Dr. Keith Roach: Is inflammation to blame for nightly bathroom trips?
Dear Dr. Roach: I am 80 years old and have had problems with a slightly enlarged prostate for years. This, of course, means frequent nightly trips to the bathroom every one and a half to two hours.
I stumbled upon the fact that if I take two ibuprofen (400 mg) at bedtime, I seldom have to go to the bathroom before my normal 6:50 a.m. wake-up time. This has been wonderful, and I wonder if there might be some good medical reasoning here, or if it is just dumb luck on my part. I’m sure many of your readers would be interested in this bedtime subject.
Dear R.H.: There have been a few small trials showing that some people’s symptoms get better with an anti-inflammatory medicine like ibuprofen. This seems to be the case with men and women, so it clearly isn’t working solely on the prostate. Some authors have speculated that inflammation of the bladder might be the underlying cause for nocturia (“noct” for “nighttime,” and “uria” for “urinating”), which is how ibuprofen might work. Small doses are unlikely to cause harm; however, some people with sensitive stomachs might have problems, and people with kidney disease need to be very careful with any anti-inflammatory.
Dear Dr. Roach: I have been taking metformin 500 mg once daily for several months, with little results. I am in my 70s, and overweight by 25 pounds. My average sugar level is still around 160.
I read that metformin will drop your glucose level by only 20 percent. Will that percentage increase if I take more?
Dear R.I.: Average sugar level, also called estimated average glucose, is a way to describe blood sugar control in people with diabetes or prediabetes. A level of 160 is equivalent to an A1c level (a more commonly used measure of blood sugar control) of about 7.2 percent This is a reasonable level for most people in their 70s, where lower levels (“tighter” control) increase the risk for dangerously low blood sugars.
Most medicines are more effective at higher doses. For metformin, 500 mg twice daily is the most common dose I see. Although it can be dosed up to 1,000 mg twice daily, it’s not much more effective in most people, and is more likely to cause side effects, especially nausea.
Not everybody with Type 2 diabetes needs to be on medicine forever. Losing weight, exercising regularly and having a prudent diet with small amounts of simple sugars all may help treat diabetes.
Dear Dr. Roach: I have used colloidal silver for years to help lichen planus in my mouth. It helps, but recently a friend of mine said not to use it.
Dear L.H.: Colloidal silver is neither safe nor effective. True poisoning is rare, but it can happen with persistent use. Talk to your dentist about proper care of oral lichen planus.
Email questions to ToYourGoodHealth@med.cornell.edu.