Daily Press (Sunday)

Vitamin deficienci­es could contribute to mental decline

- By Joe Graedon, M.S., and Teresa Graedon, Ph.D. In their column, Joe and Teresa Graedon answer letters from readers. Send questions to them via www. peoplespha­rmacy.com.

Q: As a dentist, I had a colleague refer his greataunt to me because of her extreme fear of dentists. She had been diagnosed with Alzheimer’s disease.

Following a recent surgery, she suffered a serious infection that required a prolonged hospital stay. Her greatnephe­w said she never “bounced back” and was diagnosed with dementia after that. She presented as disoriente­d and unsure of her surroundin­gs.

Her doctor had put her on a soft diet due to dental problems. The diet was rice water and Malt-OMeal.

Prolonged infections deplete vitamins C, B1 and B6, and my patient’s restricted diet was contributi­ng to the original deficiency. Along with prosthetic dental treatment, I placed her on 2 grams of vitamin C and a substantia­l multivitam­in. By the time the treatment was completed, she was engaging and alert. She had been suffering from scurvy, beriberi and pellagra since her hospital stay. A: Thank you for the reminder that malnutriti­on can contribute to cognitive deteriorat­ion. We imagine your colleague was relieved to have his greataunt recover. Patients or family members should consider vitamin deficienci­es as potential factors in mental decline.

Q: I have had severe scalp psoriasis for many years. Home remedies, injections, UV light therapy, medication­s and shampoos have not helped.

My dermatolog­ist recently prescribed

Sotyktu. Do you think this is safe for me to use?

When I read the info included with the medication, I saw a couple of red flags. I am over 50, and I have had high blood pressure that I keep under control with medication. A:

Sotyktu (deucravaci­tinib) is a relatively new psoriasis medicine. It is in a somewhat similar category as some other biologic medication­s such as upadacitin­ib (Rinvoq) or tofacitini­b (Xeljanz).

In a four-month trial of this drug for psoriatic arthritis, the most common side effects were sore throat, respirator­y infection, sinusitis, bronchitis, rash, headache and diarrhea (Annals of the Rheumatic Diseases, June 2022). Sotyktu lowers the ability of the immune system to fight infections and must not be used with other drugs that affect immune response. Some people react to this drug by developing angioedema (which can be life-threatenin­g). There are also concerns about serious infections such as tuberculos­is as well as the blood cancer lymphoma.

The price also might be a worry, unless your

insurance plan will cover Sotyktu. GoodRx reports the monthly price without coverage or coupons is more than $11,000.

Q: I have a gluten intoleranc­e. When I eat something that I shouldn’t, I get a red, itchy rash. No lotion I’ve tried helps. Only a cortisone cream gives mild relief. What else could I try to stop the itching? I’d prefer something natural. A:

The answer is completely natural, but it is not easy. As a person with celiac disease, you must avoid ALL foods with gluten (from wheat, barley and rye). Even a tiny bit could be a problem for you.

The rash usually associated with celiac disease is called dermatitis herpetifor­mis. It is extremely itchy. This is just one manifestat­ion of your autoimmune disease. The fact that you are experienci­ng a rash suggests that other bodily systems, including your digestive tract, may be reacting to gluten and putting you in danger.

 ?? DREAMSTIME ?? A reader’s malnourish­ed patient became engaged and alert after treatment with vitamin supplement­s.
DREAMSTIME A reader’s malnourish­ed patient became engaged and alert after treatment with vitamin supplement­s.

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