Dear DR. ROACH: I am using terazosin and finasteride for my enlarged prostate. A friend has proposed having zinc health supplements and having pumpkin seeds for added zinc ingestion. Is there any proof that taking additional zinc will lower the dimension of the prostate? — K.O.
Response: There are some theoretical factors, based on animal experiments and benchtop study, as to why zinc could possibly cut down the sizing of the prostate and even decrease the risk of prostate cancer. Having said that, the clinical scientific studies that have been done have not however proven a reduction in hazard, reduce in prostate dimension, or advancement in indicators from having zinc health supplements or pumpkin seed oil. Further, I have witnessed a remarkable situation of zinc overdose from zinc nutritional supplements, causing a copper deficiency with intense consequences on the man who took the surplus doses of health supplements. Getting 100% of the encouraged zinc ranges won’t harm you, but most likely won’t assistance possibly.
The mix of terazosin and similar drugs (identified as alpha blockers) with finasteride (which blocks a variety of testosterone that enlarges the prostate, as well as results in hair decline) is ordinarily fairly effective. In guys who aren’t acquiring suitable responses, I endorse a visit with a urologist to be guaranteed that the issue is genuinely the prostate and not the bladder. In guys with tested prostate enlargement leading to signs even with medication, it’s time to look at surgical therapies, of which there are numerous.
Dear DR. ROACH: I am 62 and have had a golfing-ball-sized lipoma sitting on my higher right arm around my shoulder for about a few years now. It is squishy and feels like rubber beneath my pores and skin. However, it is now commencing to hurt in the place. I would like to have it eradicated. Ought to I go to a surgeon or skin doctor?
I am right-handed. Will medical procedures influence the use of my suitable arm? — G.B.
Answer: I advise leaving a lipoma, a common benign fatty tumor, on your own until it is creating indicators. In these less-prevalent conditions when they do bring about indications, this sort of as irritation, I generally refer patients to a general surgeon, until I am fortuitous to have a dermatologic surgeon with abilities in this space. Some plastic surgeons also take out lipomas, specifically in cosmetically vital regions.
I have had various sufferers return from surgical procedure with stories that the surgery was much additional sophisticated and difficult than they anticipated. If the lipoma is connected to underlying tissues, the surgical procedures can be technically hard. These ordeals have created me even much more circumspect about recommending operation for lipomas.
DR. ROACH WRITES: A recent column on nightmares with statin medicines produced lots of letters noting identical encounters. Most writers noted this potential facet effect with atorvastatin or simvastatin, which are “lipophilic,” this means they can cross into the brain (and are more likely to have the supplemental side result of memory reduction), as opposed to the “hydrophilic” statin drugs, like pravastatin and rosuvastatin (Crestor).
1 writer famous that the nightmares went away with switching atorvastatin (Lipitor) from nighttime to morning. Cholesterol synthesis transpires mainly at nighttime, which is why statins are proposed at night. But this is much a lot less essential with extended-performing statins like Lipitor and Crestor than with shorter-performing types like simvastatin (Zocor).