DEAR DR. DONOHUE: I have never written to you before, but I have never seen much from you about Forteo. I took it for a year for osteoporosis. After a year, I had a repeat DEXA test. There was no improvement, and my hipbones were worse off.

I spent more than $7,000 for the medicine. I feel like I have been taken, since it did me no good. I would like your opinion on Forteo and why it didn’t help me. They won’t reimburse me for any of the money I spent. — Anon.

ANSWER: Forteo (teriparatide) is a lab-made replica of parathyroid hormone. We have four parathyroid glands, small glands glued to the back of the thyroid gland. If you wrap your hand around your lower neck, you’re wrapping it around your thyroid and parathyroid glands.

Parathyroid hormone regulates the body levels of calcium and phosphate. It boosts blood calcium by preventing calcium loss in the urine. It increases the digestive tract’s absorption of calcium. It also stimulates new bone formation. For these reasons, Forteo is an approved osteoporosis treatment.

Why didn’t it work for you? I have to resort to platitudes. Not every medicine works for every patient. Humans don’t respond in identical ways. Were you taking calcium and vitamin D when you were on Forteo? It needs both to work well. I can understand your disappointment and your anger. I can’t come up with any better explanation, and I admit mine is not all that good.

Other osteoporosis medicines exist, and they are not so expensive. They are the bisphosphonates. Perhaps your doctor will have you take one of them.

TO READERS: Questions on asthma are answered in the booklet on that illness. Readers can obtain a copy by writing: Dr. Donohue — No. 602, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Allow four weeks for delivery.

DEAR DR. DONOHUE: Each year we are urged to have yet another immunization — this year, two flu shots. What effect do these immunizations have on our natural immune system? I am thinking in terms of the super bugs that have evolved due to the overuse of antibiotics. — C.B.

ANSWER: Vaccinations don’t promote the rise of super bugs. They benefit our immune systems. They teach it to recognize and be prepared for germ invaders. After the vaccine has been given, the immune system can pounce on the germ and eradicate it. One way it does so is the production of antibodies, its arsenal of ammunition against bacteria and viruses. Antibodies home in on the germ and render it powerless to cause illness.

Antibiotics work in an entirely different way. They mess up a germ’s metabolic and reproductive functions. Germs learn how to dodge those antibiotic actions and become resistant to the drug.

DEAR DR. DONOHUE: What is the correct way to take a person’s blood pressure? In many doctor’s offices, I have had my arm grabbed and supported by the person taking my pressure. This forces me to tense my arm. Then they pump the cuff so high that it hurts. All this raises my pressure. — V.S.

ANSWER: The protocol for taking blood pressure goes like this. The patient should not have smoked or taken caffeine in the previous half-hour. He or she should be sitting comfortably in a chair for at least five minutes. The arm should be supported, preferably resting on something like a desk. The blood-pressure taker inflates the cuff only to the point where it obliterates the pulse at the wrist. The cuff is slowly deflated so the taker can identify both the systolic and diastolic pressures.

In the best of all worlds, pressure should be recorded in both arms.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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