Q: I am battling high blood pressure. With effort, I have been able to keep my BP at an average of 125 to 135 over 82 to 87. My BP is higher in the morning than in the afternoon, when it ranges from 120 to 125 over 77 to 82. At the doctor’s office, it was 160/95.
I have been following a low-sodium diet. But one day, I got a great deal on some pretzels and decided to indulge. I ate a few before bedtime. I was surprised the next morning when my BP was 120/77.
The next night I did the same, and the following morning it was 123/75. It seemed the salt was lowering my morning BP readings.
So I skipped the pretzels a few nights, and my morning BP readings were higher again. I’ve decided to keep my usual daily diet as “low sodium” but have just a few salty pretzels in the evening.
A: Sodium is complicated. Some people are salt-sensitive and may benefit from a low-sodium diet. For others, however, lowering salt intake too much may actually increase the risk for heart attack and stroke (The Lancet, July 30, 2016). Excessively low sodium levels might trigger a stress reaction within the body.
Some European cardiologists disagree with the very stringent sodium restriction recommended by the American Heart Association (European Heart Journal, Jan. 20, 2017). It is clear that too much sodium is unhealthy, but it is possible that too little sodium also is undesirable.
Q: Over the past six months, I have been debilitated with joint pain in my hips, knees, wrists and spine. I suddenly felt very old. Then it dawned on me that the pharmacy switched from sending me Celebrex to sending generic celecoxib. Celecoxib is worthless, and my pain has flared to horrific levels.
I can’t afford brand-name Celebrex, but I can buy it cheaper in Canada. That is what I plan to do.
A: Many other visitors to our website also have reported that some generic celecoxib pills are not effective against joint pain. While you could purchase Celebrex from a reputable online Canadian pharmacy for less, there is another option.
Ask your pharmacy about celecoxib from Greenstone. This manufacturer provides an authorized generic form of Celebrex; it should be identical.
You can learn more about authorized generic products and how to use generic drugs wisely in our Guide to Saving Money on Medicines. You also can read how to determine which Canadian pharmacies are legitimate and how to protect yourself if you go that route. You’ll find it at www.PeoplesPharmacy.com.
Q: Many years ago, I had severely cracked corners of my mouth. I discovered quite by accident that it was caused by an ingredient in the toothpaste I was using. When I changed brands, the problem disappeared.
A: Angular cheilitis (perleche) is the term doctors give to painful cracks in the corners of the mouth. They can be triggered by a reaction to chemicals in sunscreen, cinnamon or toothpaste.
People who are deficient in B vitamins, zinc or iron may be especially susceptible. Fungal infections also may cause redness, itching, burning or crusting.
Some doctors suggest a topical steroid like hydrocortisone, or an antifungal cream such as those found in athlete’s foot remedies. One person said that mixing a cortisone cream with an OTC antifungal cream solved the problem in several days.
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.”
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