Tumeric can help with arthritis pain

Dear Dr. Roach: I am 88 and have had osteoarthritis in my hands and knees since I was in my 50s. I began taking Tylenol and Advil for pain. But on a recommendation from a health food store clerk, I started taking turmeric. Since that first dose, I have never had to take any pain medication again. I also have not had a knee replacement. My specialist is very pleased with my condition, and encourages my use of turmeric. I plan to up the dose from 150 mg daily because of research that shows its benefits in avoiding Alzheimer’s disease. — D.D.L.

Answer: Turmeric has been shown to be helpful in some people with osteoarthritis, and is unlikely to have serious side effects; however, stomach upset is possible, and turmeric should be used with caution in people on warfarin or other anticoagulants.

However, there is no good evidence showing that turmeric prevents or treats dementia.

Dear Dr. Roach: My father is 72 years old. This year, he was diagnosed with an enlarged prostate. For now, the doctor has inserted a catheter. My question is: What process or what treatment is best at his age? We are in the Philippines. — M.M.C.

Answer: Enlargement of the prostate gland is a common problem for men in their 70s and older. Sometimes it gets so bad that a man cannot urinate at all or the pressure in the bladder is at risk of damaging the kidney. In those cases, a catheter often is used as a temporizing measure. Unfortunately, a catheter causes inflammation, so it may actually worsen the prostate problem temporarily while still protecting the kidneys. Because of this, the catheter usually needs to be kept in only for about one to two weeks.

During this time, medication usually is started to try to reduce prostate size. For most men, a benign (not cancerous) enlarged prostate can be treated with medication — an alpha blocker, such as tamsulosin, sometimes with a second medicine, such as finasteride. If that doesn’t work, there are several surgical options.

His doctor needs to be sure the enlarged prostate isn’t cancer. A physical exam and blood tests may answer that question; other times, a biopsy is needed.

There is no best treatment for everyone. It depends on how large his prostate is, any other medical problems he may have and the expertise of the doctor treating him. In the United States, the options include a traditional surgery, called a transurethral resection of the prostate (TURP); laser-based treatments; other heat-based treatments (microwave, water vapor ablation and radiowave); and even more newer treatments that are less well-studied. In general, medical therapy is worth a try for most men before considering surgery.

Dear Dr. Roach: I take 40 mg of lisinopril for high blood pressure. One doctor told me to take a 40-mg tablet in the morning, while another said to take 20 mg in the morning and 20 mg in the evening. Will separating the dosage better control my blood pressure? On average, mine is 130/75. — M.A.P.

Answer: For lisinopril in particular, taking the medication twice daily showed a better reduction in blood pressure than once daily, according to a study performed last year. People who took lisinopril twice daily had about a 10-point systolic (4 point diastolic) improvement in BP control, so your blood pressure might be more like 120/71 if you started taking it in two doses, if you are similar to the subjects in the study (that sounds like a big drop to me, despite the study results).

People who are doing just fine on once-daily lisinopril don’t need to change. Don’t make any changes in your medication without discussing it with your own doctor.

Email questions to ToYourGoodHealth@med.cornell.edu.