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Peter Hibberd, M.D.
Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience and a medical advice columnist for Newsmax Magazine.
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How Can I Treat Post-Shingles Pain?
Typically, anti-inflammatory, selected anti-seizure, and some low-dose antidepressant medications are used to reduce neuralgia symptoms.
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What Can I Do for Long-term Back Pain?
Most acute musculoskeletal (spinal) back pain will self-resolve given sufficient healing time. An underlying malignancy, or an inflammatory or infectious disease, may be mistaken as back-related.
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How Can I Replace Thyroid Hormones Following Surgery?
Thyroid cancer is often cured by thyroidectomy and a single oral radioactive iodine drink following surgery.
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What Medications Treat Essential Tremor?
A low dose beta blocker such as Inderal (propranolol) often helps blunt this condition. Some patients may find sufficient relief with an occasional alcoholic drink while others require low dose anticonvulsant therapy, most often Primidone (mysoline) and Neurontin (gabapentin).
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Any Suggestions for Dealing with ALS?
The cause of ALS is unknown and there is no cure. Present treatment focuses on making the disability that results from progressive paralysis more tolerable.
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What is Causing My Vertigo?
You may have a very common cause of dizziness called benign positional vertigo (BPV). It usually clears by itself in several seconds and attacks tend to disappear over the ensuing weeks or months regardless of medication.
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Can Fatty Tumors Be Dissolved?
Lipomas (known as benign fatty tumors) do not regress with medicine. They are soft, well-defined, and are not normally tender.
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Can Natural Products Lower Cholesterol?
Cholesterol management is actually very simple. You can struggle with diet, or you can get smart and increase your soluble fiber. Aim for 30 to 40 grams.
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Why Are My Ankle and Lower Leg Swollen?
The presence of varicose veins with leg edema suggests you have peripheral venous insufficiency — some of the perforating veins connecting to your deep venous system are allowing pressure to back up into your superficial veins.
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Can Exercise Heal a Herniated Disc?
Your exercise may indeed be aiding your recovery. Older wisdom used to recommend bed rest. Newer wisdom mobilizes you early, and often combines supervised physiotherapy to assist with a more rapid recovery.
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Should I Stop Drinking Red Wine?
Listen to your consultant to be safe. Remember that wine, non-prescribed "vitamins," and supplements may interact with numerous medications, especially chemotherapy, by affecting their metabolism, excretion, accumulation, effect, and toxicity.
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Why Do My Legs Tire When I Exercise?
Cramps, discomfort, or fatigue that are recurring and are induced by exercise should be evaluated by a physician. Cramps that relate to exercise and are relieved rapidly by rest may reflect inadequate blood supply, and you may benefit from an arterial insufficiency evaluation.
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What Is Normal Cholesterol?
LDL (low density lipoprotein) is the bad cholesterol and targets are under 130 for the general population. Targets are under 100 for those with or at high risk of cardiovascular disease, stroke, or diabetes.
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Aren't Drugs as Dangerous as Supplements?
The regulatory process is not perfect. Occasionally, prescription drug side effects, some very serious, escape observation until the drug has had widespread use.
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Can Lipitor Cause Cognitive Decline?
Reported decline on Lipitor has usually been transient and rare, but there seems little risk to stopping it for eight to twelve weeks and observing the effects.
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Will My Neuropathy Pain Ease?
Correcting a neuropathy often takes upwards of 12 months or more, depending upon the severity and cause. Unfortunately, many neuropathies are difficult to arrest, much less reverse, so we need to be pro-active in preventing them.
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Can You Recommend a Nasal Decongestant to Replace Oxymetazoline?
Most patients need to substitute a nasal cortisone preparation (such as Nasacort, Beconase or Nasonex) for several days or even weeks.
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Is There a Supplement for Erectile Dysfunction?
There are no non-prescription supplements I routinely recommend, although there are many prescription medications that are very effective, including Cialis, Viagra, and Levitra.
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What Are the Benefits of Flaxseed Oil?
Although diets rich in omega-3 fatty acids have been associated with improved cardiovascular risk, there is relatively little supporting evidence to justify recommending flaxseed products over other sources of omega-3 for lipid disorders and cardiovascular disease prevention.
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Can Medication Relieve Foot Neuroma Pain?
Neuromas may be injected or destroyed by chemicals or even lasers in selected cases. Sometimes a local corticosteroid injection helps with discomfort and occasionally with regression.
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Why Are My Ankles Suddenly Swelling?
Get this checked out to be on the safe side. Although swelling of feet or ankles that disappears with exercise is most often related to venous pooling, you should be evaluated for underlying conditions since the swelling is new.
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What Will Help My Foot and Leg Cramps?
Complaints of nocturnal cramps require evaluation for several conditions including circulatory and cardiovascular disorders, electrolyte imbalances, endocrine disease, and renal disease.
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Could Painless Glands in the Abdomen Indicate Cancer?
This deserves examination by a medical doctor. Malignancy of bowel and intra-abdominal contents is easily detected with very simple, painless studies such as endoscopy, colonoscopy, ultrasound, and CAT scans.
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Could I Have Sjogren's Syndrome?
You need to see your physician for evaluation of your autoimmune disease (Sjogren's syndrome is an example).
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Will Glucosamine Adversely Affect Cholesterol Levels?
Glucosamine sulphate has no significant effect on lipid levels. However experimental studies in animals suggest that glucosamine may favor lipid accumulation in body tissues.
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What Are the Different Types of Arrhythmias?
Atrial fibrillation (AF) is a specific arrhythmia of the upper chambers (atria) and is usually a nuisance problem. Ventricular arrhythmias are more serious and often result in loss of consciousness and death.
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Which Drugs Cause Peripheral Neuropathy?
Most chemotherapy agents and antimetabolite medications are commonly associated with neuropathy. Nutritional deficiency is a common precipitant for neuropathy as well as chronic alcohol intake.
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How Do I Seek Help for Anemia and Undiagnosed Bleeding?
You need to have your anemia and source of bleeding evaluated aggressively and corrected, so ask for a gastroenterology and hematology consultation.
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Can Steal Syndrome Be Treated?
Treatment of steal syndrome is surgical, and is usually performed by a vascular surgeon. There are no medicines that will reliably improve steal syndrome.
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Why Do My Ears Remain Stuffy?
Perhaps you have some simple obstruction (such as lymphoid tissue at the Eustachian tube exit in the upper mouth) that may be amenable to a simple procedure or perhaps some laser correction. Tympanostomy tubes are also an option for those with persistent Eustachian tube obstruction.
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Lowering Cholesterol Naturally
Niacin is vitamin B3, and it is good if you can tolerate it without adverse effects or medication interactions. Fish oil is generally good, and often improves lipid management.
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Will Acai Help Me Lose Weight?
Unfortunately, acai has been heavily promoted with no reliable data that shows any effectiveness for weight management. It does not cut the fat!
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Why Are Cholesterol Meds Taken at Bedtime?
The best time to take cholesterol medications (statin treatment with drugs such as Lipitor, Zocor, and Pravachol etc.) is at nighttime when our liver is usually busy synthesizing natural cholesterol.
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Should Unexplained Bleeding be Cause for Concern?
Bloody secretions are ALWAYS grounds for further evaluation. I recommend you seek advice from a urologist (specialist for male reproductive area).
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Can Antibiotics Cause Fever?
Yes, antibiotics can cause fever, but I am concerned that this has been permitted to last over two years. Investigating your complaints is long overdue.
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Getting Rid of Skin Tags
They can be easily removed at skin level by applying a cotton ligature at its base for five to seven days, or be removed by excision, cryotherapy or cauterization. Once removed, they rarely grow back.
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Is There Hope for Mental Disorder?
You should never lose hope. Our body and even our brain can recover from what seem like insurmountable challenges with disease and injury.
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Unexpected Drop in Cholesterol Level
Small variations in cholesterol readings are not unusual, but more than 10 percent variation when not expected strongly suggests a laboratory error.
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Should I Have the BRCA Test?
If you prefer not to know or you would do nothing with the results but worry, do NOT get these tests done. If you are very proactive, and would plan on aggressive measures such as an oophorectomy or bilateral preventative mastectomy, you may be able to justify doing these tests, especially if you have an Ashkenazi Jewish ancestry.
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What's Causing My 'Snowy Vision?'
We need to define whether this is occurring from damage to your visual cortex (brain), optic nerve(s), or some degenerative disorder of your retina, vitreous/posterior chamber, lens, anterior chamber, cornea or even from mild glaucoma.
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Café au Lait Spots and Neurofibromatosis
Having six or more café au lait spots of 5mm or greater before puberty or 15 mm or more after puberty has been associated with neurofibromatosis, but is not definitively diagnostic of this condition.
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Diagnosing Heart and Neurological Problems
The choice of imaging often depends upon the judgment and needs of your medical consultant(s), and may be modified by the availability of MRI (Magnetic Resonance Imaging) in your area. Heart problems are evaluated by various studies. Rate and rhythm disturbances will normally be seen on a 24 hour Holter monitor.
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An Uncomfortable Itch
The odor, irritation and distribution strongly suggest an infection may be present. Most patients will try a simple topical antifungal powder or cream before seeing their doctor, but be aware that topical cortisone preparations may fuel any infectious process.
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Switch Statins to Avoid Side Effects
All statins are not the same. I certainly wouldn't use Crestor again due to your severe side effects, but you might be able to try another as long as your physician agrees. Be sure to start with a low dose and escalate slowly.
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When Should Babies Stop Taking a Bottle?
Transition to baby food and cereal usually occurs gradually, once the child is at least three months old. Since regular food is too hard for babies to digest, once your baby is over six months, you may choose to puree food and introduce each food slowly, looking for any intolerance.
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Corneal Problems and Sjogren's Syndrome
Corneal repair by stem cell transplantation is a hot topic, but corneal transplantation remains the standard for corneal disease that has not responded to medical measures.
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How Much Folic Acid Do I Need Per Day?
The National Institute for Health's recommended dietary allowance (RDA) for dietary folate is 400 micrograms (mcg) daily for everyone older than 14.
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Can a Brain Stem Injury Be Reversed?
Brain stem injuries vary from mild to severe. They may involve the vital life-sustaining areas of our brain, our cranial nerves and the central nuclei necessary for basic functions such as breathing, balance, temperature regulation etc.
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Why Can't I Lose Weight and Keep It Off?
Starvation diets usually set us up to deposit fat tissue and deplete muscle. Avoid them and pick a sensible diet with a reasonable calorie reduction, about 30 percent, and monitor your progress with the addition of fiber where possible.
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Using Nasal Decongestant Sprays
Continuing with oxymetazoline nasal spray (Afrin, Dristan, Vick’s) will doom you to a condition called rhinitis medicamentosa, which is profound nasal congestion caused by overuse or continued use of over-the-counter nasal decongestants.
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Measuring Bone Loss
Osteoporosis is very common in post-menopausal women, and even in some men. It is reliably diagnosed with a DEXA scan that involves measurements of your lower lumbar spine and your femur/hip areas, which is expressed as a Z score and a T score.
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Thinning Hair
I am not aware of any effect your supplements would have on your hair loss, unless your diet is deficient in iodine and you are replacing a specific deficiency. Consult your physician to be sure no deficiency exists that can be corrected, and have an evaluation for conditions that may exacerbate hair loss, such as hypothyroidism, fungal scalp infection, medications, etc.
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Polyp Removal
Polyps are well-delineated growths readily removed by colonoscopy. Polyps usually form as solid tissue within the wall of the bowel which project into the lumen.
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Fish Oil and Diabetes
Diabetes is a disorder of glucose metabolism. Fish oil capsules with DHA have been shown to be protective in cardiac and high-risk patients (especially in diabetics) with lipid disorders.
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Silent Acid Reflux
So-called silent GERD without supporting information is gibberish, and cannot be used as the basis for any treatment. Recommendations should be based on evidence.
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Small Red Spots on Torso
Since there is no obvious cause of your skin condition, it would be wise to have your red spots examined to rule out harmful or co-existing health conditions. These lesions are likely Campbell de Morgan spots (CDMs), otherwise known as superficial hemangiomas.
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Middle-Aged Increase in Waist Size
The actual bony pelvis usually remains unchanged in mature adults, and the increased girth is usually fat caused by a lack of exercise and eating too much. It can raise your risk of many diseases including heart disease and diabetes.
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Treating Psoriatic Arthritis
The arthritis associated with psoriasis is a particularly aggressive and destructive form in which uncontrolled joints are rapidly and irretrievably destroyed. Enbrel is an immune modulator medication used for controlling severe psoriasis as well as rheumatoid arthritis, psoriasis and ankylosing spondylitis.
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Triglycerides and Cholesterol
Generally, fish oil is a healthy replacement for the heavily saturated oils so common in American diets. Often triglycerides are reduced, and the HDL (good) cholesterol actually improves and LDL cholesterol decreases when fish oil supplementation is initiated.
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Vytorin and Cancer
I am not convinced the malignancy data is strong enough to warrant stopping the use of Vytorin. Not all patients with elevated triglycerides, however, need Vytorin.
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Constant Post-Nasal Drip
Vasomotor rhinitis is a condition in which oversensitive blood vessels in the nasal lining dilate and cause runny nasal symptoms. Causes can be weather changes, temperature variations, emotions, sleep deprivation, stress, chemical irritants, perfumes, aerosol sprays, and pollution. Vasomotor rhinitis is simple to recognize, and your family doctor is well-suited to treat it. Testing is not necessary to diagnose this condition.
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Alternative to Surgery for PAD
Peripheral artery disease, also called PAD, may be treated conservatively at first, often using combinations that change the flexibility of red blood cells, such as Trental and aspirin, often in association strategies to lower lipid levels. If untreated, PAD may place you at risk for limb loss. You have several corrective options.
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Shingles Vaccination
You should request the shingles vaccine, despite having had a prior episode of shingles. The shingles vaccination prevents shingles in 51 percent of those immunized, and prevents the painful neuralgia in 67 percent.
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Tinnitus
Ringing or buzzing sensations in the ears (known as tinnitus) have numerous causes, one of which is exposure to loud noise. Once the condition is present, significant irreversible damage has occurred.
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Pain After Radiation Seed Treatment
Radiation enteritis refers to radiation damage to the bowel, combined with chronic inflammation. The condition, which is characterized by a watery diarrhea, is difficult to manage. When caused by radioactive seed implantation, it usually settles down after several weeks but occasionally takes several months.
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Components of Fish Oil
The omega-3 fatty acids found in fish oil that are best for cardiac risk reduction are DHA and EPA. DHA is the better of the two.
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Controlling Atrial Fibrillation
Lanoxin often is used to control atrial fibrillation, which is an irregular heartbeat, also called an arrhythmia. Atrial fibrillation may accelerate the ventricular rate (the main pumping chambers of the heart) to very rapid rates. Drugs such as Lanoxin and Cardizem usually control it.
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Does Green Tea Cause Anemia?
Iron deficiency may be one of the most common forms of treatable anemia, resulting most often from diets with insufficient red meat or rich vegetable sources of iron, which menstruating women need especially. By no means is anemia because of green tea consumption!
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Improving Kidney Function
The most common causes of kidney failure (referred to as renal failure) are related to absent or delayed treatment for hypertension, diabetes, infection, or toxic effects from ingested medications. End-stage renal failure relies on dialysis treatment until the underlying condition is corrected.
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