Some react to ibuprofen

Question: For about six months, I took ibuprofen on a regular basis to prevent muscle aches from my exercise program. During this time, I had many blank thoughts and feared I might be in the early stage of Alzheimer's disease.

Then I checked my nurses' drug manual and found that ibuprofen can have cognitive effects. Stopping the medication improved my mental status. I know the medication is effective for many people, but I would like to alert others to this possibility.

Answer: Millions take nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin IB), naproxen (Aleve) or prescription pain relievers with no problems. In fact, there is some data to suggest that such drugs might help lower the risk of Alzheimer's disease.

Unfortunately, some people are very sensitive to digestive tract irritation. It is estimated that more than 100,000 people are hospitalized each year as a consequence of NSAID-induced ulcers. More than 15,000 die from complications.

Psychiatric reactions are much less common, but there are reports of dizziness, drowsiness, headache and confusion brought on by NSAIDs. Why some are vulnerable to this effect and others appear resistant remains mysterious.

Question: I had dandruff for 26 years and tried all sorts of medicated shampoos with no success. About two years ago I got a fungus under the nail of my big toe. My podiatrist put me on Lamisil, one pill a day for three months.

While taking it, my dandruff cleared up and quit itching. I swear I am totally cured, although the Lamisil did not get rid of my nail fungus.

Answer: We're not surprised to learn that the antifungal medicine you took for your nail infection cleared up your dandruff. Dermatologists believe that bad dandruff might be caused in part by a yeast (Pityrosporum ovale). Antifungal medicines could well eliminate the yeast, which is a type of fungus.

Question: I've read that walnuts can reduce cholesterol. What I would like to know is what portion to eat each day.

Answer: The Food and Drug Administration will allow labeling on walnuts suggesting that 1.5 ounces daily might reduce the risk of heart disease. That comes to about one-third cup of walnuts.

Question: My wife has just been placed on Coumadin for atrial fibrillation. Could you tell us what foods affect Coumadin? Do you have any information about potential interactions with over-the-counter medicines? She has been told to avoid aspirin.