My first problem is that I have hair growing in places where hair should not be on women. Do you have any suggestions what I can do for this and why I have it?

My second problem is that I have very bad dry skin on my forehead and nothing has helped. What is worse is that my 5-month-old daughter has dry skin on her forehead and the back of her head. I have taken her to the pediatrician and have been told to use hydrocortisone on it. All that does is cover it up. Do you have any suggestions for this?

DEAR READER:
While not your first concern, I would be very interested to know the progression of your diabetes, high cholesterol and weight gain. These changes can manifest in a number of ways and can vary from person to person. Was the diabetes present prior to your pregnancy or did you have gestational diabetes? What about the weight increase? Was it present before your pregnancy or did you gain weight during the pregnancy that you have failed to lose? When was your high cholesterol level diagnosed?

Did a primary care physician prescribe both the Avandamet and Lipitor? Was one prescribed before the other? This would be important to know, since you may be suffering a drug interaction between the two.

Avandamet is prescribed as an adjunct to diet and exercise for type 2 diabetes. Weight loss, exercise and a restriction of dietary calories and sugar are vital for optimal results. Therefore, I assume that despite the additional work involved with a new baby, you are exercising and controlling your food intake. Dose-related weight gain has been observed in patients on Avandamet. The reason for this is unclear but likely involves fluid retention and fat accumulation.

Lipitor is a statin drug taken for lowering cholesterol levels. Side effects are weight gain, hyperglycemia, hypoglycemia, dry skin, seborrhea, contact dermatitis, eczema, leg cramps, arthritis, and more. Seborrhea can present as either very oily skin or dry scales.

My concern is that the two drugs you are on may be reacting against each other. I urge you to return to the prescribing physician to discuss this possibility. Since you don’t indicate what your cholesterol readings are, I am somewhat reluctant to recommend an over-the-counter product such as niacin, CholestOff, omega-3 oil, or others that might be adequate. If prescription medication is necessary, perhaps you can be switched to a different drug with fewer side effects.

As far as the hair growth issue is concerned, there are a number of possibilities. When a woman develops excessive amounts of hair on her chest, face or back, the condition is known as hirsutism. Up to 10% of all American women have some degree of the condition. It may be attributed to an adrenal gland abnormality, be caused by medications taken for endometriosis, from Cushing’s syndrome when the body is exposed to high levels of cortisol or from polycystic ovary syndrome. The latter results in obesity, irregular periods and more.

You should address the condition with your primary care physician or specialist who can do an examination, order laboratory blood testing for hormone levels, an ultrasound to check for tumors or cysts, or a CT scan to evaluate your adrenal glands.

Now, for your baby. Because you are on Lipitor, I assume you are not nursing. Were that to be the case, that might be the reason for her dry skin. I must question whether the dry skin on the back of her head might be cradle cap. This condition presents as a crusting, scaly rash common on the back of the head and in the area of the eyebrows. It can be treated with baby oil or olive oil rubbed onto the affected areas. The procedure should be followed with soap or shampoo especially designed for cradle cap. Cradle cap is harmless except for a possible accompanying itch and is not contagious. Generally speaking, the condition disappears by the time a baby reaches 12 months of age.

To give you related information, I am sending you copies of my Health Reports “Diabetes Mellitus” and “Understanding Cholesterol”. Other readers who would like copies 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).

In October, my local paper had an article that wrote there was an increased risk of prostate cancer in men who ate flax seeds. It recommended that men eat fish or omega oils instead. It also said that we could completely stay away from flaxseed oil and flaxseed oil pills.

For the past seven years I have been using flaxseed oil and flaxseed oil pills. I consume 2000 mg daily. My doctors have never told me there was a problem with my usage of the supplement. My PSA has varied from 4.9 to 6.9. I would like to know your opinion of this.

DEAR READER:
This is a complex issue. Not many studies have been done to determine the benefits of flaxseed.

The article you read may have been reporting on the results of several medical studies that showed a possible link between prostate cancer and alpha-linolenic acid (which is present in flaxseed). More studies are needed before an answer can be given because another study involving men with prostate cancer showed that flaxseed supplements did not increase PSA levels.

The Mayo Clinic recommends that men with or at risk for prostate cancer avoid flaxseed and alpha-linolenic acid supplements.

That being said, there are other reasons you may want to discontinue your flaxseed oil regimen. Flaxseed is omega-3 fatty acid which can be beneficial for most patients. But you have diabetes. Some studies have shown that omega-3’s can actually increase blood sugar levels. You also mention a high triglyceride level. While I often recommend flaxseed oil and omega-3 to aid cholesterol reduction, this may not be appropriate for individuals with elevated triglyceride levels as it may actually increase the level.

Flaxseed is not without side effects. Some individuals may develop allergic reactions. It can also have laxative effects and in overdose can lead to a build-up of blood levels of the toxic chemical cyanide. Rarely, if whole flaxseeds are not taken correctly or too much is taken, it can lead to bowel obstruction or even a total stoppage of intestinal movement. Flaxseed oil is only the alpha-linolenic acid of the flaxseed and may not have all the potential benefits and side effects of the whole seed.

I suggest you speak to your physician about your consumption of flaxseed oil. He or she can give you information more specific to your situation. While flaxseed and its derivatives may have health benefits, more research needs to be done.

For readers who would like to learn more about flaxseed, I recommend you go check out the article on the Mayo Clinic’s website. It can be found at http://www.MayoClinic.com/health/flaxseed/NS_patient-flaxseed.

To give you related information, I am sending you copies of my Health Reports “The Prostate Gland”, “Living with Diabetes”, “Hypertension”, and “Understanding Cholesterol”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

I’m an 83-year-old man with type 2 diabetes and am medicated pretty well. I walk sometimes but usually get little exercise. I am starting to have bad cramps at night and my legs are getting very weak. I fear losing my feet and lower legs.

Frankly, I love having a 3 oz. glass of red wine before lunch and twice that before dinner. I also love my 4 oz. dish of iced cream at about 9 PM. Are these habits which give me pleasure doing me in? Please advise me.

DEAR READER:
As you are aware, type 2 diabetes is non-insulin dependent and is the more common form. The pancreas continues to produce insulin but the body develops resistance to its effects, resulting in a deficiency. While the condition can affect people of every age, it most commonly occurs after the age of 30. Age, weight and heredity are major risk factors for type 2 diabetes.

Long-term complications can result in poor circulation that might lead to heart disease, stroke, infection, poor vision, kidney failure and nerve damage. An individual might experience gradual weakness of the arms or legs, tingling and accompanying pain of the hands and feet, difficult healing of the skin, infection, and more.

It appears that the leg weakness and cramps are among your list of unpleasant side effects. You admittedly do not exercise on a regular basis and this activity is extremely important for all diabetics. Make a plan that works for your lifestyle. Perhaps that translates simply to walking around the block every day. If you have access to a swimming pool at a community center, take advantage of the resource. Perhaps a stationery bicycle indoors will work. Your circulation is likely impaired. While you may not be able to reverse the situation completely, you can definitely take steps to improve it. Start now.

There are several remedies for the leg cramps. The first is simply to remove the wrapper from a bar of soap. Place the soap under your bed sheet at night, where your legs ordinarily rest. This should eliminate the cramps. Some people have even had success with rubbing a bar of soap on the calves of their legs. Do what works best for you.

Pickle juice or a dill pickle incorporated into your diet may help prevent muscle cramping. Both products are available in grocery stores. Numerous drinks (to include pickle juice) contain electrolytes. Read labels at your local market before making a selection.

If your medication keeps your sugar levels under good control, I urge you to continue with the medications prescribed. If you are dissatisfied with the physician you are seeing, request a referral to another primary care physician or to an endocrinologist, a specialist in the field.

To give you related information, I am sending you a copy of my Health Report “Living with Diabetes”. 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.

About 30 years ago I became hyperthyroid and lost a tremendous amount of weight. I then became hypothyroid and my menses stopped abruptly, never to reappear. I was told my thyroid condition was responsible for both.

I’ve developed a very large stomach, although my arms and legs are thinner. I’ve been tested several times for uterine cancer with consistent negative results. My face is also puffy and more rounded.

I’ve had periodic back aches that are so severe I can hardly walk. I’ve become diabetic and two years ago was put on insulin. This year my high blood pressure became permanent, even though my stress and anxiety levels are low, and lately I am always tired. It seems some of my symptoms are escalating while others — the backaches, depression and anxiety — have disappeared. I would think the insulin is responsible for my sleepiness and exhaustion after slight exertion, but I’ve had most of these symptoms for 10 to 30 years.

Until I read about Cushing’s, I felt hopeless, alone, and resigned to the fact that these were side effects of my medical conditions. Can the tests be wrong and if not, do you have any idea what could be occurring? I’d like to have some energy so I can at least function the way I did two years ago.

DEAR READER:
The common signs and symptoms of Cushing’s include abdominal weight gain, fatigue, a rounded face, depression, anxiety, and high blood pressure. The most common cause is the use of oral corticosteroid medication. The main issue here is that Cushing’s is difficult to diagnose since it shares many symptoms with other conditions.

Symptoms of hypothyroidism include weakness, a cessation of menstruation, fatigue, an extended abdomen, facial puffiness, and more. Symptoms of diabetes include fatigue, weight loss, blurred vision, poorly healing wounds, and more. Sound familiar?

I feel I am removing any hope you might have of putting a diagnosis to your symptoms, but I do not feel you have Cushing’s. Rather, the laboratory work you included with your letter indicates you do have diabetes and hypothyroidism, exactly as you pointed out. The problem is that neither condition is under complete control, despite the insulin and Glucophage for your diabetes and the Levothyroxin for your hypothyroidism.

Return to your primary care physician for referral to an endocrinologist, if you aren’t already seeing one. Sit down with your list of questions to determine together what can be done to bring both conditions under control. Once that happens, your blood pressure should drop, your fatigue should disappear, your energy should return, and life should be back to a more normal state. It’s often difficult to hit upon the right dose for a particular condition, but through the process of trial and error, it can be done.

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.

My feet are now showing some nerve damage. Any help would be appreciated.

DEAR READER:
Metformin is an oral medication prescribed for people with type II (non-insulin dependent) diabetes. The normal dosing for oral medication is 500 mg taken twice daily, while the extended release form is taken once daily in a 500 mg tablet. Therefore, I am rather surprised you are on 2000 mg daily. This appears to be a hefty dose with less than perfect results. Normal blood sugars run in the 70-150 range, with lower readings in the morning and higher readings in the evening and after meals. To have a morning reading of 160 on this elevated dose is somewhat disturbing.

The nerve damage in your feet sounds like peripheral neuropathy to me, a condition that causes pain and numbness of the extremities. It can result from infection, traumatic injuries and is seen commonly in poorly controlled diabetics. Symptoms often improve over time once the underlying condition is treated.

Lactic acidosis has been reported in some people on metformin. The condition presents as muscle or abdominal pain, lightheadedness, shortness of breath, weakness, sleepiness and a slowed heart rate. Individuals should avoid alcohol while taking this drug, as it lowers blood sugar readings and can increase the risk of lactic acidosis. As with so many other drugs, several medications can interact with metformin, so advise your physician of anything else you might be taking, including herbal supplements and over-the-counter medications. He or she will then be able to determine if the drug is right for you.

In response to your cinnamon regimen, this product has been used for many conditions, including stomach disorders, nausea, vomiting, diarrhea, gas, and bloating. Most recently, scientists have discovered as little as ½ teaspoon daily added to the diet may reduce blood glucose levels. Cinnamon can be added to your toast, sprinkled over cereal, or a stick can be swirled into coffee or tea. Having reported this, I should add that this therapy does not work for everyone. In fact, I often feel that if an individual concentrates on adding a supplement for a specific purpose, he or she rapidly becomes aware of everything consumed. This is likely to lead to better dietary choices that result in better readings.

Review your concerns with your primary care physician. He or she might choose to switch you to another drug in the same class, but in a lower dosage that will provide better results. You might also consider asking for a referral to an endocrinologist who specializes in diabetes. Such a physician will be armed with the newest drugs and research results available. Perhaps one such drug will be right for you.

To give you related information, I am sending you a copy of my Health Report “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.

DEAR READER:
Oral chelation therapy, simply put, means one substance is ingested to rid the body of another. Its primary function is to attach to and rid the body of toxic metals by expelling them in the urine.

Chelation (ethylenediamine tetraacetic acid, EDTA) therapy can be given orally or intravenously and is a recognized treatment for mercury, arsenic, lead toxicity and other types of heavy metal poisoning. However, the practice is somewhat deceptive. Its purpose is to allow toxins to be removed from the body through the passing of urine. The process is used by some physicians and alternative medicine practitioners for the treatment of coronary artery disease, but there have not been adequate published scientific studies using the current methodology to support its use, according to the Food and Drug Administration, National Institutes of Health and the American Heart Association. I am unaware of this treatment or of any approved studies for its use in the treatment of either diabetes or hypertension.

In 2003, the National Center for Complimentary and Alternative Medicine and the National Heart, Lung and Blood Institute, components of the NIH, began a nationwide study to determine if chelation is even mildly effective for individuals with coronary heart disease. When completed, the study will be larger than any other conducted for this purpose to date. Final results are anticipated in 2010.

According to some reports unrelated to the 2003 study, there is reason to believe that prolonged use of oral EDTA is harmful. Only about 5% is absorbed by mouth and while that small amount increases the excretion of lead, it also removes and blocks greater amounts of zinc, manganese and other essential nutritional dietary elements, causing deficiencies. The remaining 95% is unabsorbed and remains within the digestive tract where it mixes with essential nutrients and undigested food and causes them to be excreted in the stool.

According to some reports, oral EDTA chelation has been deceptively marketed for a number of years. Nutritional supplements containing vitamins, amino acids, antioxidants and chelated minerals are often advertised and marketed as oral chelation, but this is misleading advertising. An individual taking the supplements may feel better, but the process is not true chelation.

While you indicate your family member has diabetes and high blood pressure, I strongly urge him or her to attempt to control the diabetes through diet, exercise and the judicial use of medication under a primary care physician’s guidance, if appropriate. Hypertension, if not brought into line with diet and exercise can be controlled with prescription medication. Call me old fashioned, but I prefer to bypass questionable therapy for methods that have been proven to work successfully. I cannot endorse chelation.

To give you related information, I am sending you copies of my Health Reports “Diabetes Mellitus” and “Hypertension”. Other readers who would like copies 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).

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, either before meals or about one and a half hours after eating. Not all non-insulin independent diabetics need to perform regular blood glucose checks. However, insulin-dependent diabetics require tighter control and often need to test their glucose levels several times a day.

If I can read between the lines, I conclude your sugar level was minimally high when your doctor checked it. He or she must have felt your diabetes could be controlled by diet, without medication and without outside monitoring. This is always a favorable option I definitely endorse, since all drugs have side effects.

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 176, Wickliffe, OH 44092. Be sure to mention the title.

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.

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.