D and how much do I need?
A. Your skin makes vitamin D when exposed to the sun. In the winter this is difficult, and many people become deficient in this vitamin by the end of the season. Fish contain some vitamin D, but you will likely need a supplement. Between 400 and 1000 IU daily is appropriate.
Q. My 88-year-old mother has high blood pressure and cholesterol. I am concerned that she is taking too many medications.
Every day she takes Pravachol for cholesterol and indapamide, clonidine, Atacand and atenolol for high blood pressure. She also takes a handful of vitamins, garlic pills and a baby aspirin every day. If she suffers any aches she takes Tylenol (she says no more than 6 a day).
Her cholesterol level was up to 210 and is back down to normal now. Does she really need all those pills? She never was a drinker, but now requests red wine before dinner each day. Is it safe with all those medications?
A. An older person who takes a lot of acetaminophen (Tylenol) and drinks daily might be putting herself at risk of liver problems. Some of her medicines can also affect liver function.
One of the biggest worries for older people taking many drugs is light-headedness. This can increase the risk of a fall and a devastating hip fracture. Since some of your mother’s medications can cause dizziness, she must be extra cautious. Dry mouth is also a possible side effect and can affect dental hygiene.
We are sending you our Guides to Drugs and Older People, Cholesterol and Blood Pressure Treatment for more details. Anyone who would like copies, please send $3 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. OLB-88, P. O. Box 52027, Durham, NC 27717-2027.
Q. I love black turtleneck sweaters, but my dandruff has been especially bad this winter. I hate constantly brushing flakes off my shoulders.
I’ve tried several different brands of dandruff shampoo but none seem up to the job. Do you have a recommendation?
A. Nizoral shampoo used to be prescription only but is now available over the counter. It contains an anti-fungal ingredient (ketoconazole) that gets at the underlying cause of dandruff. Alternating every few weeks with a different kind of dandruff shampoo (Selsun Blue, Head & Shoulders, Neutrogena T/Sal) can often be effective against stubborn dandruff.
The People's Perspective on Medicine