Dear Dr. Roach: I am a 73-year-old man who was recently diagnosed with moderate to severe arthritis in my right knee. I’m trying to find a healthy way to manage my chronic knee pain. Are there any risks to long-term use of acetaminophen? I take anticoagulants (apixaban 5mg daily) and do not take NSAID painkillers. I would like to take two 500 mg tablets of acetaminophen, once or twice a day. –PD
Answer: There is at least one long-term risk that I am aware of from long-term use of acetaminophen (Tylenol), and that is kidney disease. Some studies have shown that long-term use of acetaminophen increases the risk of chronic kidney disease. It is estimated that to double your risk of chronic kidney disease, you would need to consume 2-4 kg of acetaminophen over your lifetime, which is approximately 5,000 tablets, or approximately 4 tablets per day for 8 years. will be ingested. Other studies have not shown significant kidney effects from long-term use of acetaminophen.
One of the symptoms associated with daily painkiller use is called “medication overuse headache.” This is a headache that usually occurs every day (at least 15 times a month) and occurs when a person who is already prone to headaches (particularly migraines) takes some type of pain reliever, whether over-the-counter or prescription, on a regular basis. Occurs when Headaches usually stop when the drug is stopped. This condition is most common with opiates and drugs containing barbiturates, especially Fiorinal and Fioricet.
In my opinion, people who use painkillers daily should have their kidney function tested at least once a year.
Dear Dr. Roach: I am a 70-year-old woman in fairly good health. I do water aerobics for an hour every day and weight train three times a week.
I was recently diagnosed with osteopenia. I was reading about diaphragms. Research shows it can improve bone density, balance, and strength, which are my goals. However, it appears that there may be an increased risk of cardiovascular disease, cancer, and retinal detachment. Any insight into the benefits and risks? –BS
Answer: The literature on vibrational treatment of osteoporosis is mixed. Some studies showed an increase in bone density (in postmenopausal women, but not in younger women), but the effects were small. Most studies show that it improves balance and reduces the chance of falls.
Most studies report no harm. However, fractures are a possibility (especially in people with osteoporosis), and I’ve also read about concerns about cataracts and lens detachment after cataract surgery. No reliable evidence was found linking vibrations to cancer or heart disease. Most studies suggest that low-intensity vibrations may have a better balance when it comes to benefits and harms. However, at this time, the overall benefit has not been proven.
In addition to exercise, get adequate calcium in your diet, make sure your vitamin D levels are adequate, and be sure to check your FRAX score (frax.shef.ac.uk/FRAX/tool.aspx) with your doctor. Let’s get it. , this is the single most important number that determines whether medication is recommended.
Dr. Roach regrets not being able to respond to individual letters, but will incorporate them into his columns whenever possible. Readers can email questions to [email protected] Or write to us at 628 Virginia Dr., Orlando, FL 32803.
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