Health & Family

Did ballerina’s pain reliever trigger a stroke?

Q: I am a 56-year-old woman recovering from a stroke. Although my general health was very good, I had long used NSAIDs to ease the pain and inflammation of chronic injuries from 35 years teaching classical ballet.

No clear cause for the almost-fatal blood clot has been identified, but ibuprofen use is highly suspected. No more NSAIDs for this old ballerina! What else can I do?

A: Researchers have long known that nonsteroidal anti-inflammatory drugs (NSAIDs) like celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), ibuprofen (Advil, Motrin, etc.), meloxicam (Mobic) and naproxen (Anaprox, Aleve, Naprosyn) can cause serious side effects. In 2005, the Food and Drug Administration issued a stern warning that “NSAIDs may cause an increased risk of serious cardiovascular thrombotic events – blood clots, myocardial infarction, heart attack and stroke, which can be fatal.”

It is impossible to prove that a particular heart attack or stroke was triggered by an NSAID, but your story is compelling. You may want to consider nondrug approaches such as herbs (boswellia, ginger or turmeric), supplements (stinging nettle, MSM) or home remedies (Certo in grape juice, gin-soaked raisins). There are details in the “Guide to Alternatives for Arthritis” we are sending you.

Synthroid and coffee

Q: Can I drink coffee after taking Synthroid?

A: Synthroid (levothyroxine) is absorbed best when it is taken on an empty stomach. Patients often are advised to take it first thing in the morning, but drinking coffee or eating breakfast even 15 minutes after taking the pill can greatly reduce the amount of thyroid hormone that gets into the bloodstream (European Review for Medical and Pharmacological Sciences, 2014; Vol. 18, Pages 451-456). Grapes, soybeans, papaya and dietary fiber also can reduce levothyroxine absorption.

The usual advice is to wait at least an hour after taking Synthroid before having your coffee or a meal. Some people find that taking the medicine at bedtime, at least two hours after supper, solves the problem (Archives of Internal Medicine, Dec. 13-27, 2010).

Chelation and plaque

Q: How effective is chelation for reducing carotid plaque?

A: Chelation is a way of removing toxic heavy metals such as lead or cadmium, and the chelating agent EDTA (ethylenediamine tetra acetic acid) is used for this purpose without controversy.

Decades ago, some physicians proposed that EDTA chelation also might help against atherosclerosis (the buildup of plaque in coronary arteries). Last year, the results of a randomized controlled trial showed that EDTA chelation reduced the likelihood of a second heart attack or a stroke in volunteers who had had a heart attack (JAMA, March 27, 2013).

A high-dose vitamin/mineral regimen plus chelation significantly reduced the chance of heart attacks, strokes or cardiovascular hospitalizations in these patients compared with placebo (American Heart Journal, July 2014). The study, which is the best one completed to date, did not examine plaque buildup in the arteries, so EDTA needs to be considered unproven for reducing carotid plaque.

Reach Joe and Terry Graedon at PeoplesPharmacy.com.

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