Tri-State Neighbor: South Dakota Farm Newspaper

Q:I've had extreme chronic pain in my lower back, pelvis, hips and legs for nearly four years. Lying flat was agony, so I had to sleep propped up on a love seat.

I went to many doctors who said there was nothing wrong with me. Then I found a rheumatologist who checked my vitamin D and found it was extremely low.

I've been taking 1,600 IUs of vitamin D a day and have been feeling much better and happier. At this rate, I think I'll be about back to normal in six months. It's terrible that anyone should suffer for so long from this. If in doubt, get your vitamin D checked.

A:Vitamin D deficiency is common and is often underestimated as a cause of chronic pain. Low levels of this vitamin can contribute to arthritis, cancer, diabetes, osteoporosis and high blood pressure. In a high-tech society where most people work indoors and wear sunscreen whenever they are outside, vitamin D insufficiency may be far more common than most doctors suspect.

Q:As a dermatologist, I am dismayed by your article suggesting that milk of magnesia could treat cystic nodular acne. This is not a recommended treatment, and the false belief that it might be helpful could cause great harm by delaying proper treatment.

Accutane will cure acne when used properly for eight to 10 months. Keeping the dose low can prevent side effects.

I am willing to bet that the person who said the milk of magnesia worked better than prescribed treatment was making this up or did not see a dermatologist for appropriate care.

A:The mother who contacted us said that her son had been under dermatologist's care for many years, and the thousands of dollars they had spent had not cleared his condition. She was pleased that the milk of magnesia applied to his face at bedtime had been helpful.

This home remedy has not been tested for acne and might not help other people. Nevertheless, it is inexpensive and accessible.

Accutane has been a revolutionary treatment for cystic acne. It is, however, quite expensive and highly controversial.

Some side effects listed in the prescribing information include depression, suicidal thoughts, aggressive behavior, inflammation of the pancreas, hearing loss, inflammatory bowel disease, high triglyceride, hair loss, dry lips and itching.

Physicians are specifically warned not to prescribe Accutane for more than five months at any one time. “Long-term use of Accutane, even in low doses, has not been studied, and is not recommended.”

Q:I am alarmed by recent reports that Vytorin and Zetia are associated with plaque buildup in the carotid artery. My doctor tells me that until more is known, I should continue taking the prescribed medicine. Do you agree? Is it harmful to switch abruptly to another cholesterol-lowering medicine such as simvastin?

A:In the wake of the ENHANCE study that produced such disappointing results with Vytorin, the American College of Cardiology convened an expert panel to advise their colleagues. These thought leaders suggest that doctors should stick with statin-type cholesterol-lowering drugs, which have a proven track record.

Until there is more convincing data about Vytorin or Zetia, the cardiologist recommend using them only as a last resort. There should be no danger of switching to simvastin since it has been shown to be effective.

Q:I have a history of sleeping problems. I just started taking half an acetaminophen PM tablet just before bed. This allows me to sleep at night. Is this safe?

A:If pain is not an issue, you don't need the acetaminophen. The PM part of the pill is diphenhydramine (DPH). This is the antihistamine found in Benadryl, and it makes people drowsy. At the dose you are using, there should be few, if any, side effects.

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