Joe and Teresa Graedon King Features
Q. My doctor added fenofibrate to my medications because I had high triglycerides (over 400). Within six weeks, my triglycerides were down to 179.
As a bonus, the uncontrolled diarrhea that I have been experiencing for almost two years has almost completely disappeared. The gastroenterologist I have seen says that fenofibrate can bind fat and lower triglycerides.
So far, it’s been good for me. Is there anything else I should know about it?
A. Fenofibrate is a drug that is often overlooked in clinicians’ lipid management toolbox. It was approved by the Food and Drug Administration in 1993 and was first sold in the US under the brand name Tricor in 1998.
In addition to lowering triglycerides, it can also lower total and LDL cholesterol and increase “good” HDL cholesterol. People with metabolic syndrome (high cholesterol, triglycerides, blood glucose, and blood pressure along with a large waistline) are more likely to benefit from fenofibrate. Side effects include liver enzyme elevations, digestive discomfort, and headache.
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Fenofibrate may also have unexpected benefits for the brain. There is preliminary evidence of antidepressant and neuroprotective activity (Biomolecules, May 2022).
You can learn more about fenofibrate and other lipid management strategies in our “Electronic Guide to Cholesterol Management and Heart Health.” It also contains information on the risk factor Lp(a), which is often overlooked. This online resource is available under the Health eGuides tab at www.PeoplesPharmacy.com.
Q. Not long ago, a woman wrote to you about heel pain due to plantar fasciitis. When I had this problem, I sought physical therapy for it.
What helped me the most was that the physical therapist massaged my heel with diclofenac sodium cream. That eliminated the pain for several hours. At the time, the cream was only available by prescription, but now you can buy it without a prescription.
After about six months, I finally got rid of my heel pain permanently by stretching my foot several times a day. He would pull his toes towards me with his hands for up to 30 seconds at a time. You can find demos of this stretch online. I’m still doing these stretches every day 10 years later and the plantar fasciitis hasn’t returned.
A. We are not surprised that the topical NSAID diclofenac (Voltaren Gel) has helped relieve heel pain. The foot stretch you describe is often recommended to help prevent or overcome plantar fasciitis.
Q. Thank you for writing about amiodarone. My late husband was prescribed amiodarone after bypass surgery. I guess it was just a precaution, because he didn’t have atrial fibrillation.
It caused pulmonary fibrosis that caused his death five years later. Of course, the cardiologist denied that was the cause and we couldn’t prove it. Still, the pulmonologist had no doubt that the drug was responsible.
A. We are very sorry to learn of this tragedy. According to the FDA, doctors should prescribe amiodarone only to patients with life-threatening heart rhythm disturbances that have not responded to other treatment. That is because this drug is very dangerous.
The official prescribing information warns that: “Pulmonary toxicity rates have been reported as high as 17% and are fatal in approximately 10% of cases.” In addition to lung problems, amiodarone can change thyroid and liver function. It can also interact with many other drugs.
Questions for Joe and Teresa Graedon can be emailed through their website: www.PeoplesPharmacy.com.