Greetings, Dr. Roach My right knee, which is 73 years old, has been diagnosed with moderate-to-severe arthritis. I’m looking for a healthy solution to deal with my persistent knee pain. Does using acetaminophen over an extended period of time pose any risks? I don’t use any NSAID painkillers because I take an anticoagulant (5 mg of apixaban daily). Once or twice a day, I would want to take two 500 mg acetaminophen capsules. — P.D.
ANSWER: Kidney damage is the only long-term risk associated with long-term acetaminophen (Tylenol) use that I am aware of. Numerous studies have demonstrated that long-term acetaminophen users have a higher chance of developing chronic renal disease. An estimated 2-4 kg of acetaminophen, or around 5,000 tablets, or roughly four tablets per day for eight years, must be used over the course of a lifetime to double the chance of developing chronic kidney disease. Long-term acetaminophen use did not significantly impair kidneys, according to other research.
Medication overuse headaches are one symptom linked to everyday usage of painkillers. People who are already prone to headaches, particularly migraines, typically have this type of headache every day (at least 15 times per month) when they use regular painkillers of any kind, whether they are prescription or over-the-counter. The headaches normally stop after the medication is stopped. I most frequently see this issue with medications that contain barbiturates and opiates, particularly Fiorinal or Fioricet.
I believe that people who take painkillers on a daily basis ought to get their renal function checked at least once a year.
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Greetings, Dr. Roach At seventy, I am in rather decent health. I lift weights three times a week and perform an hour of water aerobics every day.
I just received a diagnosis of osteopenia. Regarding vibration plates, I have been reading. According to the research, they can help me achieve my goals of increasing muscle strength, balance, and bone density. Nonetheless, it appears that the risk of cancer, detached retina, and cardiovascular disease may be elevated. Are you able to weigh the risks and rewards? — B.S.
ANSWER: Research on vibration therapy for osteoporosis is conflicting. Although the effect was minimal, other studies found that postmenopausal women had higher bone density than younger women. The majority of trials demonstrated improved balance and a decreased risk of falls.
Harms are not reported in the majority of the research. Nevertheless, fractures can occur, particularly in people with osteoporosis, and I’ve heard of cataract and lens detachment issues following cataract surgery. I couldn’t discover any solid proof that vibration is related to heart disease or cancer. According to the majority of research, the advantages and disadvantages of low-intensity vibration may be more evenly distributed. I can’t say, however, that the overall benefit has been demonstrated as of yet.
Along with exercise, you should ensure that you consume enough calcium from your diet, check your vitamin D levels, and have your doctor check your FRAX score (frax.shef.ac.uk/FRAX/tool.aspx), which is the most crucial metric for deciding whether to prescribe medication.
Although he regrets not being able to respond to each letter individually, Dr. Roach will try to include them in the column. Questions can be sent by mail to 628 Virginia Dr., Orlando, FL 32803 or by email to [email protected].
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