MARIETTA WOMAN SHEDS 41 POUNDS

Q: I’d like to share my approach to cold sores. Aside from preventive tactics such as avoiding stress and fatigue, as well as exercising, eating appropriately (getting all your vitamins and proteins, increasing lysine intake and avoiding arginine-rich foods), there is a winning formula of four treatments that fight any outbreak.

As soon as I feel the dreaded tingle, I: 1) take L-lysine supplement pills daily, 2) take two prescription valacyclovir pills every 12 hours for two days, 3) put prescription Zovirax cream on the sore every three hours, and 4) apply Abreva cream at the same time as Zovirax (mix both together and apply generously). This combination has been working for me for eight years.

A: Thank you for sharing your unorthodox combination. Such an approach has not been tested in clinical trials, but it does make some sense.

Valacyclovir (Valtrex) is an oral antiviral medicine proven to shorten the duration of cold sores. Topical acyclovir (Zovirax) works in a similar manner to keep the virus from replicating. Abreva is an OTC anti-herpes cream that works differently from acyclovir, so perhaps the combination would be more effective than either drug alone. We could find no research to support your strategy, though.

Q: My doctor prescribed amlodipine for high blood pressure. It made my ankles swell so much that he switched me to lisinopril instead. I took one lisinopril pill and ended up in the emergency room with a swollen tongue and chest pains. I could hardly breathe.

I was given an EKG, and later I was told I could go home or stay overnight. I decided to go home, but in the middle of the night I broke out in itchy red hives from head to toe. I thought it was from the sticky patches they put on your body for the EKG. However, it turned out that it was from the lisinopril. What can I do now?

A: One of the most common side effects of amlodipine (Norvasc) is edema or fluid retention. Women appear to be more susceptible to this problem. Up to 15 percent complain of swelling in their feet, ankles and legs.

Lisinopril, an ACE inhibitor, can cause a kind of allergic reaction called angioedema. In this condition, the face, neck, tongue and throat can swell. This potentially life-threatening reaction requires immediate emergency treatment. Because of your reaction to lisinopril, you will need to find a completely different approach to blood pressure management. There are other antihypertensive drugs that should not cause this dangerous reaction.

In addition, regular exercise is nearly as effective as medication for people with high blood pressure (British Journal of Sports Medicine, Dec. 18, 2018). A DASH (Dietary Approaches to Stop Hypertension) diet with lots of vegetables and fruit and very little meat or sugar also is helpful. Deep-breathing exercises can lower blood pressure as well. You can learn more about these lifestyle approaches and other medications that you and your doctor might discuss in our Guide to Blood Pressure Treatment. It is available online at www. PeoplesPharmacy.com.

Q: I read that you should wait at least an hour after taking Synthroid before you drink coffee or eat breakfast. To get around this restriction, I take my Synthroid when I get up in the middle of the night to go to the bathroom.

A: Your solution is sensible. Some people take their levothyroxine before bed to accomplish the same goal.

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