Vitamins for macular degeneration coincide with new cramps

Dear Dr. Roach: I have been told at the age of 70 that I have early stages of the eye disease macular degeneration. The doctor told me to take Preser-Vision AREDS 2 vitamins.

He said I will be taking them for the rest of my life. I started them immediately, and in a few nights, I started having severe left leg cramps to the point where I woke out of a sound sleep to a jump out of bed and shake off the cramp. Is this typical?

C.L.

Answer: For the dry form of age-related macular degeneration, the AREDS and AREDS2 vitamins are the usual treatment. Although they are not a cure, they do slow progression of the disease.

My experience with these has been that they almost never cause side effects, and muscle cramping is not a reported side effect by the manufacturer. The timing, however, certainly is suspicious. You can try stopping them for a few days, then restarting them to see if the cramps are truly affected by the vitamins.

If they are, you have two choices. The first is to deal with the cramps in the same way that people who get leg cramps at night for no particular reason deal with it, which is getting regular moderate exercise and stretching the calf and hamstring muscles before bed. Having weight on the toes is a trigger for many people, so very light bed covers that aren’t tucked in can be surprisingly helpful. I’ve had a few readers come up with devices to keep all weight off of their toes in bed.

Your second option is to discuss an alternative with your eye professional. The AREDS and AREDS2 formulas were shown to be helpful, but some eye professionals only choose a few components of the formula.

Dear Dr. Roach: I recently had a CT scan of my chest and pelvis that resulted in an incidental finding of “mild bibasilar atelectasis.” My doctor does not seem to be concerned at all. Should they be?

J.M.

Answer: “Bibasilar atelectasis” is a scary-sounding term unfamiliar to most people, so I understand why you might be concerned. “Atelectasis” refers to non-inflation of some of the tiny air structures in the lung, called the alveoli. The bottom of the lungs are the bases, so “bibasilar atelectasis” means a partial collapse of the lung at the bases.

This is very common in people who aren’t breathing deeply, such as those who undergo surgery. In healthy people, this finding is not likely to represent serious disease of the lung. Before getting (and while you were getting) your CT scan, you might not have been breathing very deeply, allowing a very small portion of the lungs to deflate a bit. A few really deep breaths are all that is usually needed to open up those air sacs again. Sighing is a mechanism found in virtually all animals that helps treat and prevent atelectasis.

If that was the only finding on your CT scan and you are otherwise healthy, your doctor is very likely right not to be concerned, although I wish they had explained it a little better to keep you from getting concerned in the first place.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.