When Does a Patient Have Too Many Blood Pressure Prescriptions?
Question: I don’t believe my body can handle all the blood pressure medicines I take. First, my internist prescribed Zestril and Norvasc, together with an aspirin a day. My ankles swelled up and I started coughing, so he switched me to atenolol, Plendil and Prinivil.
Now I become short of breath and tired, but when he did tests there were no heart problems. I am especially concerned because I am so often dizzy and forgetful. He referred me to a neurologist, who couldn’t find anything wrong and suggested that my troubles are caused by my blood pressure medicines.
The neurologist suggested backing off on these drugs, but my internist says they are essential. My blood pressure does fluctuate somewhat but averages about 120/80. I feel I am in a quandary and hope you can give me some advice.
Answer: Doctors don’t always agree on how aggressively to treat high blood pressure. Your internist might be focused on preventing heart disease; your neurologist seems to be taking your dizziness and forgetfulness more seriously.
Tell your internist about the symptoms you are having. Fatigue, forgetfulness and shortness of breath might be drug-related. Your blood pressure is currently in a good range, so he might be willing to reevaluate your regimen.
Dizziness can be more than uncomfortable. A fall could be disastrous. It should be possible to control blood pressure without intolerable side effects.
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Q: I am a 47-year-old male who has smoked marijuana for 30 years. I think I recall reading in your column that this drug can cause breast enlargement in men. If so, will my breasts shrink if I discontinue usage?
A: Breast enlargement in men, called gynecomastia, can be distressing, though it is not usually dangerous. Marijuana and quite a few other drugs, including Aldactone, Calan and Tagamet, have been linked to gynecomastia.
Your breasts might return to their normal shape after you stop smoking marijuana, but 30 years is a long time. If the enlargement persists, see your doctor. Breast cancer is rare in men, but it needs to be ruled out.
Alternatives
Q: I have heard that feverfew, garlic and some other herbs might be helpful for migraine headaches. Since I suffer from these horrible headaches several times a year, I would appreciate any information you can send me.
A: Feverfew is an herb renowned as a deterrent against migraines. In a double-blind study, it proved useful in preventing migraine headaches, and a standardized preparation has been approved for this purpose in Canada. The usual dose is two or three fresh leaves or 125 milligrams of dried herb daily.
Some people taking feverfew develop troublesome canker sores, indigestion or gas. It shouldn’t be discontinued suddenly or combined with Coumadin or other blood thinners.
Magnesium (600 milligrams a day) has also been tested and found effective for migraine prevention. Keep in mind that too much magnesium can cause diarrhea.
If a headache begins, sipping hot, spicy soup might prevent a migraine. An ice pack on the back of the neck can also help by interrupting the blood-vessel dilation that triggers the headache.
If home remedies don’t work, ask your doctor about a “triptan” medication. For many people, these prescription drugs reverse the headache quickly.
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Q: My aunt just had a baby, and right after that came down with arthritis in her wrist. She never takes any kind of medicine, not even Tylenol for headaches, so she won’t take prescribed medicine.
I’m 15, and I love my aunt. Can you help me tell her what to take, like vitamin pills, herbs or home remedies?
A: Over the years people have come up with lots of home remedies for arthritis. Sometimes just soaking the sore joint in warm water will make it feel better. Other popular remedies include gin-soaked raisins, vinegar and honey, or Certo and grape juice. None of these has been studied, but they all help some people.
Herbs that have been used for arthritis include boswellia and curcurmin from India. We have also read of a placebo-controlled trial of stinging nettle. (Lancet, June 3, 2000.) Applying the leaf to the sore joint significantly reduced pain and disability.
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Q: I’m taking aspirin for my heart and ginkgo to help boost my memory. My wife says you have written that this combination is risky. Can you tell me more, so I can decide whether to continue?
A: We worry that ginkgo and aspirin could interact to increase the risk of bleeding. Although there have been several cases of hemorrhage with this combination, there has not been a study to determine the significance of this possible complication.
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Q: My kids were at the pool last week and were stung by yellow jackets. Someone suggested putting mud on the stings, but it didn’t help much. Do you have a better remedy?
A: Our favorite is a paste made out of meat tenderizer and vinegar. Get it on the sting as quickly as possible. A paste made out of baking soda and vinegar also works, as does the cut surface of a fresh onion.
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Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their column runs every Monday. Send questions to People’s Pharmacy, King Features Syndicate, 235 E. 45th St., New York, NY 10017, or e-mail them at pharmacy@mindspring.com.
