Q: May I know whether you use ketoconazole whenever you see signs of Tinea versicolor or do you use it as a preventive measure? If as a preventive measure, how often do you take it?
A: I use ketoconazole only if I see Tinea versicolor. Once it is treated, it often doesn't return. If there are recurrences, I use selenium shampoo (Selsun Blue, for example) on the body once per week as a preventive measure.
Q: I live near Edmonton, Alberta, Canada. Recently on our local TV news was an item of interest to me, and I would appreciate more information on it. The Cleveland Clinic is using acupuncture for weight loss in the form of an ear staple with many testimonials on women dropping 30, 50 and 70 pounds. I am a diabetic and overweight by approximately 90 pounds and would like to know more about this procedure. Is anyone doing this procedure in and around the Edmonton area?
A: I was asked to comment on the role of ear stapling as a method of weight loss. I did not advocate it on the news. I, instead, was (and am) very concerned about the possibility of infection in those who try it. The staple is placed in the cartilage and remains there for months. It acts as a “foreign body” in the cartilage and can act as a vehicle for bacteria to enter. Infected cartilage is very difficult to treat due to its blood supply, and once infected, it can have disastrous and disfiguring consequences. Ear acupuncture has been studied and found effective for weight loss. We do have acupuncturists at the Cleveland Clinic who can perform acupuncture for weight management.
Q: I was diagnosed with PCOS (polycystic ovarian syndrome) years ago. At the time they did not know a lot about it. I was put on Aldactone and was told that it was incurable and basically that I had no choice but to live with it. Now I understand more research has been done and a lot more can be done to help improve this condition. My question is: are there any natural alternatives that work as well as prescriptions? I understand that women with PCOS are being put on a medication that is normally given to diabetics. The reason for this is because it helps to even out insulin levels. Do you have any suggestions for me?
A: PCOS is associated with the metabolic syndrome, which is characterized by obesity (especially abdominal), hypertension, diabetes and high cholesterol. It is also associated with anovulation (not producing an egg monthly) and infertility. Studies have shown that the drug metformin, which improves insulin resistance, can help with infertility associated with PCOS. Other studies have shown that weight loss can also help with PCOS and metabolic syndrome. I recommend that patients try a low carbohydrate, anti-inflammatory diet, which emphasizes fish, nuts, seeds and beans as protein sources, as well as plenty of vegetables, and low glycemic index (less sugary) fruits. I also recommend fish oil, which has been shown to help with diabetes, hypertension and high cholesterol, for patients.
Tanya Edwards, M.D., M.Ed., is the Medical Director for the Center for Integrative Medicine and is a staff member in the Department of Family Medicine at the Cleveland Clinic. As a Family Practice physician, she sees patients at the Cleveland Clinic Independence Family Health Center, and will begin wellness consultations at the new Cleveland Clinic Wellness Center. For the past seven years, she has been teaching complementary and alternative medicine courses at the Case Western Reserve University School of Medicine.
Some questions in the “Ask Dr. Edwards” column appear courtesy of NetWellness.org.
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