Tri-State Neighbor: South Dakota Farm Newspaper

Q:I was prescribed Advair for asthma. It worked well for my breathing problem, but my skin became thin, and I started bruising badly. Then I experienced horrible damage to my skin, with deep gashes from a slight bump. One day, I leaned on the bathroom counter, and several inches of the skin on my arm peeled off.

My lung specialist insisted Advair was not responsible for thinning skin. I asked my pharmacist, “Have you ever seen anything like this?” She looked at my bruises and said, “It could be from taking steroids.”

She checked my meds and told me Advair contained a steroid. I spoke to my doctor, but he still said it was not the medication. I switched to another clinic and got a different asthma medicine, Serevent. My healthcare provider, a nurse practitioner, told me she had seen a few others whose skin reacted as mine did. After several weeks off Advair, my skin returned to normal, and I no longer have bruises or serious gashes.

A:We're surprised the specialist you consulted was unaware that Advair can affect the skin. The official prescribing information lists bruising and wounds as potential adverse reactions.

The steroid in the asthma inhalers Advair and Flovent is fluticasone. Although not as risky as oral prednisone, there can be some systemic side effects with this drug. Higher risks of cataracts, glaucoma and pneumonia have been reported with long-term use.

Q:I have an underactive thyroid and take Synthroid. After three years, I do not feel any better.

I asked my doctor if I could try an alternative to Synthroid like Armour Thyroid. She told me she prefers the synthetics over the natural form. I was surprised by that because many people seem to do well on it.

I feel that adding T3 from the natural product might help, but I do not think my physician is going to be willing even to try it. Do you have more info on treating thyroid problems if Synthroid is not working well?

A:If you experience symptoms such as fatigue, depression, hair loss, constipation, puffy eyes, dry skin and brittle nails, you may indeed be suffering from too little thyroid hormone. Although the research is controversial, some people report feeling better when they get a mixture of T3 and T4 forms of thyroid hormone. Synthroid contains only T4 (levothyroxine).

Dried thyroid glands have been used for more than 100 years, before the FDA existed. Doctors may prescribe Armour or other natural thyroid preparations.

Q:I heard that eating an Atkins diet could raise good HDL levels. Surely that is not true. Presumably all that saturated fat raises bad cholesterol even more.

A:In a recent study (New England Journal of Medicine, July 17, 2008), a low-carb, Atkins-style diet resulted in higher good HDL cholesterol and lower triglycerides than a standard low-fat diet. Bad LDL cholesterol was not significantly different.

Q:An elderly relative was struggling with insomnia and tried Tylenol PM. She took it for several days and developed severe psychological side effects, including hallucinations. Not only was she spaced out and confused, it made her sleeping worse.

My doctor said that PM sleep aids are bad for older people. After we stopped her medication, my relative recovered. Can you suggest some natural approaches to help her get some sleep?

A:Allergy medicine such as Benadryl and nighttime pain relievers like Advil PM, Excedrin PM and Tylenol PM all contain the antihistamine diphenhydramine. This drug may cause memory problems, confusion or delirium in the elderly (Archives of Internal Medicine, Sept. 24, 2001).

Safer sleep aids may include acupressure, magnesium, melatonin or herbs like lavender, lemon balm or passionflower.

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