Q. My 71-year-old husband is in very good health and doesn’t need any prescriptions at this point. We are being urged to sign up for the Medicare drug plan, and we realize he might need it some day.
We have four advanced degrees between us and neither of us can figure out how he would sign up and what good it would do him if he did.
We have read that it will cost more if he waits. What about people who are on Medicare and take no prescriptions?
A. You’ve got a great point. Assuming that every older person takes prescription medicine is simplistic.
According to Medicare, most people will need prescription drugs to stay healthy as they get older. The feds claim that “joining now means protecting yourself from unexpected prescription drug bills in the future.��?
The government is encouraging people to sign up now by charging a one percent penalty per month for waiting past the deadline (May 15, 2006). If your husband never needs a lot of expensive prescriptions, paying a monthly premium for years could add up.
The variety of plans being offered makes it confusing to pick the best one, especially if you’re not taking many drugs at this time.
Q. A man claimed in your column he was careful about his diet but still had a cholesterol level of 240. There is one sure thing that will lower his cholesterol without using unnatural, expensive drugs that have side effects. If he eliminated all meat and dairy products he could get his cholesterol under control and reduce the risk of other diseases like cancer.
A. For many people, a vegetarian diet can indeed lower cholesterol. One study examined a “dietary portfolio��? that used soy protein and nuts instead of meat and included foods rich in plant sterols and soluble fiber. Following such a diet lowered most people’s cholesterol about as much as the drug lovastatin (Current Atherosclerosis Reports, Nov. 2004).
In another study, researchers substituted protein, half of it from plant sources, for some of the carbohydrate in a diet to lower blood pressure. People eating that diet were able to lower blood pressure, cholesterol and triglycerides (Journal of the American Medical Association, Nov. 16, 2005).
Not everyone can control cholesterol with diet alone. In some cases, blood fats rise on a vegetarian diet. Since the body makes cholesterol, eliminating it from the diet may actually increase internal production of cholesterol. In such cases, people may need another intervention in addition to diet.
Q. I would like to try pomegranate juice for its health benefits. Will it interact with Lipitor?
A. Pomegranate juice can lower blood pressure and delay atherosclerosis. But it interacts with drugs much as grapefruit juice does (Drug Metabolism and Disposition, May 2005). Grapefruit juice can raise blood levels of some cholesterol-lowering drugs, including Lipitor, Zocor and Mevacor (lovastatin) and increase the risk of side effects.
We would like to send you our Guide to Grapefruit Juice Interactions, so you can gauge what other medicines pomegranate juice may affect. Anyone who would like a copy may download it from this Web site www.peoplespharmacy.com or send $2 with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ The People’s Pharmacy®, No. J-91, Durham, NC 27717-2027.
The People's Perspective on Medicine