Q: Now that I am on Crestor, would it be OK if I eat eggs? I have been avoiding them for years because my cholesterol was high.
My doctor also is suggesting a low-carb diet because my blood sugar is creeping up. That’s a big switch from my low-fat diet.
A: Even if you were not taking Crestor (rosuvastatin) to control your cholesterol, it is unlikely that eggs would pose a great risk. A meta-analysis of large long-term studies concluded: “Higher consumption of eggs (up to one egg per day) is not associated with increased risk of coronary heart disease or stroke” (BMJ online, Jan. 7, 2013).
Statins like Crestor can sometimes raise blood sugar or even trigger diabetes in susceptible individuals. A low-carb diet is sensible in this situation, though it may not overcome the drug effect. You can learn more about nondrug approaches to heart health in our book, “Best Choices From The People’s Pharmacy” (online at www.PeoplesPharmacy.com).
Q: My sister-in-law said she took too much naproxen for pain over an extended time. It damaged her liver, and now she is afraid to take any NSAID.
I’ve found fish oil and turmeric great to manage my arthritis pain without the risk of long-term heavy NSAID use. Is the mechanism by which fish oil and turmeric reduce inflammation likely to cause a problem like the one my sister-in-law experienced?
A: Liver damage is considered a relatively rare side effect of NSAID-type pain relievers such as ibuprofen, naproxen and diclofenac. So many people take these medicines for chronic pain, however, that many cases of liver injury are now attributed to NSAID use.
We could find no evidence that fish oil or curcumin, the active ingredient in turmeric, harms the liver. In fact, research in animals suggests that either of these dietary supplements might help protect the liver against chemically induced damage (Evidence Based Complementary and Alternative Medicine online, July 17, 2013).
Q: I learned from analysis of my DNA that I cannot efficiently metabolize many medications. It’s unfortunate that our doctors don’t usually recommend this type of testing that could help so many.
I took the initiative and paid for the testing myself. It has paid off many times over. My guess is that some people who experience severe side effects from their medicine have a similar DNA structure that makes them poor metabolizers (low or inefficient CYP2D6).
A: The enzyme known as cytochrome P450 2D6 helps to metabolize approximately one-fourth of the drugs in common use. There is a lot of genetically determined variability in the amount of this enzyme we make. Some people churn out lots, and are able to clear these drugs from their bloodstream quickly. Others make little or none. When they take such a medication, blood levels may be high for a longer period of time, leading to a higher risk of side effects.
Since you know your genetic profile, you should ask your doctor to check on any new prescription to see if it is metabolized by CYP2D6. Some of the drugs affected include antidepressants (fluoxetine, paroxetine, sertraline, venlafaxine), powerful pain relievers (hydrocodone, oxycodone, tramadol), beta blockers (carvedilol, metoprolol, propranolol) and the cough medicine dextromethorphan (the DM in OTC cough syrup).
Joe and Teresa Graedon answer letters from readers. Email them at their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”
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