Is creatine safe for my teenage son?

Posted May 14, 2012

DEAR DOCTOR K: My son wants to play football, but he’s smaller than the other boys. Is it safe for him to take a nutritional supplement such as creatine to increase his muscle?

DEAR READER: Many teens, especially athletes, want to be bigger and stronger, and a fair number use creatine to do so. One study found that nearly 10 percent of high school boys have used it. Another study found that nearly half of college men have used it. Creatine is sold as a supplement, but it is found naturally in the body, mostly in muscle.

Is it safe to take a sleeping pill every night?

Posted April 18, 2012

DEAR DOCTOR K: I am 70 and have always had sleep problems. I’ve started to take a prescription nonbenzodiazepine sleeping pill every night. It’s working very well. Is it OK if I keep on taking it?

DEAR READER: To answer your question, I consulted with my colleague, geriatrician Suzanne Salamon. She told me that she is reluctant to prescribe sleeping pills to her older patients. They lead to daytime grogginess and may contribute to cognitive problems, poor balance and falls.

What causes drug shortages?

Posted March 13, 2012

DEAR DOCTOR K: It seems like every day in the paper I read about doctors and hospitals running out of medicines because the pharmaceutical companies can’t manufacture enough of them. Why are we having these problems?

DEAR READER: You aren’t just imagining this; the problem really has gotten worse. There have been shortfalls of common drugs for ADHD, cancer, pain and heart disease. Like other doctors, I’m frustrated. Understandably, our patients are scared. Although drug shortages are not new, they seem to be on the upswing. According to The Associated Press, tracking information from the University of Utah Drug Information Service shows 267 newly reported drug shortages in the United States in 2011, up from just 58 in 2004. Clearly, this is not in the public interest.

Are bioidentical hormones safe?

Posted January 24, 2012

DEAR DOCTOR K: I’ve been hearing a lot about “bioidentical hormones.” I’m curious about them, because I’d like a better way to treat my menopause symptoms. Are bioidentical hormones any safer than synthetic ones?

DEAR READER: In the past few years, there’s been growing interest in bioidentical hormones. That’s because advocates promote them as safer and more effective than FDA-approved, conventional hormone therapy (HT). Women have good reason to be interested in a new treatment option. Conventional combined hormone therapy (estrogen and progesterone) raises the risk of blood clots and breast cancer. It can increase the risk of heart disease, stroke and dementia in women older than 60 (or 10 years past menopause).

Should I take aspirin to prevent a heart attack?

Posted December 29, 2011

DEAR DOCTOR K: Although some members of my family have heart disease, I haven’t been diagnosed with it. I know people with current cardiovascular problems should take aspirin, but should I be taking it to prevent future problems?

DEAR READER: Your question seems simple enough. I wish I had a simple answer. The problem is that aspirin, like virtually all medical treatments, has benefits and risks. The main risk of aspirin is bleeding. But for people who have heart disease, regularly taking low-dose aspirin definitely reduces the risk of heart attacks in the future. The benefits and risks are different for one person than for another.

Do proton pump inhibitors have long-term side effects?

Posted December 28, 2011

DEAR DOCTOR K: I suffer from heartburn and have been taking a proton pump inhibitor for the past few years. Should I be worried about long-term side effects?

DEAR READER: For many people with heartburn, proton pump inhibitors (PPIs) provide great relief. Stomach acid contains lots of hydrogen ions, which are protons. PPI drugs inhibit the production of those protons. The PPIs include esomeprazole (Nexium), lansoprazole (Prevacid) and omeprazole (Prilosec).

Should I take a multivitamin?

Posted December 07, 2011

DEAR DOCTOR K: I try to eat a balanced diet but don’t always succeed. Should I take a single vitamin supplement? How about a multivitamin?

DEAR READER: This apparently simple question is tough to answer. Here’s why. In the past 200 years, doctors discovered several diseases that were caused by severe deficiencies of particular vitamins. An example is scurvy, a disease that was caused by lack of vitamin C.

Do expiration dates matter for medications?

Posted October 20, 2011

DEAR DOCTOR K: My husband refuses to throw out pills that are past their expiration date. I think this is dangerous. I hope you’ll convince him to clean out his medicine cabinet!

DEAR READER: I understand your concern. But you may be able to cut your husband a little slack about his pills. Believe it or not, there is relatively little scientific data about outdated medication. As pills get older, it’s fair to ask two questions about them: Do they lose their strength, and do they become toxic or harmful?

Drugs and Supplements