Dr. Roach: Vitamins turn out to be the unlikely cause of reader’s headache

Keith Roach
To Your Health

Dear Dr. Roach: All my life I have had severe headaches almost daily. I have been to various doctors, and none of the treatments — including medications, stress management and identifying food triggers — were effective. Doctors told me to live with it.

I have always taken vitamins. Last April, I missed my vitamins by accident, and that day I had no pain. The next day, I skipped them, and again no pain. I tried the vitamins again, and had severe headaches. No doctor ever suggested vitamins could be the cause of my headache. To the millions of headache sufferers: Try quitting vitamins!

Dr. Keith Roach

— S.A.

Dear S.A.: Millions of people take vitamins in hopes of preventing disease. There are only a few instances when taking vitamins in people with no symptoms of deficiency has definitively been shown to be beneficial. One example would be pregnant women, where the B vitamin folic acid has been shown to reduce a type of birth defect, neural tube abnormalities. Vitamin D is beneficial in older people at risk for falls or with osteoporosis. Otherwise, the studies looking at taking vitamins have generally not shown a benefit. This is probably because most people involved in such studies generally have a healthy diet. It remains debated whether vitamin supplementation is beneficial in those with a not-so-healthy diet: They probably do.

The harms of vitamins are small. I have seen a handful of cases of allergies (probably due to fillers or dyes, rather than the vitamins themselves), and headaches are well-documented, particularly from vitamin A or niacin, especially at higher doses. Some people get upset stomach or an unusual taste. Given a probable lack of benefit, it might be worth stopping vitamins for possible side effects.

Dear Dr. Roach: How long can a woman carry chlamydia? What are the symptoms? Is it possible for her to still have infection after 18 months?

— Anon.

Dear Anon.: Chlamydia trachomatis is the most common bacterial sexually transmitted infection. In most women, the infection has no symptoms. However, symptoms may include a change in vaginal discharge and bleeding in between periods or after intercourse. Chlamydia may also mimic a urinary tract infection. In 2% to 5% of women with a chlamydia infection, the infection can affect the uterus, fallopian tubes or ovaries, causing pelvic inflammatory disease, a serious condition that may affect fertility.

Without treatment, about half of women will continue to have detectable (and potentially transmissible) bacteria a year after infection, and it is certainly possible to have persistent infection three years after acquiring the infection. This is why screening for chlamydia is so important in any sexually active person with a cervix, especially among those younger than 25, where chlamydia infections are most common.

You didn’t ask about men, but men also get chlamydia infections, and they also are often without symptoms. The most common symptoms, if any, are penile discharge and burning with urination. The infection can sometimes involve the epididymis (one of the tubes that carry sperm from the testes to the urethra), causing testicular pain.

Chlamydia can be effectively diagnosed now by gene tests from a swab or urine. Treatment is usually straightforward once the diagnosis is made.

Readers may email questions to ToYourGoodHealth@med.cornell.edu.