Q: I have a friend who is 57 and never smoked. She fell and broke her hip a couple of months ago, and now has taken up chewing nicotine gum like it was candy.
I can’t believe nicotine gum, which is for those trying to quit smoking, could be good for her in any way. I told her my concerns and she told me her doctor said it’s fine.
What kind of doctor would think it’s OK to use nicotine? What could chewing the gum do to her health, when she was never a smoker to begin with?
A: We share your concern. Fifteen years ago, animal research demonstrated that nicotine has a negative impact on bone healing (Journal of Biomedical Materials Research, June 15, 1999). That might get her attention, since it takes time for a broken hip to heal. We are as puzzled as you are as to why she would have taken this up.
Q: After reading about antibiotic treatment for asthma on the People’s Pharmacy website, I am now taking azithromycin. My pulmonologist was aware of this treatment and agreed to me trying it.
After four days, I already feel a difference — no inhalers, no chest constriction or shortness of breath, no continual coughing all night. It is like a miracle. Thank you for making me aware of an alternative to the steroid inhalers that were not working for me.
A: Although many pulmonologists are not familiar with this approach, there is increasing evidence that some cases of hard-to-treat asthma result from a persistent infection. Bacteria such as Chlamydia pneumoniae can lurk in lung cells and cause serious inflammation that does not go away.
Eliminating these bacteria takes more than a few days. David Hahn, M.D., M.S., has found that azithromycin is effective in most cases, but it can take 12 weeks or more of once-weekly medication. To learn more about the protocol and the science behind it, you may wish to read “A Cure for Asthma? What Your Doctor Isn’t Telling You — and Why,” written by Dr. David Hahn and published by People’s Pharmacy Press.
Q: Earlier this year, I heard that ibuprofen can contribute to heart disease, but I’ve heard no more about this. Are you aware of any information about this?
I also have heard that ibuprofen use can block the benefits of low-dose aspirin. Is that true?
Do you have any recommendations for OTC analgesics? As a dentist, I want to make the best recommendation for my patients.
A: There isn’t much difference in pain relief from aspirin, ibuprofen or naproxen. Our choice for occasional, temporary pain relief is aspirin for those who can tolerate it and acetaminophen for those who cannot. Regular use of a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen can increase the possibility of a heart attack (Basic and Clinical Pharmacology and Toxicology online, April 25, 2014) and counteract the heart-healthy effects of low-dose aspirin (Thrombosis and Haemostasis online, Dec. 13, 2012).
Naproxen may be somewhat less likely than ibuprofen to contribute to cardiovascular risk. NSAIDs such as ibuprofen and naproxen (as well as diclofenac and other prescription pain relievers) raise the risk of a heart-rhythm disturbance called atrial fibrillation (BMJ Open online, April 8, 2014). NSAIDs also can raise blood pressure, so you may want to ask about antihypertensive medication before recommending one for pain relief (Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, June 2014).
Joe and Teresa Graedon answer letters from readers through their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”
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