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Say 'Aaah' | The People's Pharmacy

Safer Than Smoking, Gum With Nicotine Still Has Risks

May 08, 2000|Joe Graedon and Teresa Graedon | Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert

Question: My fiance has been addicted to about every form of tobacco there is. Last year, he agreed to try to quit and started chewing Nicorette gum to help.

Now he's addicted to the gum. I guess this is better for him than inhaling smoke, but I've been unable to find out if there are any bad effects from prolonged use of this gum. He chews about six pieces a day.

Can you give me any information about the possible effects on his health?

Answer: Some people do have a very hard time giving up nicotine, whether it comes from tobacco products or chewing gum. Although a nicotine patch or chewing gum is far safer than smoking, there are potential side effects. Stomach upset, nausea, indigestion, diarrhea, headache and heart palpitations are possible.

Gradually reducing the amount of Nicorette he uses should eventually allow him to get off the gum. If this is too difficult, switching to a nicotine patch and then phasing out its use might help make this process easier.

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Q: Can cholesterol medicine affect your mood? My doctor first prescribed Zocor and then switched me to Lipitor. It brought my cholesterol down to below 160, but I feel depressed, and I wonder if my medicine could be the cause.

My doctor thinks there's no connection and is ready to prescribe Prozac. The pharmacist said depression could be a possible side effect of Lipitor. Can you give me any information on this?

A: Cholesterol-lowering drugs such as Lipitor, Zocor or Pravachol occasionally cause depression in some people. It is not clear, however, if this is a direct consequence of the medication or if it results from lowering cholesterol too far. A recent large study in the Netherlands found that men with very low cholesterol were more likely to experience symptoms of depression.

Psychological side effects can be insidious. They can be triggered by a wide range of medications, from steroids like prednisone to certain antibiotics, such as Biaxin or Floxin, or blood pressure pills such as propranolol or metoprolol.

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Q: About two months ago, I started taking Celebrex for arthritis pain. It really helped, but while I was on it, my breasts--and especially my nipples--started to hurt so badly that I couldn't touch them or even put on a bra.

I didn't connect this problem to Celebrex at the time. When the prescription ran out, I didn't renew it right away. I wanted to find out if the pills were working.

The pain in my hips returned, but the tenderness in my breasts lessened tremendously. Three days ago, I went back on the Celebrex and my breasts are once again screaming. What's the connection?

A: We can't explain it, but breast pain has been reported by some patients taking Celebrex. We don't know if a different medicine such as Vioxx would be any better for you. Please discuss this issue with your physician.

Alternatives

Q: I've had severe arthritis since I was 19, more than 48 years ago. I've been treated with dozens of drugs, but they have no effect, help for only a few months or cause allergies. Just one Motrin almost killed me.

A doctor suggested I try hot pepper. Now I chop peppers into a coarse relish, soak them in white vinegar for three weeks to kill the pepper taste and eat a tablespoon or two several times a week with meals. With the hot pepper, I take two regular-strength Tylenol in the morning and two at bedtime. Before, I needed as many as eight 500-milligram Tylenol tablets a day. I hope this helps someone else.

A: There are two possible explanations for your positive experience with hot peppers. The ingredient that makes chili peppers hot, capsaicin, interferes with the breakdown of acetaminophen and might increase its levels. This could explain why you get the same benefit from a lower dose of Tylenol (acetaminophen).

Capsaicin has been used in topical treatments for arthritis for decades. None of these liniments and rubs are cures, but some people find they help ease pain. We haven't heard before of eating hot peppers to get the same benefit of arthritis pain relief, but we are pleased to know that it can be helpful.

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Q: Thank you for suggesting sauerkraut juice to get rid of canker sores. I have been troubled with canker sores all my life, and since I've started rinsing with sauerkraut juice I've had very few.

A: We first heard about using sauerkraut juice to treat canker sores from D.W. in Garland, Texas. His mother had been a dental assistant in the 1930s. The dentist she worked with told his patients with canker sores to swish the mouth with sauerkraut juice several times during the day, then swallow about a tablespoon.

Since then we have heard from people such as yourself that it can provide rapid relief. One physician who benefited arranged for analytical testing of sauerkraut juice and discovered a number of active compounds that might be responsible for its healing properties.

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Q: What can you tell me about gas and constipation? I have suffered with the embarrassment of digestive noises for longer than I care to admit.

I eat cereal with bran, drink at least eight glasses of water daily and take psyllium. Nothing has helped.

A: The bran and psyllium might be contributing to your gas problems. While good sources of fiber, they can create flatulence.

Flaxseed might help with both the constipation and gas. Fennel seed has also been shown to help reduce flatulence. Make a tea with a teaspoon of crushed seeds.

Other approaches to gas include using Beano or avoiding foods that produce gas, such as cabbage, cauliflower, beans, broccoli and onions.

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Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their column runs every Monday. Send questions to People's Pharmacy, King Features Syndicate, 235 E. 45th St., New York, NY 10017, or e-mail pharmacy@mindspring.com.

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