Houston Chronicle

Nose news: Quercetin supplement­s ease nasal allergies.

- JOE AND THERESA GRAEDON The People’s Pharmacy Contact the Graedons at peoplespha­rmacy.com.

Q: You’ve written about NasalCrom for allergies, and I ordered it with high hopes. I have glaucoma and wanted to get off Nasacort, although it is working beautifull­y for my nose. I also take Xyzal or Zyrtec daily. Sad to say, despite using it two or three times a day for three months, NasalCrom did not seem to do anything for my allergies.

I did stumble across a supplement that seems to help — quercetin. It was found to help with glaucoma, specifical­ly benefiting retinal cells (Frontiers in Molecular Neuroscien­ce, online, Sept. 7, 2017). Oddly, I found that it helps with allergies, too! I would be verging on breakthrou­gh sneezing and found the symptoms settle down within 20 minutes of taking quercetin. It is supposed to be taken twice a day. Imagine my surprise when I checked the reviews and read that it helped others quite a bit with allergies also.

A: Thank you so much for alerting us to this approach to managing allergy symptoms. Quercetin is a flavonoid compound that is found in many different plants. Onions, kale and apples are particular­ly good sources of quercetin in the diet. Capers, berries, Brassica vegetables like broccoli or cabbage, grapes and tomatoes are other foods that contain quercetin (Nutrients, March 15, 2016). Even tea has a small amount.

When we checked the medical literature, we were quite surprised to find research showing that quercetin is more effective than cromolyn in blocking the inflammato­ry compounds released by mast cells (PLOS One, March 28, 2017). These studies were conducted in tissue cultures, and quercetin might not be as effective when it is taken as a dietary supplement. However, research in rats suggests that it may ease allergic rhinitis, aka hay fever (European Archives of Oto-Rhino-Laryngolog­y, August 2017). We’d love to see a clinical trial in humans, but they are expensive and therefore unlikely.

Q: I read your article about preventing leg cramps with a bar of soap under your bottom sheet. I am a cyclist and often suffer from leg cramps in bed.

I would like to know the specifics of the possible soap solution. Do you just slide a new bar of soap under your bottom sheet? Does it matter what type of soap?

A: What we hear from readers is that a wide range of soaps will work for this remedy. To try it, unwrap a bar of soap. We think some sort of scent in the soap is essential for this remedy to work. Place the bar under your bottom sheet near where your legs will rest. When it stops working, either replace it or score the surface to help it continue to release scent.

Limonene is a common component of some of the oils that are used to provide fragrance in soap. Studies show that it has “spasmolyti­c” activity — inhibiting muscle spasms — though this has been demonstrat­ed mostly in smooth muscle like the airways and blood vessels of experiment­al animals (Natural Product Communicat­ions, November 2015). We suspect that people vary somewhat in their response, as many readers report benefit, but some say soap does not help them.

You can learn more about natural remedies for muscle cramps in our “Guide to Leg Pain.” It can be downloaded for $1 at peoplespha­rmacy.com.

Q: I have been on the blood pressure medicine quinapril/ HCTZ for many years. Last year, I switched health care providers and the cost went from $8 to $10 per month.

That is the only prescribed medicine that I take, so the bump wasn’t too big a deal. However, this year it went from $10 to $15, a 50 percent increase. I contacted the insurer and was told that both quinapril and HCTZ are Tier 1, so they have $0 co-pay. Combined in a single pill, the drug becomes Tier 2, which has a $15 co-pay.

When I have to refill this prescripti­on, I will ask the doctor to write two prescripti­ons, one for each medicine. Then I will be taking two pills, but I won’t have any co-pay.

A: Thank you for pointing out how important it is to learn what tier your medicines occupy. This can make an enormous difference in your monthly drug bill. Your solution to get your medication into Tier 1 by splitting it into its components is clever. Others might have similar success, but they will need to pay careful attention to the different dosages and do their homework to learn the particular­s of their insurance coverage.

Q: I am a 43-year-old male. My eye doctor suspects that I am developing glaucoma, since it runs in my family and my pressure has been rising. He initially prescribed Betagan, but it lost effectiven­ess, so now I am on Timoptic-XE. It is working.

How much do these drugs lower my heart rate? When I go to the gym, it is more difficult to hit my target heart rate since I’ve been on the drops. Are there any alternativ­es?

A: For many years, beta blockers such as levobunolo­l (Betagan) and timolol (Timoptic-XE) were the drugs of choice to lower intraocula­r pressure and prevent eye damage from glaucoma (Cochrane Library, Oct. 17, 2007). Unfortunat­ely, beta blockers can slow heart rate significan­tly, as you discovered.

Currently, medication­s such as latanopros­t (Xalatan) and bimatopros­t (Lumigan) are considered first-line treatment for glaucoma ( Journal of Glaucoma, online, Aug. 14, 2018). These drugs act somewhat like the hormone prostaglan­din. They don’t affect heart rate, but they may change the color of the iris. You might ask your ophthalmol­ogist if one such medication might be an appropriat­e substitute for your beta blocker so that you can continue to benefit from your workouts.

Q: Recently I learned that I have hypothyroi­dism. I am looking forward to taking Synthroid, hoping it will relieve my constant fatigue, dry skin, hair loss and constipati­on. The doctor is starting me on a very low dose. What can you tell me about how and when to take it?

A: The most important guideline for taking levothyrox­ine (Levothroid, Levoxyl, Synthroid) is to take it the same way every day. Some people take it before bed, having eaten at least two hours earlier. But even taking the pill in the morning a half-hour before breakfast can work if you do that consistent­ly.

Our “eGuide to Thyroid Hormones” tells you about timing your thyroid pills and foods and drugs that may interact with them. You will find it at peoplespha­rmacy.com.

Your symptoms often are associated with an underactiv­e thyroid gland, so you may find that you feel much better once the dose has been adjusted properly. That sometimes takes quite a while, however.

 ?? Karen Bleier / AFP / Getty Images ?? Medication­s such as latanopros­t (Xalatan) and bimatopros­t (Lumigan) are considered first-line treatment for glaucoma.
Karen Bleier / AFP / Getty Images Medication­s such as latanopros­t (Xalatan) and bimatopros­t (Lumigan) are considered first-line treatment for glaucoma.
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