March 12, 2007
People in pain are caught between a rock and a hard place. On the one hand, they have to deal with sore joints or chronic back problems that make it hard to enjoy everyday activities. On the other hand, the pain relievers they count on to ease their discomfort pose serious risks.
We have known for decades that nonsteroidal anti-inflammatory drugs (NSAIDs) can be irritating to the digestive tract. That’s true whether someone is taking a prescription like diclofenac (Cataflam or Voltaren) or an over-the-counter pain reliever such as ibuprofen (Advil, Motrin) or naproxen (Aleve). Regular use may lead to life-threatening bleeding ulcers.
Vioxx and Celebrex were supposed to be safer for the digestive tract. But when Merck revealed that Vioxx increased the risk for heart attacks and strokes, scientists started looking at all pain relievers. What they found is deeply disturbing.
Researchers who studied nearly 100,000 people between 2000 and 2004 found that those taking Vioxx were more likely to suffer heart attacks than those taking no pain relievers. Those taking ibuprofen were 24 percent more likely and those taking diclofenac were 55 percent more likely to have heart attacks (British Medical Journal, June 11, 2005).
A new study just out may offer one possible explanation (Archives of Internal Medicine, Feb. 26, 2007). Investigators followed 16,000 male health professionals for four years. Those who regularly took pain relievers had a greater likelihood of being diagnosed with high blood pressure.
Men taking NSAIDs six or seven days a week had 38 percent greater risk of hypertension. Those who took acetaminophen (Tylenol) often had a 34 percent higher chance of that diagnosis.
Most people assume that acetaminophen is relatively safe since it is unlikely to cause stomach irritation. But the new finding that it, too, might affect blood pressure means that people in pain have no easy options.
Even aspirin may pose a risk. Although it helps protect men and women from heart attacks, the male health professionals who took aspirin daily were also one-fourth more likely to have elevated blood pressure than those who took nothing.
For those without any risk of heart disease, such drugs may offer more benefit than harm as long as blood pressure is carefully monitored. But 65 million Americans have hypertension, and most do not control it adequately. For them, relying on acetaminophen, ibuprofen or other popular pain relievers could promote this “silent killer.”
Hypertension increases the risk of heart attacks, strokes, kidney disease and dementia. Treating it with medication while you are taking a pain reliever may be a little like running up stairs with lead overshoes.
The American Heart Association has responded to the new research with a recommendation that physicians first try non-drug treatments for their patients in pain. They suggest physical therapy, exercise, weight loss and heat or cold therapy.
To learn more about other non-drug approaches such as vitamin D, fish oil, glucosamine and chondroitin, cherry or pomegranate juice, magnets and anti-inflammatory herbs, consider Best Choices From The People’s Pharmacy (Rodale Books).
THE PEOPLE’S PHARMACY
Q: I read about the woman whose mother was diagnosed with dementia while taking Darvocet. My mother was also given Darvocet while hospitalized. Overnight she became disoriented and suffered hallucinations.
The doctors claimed this was because she was depressed, but after three days they took her off the medicine. Almost overnight she was back to her normal lucid self.
A: Propoxyphene is an ingredient in both Darvon and Darvocet. Some people are very sensitive to potential side effects such as hallucinations, dizziness, confusion and drowsiness. Older people are especially susceptible, and doctors have been advised to use other pain relievers for them.
Q: My lips are constantly dry, so I use ChapStick repeatedly. The relief is short-lived, though. I seem to be addicted to ChapStick. Is there a safe alternative?
A: Most dermatologists deny that lip balms such as ChapStick pose problems. They suggest that people continue to use lip moisturizers because moist lips feel better. They often blame dry lips on repeated licking.
Some consumers insist, however, that this is a real addiction. There is even a Web site called Lip Balm Anonymous devoted to the controversy.
To cut back on lip-licking, you might try a moisturizer that tastes bad to you, such as castor oil.
We heard from a woman who found that a lanolin-containing product for breast-feeding mothers works as an alternative: “I started to use it on my lips instead of ChapStick, and I have not had dry lips since. A little goes a long way, as it is very thick and does not wear away easily.”
Q: I have been taking Effexor for depression for nearly a year. I have noticed that if I miss a day or two, I feel extremely unwell both mentally and physically. It makes me a little worried to think I am so dependent on this prescription.
I have expressed these concerns to my doctor, and she basically says I am “married” to this drug because of my chemical imbalance. Should I worry about becoming dependent?
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A: Effexor can be an effective antidepressant, but stopping it suddenly (even for just a day) can trigger uncomfortable withdrawal symptoms. Others have reported dizziness, nausea, sweating, chills or anxiety if they stop an antidepressant abruptly.
We discuss the these problems in greater depth in our Guides to Psychological Side Effects and Antidepressant Pros and Cons. Anyone who would like copies, please send $2 in check or money order with a long (No. 10), stamped (63 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. MX-23, P.O. Box 52027, Durham, NC 27717-2027.
There is no reason to worry about continuing on an antidepressant that is working. If you have to stop, however, you will need to do this very gradually under medical supervision.
Q: Can eating ice, literally all day long, be harmful to my health? A couple of months ago I suddenly developed an intense craving for ice, and now I start eating crushed ice first thing in the morning and do not stop until bedtime. What could have caused this?
A: Check with your doctor and ask to be tested for anemia. Sometimes a deficiency of iron or zinc will lead to a strong craving for ice or other unusual items that aren’t normally in your diet. Correcting the deficiency may banish the craving.
THE PEOPLE’S HERBAL PHARMACY
Q: I’m 52, and since I was a teenager I’ve had various degrees of dry skin or, as my dermatologist puts it, “atopic dermatitis.” He tells me it is genetic and stress-related.
The skin on my hands dries out, peels off, splits and cracks. As one area heals, another area splits. I’ve tried an assortment of hand creams, lotions and ointments from Avon or Burt’s Bees to petroleum jelly and prescribed steroid creams. Nothing really seems to do the trick. At times I even sleep with greased-up hands in white cotton gloves. Do you have any recommendations?
A: Dealing with the dry skin of atopic dermatitis is a challenge. Japanese researchers reported benefit when they had patients with hard-to-treat atopic dermatitis drink three to four cups of oolong tea (a liter) daily (Archives of Dermatology, January 2001). Anti-inflammatory compounds in the tea may account for this effect.
Another approach comes from readers: “Someone wrote in about using a vinegar/water mixture (2/3 white vinegar and 1/3 water) for dried, chapped hands. Each winter my hands would get terribly dry and the tips of my fingers would crack and bleed. It was so painful.
“I dipped my hands in the vinegar and water mixture daily. I left it on for about a minute, then rinsed it off. I only had three cracks on my fingertips all winter. That reader earned my thanks!”
The reader who first reported using this remedy keeps a spray bottle of the mixture in the shower to apply to hands and feet.
Q: I used your Certo remedy for arthritis with my beloved Rachel Dog for seven years. She thrived without side effects and was as pain-free as her debilitating arthritis would allow for the duration. I am a believer!
A: We are glad the remedy worked for Rachel Dog, but we don’t recommend this approach for other dogs. There are several cases in the veterinary literature of grapes and raisins causing kidney damage in dogs (Journal of Veterinary Internal Medicine, September-October 2005). Because the remedy calls for Certo, a plant pectin used in home canning, to be dissolved in grape juice, we cannot be sure this is safe for dogs.
There is no research proving that Certo dissolved in grape juice will ease arthritis pain in people, but many readers tell us that it is helpful. We describe this and the gin-soaked raisin remedy, along with other non-drug approaches to common ailments, in our Guide to Home Remedies. Anyone who would like a copy, please send $2 in check or money order with a long (No. 10), stamped (63 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. R-1, P.O. Box 52027, Durham, NC 27717-2027. It can also be downloaded for $2 from our Web site: www.peoplespharmacy.com.
Q: Many people have horrible leg cramps and cannot take quinine because it is being taken off the market. I am 70 years old and have suffered with leg cramps all my life. Years ago, I used to take OTC quinine tablets. Quinine water never worked for me.
A long time ago, I found that 250 mg tablets of magnesium at bedtime worked like a charm in warding off leg cramps and restless leg syndrome.
A: Others have also reported that magnesium may be helpful against leg cramps. Taken before bedtime, it might also help insomniacs fall asleep. Too much can cause diarrhea, though, and can also be dangerous for people with kidney problems.
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