Health Advice



Recreational tianeptine has potential for abuse, overdose

Health Advice / Keith Roach /

DEAR DR. ROACH: I've been hearing about tianeptine being sold at gas stations. Is it really dangerous? -- S.F.

ANSWER: Like so many substances, tianeptine can be a useful drug when prescribed and taken correctly (it's used in several countries for depression), but is indeed dangerous when used recreationally. Its use has been banned in several ...Read more

New medication for Type 2 diabetes has so far proven safe

Health Advice / Keith Roach /

DEAR DR. ROACH: Please give me your opinion on the drug Rybelsus. It is advertised on TV as a wonder drug to reduce the A1C count for diabetics. My last A1C level was 6.8. My only problem with taking Rybelsus is that, in the package insert (or medication guide), it reads "not recommended as the first choice of medicine for treating diabetes." ...Read more

Understanding peak versus trough levels when dosing meds

Health Advice / Keith Roach /

DEAR DR. ROACH: My doctor invariably prescribes four 200 mg Advils (ibuprofen), to be taken three times every 24 hours for a few days. I suspect this will create useful peaks, but also create unwanted troughs, compared to taking a smaller dose more frequently that results in the same aggregate dose every 24 hours.

My suspicion is that they are ...Read more

Statins recommended in cases where benefit outweighs risk

Health Advice / Keith Roach /

DEAR DR. ROACH: I'm a 74-year-old woman with good cholesterol numbers and normal blood pressure. I've exercised regularly since I was 17 (that's 57 years), and weigh 98 pounds. I have no history of heart attack or stroke. Still, my doctor is giving me a strong sales pitch to take a statin with no mention of potential harsh side effects and no ...Read more

Salt substitutes help reduce blood pressure, stroke and more

Health Advice / Keith Roach /

DEAR DR. ROACH: I have read that dietary potassium is very important in reducing heart disease risk, along with reducing sodium. I use a potassium-based salt replacement at home. Is there a maximum amount I should use? Why don't restaurants offer salt substitutes for people who want to reduce sodium and heart risk? -- T.S.

ANSWER: I think you ...Read more

Statins and thiazides can increase blood sugar, risk of diabetes

Health Advice / Keith Roach /

DEAR DR. ROACH: My question regards the results of my fasting glucose tests for the past couple of years. I am 81 and weigh around 150 pounds. The medications I am taking concern me, with relevance to the A1C levels of my quarterly blood work. My A1C levels have mostly been near mid 5%; last was 6%. Medications relevant to this that I am ...Read more

Explaining monoclonal gammopathy of uncertain significance

Health Advice / Keith Roach /

DEAR DR. ROACH: Would it be possible for you to explain my recent diagnosis of monoclonal gammopathy of uncertain significance (MGUS)? Apparently, 3% to 5% of the population over the age of 50 show this blood abnormality. My last M-Spike result was 0.2 g/dL. -- A.M.P.

ANSWER: By definition, MGUS has no symptoms, so many people get the diagnosis...Read more

No delay necessary in getting a mammogram after vaccination

Health Advice / Keith Roach /

DEAR DR. ROACH: I recently had a COVID booster. Not even considering that the vaccine might impact my annual mammogram, I had my mammogram done the day after my vaccine. I had no ill effects from the vaccine. I was not advised against having the mammogram so soon after the vaccine. Because of a concern with my lymph nodes, dense breast tissue ...Read more

Sleep problem persists for over two decades

Health Advice / Keith Roach /

DEAR DR. ROACH: For over 20 years, I have experienced difficulty with getting enough sleep at night. I typically get between five and six hours of sleep per night. I fall asleep quickly at about 10 p.m., but wake up between 3:30 a.m. and 5 a.m., unable to fall back asleep.

I have tried various sleep medications over the years, including over-...Read more

Treating hearing loss in Meniere's disease versus SSNHL

Health Advice / Keith Roach /

DEAR DR. ROACH: You recently answered a question from a reader with a friend who had sudden hearing loss with tinnitus after experiencing vertigo and dizziness. You attributed the hearing loss to sudden sensorineural hearing loss (SSNHL). I have been dealing with Meniere's disease for over eight years, and the symptoms you described are ...Read more

High doses of vitamins lead to vitamin D toxicity

Health Advice / Keith Roach /

DEAR DR. ROACH: I have been diagnosed with vitamin D toxicity, according to the blood work from a month ago -- my result was 122 ng/mL. I was taking high doses of vitamin D3 in pill form (15,000 IU a day for three years) bought from a drugstore. I have stopped taking it, but I need to know how long it will take to have a normal amount in my body...Read more

Zinc supplements don't show much benefit for prostate issues

Health Advice / Keith Roach /

DEAR DR. ROACH: I am taking terazosin and finasteride for my enlarged prostate. A friend has suggested taking zinc supplements and eating pumpkin seeds for additional zinc intake. Is there any proof that taking additional zinc will reduce the size of the prostate? -- K.O.

ANSWER: There are some theoretical reasons, based on animal studies and ...Read more

Looking at the risks of taking hormone replacement therapy

Health Advice / Keith Roach /

DEAR DR. ROACH: One has to wonder which is worse for longevity: living a life without sleep, the ticking time bomb of hormone replacement therapy (HRT), or prescription sleep meds?

I am a 71-year old woman who began having insomnia and sleep issues when I went through menopause in my mid-40s. Sleep has been a difficult struggle for over 30 ...Read more

Meds for restless leg syndrome can worsen IBS symptoms

Health Advice / Keith Roach /

DEAR DR. ROACH: Could you please give me some information regarding irritable bowel syndrome? I am taking carbidopa/levodopa for restless leg syndrome. I also take Unisom to help sleep onset. Do the meds I'm taking have any relationship to the IBS? I went through a stressful time lately and wonder if it could be related to the IBS. -- S.P.

...Read more

Not getting enough iodine is rarely a concern in the U.S.

Health Advice / Keith Roach /

DEAR DR. ROACH: I notice that the specialty salts I now buy, such as Himalayan or sea salt, are not iodized. Should I be concerned about getting enough iodine in my diet? -- P.M.

ANSWER: Iodine is necessary to make the thyroid hormones. In the United States, the areas with the least iodine are the Great Lakes, Appalachians and Pacific Northwest...Read more

Case of hot flashes has yet to be resolved, despite therapy

Health Advice / Keith Roach /

DEAR DR. ROACH: I am 78 years old. I had a hysterectomy in 1976 due to excessive vaginal bleeding, but I still have my ovaries. I have had hot flashes since undergoing menopause -- they usually last three to five minutes, and I have them about every two hours around the clock (which obviously interferes with my sleep).

Over the last 28 years, I...Read more

Can melatonin provide benefits to those with Parkinson's?

Health Advice / Keith Roach /

DEAR DR. ROACH: I am an 84-year-old woman. Unfortunately, I have been diagnosed with Parkinson's disease this past month. (Of course, I am mightily researching now.)

A friend of ours, who has had Parkinson's for six years, is very much impressed with melatonin. Have you heard the same?

Even if it turns out that it is not all helpful for ...Read more

Patient with high PSA score refused by urologist due to age

Health Advice / Keith Roach /

DEAR DR. ROACH: I'm writing to you about an elderly patient who is currently 96 years old. For the last three years, his PSA score for his prostate has hovered around 30 ng/ml. He initially received an ultrasound and was determined that the prostate looked normal, despite the high PSA score. The general physician, under the following ...Read more

Shingles complication might require different drug combos

Health Advice / Keith Roach /

DEAR DR. ROACH: Is there anything that I can do for pain after having shingles? I had shingles 18 months ago, and I still have pain on my right side in my breast and arm. I took gabapentin, plus two other prescriptions, and they all upset my stomach so bad that I had to quit. I have used lidocaine patches, but they help very little.

Some days, ...Read more

Supplements over statins not recommended for cholesterol

Health Advice / Keith Roach /

DEAR DR. ROACH: I am a 71-year-old female in good health who is quite physically active. I have been taking red yeast rice with CoQ10 to help with my cholesterol levels. (My son-in-law, who is a chiropractor and pretty knowledgeable about supplements, suggested this to me.) My cholesterol levels are still somewhat high, but my doctor has not ...Read more



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