Dear Dr. Roach: I just read your column about ulcerative colitis. Many years ago, I read about a possible relief: nicotine. I had a friend who was in dire straits for years and he was ready to get a colostomy. He had not responded to all kinds of steroids and expensive meds.
He was treated with nicotine patches and in 48听hours he had relief. He wore a patch for at least a听year. He moved years ago, but when I knew him, he looked at nicotine as a听cure. Any thoughts?
R.
I learned in medical school that ulcerative colitis could appear or flare after quitting smoking, and that studies were being done to look at nicotine as a treatment. Since then, nicotine has been more extensively studied but has not found a major role in the treatment of UC.
It is used occasionally and even more occasionally successful in people who have not had relief with more-common treatments. The side effects of high doses cause many people to not tolerate it.
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Dear Dr. Roach: Have you heard of Boswellia? Would you recommend it for arthritic pain? If so, what dosage and how often would be safe? What about negative side-effects?
F.P.
Boswellia, also called Indian frankincense, is a herb that has been used for millennia in India as an anti-inflammatory for relief of arthritis pain. I was able to find a well-done study from 2011 that showed significant benefit in reducing pain and improving function in people with osteoarthritis of the knee. The only side effects seen were minor headache and nausea. Other studies, all small and relatively short, confirmed these results.
Based on these small studies, it appears that Boswellia extract may have benefit in improving pain and function in people with osteoarthritis of the knee. I found products that are labelled as having what the study medicine did (most commonly 100 mg once daily, containing at least 20 per cent AKBA, the active ingredient).
However, let me emphasize that supplements are not subject to oversight by the U.S. Food and Drug Administration. Just last month, the New York state attorney general鈥檚 office accused four major retailers of selling fraudulent and potentially dangerous herbal supplements under their store brands.
Of the products they tested, 78 per cent did not contain any of the herbs on their labels, and some contained substances potentially dangerous to those with allergies (including wheat in products labelled 鈥渨heat- and gluten-free,鈥� and powdered legumes, a potential risk for those with peanut allergies). These products were labelled 鈥渟tandardized鈥� and 鈥済uaranteed.鈥�
It is very frustrating to learn about potentially valuable therapies that offer an alternative to prescription medicines, and have the companies that supply them be untrustworthy. There may be good manufacturers, but with no way of independently testing their products, I cannot give a recommendation for a particular brand.
A recent episode of CBC television鈥檚 Market Place on drug store 鈥渕edicines鈥� suggests the situation in sa国际传媒 is similar.
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Dear Dr. Roach: What is the body鈥檚 rate of absorption for calcium?
A.
The textbook answer is 20 per cent to 40 per cent, but in reality, the answer is very complicated, as it depends on total body and intracellular calcium, vitamin D levels, presence of phosphates in food and other factors.
The short answer is that it is usually exactly what it needs to be when things work properly. If the body is deficient in calcium, then absorption is maximal, but still most calcium in food is not absorbed.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected].
