Dear Dr. Roach: Please look into citrus bergamot. It is a beneficial supplement that lowers cholesterol very efficiently and effectively. It lowered my cholesterol by 70 points.
R.M.
You are right. The early data suggest that bergamot may be effective at improving cholesterol results. This was found in people who are resistant to statins and in people with the common metabolic dysfunction-associated steatotic liver disease.
The results you saw are certainly dramatic. However, I have seen many promising treatments for cholesterol fail in large trials. Not only does the product need to be proven to lower cholesterol, it needs to be proven to do so with a high degree of safety. Most importantly, it needs to have a real benefit to the person taking it, meaning it reduces their risk of heart attacks, strokes, or death well enough that it makes taking the product worthwhile.
A 2023 study compared a statin (low-dose rosuvastatin) to a placebo, fish oil, cinnamon, garlic, turmeric, plant sterols, and red yeast rice. None of these supplements lowered cholesterol compared to the placebo. Sadly, bergamot was not included.
It may be that in larger trials, bergamot will prove to be a safe and effective means of lowering cholesterol and preventing heart disease. I’m waiting until then to prescribe or recommend it, and with my high-risk patients, I will continue to discuss the risks and benefits of statins.
Dear Dr. Roach: I had a total hip replacement 10 years ago and had no problems afterward. However, I have fallen four times since then, with the latest being in March of this year. Now my thigh bothers me, and my foot wants to turn in a way that makes walking difficult. Could I have damaged my implant?
R.B.
It is unlikely that you damaged the prosthesis, which is extremely hard and durable. However, it is possible that you have a long-term complication of the prosthetic, such as loosening of the prosthesis, which is caused by years of wear. This has been said to occur in about 1% of cases per year, but newer prostheses and better techniques have reduced this incidence. I hardly ever see my patients require a new hip because of this problem.
Certainly, a visit to your surgeon is in order, and they are likely to do a careful exam and X-rays. I suspect that the problem may not be the prosthesis at all. There are many common problems that might be affecting your gait, including your other joints, like the knee. If you had arthritis of the hip that required surgery, you might have knee arthritis as well. If they aren’t able to find a specific issue, it may be that physical therapy is in order to help you relearn how to walk and reduce your falling risk.
There are many interventions that can help reduce the risk of a fall, and they are more important once a person has had multiple falls. Strength training and balance exercises (such as tai chi) have been proven to reduce falls. Your regular doctor should also carefully review any medicines you take, as different medicines can increase the risk of falls.
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]
