Readers follow up with questions about past columns

Hello, dear readers, and happy summer! We hope you’re getting a chance to enjoy the longer days and warmer weather. Here at Ask the Doctors headquarters, our mailboxes continue to overflow. Let’s dive in.

— Regarding the column we wrote in response to a reader who has frequent bouts of strep throat, we heard from Martha, a reader whose family had an unexpected experience with the bacterium:

“One of our children got repeated and frequent strep infections,” she wrote. “Finally, the pediatrician suggested we test the whole family, and we found we had a carrier — our then-toddler, who had no symptoms at all.” Once the toddler was treated with a course of antibiotics, the incidents of strep within the family stopped.

The toddler is an example of what is known as an asymptomatic carrier. That is, although the individual is a host for a bacterium or a virus, they are not adversely affected. However, as Martha and her family learned, people who come into contact with the carrier can become infected and fall ill. Strep, typhus, C-difficile, norovirus, Epstein-Barr and even HIV are just a few examples of infectious agents that have been found in individuals with no outward symptoms.

— After reading our column about genital herpes, a reader asked for help in dealing with the pain and itching that often accompany an outbreak. Although there is no cure for herpes, there are several antiviral medications that can curtail the length of an outbreak by several days, if taken at the first sign of symptoms. The antivirals acyclovir, famciclovir and valacyclovir are prescriptiononly. People living with herpes who have frequent outbreaks sometimes opt for suppressive therapy. That is, they take an antiviral every day.

For localized symptoms like pain, over-the-counter pain relievers can be helpful. As for itching, an intriguing study found that ointments and creams containing propolis, a resin-like substance made by honeybees, was more effective than both a placebo ointment and a topical treatment containing the antiviral acyclovir. Dosing depends on a user’s age and general health, so if you decide to give this alternative treatment a try, please check with your family doctor for user guidelines.

— We heard from a reader regarding the claims that coconut oil is useful as an agent to either prevent or treat Alzheimer’s disease. One of the theories behind the idea is that the brains of Alzheimer’s patients can’t break down glucose and that certain properties of coconut oil provide an alternative energy source.

Although the use of coconut oil has shown promise in several small clinical trials, the benefits at this time remain largely anecdotal. The good news is that there is now increasing interest in this area of study, and the larger studies that are needed to corroborate and expand on the existing research are quite likely on the horizon.

In the meantime, for those of you following through with the use of coconut oil, please remember that it is a saturated fat. Depending on your daily diet, its use may require you to make corresponding adjustments.

Send your questions to askthedoctors@mednet.ucla. edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095..