Dear Dr. Roach: I am a healthy 90-year-old woman. I enjoy playing tennis and bridge. A week ago, I started to take the drug metformin. I do not have diabetes. The reason for taking it is that I read an article about it by an expert in longevity. My only concern is that the drug may lower my sugar level to a dangerous point.
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A.L.
I also have read about the use of metformin as a possible extender of longevity, and have looked at two different study designs that hope to determine whether the medication can affect the aging process. It certainly would be exciting if that were the case.
However, I don鈥檛 recommend taking the medication outside of a study situation, as metformin has several possible side-effects. It may cause nausea and GI upset. It may indeed lower blood sugar, which seems to happen far more often than it is supposed to, in my experience using it in people with mild diabetes. And very rarely, but seriously, it can cause potentially fatal lactic acidosis, especially in people with kidney disease.
My guess is that you are more likely to improve your length and quality of life with your tennis and bridge than with metformin, but I would love to see metformin proven effective.
Dear Dr. Roach: Yogurt seems to be touted as a 鈥渕iracle food鈥� due to the probiotics. Is it good for our gut? If so, how do I know which one to eat?
M.M.S.
There are no miracle foods. The best diet has plenty of diversity, lots of fruits and vegetables, the right amount of healthy fats and adequate protein.
Yogurt is a good calcium source, and some yogurts have live bacteria that can improve symptoms of irritable bowel in some people. Yogurt is not necessary for good health, and not everybody who uses yogurt for symptoms of diarrhea, constipation or cramping will get benefit from it.
However, if you choose to try it, I would recommend a plain, low-fat or nonfat yogurt that has live yogurt cultures, of which there are many brands. I recommend adding a little honey or fruit preserves to plain yogurt if you like to sweeten it 鈥� it tastes much better than most presweetened yogurts, and it has far less sugar if you use a small amount.
Dear Dr. Roach: In a recent column, you stated that bacteria are not present on toilet seats. I am a 60-year-old woman who contracted genital herpes back in 1977 (a year after I was married).聽 I had never been with anyone but my husband, and he didn鈥檛 develop it until a year after I did. So all these years, I believed I had picked up the virus from a toilet seat
L.D.
I am sorry, but it鈥檚 very unlikely that's the case. Neither bacteria nor viruses are present on toilet seats in high numbers, and it would be improbable for you to acquire an infection that way. 聽
Genital herpes often has no symptoms but may still be transmissible, and one likely explanation is that your husband had acquired the virus before you married. It could have been years before, and he may never have known until he had his first outbreak back in 1978.
Although HSV-2 is the most likely cause of genital herpes, by far, I have seen several cases of women with outbreaks of genital herpes from HSV-1. That is also a possibility for you.
Dear Dr. Roach: I have been taking EDTA for about 10 years for the chelation effect. My question is whether you think it would be more effective if taken on an empty stomach, or after meals?
D.
Plaque, the material inside arteries that blocks blood flow, is made out of cholesterol and calcium. The major theory behind chelation is that the calcium can be removed from the plaque by introducing a molecule into the bloodstream (EDTA) that binds to calcium, and removes it from the artery, improving blood flow. However, this mechanism hasn't been proven.
Oral EDTA has never, to my knowledge, been evaluated, let alone been proven effective, for heart disease, and may cause more harm than good. I do not recommend oral EDTA treatment to prevent or treat heart disease, neither before meals nor on an empty stomach. 聽
However, a 2013 trial with intravenous EDTA showed about a 3.5 per cent reduction in cardiac events, mostly in the need for surgery or angioplasty. The study was severely criticized, and the benefit was limited to people with diabetes. Ultimately, the authors noted that 鈥渢hese results provide evidence to guide further research but are not sufficient to support the routine use of chelation therapy for treatment of patients who have had a myocardial infarction.鈥� I agree. IV chelation therapy is not an appropriate standard therapy, but it may deserve more study. 聽
Dear Dr. Roach: In a recent column, you imply that taking folic acid in the presence of B-12 deficiency could be a problem. Please clarify this and explain exactly what you mean.聽 I usually have a borderline B-12, and I take folic acid daily. Am I causing harm to myself?
P.A.M.
In people with an undiagnosed B-12 deficiency who also have low folic acid, taking a folic acid supplement can cause the production of red blood cells to accelerate, which further depletes the B-12 stores. Very low vitamin B-12 can cause serologic and psychiatric complications, and many physicians check B-12 levels before starting on folic acid. If B-12 is low, supplementation of B-12 before starting folic acid should prevent this complication.
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].
