Mayo Clinic Q & A - July 2015 Archives

DEAR MAYO CLINIC: What is the most effective way to whiten teeth? Is it worth it to pay the extra expense for treatment from a dentist, or do the over-the-counter options work just as well? Are they safe for your teeth? ANSWER: There are quite a few choices available if you want to whiten your teeth. The approved products — both those you can buy at drugstores and those available from your dentist — are safe. Just make sure you follow the directions carefully. Many teeth whiteners are quite effective, particularly if you use them for an extended period of time. If cost is a concern, try the over-the-counter options first. If those don’t give you the results you want, then talk to your dentist about other choices he or she offers. One of the simplest options is whitening toothpaste. It whitens teeth by removing surface stains, such as those caused by drinking coffee or smoking. Some whitening toothpastes contain the chemical blue covarine. It stays on the surface of the teeth and makes them appear less yellow.

DEAR MAYO CLINIC: I am a healthy 78-year-old man and have never had shingles or the shingles vaccine. I did have chickenpox when I ...

DEAR MAYO CLINIC: I didn’t have allergies when I was younger. But now in my 40s, I seem to get allergy symptoms during the spring and summer. Is it possible to develop allergies as an adult? Should I get tested? If so, what do allergy tests involve? ANSWER: You can develop allergies later in life, and there is definitely value in getting tested to see if your symptoms are due to allergies. If they are, the test results will give you information about what you’re allergic to and help guide you as you decide on treatment. Allergy tests usually involve a skin test, a blood test or both. Allergy development typically has two phases. During the first phase, called sensitization, you come in contact with a harmless substance, and your body mistakenly starts making allergic antibodies, called IgE antibodies, to fight that substance. Those antibodies don’t do anything until you are exposed to the substance, or allergen, again. At that time, the second phase starts. The allergen binds to the IgE antibodies. That sets off a cascade of immune reactions in your body, such as itchy or watery eyes, nasal congestion and sneezing, among others.

DEAR MAYO CLINIC: My blood test for celiac disease came back negative, but I am still having symptoms. Is it possible that I still could have it? What should my next steps be? ANSWER: The symptoms and presentation of celiac disease can vary quite a bit from one person to another. The most common symptoms are bloating and weight loss. Diarrhea or constipation may also affect some people. Less commonly, patients may experience an itchy, burning rash, called dermatitis herpetiformis, as well as heartburn, headaches, fatigue and joint pain, among others. Celiac disease may also cause iron deficiency anemia and neuropathy — tingling or pain in the feet and hands that doesn’t go away. Eventually, if left untreated, celiac disease may cause damage to the nervous system, bones, brain, liver and other organs. If you have celiac disease, eating gluten — a protein found in wheat, barley and rye — triggers an immune response in your small intestine that leads to inflammation. Over time, that inflammation damages the lining of the small intestine, making it difficult for the small intestine to absorb some nutrients.

DEAR MAYO CLINIC: I am 24 and was recently diagnosed with polycystic ovary syndrome. How will this affect my fertility? ANSWER: The effect of polycystic ovary syndrome, or PCOS, on fertility can vary quite a bit from one woman to another. In some women, PCOS can make getting pregnant more difficult than usual. But that’s not always the case. When PCOS does have an impact on fertility, there often are treatments available that can help. There’s no single test that shows you have PCOS. Instead, a diagnosis is made when you have two out of three signs of PCOS. The first sign, irregular or less-frequent periods, suggests that you are not ovulating every month. Ovulation is the process where the ovaries develop a mature egg that is then released into the uterus and can be fertilized by sperm. Women with PCOS usually have less than nine periods per year, or there is other evidence that they are not ovulating every month.

DEAR MAYO CLINIC: I’ve had a cough and some wheezing that won’t go away. My doctor suspects asthma and ordered an exhaled nitric oxide test. Can you tell me more about this test? ANSWER: Asthma is usually diagnosed based on symptoms, a physical exam and certain tests — such as peak flow measurement and spirometry tests — to see how well your lungs are working. But sometimes the diagnosis is still uncertain. To gather more clues, your doctor may use an exhaled nitric oxide test. This simple test takes only a few minutes and can be performed in your doctor’s office or in a lung function laboratory. Asthma causes a particular inflammation of airways in your lungs. Studies have shown that an elevated exhaled nitric oxide — a gas that’s expelled when you breathe out — can be a reliable marker for asthma airway inflammation in certain patients.

DEAR MAYO CLINIC: I have decided that I want to have bariatric surgery, but was told that I need to first go through counseling. What will those sessions involve, and does it really improve my chances of the surgery being successful? ANSWER: Before you have weight-loss surgery, it’s important to understand what to expect and to prepare yourself, physically and mentally, for what’s ahead. Working with a counselor for several months prior to the procedure can help set you up for long-term success following your surgery. “Bariatric surgery” is the broad term used to describe all types of weight-loss surgery, including gastric bypass, gastric sleeve, placement of an adjustable gastric band and a procedure known as a duodenal switch, among others. Although the techniques used in each vary, all are considered major procedures that can pose serious risks and side effects. Going through counseling beforehand can help identify if having such a significant surgery is the best choice for you.

DEAR MAYO CLINIC: I have read that the antioxidant vitamin E provides a lot of health benefits. Is taking a daily vitamin E supplement a good idea? Can it be harmful? ANSWER: The proposed benefits of vitamin E rest on its powerful antioxidant properties. Antioxidants are substances believed to protect cells from damage caused by free radicals, which are produced by your body. Exposure to certain environmental substances, such as sunlight, tobacco smoke or radiation, also can create free radicals. Normally, free radicals perform a number of useful tasks. But too many free radicals cause what’s known as oxidative stress. They overwhelm and damage cells, resulting in tissue breakdown and damage to DNA. Oxidative stress has been tied to a number of conditions, including cancer, heart disease, diabetes, Alzheimer’s, Parkinson’s, cataracts and macular degeneration.