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.

After doing another internet search, this time on TGA episodes, he found that some people (including a retired NASA physician) think that there may be a connection between these episodes and statins. (He also discovered that red yeast rice is a statin.) He also found, after talking to one of his sisters who takes statins, that she has had as many eight TGA episodes. On several occasions she had to be taken to the ER but the connection with the statins was never brought up and she was never told to stop them.

My husband has since decided it best to avoid all statins, despite a family history of cholesterol problems. Given his past experience and that of his sister I cannot blame him so we are working together to modify his diet. We have read your cholesterol newsletter and while he isn’t totally inline with it, he is close and eats oatmeal, grapefruit and bananas on a daily basis. He will have his cholesterol tested in a few weeks to see if it is working. Oh, and he is lactose intolerant so high fat diary products are very easily avoided.

DEAR READER:
Transient Global Amnesia is a sudden and temporary episode of memory loss. It is not associated with any neurological condition. During an “attack”, the sufferer’s ability to recall recent events disappears. They do not know where they are or how they got there and in some cases the individual cannot recall events from a day, month or even a year ago, yet they remember who they are and recognize family and long-time friends.

During an episode it is important to get the individual to the hospital to rule out other causes of amnesia, such as epilepsy, stroke, or transient ischemic attack (TIA or mini-stroke). Transient Global Amnesia doesn’t appear to have any lasting complications but can cause plenty of emotional distress so after an episode it is important to relax.

Nearly half of all TGA episodes occur immediately after physical or emotional stress such as sudden immersion in hot or cold water, medical procedures (such as angiography), strenuous physical activity and more. Individuals who suffer chronic migraines and are between the ages of 56 and 75 appear to be at a higher risk.

That being said, both you and your sister appear to have had similar effects of TGA episodes after taking statin drugs. While medical science may have no answer for this, it is likely that there simply are not have enough reports from consumers to warrant further testing. The medical community can only know as much as drug manufacturers and scientists tell us and if they have failed to research properly these complaints or have simply not informed consumers of this possible side effect, then shame on them.

In my opinion your husband is taking appropriate steps. If diet alone does not work (which is likely because there seems to be a genetic predisposition) I recommend he try omega 3 oil, flax seed oil, or niacin. He still needs to have his cholesterol tested regularly to determine if his modifications are working. Niacin can have the uncomfortable side effect of flushing and can raise liver enzymes (rarely) but can be used in lower quantities (to reduce side effects) in conjunction with either or both of the oils. Be sure to inform your husband’s doctors of any and all changes and medication (even over-the-counters) he is taking to ensure he has proper testing and follow-up.

To give you related information, I am sending you a copy of my Health Report “Understanding Cholesterol”. 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:
Niacin is an excellent alternative choice for lowering cholesterol levels. I often recommend patients to start with a relatively low-dose of 250-500 mg daily and then slowly work up to 1000-1500 mg daily, usually in increments of 250 mg. This is primarily to allow the body to become accustomed to the vitamin and reduce the chance of side effects, namely, flushing.

It is important also to have your cholesterol level checked every few months, as well as liver function, to ensure that the medication is working and not causing any damage.

Some individuals are very sensitive to the medication and cannot tolerate it well. For these individuals, I recommend omega-3 oils or flaxseed oil. These do not, to my knowledge, have any side effects but cholesterol testing is still important to determine if the medication is working. If that fails, try combining therapy such as niacin and flaxseed oil daily. This can also reduce the dosage of the niacin leading to a smaller incidence of side effects.

As for red yeast rice, I do not recommend it because it is basically a natural form of the drug Mevacor which is a statin. It is more likely to cause side effects similar to those of other statins, such as muscle/joint pain and liver damage.

To give you related information, I am sending you copies of my Health Reports “Understanding Cholesterol” and “Dr. Gott’s Compelling Home Remedies”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure mention the title.

DEAR READER:
Lipitor will work the same regardless of what time of day it is taken or even if it is taken with or without food. In my experience most physicians recommend some medications be taken in the morning and others at night simply to reduce the number of pills taken simultaneously and to reduce the chance of drug interactions. If your physician has said you can safely take the Lipitor in the morning, I recommend you take his advice. If that fails to stop the sleeplessness, perhaps you could successfully be switched to another cholesterol lowering medication. You may also choose to try other treatments such as omega 3’s, niacin or flaxseed oil. Ask your doctor about this.

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

The only niacin a person can buy without a prescription is the non-flushing kind that does nothing for high density lipoprotein (HDL) levels. The one that helps is Niaspan that requires a prescription and can definitely cause flushing — to the degree that some people cannot take it at all.

Can you please clear this up?

DEAR READER:
Non-flushing niacin contains an ingredient called inositol which does nothing for reducing cholesterol levels and may prevent the niacin from working correctly. Straight niacin or sustained-release niacin is available over-the-counter and does work toward reducing high counts. Flushing and itching are common side effects. However, taking an antihistamine or 81 mg aspirin 10 or 15 minutes prior to the niacin or splitting the daily intake between morning and evening may reduce or eliminate the unpleasant side effects. Another option is to work up to a higher level slowly.

Many readers have successfully used omega 3 fish oil, flax seed oil or a combination (niacin and one of the oils or both oils).

A low fat, low or no salt diet is a must for individuals with high cholesterol levels. See your physician for his or her recommendations. Prescription medications might be necessary to achieve lower readings. Periodic testing of cholesterol levels (and liver enzymes if on medication) should be done to be sure you are on the right track.

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

I have a question that I cannot seem to find an answer to. Can calcium and fish oil be taken at the same time? I find it easier to remember if I take all my pills at once but worry that I am not getting all the possible benefits.

DEAR READER:
As far as I know, there is no problem taking fish oil and calcium together. The benefits should not be adversely affected. If you are worried about taking medications together, I suggest you speak to your pharmacist who will be able to help. He or she should know of any possible dangers or complications that may occur between two or more medications taken at the same time.

He is 41, in great physical shape, has high triglycerides and takes several medications (Niaspan, half an 81 mg aspirin, and Pravachol). He also has borderline hypertension that he is trying to control with diet.

The sweats happen whether he takes his medication or not. They seem to appear more on days when he has exercised very hard. Is this a sign of some type of health problem? What can he do about it?

DEAR READER: I’m not certain that your husband’s medications are to blame as a cause for his night sweats. Niaspan (prescription niacin) is known to cause flushing, sweating, chills and more. Side effects generally decrease after three to four weeks of therapy, however. Sweats can also, rarely, be a symptom of hidden infection.

I recommend that your husband be examined and tested by his primary care physician. While awaiting his appointment, he may wish to discontinue the Niaspan temporarily . He should continue the Pravachol, however. If this simple remedy stops the night sweats, his physician can forego the testing and take him off the Niaspan. Your husband may wish to try some other alternative therapy such as Omega 3 or Flaxseed oil in conjunction with the Pravachol. If the night sweats continue, your husband should then follow through with an exam and testing by his primary care physician.

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

I take Lipitor for high cholesterol and high triglyceride levels and would like to try this approach. However, since niacin can cause side effects, I don’t want to try it until I know it will not adversely interact with the Lipitor. Any thoughts on this?

DEAR READER: Don’t make any changes in your medication unless your doctor has approved of them. Niacin doesn’t work for every body and it has the unpleasant side effect of flushing. Non-flushing niacin does not produce the flushing but may not have the outstanding results of standard niacin.

There are no harmful drug interactions between Lipitor and niacin (a vitamin) to my knowledge. You could certainly try the combination, but — once again — run this by your primary care physician. He or she may prefer you stop the Lipitor while trying the niacin. This will better gauge whether your cholesterol and triglyceride levels will decrease with niacin. If it does not work for you, continue with the Lipitor. If it has minimal effects, it may be best paired with the Lipitor or perhaps you could try flaxseed oil or omega-3 fish oil. You may even be lucky enough to have dramatic results and not need to go back on the Lipitor.

To give you related information, I am sending you a copy of my Health Report “Understanding Cholesterol”. 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: Unfortunately, yes. However, your husband appears to be willing to make some modifications. He has taken a step in the right direction by using niacin. For appropriate benefits from this vitamin, he should be taking 1000-1500 mg every day (500-750 mg twice daily works best).

An important step he has yet to take is to modify his diet. A low fat, low cholesterol diet may, by itself, reduce his cholesterol level dramatically. From your brief note, it appears his cholesterol is high due to dietary and lifestyle choices, rather than genetic factors. If diet does not significantly lower his numbers he may have a genetic predisposition to elevated cholesterol and will need medication. If he chooses to start with alternative therapies, I recommend niacin, flaxseed oil and omega-3 fish oil. These can be taken individually but may have a bigger impact if taken together. If these fail, he may then need to consider prescription medications, such as Vytorin or Lipitor.

Your husband needs to make changes. He is at risk for coronary disease, heart attack and more. However, he will not change until he is ready. Unfortunately for many people, it takes having a heart attack or other serious health disorder, before they become serious about making changes and understand that it could have been prevented if they had just made a few early changes. I hope your husband is not one of these people and that he takes his health seriously.

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