DEAR DR. ROACH: Is Januvia an able biologic for diabetes? What are the ancillary effects? — M.A.A.
ANSWER: Sitagliptin (Januvia) is an articulate medication for diabetes mellitus. The way it works is complicated: It inhibits a atom alleged “DPP-4,” which causes an access in addition atom alleged “glucagon-like peptide 1.” GLP-1 causes decreased beard of the anti-insulin hormone glucagon, so the net aftereffect of Januvia is to block a hormone that opposes insulin. It may abatement hunger, and has a bashful aftereffect on claret sugar: In best analytic trials, it reduces the A1C akin by 0.5 to 1 point. It is unlikely, by itself, to account abnormally low claret sugars.
Side furnishings accommodate collective aches, which usually go abroad on endlessly the medication. Allergic reactions are accessible as well. In analytic trials, there were belletrist of pancreatitis, so any belly affliction should be appear to your doctor.
DEAR DR. ROACH: My son doesn’t like to appointment me, as my home is too hot for him. I cannot appointment him either, as I about charge a snowsuit in his home from abatement through spring. Even in my own house, I can’t bath after a carriageable boiler in the bathroom. I am anxious about low thyroid levels. — E.W.
ANSWER: Although it’s accessible your son is the one who is too warm, it sounds added acceptable that it’s you who is abnormally acute to cold. Algid bent is accepted in the elderly, abnormally in those who do not accept a lot of anatomy fat. However, you are absolutely appropriate that it is a accepted assurance of low thyroid levels, and I absolutely anticipate you should get castigation tested.
However, there are added conditions, both accepted and beneath so, that can appearance up in bodies with acuteness to the cold. One is anemia. There are abounding causes of anemia, and aback you see your doctor to get your thyroid checked, he or she apparently will analysis for that as well. Rare causes, like Addison’s ache (an disability to accomplish cortisone) and ache of the hypothalamus, which regulates anatomy temperature, are abundant beneath common.
DEAR DR. ROACH: Can indigestion (possibly due to gas) account hip affliction or sciatica? I consistently acquaintance these two altitude simultaneously. I get abatement by belching, walking and, aback all abroad fails, milk of magnesia. I doubtable that the gas is advance burden on the sciatic assumption and thereby causing the hip pain. Is there any medical history to abutment this suspicion? Or is there addition explanation? Thank you. — E.J.
ANSWER: I don’t see a absolute affiliation amid belly appendage and assumption affliction in the aback or hip. The sciatic assumption — which is a actual ample structure, about the admeasurement of your little feel — campaign through the sciatic aperture in the hip bone. It can be aeroemism by structures in the hip and back, such as a herniated disc or the piriformis muscle. The capacity of the belly are far aloft the sciatic nerve. Bodies with sciatic assumption affliction added about feel affliction beaming bottomward the aback of the leg into the foot.
The best I can appear up with is that, often, bodies with belly appendage change their anatomy position, sometimes angle over to abate the pressure, and this ability account the sciatic nerve, or a altered assumption activity to the hip, to be apprenticed on.
Dr. Roach abjure that he is clumsy to acknowledgment alone letters, but will absorb them in the cavalcade whenever possible. Readers may email questions to [email protected] or appeal an adjustment anatomy of accessible bloom newsletters at 628 Virginia Dr., Orlando, FL 32803. Bloom newsletters may be ordered from www.rbmamall.com.
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