COVID may be cause of saliva change
Dear Dr. Roach: I am an 82-year-old woman in good health. I tested positive for the COVID virus in December 2020 and was hospitalized but did not need a ventilator. I needed oxygen for about two weeks after release. Four or five weeks ago, I noted thicker saliva in my mouth. The liquid hardens in the morning, and I have to pry my lips from my teeth. No pain; it’s just extremely aggravating. Have you come across this strange malady?
J.M.
Answer: There have been many reports about changes in saliva during and immediately after COVID-19 infection. The virus attacks, among other places, the lining of the mouth. However, since it started more than a year after the infection, I think it’s unlikely to be related to the COVID infection.
What is possible is that the virus has triggered an autoimmune attack on the saliva-producing cells in the three different salivary glands, a condition known as Sjogren’s syndrome. Sjogren’s syndrome can be diagnosed only after a comprehensive evaluation, including blood tests that look for evidence of autoimmune disease. A rheumatologist might provide additional insight. Dry eyes are common in Sjogren’s, so that could be confirmed by an eye specialist.
Dear Dr. Roach: Is there any correlation between elevated folic acid levels, and fogginess and insomnia? My folate level when I last had my blood tested was elevated (29.2, with a normal range of 3.1 to 17.5). My doctor told me to stop taking my multivitamin that has high levels of folate. I’ve stopped, yet my problems continue.
S.M.
Answer: Supplemental folic acid is normally metabolized in the body to 5-methyl tetrahydrofolate, the active vitamin, which is measured in the blood. High folic acid levels also can cause problems in people with vitamin B12 deficiency. Both B12 and folate are used to make red blood cells. In a person with low vitamin B12, giving folic acid can cause B12 levels to go low enough to cause neurological and psychiatric symptoms. In severe cases, the damage to the nervous system can be irreversible.
The symptoms of fogginess and insomnia may have nothing to do with the folic acid. Sleep disturbance alone can cause brain fogginess, so treating the sleep disturbance may be the answer.