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Dear Dr. Roach: I have arthritis in my hands and knees. For at least three years, I took ibuprofen (about 1,200 mg daily). Then two years ago, I switched to a natural health-care product derived from turmeric. It works just as well for me as the ibuprofen, and no side effects (I think). What are your thoughts about this?

M.K.

Dear M.K.: Curcumin, the active chemical in the spice turmeric, has several potential uses. I wrote some months ago about its possible use in inflammatory bowel disease, but I was able to find several studies showing benefit in people with both osteoarthritis and rheumatoid arthritis. The usual dose was 500 mg (of curcumin) two or three times daily. There were few side effects in the studies, but there is the potential to worsen bleeding in people taking anticoagulants, such as warfarin. Curcumin seems a reasonable alternative to anti-inflammatories in people with arthritis, and it might be worth a trial, especially in people who experience side effects on the standard drugs. As always, finding a high-quality product is essential, since supplements are largely unregulated.

Dear Dr. Roach: I am 69 years old and had several retinal tears in both eyes 15 years ago that resulted in multiple large floaters that obscure my vision. Four different ophthalmologists have discouraged me from getting a vitrectomy due to the many risks involved, and I have reluctantly followed their advice. Just recently I stumbled on a treatment called YAG laser, where they can pulverize floaters with laser beams. It is somewhat expensive, and the doctor that I contacted does not work with Medicare. I would like your opinion as to the success of such treatment.

C.D.

Dear C.D.: Floaters are broken-up bits of dead cells that stay in the vitreous humor in the back of the eye. Most people have them and usually are not aware of them, but the sudden appearance of many can be a sign of a torn retina, as you had. Unfortunately, the eye has no way of removing them. If they aren’t affecting vision, they do not need to be treated, but I can understand in your case why you might want to get them treated. Both laser treatment of the floaters and surgical vitrectomy have been successful, and I had several readers tell me they had good success with the treatments. There are ophthalmologists who exclusively treat floaters, and report good results. If you decide to proceed, I certainly would get as much information as you can from the ophthalmologist about how often he or she performs the procedure and what the success and complication rates are.

Dr. Roach Writes: In a recent column, I gave the range of INR (a type of test for coagulation) for people treated with warfarin as 2.5 to 3.5. That is the dose for people with mechanical heart valves. For almost all other indications for warfarin, the usual range is 2.0 to 3.0. My thanks to Alan Kelley, Pharm.D.

Email questions to ToYourGoodHealth@med.cornell.edu.

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