DEAR DR. ROACH: My son, in his mid-20s, uses a preworkout energy supplement to which I am opposed. Can you tell me if this is harmful so that I can show him scientific research and your educated and medically sound response?

The supplement he uses contains alanine 1 g, creatine 1 g, arginine 1 g, tyrosine and velvet bean seed extract. It also contains 150 mg caffeine. — B.G.

ANSWER: It’s not always easy to tell what supplements are safe or effective for the condition they are marketed for, and the information available through a Web search often is biased. One place I start to get information is Medline Plus (www.nlm.nih.gov/medlineplus/), which has reliable information about many supplements, but you often have to search individually.

In this case, alanine, arginine and tyrosine all are amino acids. These are the building blocks for proteins, and are safe in reasonable amounts. Creatine is generally safe for adults, and has been shown modestly effective at helping improve strength in young male weightlifters. One gram is a fairly low dose and is generally considered safe. The 150 mg of caffeine is about the same as a cup of strong coffee.

Velvet bean seed extract I had to look up. It has been used both as a food crop and in traditional medicines. It has toxicity at high doses, but at the dose in the supplement, it should be safe.

In summary, I think this supplement is not likely to be harmful if taken in recommended doses, and it might have some small benefit. There is nothing in the supplement that cannot be obtained easily and cheaply from food, apart from the velvet bean, which I think has the least proof of benefit of all the components of the supplement.

DEAR DR. ROACH: I am 49 years old and in good health. I recently was told by my doctor that what was first diagnosed as a swollen lymph is actually a condition called carotidynia. Can you please publish some information about this condition and what I can expect? Sometimes it is worse than at other times, but it never really goes away. I would not consider it painful; it is just uncomfortable, and when severe, it radiates up into my ear and down into my chest. — S.W.

ANSWER: Carotidynia (literally, “pain in the carotid artery”) can come from several distinct causes, some of which are catastrophic such as a carotid artery dissection, which is a tearing of the lining of the artery. In some cases, carotidynia may be a form of migraine. After surgery or angioplasty to the carotid artery, one also can get pain that comes from the carotid itself.

In the case of no other cause being identified, the condition is sometimes called idiopathic (which simply means “of unknown cause”) carotidynia, and some, but not all, experts think this condition comes from a type of inflammation around the artery, which can sometimes be seen on CT or MRI scan.

Idiopathic carotidynia is usually treated with anti-inflammatory medicines — ibuprofen, or prednisone in more severe cases. Most cases respond quickly, in a few days or up to a few weeks. However, I want to emphasize the need to thoroughly search for other concerning causes of neck pain.

The booklet on abnormal heart rhythms explains atrial fibrillation and the more common heart rhythm disturbances in greater detail. Readers can obtain a copy by writing: Dr. Roach Book No. 107, 628 Virginia Dr., Orlando, FL 32803. Enclose a check or money order (no cash) for $4.75 U.S./$6. Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.

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