By Joe Graedon, M.S., and Teresa Graedon, Ph.D.
Q. The doctor added fenofibrate to my meds because I had high triglycerides (400-plus). Within six weeks, my triglycerides were down to 179.
As an extra benefit, the uncontrolled diarrhea I’ve been experiencing for almost two years has almost completely disappeared. The gastroenterologist I’ve seen says fenofibrate can bind with fats and lower triglycerides.
So far, it has been good for me. Is there anything else I should know about it?
A. Fenofibrate is an often-overlooked drug in the doctors’ lipid-controlling toolbox. It was approved by the Food and Drug Administration in 1993 and first sold in the U.S. under the brand name Tricor in 1998.
In addition to lowering triglycerides, it also can reduce total and LDL cholesterol and raise “good” HDL cholesterol. People with metabolic syndrome (high cholesterol, triglycerides, blood glucose and blood pressure along with a large waistline) are especially likely to benefit from fenofibrate. Side effects include liver enzyme elevations, digestive discomfort and headache.
Fenofibrate may also have unexpected benefits for the brain. There is preliminary evidence of antidepressant and neuroprotective activity (Biomolecules, May 2022).
You can learn much more about fenofibrate and other strategies for lipid management in our “eGuide to Cholesterol Control and Heart Health.” It also contains insights on the often-overlooked risk factor Lp(a). This online resource is available under the Health eGuides tab at www.PeoplesPharmacy.com.
Q. Not long ago, a woman wrote to you about heel pain due to plantar fasciitis. When I had this problem, I sought physical therapy for it.
What helped most was the physical therapist massaging diclofenac sodium cream into my heel. That got rid of the pain for several hours. At the time, the cream was only available by prescription, but now you can buy it over the counter.
After about six months, I finally got rid of the heel pain permanently by stretching my foot several times a day. I’d pull my toes toward me with my hands for up to 30 seconds at a time. You can find demonstrations of this stretch online. I continue doing these stretches everyday 10 years later, and the plantar fasciitis has not returned.
A. We’re not surprised that the topical NSAID diclofenac (Voltaren Gel) helped ease your heel pain. The foot stretch you describe is often recommended to help prevent or overcome plantar fasciitis.
Q. Thank you for writing about amiodarone. My late husband was prescribed amiodarone after bypass surgery. I guess that was just as a precaution, because he didn’t have atrial fibrillation.
It caused pulmonary fibrosis that resulted in his death five years later. Of course, the cardiologist denied that was the cause, and we couldn’t prove it. Still, the pulmonologist had no doubt the drug was responsible.
A. We are so sorry to learn about this tragedy. According to the FDA, doctors should prescribe amiodarone only to patients with life-threatening heart rhythm disturbances that have not responded to other treatment. That’s because this drug is so dangerous.
The official prescribing information warns that: “Rates of pulmonary toxicity have been reported to be as high as 17% and is fatal in about 10% of cases.” In addition to lung problems, amiodarone can change thyroid and liver function. It may also interact with many other drugs.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, Fla., 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”
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