Beet juice or beetle juice for plantar warts?

Q. I read on your website that someone used beetle juice to get rid of plantar warts. Was that an error? Perchance the person meant beet juice?

A. We suspect you may have read this comment: “I suffered from plantar warts on my big toe and on the ball of the same foot for many years. I finally saw a podiatrist, who applied a topical solution made of beetle juice to my warts. Half a dozen such treatments made the warts disappear within a few months.”

The “beetle juice” referred to above is cantharidin, a substance secreted by blister beetles. When it is applied to skin, it can cause blisters. It has been used to treat warts but must be applied by a health professional. It is not a do-it-yourself remedy and can be quite painful. As far as we know, beet juice would be totally ineffective against warts.

Q. You recently answered a question in your column, but I think you missed an important point. The reader asked about pain medication for his joint pain.

You ignored the fact that he was on a high dose of atorvastatin (80 mg). His joint pain might be due to the statin.

He should be advised to speak to his cardiologist. I am a cardiac nurse, and I have seen many patients get relief from muscle and joint pain simply by switching statins.

A. Thank you for reminding us that some people are especially susceptible to statins and experience both muscle and joint pain. We agree that the cardiologist might want to re-evaluate his prescription.

For those who cannot tolerate any statins, we offer our Guide to Cholesterol Control and Heart Health, in which we discuss other ways to reduce the risk of heart attacks. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (71 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. C-8, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.

Q. I take Premarin, and the drug is very expensive. Both my doctor and pharmacist say there is no generic version of this drug. How can this be true? It is my understanding that this hormone treatment has been on the market for decades.

A. Premarin (conjugated estrogens) was approved by the Food and Drug Administration in the early 1940s. According to the company, more than 30 billion doses have been dispensed over the past 70 years to treat menopausal symptoms.

The estrogens in Premarin are made from purified pregnant mare’s urine, which has stimulated a lot of controversy from animal-rights advocates. The uniqueness of the formulation has made it hard for the FDA to approve any generic substitutes.

The cost of a month’s supply of Premarin in our area is more than $140. Forty years ago, the cost of a three-month’s supply of Premarin was under $7.

You might ask your physician for an alternative to Premarin. There are a number of synthetic estrogen options as well as natural estrogens formulated by compounding pharmacists.

Q. My husband takes metformin and some other medications, as well as supplements. His last bloodwork showed a B-12 level of more than 2,000 pg/ml, which is very high. Is this level harmful, and what could be causing it?

A. Your husband needs a thorough workup. High vitamin B-12 levels are unusual for someone on metformin and could be a sign of liver problems or another serious condition.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or email them via their Web site: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”