DEAR DR. DONOHUE: Would you write something about prednisone? What exactly is it? My 78-year-old husband suffers from arthritis. He had both hips replaced, but one is not right, and he’s unable to walk more than 500 feet without debilitating pain. He was recently put on a combination of antibiotics and prednisone for a bronchial infection. He felt wonderful, better than he had for the past six years. He had plenty of energy and wasn’t tired from walking. He asked why he couldn’t keep taking prednisone. I assume it’s because it’s a steroid. But at his age, what difference could it make? — R.J.

ANSWER: Prednisone is one of the cortisone drugs. It’s the one most often prescribed. The cortisone drugs are extremely potent suppressors of harmful inflammation. These drugs are steroids, but they are different from the steroids athletes use to build muscles. The muscle-building steroids are in the family of male hormones.

Cortisone is also made by our adrenal glands. Without it, we couldn’t live.

In the late 1940s, doctors at the Mayo Clinic began to use cortisone for patients with rheumatoid arthritis. Just like your husband, these patients’ lives were turned around. Their pain left. They were filled with energy. They felt like a million dollars. Soon, however, the side effects of prolonged cortisone use began to show up, and they were as dreadful as the illness. Stomach ulcers, bone weakening (osteoporosis), a rise in blood pressure, muscle weakness, glaucoma, cataracts and a susceptibility to serious infections are the consequence of long-term cortisone use. Your husband doesn’t want these happening to him. Cortisone, therefore, isn’t suitable for most chronic illnesses. In a few, however, when it is the only drug that can preserve life in the face of a deadly inflammatory illness, its side effects have to be tolerated.

DEAR DR. DONOHUE: You have stated many times that our bodies produce cholesterol. Why does the medical community recommend low-fat foods?

It’s agreed that seborrhea (dandruff) is a yeast infection of the scalp. Why isn’t there a medicine that kills the yeast? We conquered polio. — I.S.

ANSWER: Trans fats and saturated fats prod the liver to make cholesterol. That’s why those fats are limited. The fat story has changed some. I’ll go into it at another time.

Seborrheic dermatitis (dandruff) is partly due to a yeast called Malessezia. Anti-yeast shampoos do exist. Nizoral A-D, 1 percent, is an example. It can be bought without a prescription. The 2 percent version requires a prescription. Loprox (ciclopirox) is another yeast-killing product. It’s a prescription item.

Head and Shoulders Shampoo (zinc pyrithione), Head and Shoulders Intensive Treatment (selenium sulfide) and Selsun Blue Medicated Treatment also work against the yeast of seborrhea.

Quite often, a cortisone lotion, spray or gel, in combination with one of the above products, is needed to rid the scalp of inflammation.

Dandruff tends to be a chronic condition, so a lifelong war has to be waged to achieve victory.

DEAR DR. DONOHUE: I am a healthy, 44-year-old woman. I had gestational diabetes with both of my pregnancies. I am not a regular drinker, but I do have a cocktail or a glass of wine socially. If I have a glass of wine with dinner, I am fine. If I have more than two glasses, later that night when I get up to go to the bathroom, I become very weak, sweat, shake and am lightheaded. Is this hypoglycemia? Is it something I need to address with my doctor or should I just not drink? We are without medical insurance. — R.U.

ANSWER: Your symptoms are suggestive of hypoglycemia, low blood sugar. Alcohol can be responsible. How do you stop the reaction? Does sugar give you prompt relief? It should, if this is hypoglycemia.

You don’t have to see a doctor right away. You’d be wise, however, to stop drinking if these episodes are a regular occurrence.

Do you have a diabetic friend who tests her own blood sugar? Perhaps she could test your sugar some morning to see what’s going on.

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.

Copy the Story Link