Ask the Doctors 6/17
Hello, dear readers, and welcome back to the monthly letters column. We continue to get questions about the coronavirus vaccine and virus variants, and we’ll address them in a separate column soon. This time, though, we’ll focus on nonvirus questions and concerns.
• In response to a column about psoriasis, a reader asked about natural remedies. “I have severe psoriasis but am terrified to take a biologic,” she wrote. “Is there a safe anti-inflammatory herbal product that could help?” Biologic drugs use biotechnology to act on a wide range of cellular processes. They can be quite effective, but some people aren’t comfortable using them. Since psoriasis is a skin disorder rooted in inflammation, anti-inflammatory supplements may be useful in some cases. Turmeric, a flowering plant used as a cooking spice, contains a powerful anti-inflammatory called curcumin. It, along with ginger and omega-3 fatty acids, have the best data as natural approaches to psoriasis management. Aloe extract cream and barberry, also known as Oregon grape, both have anti-inflammatory properties and may be helpful. Before you add supplements to your treatment regimen, check with your health care provider. They can help you decide which ones to try, and how to use them.
• After reading a column about a regular blood donor who was turned away due to chronic anemia, a fellow blood donor shared her own experience. “Some years ago, when I began taking calcium for osteoporosis, I began being deferred for donations,” she wrote. “When a blood bank technician learned that I took my iron and calcium supplements at the same time, she told me that calcium blocks the absorption of iron. Since I stopped taking my iron with calcium, I haven’t been deferred.” It’s correct that calcium can interfere with iron absorption. We recommend taking iron supplements with vitamin C, which enhances absorption, and calcium supplements separately. But as we said in the column, when an older adult develops chronic iron deficiency anemia, it’s imperative that they be evaluated for occult bleeding.
• In a discussion about managing medications for older adults, we talked about the use of weekly pill organizers. A reader pointed out that this isn’t an answer for everyone. “These types of pill organizers, especially the ones that store three weeks’ worth of pills, can be dangerous for some elderly people,” they wrote. “They can get confused about what day of the week it is, and run the risk of taking the same day’s pills twice.” It’s true that for people with cognitive issues, taking medications can be a challenge. A possible solution is an automatic pill dispenser. This is a portable locked device that is programmed to dispense one round of medications at a time. Most include a visual and audio alert as well. These are somewhat costly, in the range of $80 to $100, and, unfortunately, are not automatically covered by Medicare.
Thank you, as always, for taking the time to write to us. We enjoy knowing where you’re writing from, and we never use your names in our columns.
Send your questions to askthedoctors@mednet.ucla.edu.