To Your Good Health
DEAR DR. ROACH: Several years ago, a friend gave me a recipe to lower blood sugar. He said his mother used it and it helped her. I want to know if it is for real or an old folk remedy that was passed through the generations.
You mix apple cider vinegar with apple and grape juices and drink 2 ounces in the morning and 2 ounces in the evening. I made a batch but halved it because it seemed like a lot to start. My blood sugar dropped seven points since I started taking it two days ago. Can you tell me if this is a real thing or a temporary situation until I see my doctor next week? Does something like this really work? Or was my sugar just going down naturally? — R.C.
ANSWER: Some old folk remedies do work, and it has taken years for scientists to try to find out which ones are really useful and, if so, why. In the case of apple cider vinegar, there is a small study showing that 20 grams of apple cider vinegar (about 4 teaspoons) did lower blood sugar when volunteers with diabetes were given a meal of a bagel with butter and orange juice. The magnitude of the effect is small — usually not enough to be an effective treatment by itself. I also am concerned about the effect of vinegar on the teeth.
Adding fruit juice to the vinegar doesn’t seem to be necessary (fruit juice wasn’t used in the study) and it adds sugar, which is generally not a good idea in people with diabetes.
DEAR DR. ROACH: After six weeks of severe headaches, which were originally thought to be migraines, I was diagnosed with thunderclap headaches. These headaches suddenly stopped, and I have not had another for over two years. The doctor gave me a prescription for Maxalt to be taken as soon as I feel a headache coming on. It can be repeated twice within 30 minutes of each dose. Would you please explain this condition? — P.M.
ANSWER: A thunderclap headache is, as its name suggests, a very severe headache that begins suddenly and reaches full intensity within one minute. This is a medical/surgical emergency, as one of the most common causes of TCH is a subarachnoid hemorrhage, usually caused by rupture of an aneurysm. This possibility must be evaluated immediately (call 911!) with imaging studies and a lumbar puncture, also called a “spinal tap.” People will usually describe it as “the worst headache of my life,” and treatment is aimed at repairing the aneurysm as quickly as possible.
There are other causes of thunderclap headache, which can be considered after exclusion of subarachnoid hemorrhage. The course of your condition — that is, multiple episodes over several weeks — suggests you have a condition called reversible cerebral vasoconstriction syndrome. In this condition, some of the arteries in the brain constrict and stay constricted for a prolonged time. It is not known why this happens. Triptans, such as rizatriptan (Maxalt) is one of the medicines that can trigger reversible cerebral vasoconstriction syndrome, and many authorities recom