DEAR READER: Steroids are powerful hormone-like substances prescribed for a great number of disorders. Athletes have been known to take them for performance enhancement. I cannot stress strongly enough that they and all herbals or OTC substitutes should be prescribed only for a specific cause by a qualified healthcare professional who knows your medical history. They should be taken under detailed instruction because of vital dosing reductions that must be adhered to.

That said, there are several herbals that might be taken alone or in conjunction with other OTCs. They include nettle root, saw palmetto, hydrangea root, pygeum bark, pomegranate, viburnum, ginkgo biloba, black cohosh, lemon balm, chaste tree berry (monk’s pepper) and hawthorne. As you can imagine, the list goes on and on.

You neglected to indicate why you or someone else might choose an alternative, and there are countless disorders for which a physician might make the recommendation. Is it for menopause, pain, poison ivy, low testosterone levels or performance enhancement? The possibilities are limitless, so without knowing the specific reason, I cannot even consider what might be appropriate.

Speak with your primary-care physician or a naturopath for direction. Good luck.

To provide related information, I am sending you a copy of my Health Report “Herbs and Other Healing Fads.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: Arthritis is pain and stiffness of the joints. You don’t specify what type she has, so I will generalize because there are actually more than 100 forms.

Osteoarthritis is pain in the joints accompanied by progressive stiffness without extensive inflammation, chills or fever. It is a chronic disease of the joints resulting from a cartilage breakdown. Rheumatoid arthritis has pain, inflammation, swelling and stiffness that typically occurs symmetrically on both sides of the body. The infectious form includes symptoms of inflammation, chills, fever and pain, and may be linked to another illness. Then there’s gout, Behcet’s Syndrome, CREST syndrome, fibromyalgia and a whole host more.

Some patients respond to topical ointments with capsaicin or castor oil rubbed onto painful joints; purple grape juice and liquid pectin mixtures; or omega-3 fish oils.

Plantar fasciitis is pain and inflammation in a dense band of tissue of the foot that connects the heel bone to the toes. It is common in runners, overweight people, pregnant women and in those who wear shoes without adequate support.

The methylprednisolone your friend has been prescribed is a steroid that prevents the release of substances in the body that cause inflammation. It is also used to treat several allergic disorders, arthritis, psoriasis, ulcerative colitis and a number of other conditions.

Steroids can weaken a person’s immune system, thus making him or her more susceptible to infection. They also have the ability to reactivate recent infection. Steroids should be reduced slowly and not discontinued abruptly because of potential side effects from withdrawal. Your friend should avoid being near people with chickenpox, measles, active infections or who are otherwise sick. She should not receive any “live” vaccines while on the drug. The drug can also alter certain medical testing, so she should be sure to make her usage known to avoid being misdiagnosed.

Side effects of high doses include hypertension, heart arrhythmias, muscle weakness, chest pain, shortness of breath, visual problems, tarry or bloody stools, pancreatitis and more. Long-term use can lead to easy bruising, acne, facial hair, loss of libido, headache, insomnia, nausea, changes of body fat and more.

The bottom line is that she should take the drug precisely as it is prescribed. Modifications (which are obviously acceptable) might be made by her prescribing physician. Should she develop kidney disease, osteoporosis, glaucoma, cataracts, congestive heart failure or a number of other conditions, her doctor will likely make dose adjustments and order special testing while she is on the medication.

To provide related information, I am sending you copies of my Health Reports “Consumer Tips on Medicines” and “Fibromyalgia.” Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a $2 check or money order for each report to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER:
Chronic use of steroids can lead to osteoporosis. I assume this is the cause of your problem. I urge you to start taking 1000-1500 mg of calcium and 800 IU of vitamin D daily immediately.

For added benefit I recommend you discontinue the steroid medications. Ask your dermatologist about non-steroid, alternative treatments. While psoriasis and eczema are annoying, they are harmless and both have shown positive responses to some home remedies such as medication chest rubs or banana peels.

As for osteoporosis medications, speak to your physician or an endocrinologist who will be able to answer your questions and quell your concerns.

To give you related information, I am sending you copies of my Health Reports “Osteoporosis” and “Dermatitis, Eczema and Psoriasis”. 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(s).