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Sunday Column

July 13, 2008 By Dr. Gott

DEAR DR. GOTT:
My wife is 68 years old, a diabetic, has high blood pressure and is bothered with a constant throbbing in her head, especially in bed at night. She takes Digitek, Amlodipine and HCTZ plus two others I can’t remember the names of.

If you have any ideas that will help her, it would be greatly appreciated.

By the way, your article on grape seed extract helped her cure her Parkinson’s immediately. She had it over 5 years. Thank you very much.

DEAR READER:
Most headaches are minor and can be treated with over-the-counter pain relievers, while others can signal a serious medical problem. It certainly appears your wife falls in to the latter category.

Digitek is generally prescribed for cardiac-related conditions such as atrial fibrillation and heart failure but can also be used for impaired kidney function, electrolyte and thyroid disorders, and more. [Read more...]

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Daily Column

July 10, 2008 By Dr. Gott

DEAR DR. GOTT:
My doctor told me I have diabetes. My choice was to control it by dieting and my doctor set me up to see a dietician. I followed the diet and later asked my doctor for a prescription for a glucose meter so I could monitor my levels. She refused. I asked her again later, leaving her a message and she never called me back.

Is it standard for a doctor to refuse a prescription for a meter to activate insurance coverage when controlling diabetes by dieting?

DEAR READER:
It is true that glucose meters help people check their blood sugar levels at home or in locations outside a doctor‘s office or laboratory. As a general rule, levels stay within normal limits throughout the day, are lowest in the morning and higher after meals. Diabetics or individuals on special diets controlled through medication in tablet form generally monitor their readings once or twice a week, [Read more...]

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Daily Column

May 3, 2008 By Dr. Gott

DEAR DR. GOTT:
Your recently wrote a column about a gentleman who was taking 16 medications. My husband, who is 82, is taking 19.

He has survived Hodgkin’s Lymphoma (1988), a 5 way by-pass surgery (1991), stroke (1997), and two carotid artery surgeries (1997 and 1998). He has type two diabetes as a result of his lymphoma chemotherapy. He is in kidney failure, was diagnosed with bladder cancer in 2005 and myelodysplasia.
He regularly sees an oncologist, endocrinologist, nephrologist, urologist and cardiologist. His medications include pain relievers, blood thinners, cholesterol reducers, calcium, vitamins, water pills, and many more.

I would like your opinion. We have insurance which I am very thankful for. I respect his doctors and their opinions as I do yours. I am worried, though, that he is over medicated. I also am worried that if he stops any of these, it would be his end. He leads a fairly normal life other than sleeping a lot, but given the situation, I would expect this. He does not do much, cannot play golf and is no longer sexually active (even though he would like to be). It is just not possible for him to do the things he wants and enjoys the way he used to.

DEAR READER:
Your husband has several serious medical ailments for which he is taking various (and mostly appropriate) medications. In your list, I do see two medications that I believe could be safely stopped. Valtrex is given to individuals with genital herpes as an outbreak preventive or treatment. Because your husband is not sexually active, there is little risk of him passing this condition on to you. You also state that your husband sleeps a lot. I note that he is taking Lunesta which is a sleep aid. If he is getting more than adequate sleep (7-8 hours) I don’t believe he needs this. If he is taking it because he cannot fall asleep at night, perhaps this is a result of him sleeping too much during the day. Try to keep your husband as active as possible during the day and he should have no problem sleeping at night.

Before making any modifications, I suggest you discuss your concerns with his physicians. Perhaps they would be willing to set up a conference call or meeting at which you and your husband can discuss the necessity of his medications and whether or not any can be modified, reduced or stopped. It is important, given his various ailments, that all his physicians agree on medication modifications. Perhaps now is also the time to involve a primary care physician who can help you sort out his medications and treatments. This will also help in the future if his situation becomes worse. At that time he may wish only to have medication to make him comfortable. Your husband’s quality of life should be of the utmost importance and if he is not enjoying his life and is missing out on the things he loves, his is, in my opinion, suffering. This can also lead to depression.

To give you related information, I am sending you a copy of my Health Report “Consumer Tips on Medicine”. Other readers who would like a copy should send a self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

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Daily Column

April 29, 2008 By Dr. Gott

DEAR DR. GOTT:
My recent NON-fasting glucose was 102 and my A1C was 6.21. My physician wants to repeat the A1C in three months and if it is still elevated, he will recommend oral diabetic medication. What is your opinion? I am 82.

DEAR READER:
Your blood tests do not unequivocally indicate diabetes. Even if these numbers were based on a fasting glucose and A1C I would not recommend medication. Non-fasting blood tests for diabetes, cholesterol and other disorders, are not reliable enough on which to base diagnosis. First, the tests measure not only what your body is making and storing, but also whatever fats, sugars, and so forth, were in the food you ate in last 6-12 hours. This is why most physicians order blood work when a person has not eaten anything since dinner the night before the testing.

I urge you to request a retest after fasting. This will give a more accurate result. If your numbers are similar, you do not need medication. I believe that your numbers, however, will be even lower in the normal range.

If your numbers are abnormal, don’t take any medication before trying alternative treatments, such as increasing your exercise, losing weight if you are stout and cutting back on sugar and sweets.

Given you age and the normal blood tests, I’d simply follow up with blood sugar testing once or twice a year.

To give you related information, I am sending you a copy of my Health Report “Living with Diabetes Mellitus”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

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Daily Column

April 6, 2008 By Dr. Gott

DEAR DR. GOTT:
I am an 81-year-old male in fairly good physical condition. I have had some serious bouts with asthma and pneumonia and now take several nebulizer treatments a day as well as an inhaler. I get along pretty well with my breathing though.

Now to my question. I have type 2 diabetes. A few months ago I read that cinnamon was good for lowering sugar levels. I decided to try it mixed with Splenda on toast several times a day and it seemed to work. I then purchased 500 mg cinnamon capsules and started taking them twice a day, after breakfast and dinner.

Before the cinnamon, I was trying to control my diabetes with diet and exercise but it wasn’t really working. I would often have spikes of 250 or higher (before a meal) for no apparent reason. After the cinnamon, I have not had a reading over 130 before a meal.

Is there anything wrong with this treatment? Are there any side effects? I have also told a friend with severe diabetes about this. It seems to work for him as well.

DEAR READER:
I have received several letters from readers, such as you, who have had a favorable response to cinnamon therapy for diabetes. At the time cinnamon was first mentioned in my column by a reader who was using it for diabetes, he also claimed it lowered his cholesterol levels as well. Cinnamon for cholesterol does not appear to work for the number of readers who wrote to me with their results.

The one side effect I have heard about from my readers is diarrhea. It appears to be dose related. I do not know if this is common in the general public, however. Therefore, I see no reason why you shouldn’t try it (with doctor’s permission, of course).

That being said, there have been a couple of studies on the subject. One of note is found on www.WebMD.com. A researcher with the NWFP Agriculture University in Peshawar, Pakistan says that cinnamon, cloves, bay leaves, and turmeric have shown promise in improving insulin’s action in lab studies. He also says that cinnamon can improve glucose and cholesterol metabolism, improve function of small blood vessels and remove artery-damaging free radicals from the blood. Korean ginseng, flaxseed, garlic, and onions have similar effects.

The best results were achieved in individuals who took three to six grams (6-12-500 mg capsules or 1-1 ¾ teaspoons) each day. This is by no means a small amount and favorable results diminish soon after the cinnamon is stopped. For those people who participated, insulin sensitivity improved, triglyceride and LDL “bad” cholesterol levels were reduced and changes to the HDL “good” cholesterol levels were minor.

If you would like to read the WebMD article it can be found at http://diabetes.webmd.com/news/20031205/cinnamon-helps-type-2-diabetes.

To give you related information, I am sending you copies of my Health Reports “Living with Diabetes Mellitus” and “Understanding Cholesterol”. Other readers who would like copies should send a long, self-addressed, stamped envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

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Daily Column

March 27, 2008 By Dr. Gott

DEAR DR. GOTT:
As odd as this sounds, I promise this is not a joke. When my husband sneezes, the air he expels as an odor to it. I would associate it with the smell of marigolds or musty urine. We have noticed this over the course of the last month or so.

I offer the following information in case it has any bearing (but we believe not).

He has been diagnosed with colitis but it is under fair control with diet. (He has been fairly closely following your no flour, no sugar diet.) He does not smoke anymore, having quit four years ago. He is a mild/moderate social drinker. His lymph nodes swell up on occasion but I assume that is from fighting off infection. It does not seem to have any correlation with the smell. He also has heartburn and uses antacids a few times a week. He takes vitamin C regularly but no other multi-vitamin. We cannot think of any major dietary or lifestyle changes in the last month that might cause this bizarre occurrence.

We wonder if ammonia-smelling sneezes have an obvious cause and should they be something to be concerned about? Is this something you have ever heard of before?

DEAR READER:
Ammonia-smelling breath is a well-recognized consequence of diabetes, kidney disease and liver disorders. Don’t ignore your husband’s symptom. He needs to be checked. Although the ammonia odor may simply reflect inefficient digestion that is characteristic of colitis and other intestinal disorders, I worry that a more serious situation is developing. Get him to your family physician for testing and let me know the outcome.

To give you related information, I am sending you copies of my Health Reports “Living with Diabetes Mellitus” and “Kidney Disorders”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 FOR EACH report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

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High potassium a concern?

February 25, 2008 By Dr. Gott

DEAR DR. GOTT: I am a 76-year-old male with several health problems. I have had type II diabetes for 40 years. I keep good control with no known damage from it. I also have well-controlled (with medication) high blood pressure. I am now having a problem with a high potassium level. It went from 4.9 to over 6.5 in one year. I have included a copy of my blood work.

Do you have any suggestions?

DEAR READER: Thank you for including your lab results because they tell the story. Your kidneys do not appear to be functioning properly. As a result, they are not excreting as much potassium as they should. Your blood urea nitrogen (BUN) is quite high at 60. It should be below 20. Finally creatinine is also high (2.1). It should be under 1.0.
[Read more...]

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