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November 09, 2006
Vitamins and macular degeneration
Q I am 88 and take drops for glaucoma. My eye pressure is controlled, and I have no symptoms. My eye doctor tells me I am at risk for age-related macular degeneration. He has me taking AREDS vitamin pills. I have 20/20 vision, but the prospect of macular degeneration worries me. Is it inevitable? Will the pills work?
A The prospect of age-related macular degeneration worries everyone; just about everyone is at risk for getting it. About 25 per cent of people older than 75 have some signs of it. It usually progresses slowly, for most people. If, at 88, you have 20/20 vision, your worries are minimal. Macular degeneration is not inevitable.
The macula is the small, central portion of the retina –– the light-sensitive layer of cells at the back of the eye that transmits images to the brain. The macula is responsible for central vision, the kind needed to read a newspaper, sew, drive and see faces. Macular degeneration spares side vision (peripheral vision).
AREDS stands for the “age-related eye disease study,” which showed that high doses of vitamins C, E and A (as beta carotene), along with zinc and copper, can slow the progression of macular degeneration when it has reached the intermediate or advanced stage.
Many brands of vitamins and minerals in doses used in the AREDS study are new on the market. The doses of both the vitamins and minerals far exceed their recommended daily allotments, but apparently nothing bad has happened to people using the pills. However, this is not a matter that people should take into their own hands. AREDS vitamins should be used only when a physician recommends them. The doctor can monitor whether patients are getting too much of a good thing.
I refer to dry macular degeneration, the more common form. Wet macular degeneration is another story.
Q I have costochondritis. Kindly give me some information and a prognosis. I have led an active sports life.
A “Costo,” is “rib,” and “chondritis” is “cartilage inflammation,” so costochondritis is an inflammation of the cartilage that holds the rib in place at the breastbone. It can come from a viral infection, from trauma or from unknown causes, and the latter “cause” is the most frequent.
The pain of costochondritis often imitates the pain of a heart attack. However, costochondritis pain worsens when a person twists the chest, takes a deep breath or coughs.
This condition waxes and wanes for anywhere from weeks to several months. In most cases, it’s gone in a year, at most. Aspirin or anti-inflammatory drugs like ibuprofen can generally take the edge off of it. Some find that applying cool compresses to the painful area helps. Others are benefited more by using a heating pad. If pain persists, the doctor can inject the area with cortisone, and that frequently calms the inflammation.
The prognosis is eventual victory for you.
Q Since winter is upon us, I need to settle a heated debate between my 15-year-old son and myself. He insists on showering in the morning before school and then proceeds outside with a soaking-wet head of hair in temperatures below 20ºF. I say he’ll catch pneumonia. He says you have to come into contact with a germ to do that. Who’s right?
A A wet head doesn’t cause pneumonia or a cold. Germs –– bacteria and viruses –– do. However, your son shows a lack of common sense. Why doesn’t he bother to dry his body before going out in the cold? Water freezes, and he can freeze his scalp by running outside in the winter with a wet head.
Dr Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write to him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 328536475. Readers may also order health newsletters from www.rbmamall.com.
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