Insurance Rejection Does Patient Favor on Niacin Use

Q. I recently applied for life insurance and was rejected, even though I’m in very good health. I keep my cholesterol down with regular exercise and niacin. My blood pressure’s fine, and I don’t need any medicine. But they said my liver enzymes were too high.

I’ve never had any trouble with my liver and I am not a drinker. The insurance physical was done when I was getting over the flu. Could the Tylenol I took while I was sick affect liver enzymes?

I’m afraid that when I apply for insurance again they will ask me if I’ve been turned down for life insurance before and hold this against me.

Please help me figure out what is going on.

A. The insurance company did you both a favor and an injustice. The favor was that they discovered a potentially serious problem. The niacin that you rely on to control your cholesterol can elevate liver enzymes. So can Tylenol (acetaminophen).

Have your doctor recheck your liver function and reevaluate your niacin dose. Stay away from acetaminophen until your liver enzymes return to normal.

The medical personnel at the insurance company should be told your liver problem may have been caused by over-the-counter medications. You should be allowed to reapply for insurance if your test results normalize.

A surprising number of drugs elevate liver enzymes, including many cholesterol-lowering medications, antibiotics, arthritis drugs and blood pressure pills.

Q. My 3-year-old daughter has had two urinary tract infections over the past year and I worry that her kidneys could be damaged. I can’t always tell when she starts having trouble but I can’t afford to take her to the doctor every week or so for a test.

Is there a safe antibiotic she could take regularly until she gets over this problem?

A. Although some doctors do prescribe a preventive antibiotic regimen, your daughter may not need this.

There are urine tests that are easy to use at home. You can buy Microstix-Nitrite Reagent Strips or Biotel u.t.i. home screening tests for urinary tract infections.

If they show an infection, contact your doctor immediately.