DEAR DR. ROACH: I recently read about turmeric for osteoarthritis. I am on a limited income. Please tell me more about it, like how much it costs and where I can get it. – BATHROOM
ANSWER: Turmeric, a spice that has been used for millennia, is the source of curcumin, which has been shown to improve symptoms of osteoarthritis, at least in short-term studies. It is generally believed to be safe, as most people have no side effects or only occasional stomach upset, nausea or diarrhea. A theoretical concern is bleeding, in association with blood thinners, but this appears to be rare.
Many patients have tried curcumin, and it improved symptoms in about half of those who tried it. Turmeric is easy to find at any grocery store, but when curcumin is used as a supplement, it’s usually paired with other supplements to help with absorption. A common one is piperine, derived from black pepper. It is difficult to use turmeric from food to achieve pharmacological effect. The usual dose is 400 to 500 mg two or three times a day. A month’s supply from a reliable online retailer I found costs around $10.
DEAR DR. ROACH: My husband has psoriasis on his hands and he thinks it’s from stress. He had psoriasis a long time ago, and now it’s back. He’s stressed because I’m sick. Please tell me what cream he can use. Before, he used a good Yugoslav cream called Vipsogal. — MAM
ANSWER: Psoriasis is a common skin condition thought to be caused by abnormalities in the immune system. There are several forms, but most people with psoriasis notice patches or bumps on the skin. Treatment depends on the type and severity of psoriasis, but the important thing is that it requires assessment before treatment, both to determine the correct diagnosis and to assess severity. This includes at least a joint examination for psoriatic arthritis and a careful history to look for other associated conditions, such as in the eyes. Severe illness may require systemic therapies, including biological therapies.
I researched Vipsogal and it is a combination of several drugs especially strong steroids. They are the mainstay of treatment for most people with mild to moderate psoriasis and are only available in the United States and Canada by prescription. It is a powerful drug with the potential for real harm if used incorrectly. Your husband should see a dermatologist.
DR. ROACH WRITES: A recent column on fructose malabsorption in adults may have been confusing. I also mentioned hereditary fructose intolerance, which is very different from the fructose malabsorption that I talked about. IHF is a potentially serious disease, usually diagnosed in children and often unrecognized. It is caused by a deficiency of an enzyme called fructose-1-phosphate aldolase, isozyme b. This disorder is diagnosed by sophisticated tests or genetic analysis. The treatment is to completely eliminate fructose from the diet, which is a difficult task.
Fructose malabsorption in adults is a much milder condition. It is processed by avoiding large amounts of fructose on its own (as in honey, fructose-sweetened foods, and fruits with net high amounts of fructose, such as apples, pears, sweet cherries, prunes, and dates), and avoiding the artificial sweetener sorbitol.