Woman’s cries keep family awake

DEAR DR. GOTT: Last night was one of my worst. No one in my house was able to sleep because I made so much noise.

I have severe rheumatoid arthritis and take numerous medications. In the last few years it has become harder to sleep each night. I moan, groan, talk, yell, mumble, etc. while I sleep. I usually do not hear myself but everyone else in the house does. Sleep medication does not help me and ear plugs do not help others.

Do you have any ideas what I can do? No one wants to stay with me. I have had sleep studies with no answers. I need help.
[Read more...]

Another new antioxidant

DEAR DR. GOTT: Have you ever heard of the supplement Protandim? I’ve been told that it could help my rheumatoid-arthritis pain. What can you tell me about it? And if it’s so great, why don’t doctors tell us about it?

DEAR READER: Let me start by saying I have no affiliation with this product.

Protandim’s ingredients include milk thistle, Bacopa extract, Ashwagandha, green-tea extract and turmeric extract. This dietary supplement is an antioxidant that has received a fair amount of publicity on national television, in newspapers and elsewhere as a new breakthrough in boosting the immune system.
[Read more...]

Touting the virtues of cod-liver oil

DEAR DR. GOTT: I am a fairly young man of 90 years. I was born in Norway in 1919 and similar to most Norwegians ate a lot of fish. A few of us might take cod-liver oil as a supplement, but in view of the general Norwegian diet, it might be less important.

When I arrived in this country at the age of 28, I started taking cod-liver oil regularly with breakfast every single day. When a nephew of mine from Norway visited some time ago, I asked him what he thought of the value of cod-liver oil. Arthritis was his specialty, and he thought it was useful against rheumatoid problems. He said it works painlessly, almost like oiling a joint.
[Read more...]

Unusual Type Of Arthritis Painful, Disabling

DEAR DR. GOTT:
In my mid-40’s I began experiencing knee pain and buckling. My doctor told me it was probably arthritis. The pain then started to move to other areas of my body.

I am now 50 and have just been diagnosed with ankylosing spondylitis and several herniated and bulging discs following an MRI of my spine.

I have pain down my legs into my feet and am unable to bend my legs sometimes. I received a spinal injection but it didn’t work. I experienced extreme pain in the joints of my fingers, wrists, hips, neck, and legs. My two pinky fingers have bent inward and I can no longer straighten them.

I have seen a neurologist who disclaimed nerve damage. I have even experienced severe needle-like sticks in my skin and am totally exhausted.

Is all of this really the result of arthritis? [Read more...]

Sunday Column

DEAR DR. GOTT:
I have rheumatoid arthritis (RA) and my greatest wish is for you to write one column on this subject. I am sure you will please millions of people with RA by informing people of the difference between arthritis and RA.

Everyday I run into people that notice when I limp or move slowly in pain and ask what’s wrong. I inform them I have rheumatoid arthritis and before I can finish my sentence they are telling me how they have the same thing and start telling me how bad it is in their knee, etc.

When I question them, I realize they have normal aging and osteoarthritis. People do not understand RA patients and the difference because both have arthritis in the name.

Please dedicate one column to this subject. Your column will help educate the public as it has helped educate me on so many disorders. [Read more...]

Daily Column

DEAR DR. GOTT:
I am 72 years young, active, and do all my own housework. I recently read your letter concerning hair loss after taking medication. I am on three medications and three over-the-counters. The first drug is lisinopril 20 mg tabs, one and a half pills every day. The second is prednisone 4 mg daily prescribed by a rheumatologist because of rheumatoid arthritis . The third is blood pressure medicine known as metoprolol 50 mg that I’ve been on for over four years. I was taking one in the morning and a half every evening until my doctor increased the medication to two a day.

My over-the-counter drugs are a one-a-day multi-vitamin, calcium 1000 mg plus D daily, and calcium citrate 315 mg with 200 IU of vitamin D.

Years ago I noticed hair loss and attributed it to the metoprolol. The problem keeps increasing and, in fact, if it continues, I will need a wig in another year. I mentioned the problem to my doctor and her reply was that all medicines make people lose hair. Would I be wrong in asking my doctor to take me off the metoprolol and prescribe another medication for my high blood pressure? I showed her the drug information provided by my pharmacy indicating hair loss as a side effect.

I recently changed primary care physicians since my first doctor wasn’t concerned at all about my hair loss. What can I do?

DEAR READER:
Let me begin with some general information. Medications must go through several clinical studies before being approved. This is done by giving thousands of people a drug, while others are given a placebo. During the studies, no participant knows if he or she is taking the real thing or a placebo. An adverse consequence in more than 1% of the people studied in both categories is referred to as a common side effect, while less than that amount is referred to as rare. Once a drug is approved, it is no longer studied.

Now for the bad news. You are on lisinopril, metoprolol and prednisone. Rare side effects of all three drugs list hair loss as a possibility. Steroids are known to precipitate hair loss in men, yet all women have some male hormones. Therefore, of the prescription medications you take, all three share a similar consequence. The good news, according to my resources, is that the hair loss is generally reversible once a drug is discontinued.

It could be difficult in your situation to determine which drug might be causing your hair loss, unless you kept meticulous records indicating when the pattern began. As we age, we suffer wrinkles, heart problems, hypertension, arthritis and more. It’s difficult enough dealing with the problems over which we have little control. We shouldn’t have to deal with balding when it might be preventable. I recommend you speak with your new primary care physician who might be able to prescribe different medications in each instance without such an emotionally devastating side effect, no matter how rare it might be.

To give you related information, I am sending you a copy of my Health Report “Consumer Tips on Medicines”. 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.

Daily Column

DEAR DR. GOTT:
I need help. I have seen several doctors but none can put my symptoms together and come up with a diagnosis. I am anemic, have fluctuating high blood pressure, throat and sinus inflammation, inflammation behind my eyes, Meniere’s disease symptoms, an elevated rheumatoid factor, and elevated Ig antibodies.

I am only 47 years old and have been healthy my whole life. I need a diagnosis or at least a hint of what could be wrong with me.

DEAR READER:
I urge you make an appointment with a rheumatologist (immune system specialist).

Inflammation of the throat, sinuses, area behind the eyes, and anemia suggest to me you have an autoimmune disorder. These symptoms are common in Wegener’s Granulomatosis, a rare disorder that involves vasculitis (inflammation of the blood vessels). Wegener’s could also explain your Meniere’s type symptoms because ear infections are common and can cause hearing loss, tinnitus, pain, and more. Blood pressure is also affected by vessel inflammation.

I suggest you mention the possibilities of Wegener’s and vasculitis to the specialist, as well as requesting an anti-neutrophil cytoplasmic antibody test (positive in 80-95% of sufferers). Wegener’s may be fatal if left untreated so I urge you to seek medical help.

If I am off base, I apologize. However, based on your symptoms and tests, a rheumatologist is your best bet. You should also be tested further for rheumatoid arthritis, lupus and similar disorders to explain your abnormal rheumatoid factor and Ig antibodies.

Daily Column

DEAR DR. GOTT:
I have a friend who drinks anything mixed or beer like there’s no tomorrow. His triglycerides are very high. I told him I thought all the alcohol he drinks could be the cause of the elevation. He claims his doctor told him it’s not. He runs around with others who behave the same way.

I may be wrong but he seems to be in his glory when he has a drink in his hand.

DEAR READER:
Your friend appears to be drinking inappropriately. I would likely label him an alcoholic if I had more information about his drinking habits. What you have to remember is that he will not make significant changes in his lifestyle (and alcohol consumption) until HE is ready to do so. Such a change in attitude is often the product of a DWI (driving while intoxicated), a DUI (driving under the influence) or a serious accident or illness. If I were you I’d pull back, tell him about your concerns and hope that your friend will moderate his drinking or — better yet– stop altogether.

To give you related information, I am sending you a copy of my Health Report “Mental/Substance Abuse”. 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.

Daily Column

DEAR DR. GOTT:
My husband is 48 years old and suffers from rheumatoid arthritis. He is on immunosuppressive therapy. Three years ago he came down with a mild case of shingles. Would you advise him to get the new shingles vaccine considering the aforementioned facts?

DEAR READER:
No.

Several groups of people should not receive the vaccine. They include women of childbearing age or who are pregnant, anyone taking medication that affects the immune system, those with an allergy to any of the vaccine components, and individuals with a history of primary acquired immunodeficiency (such as HIV).

Because your husband is on immunosuppressive therapy he is not a candidate for the vaccine. His age also is a factor. The shingles vaccine is primarily recommended for individuals age 60 and older.

I recommend that you and your husband speak with his primary care physician and rheumatologist. They are familiar with his case and can answer your concerns.