Q. In a recent news article you asked for comments from those who have been on statin drugs.

I was prescribed Mevacor after a mild heart attack in 2001. Within a year, I was finding that my memory was noticeably deteriorating (I was forgetting customers' orders, which I had never had a problem with before), had upper arm muscle paid so severe that I could not lift my arms above shoulder height nor put on a jacket, because my arms would not go back past my sides; had a cataract that became noticably worse, and developed a hand tremor similar to Parkinsons' disease. I read somewhere about memory loss associated with statin drugs, so I discontined taking the medication. Within two weeks, I could feel my brain fog clearing, the hand tremor disappeared never to return, my vision returned to a previous level, and the am pain disappeared. It took a year, however, to regain full range of motion. I asked my opthamologist if he had noticed a relationship between statins and cataracts, and he said that he had had other patients whose vision deteriorated after taking statin drugs. My memory is still not as good as it was, and I have a family history of mental acuity for the whole of a long life. I had my heart attack at the age of 61, with no previous heart history. A cousin three years younger than I also had a heart attack at the same time. I saw him last summer, and when he picked me up from the airport he didn't see me for about 6 circuits of the pickup area, and took 4 1/2 hours to get to where I was staying, which is normally 45 minutes from the airport and somewhere he has delivered me any number of times over many years,in a part of town he used to work in. I asked what meds he was on, and it was Lipitor and niacin. I contacted his sister when I returned home, and she said she, as well his daughter, were also concerned but that his doctor had him convinced that the meds were absolutely critical, and his reasoning skills had deteriorated to where he was not comprehending our concern. I have had a number of other friends that had similar stories, and whose doctors refused to believe what they were saying. The more research I do, the more convinced I am that I am much better off without these meds, and I work full time and feel great.

A. Thank you so much for sharing your experience with statins. I think the only way we can shine a light on these concerns is for patients to share their experiences. Certainly what happened to you is troubling. I am glad you are okay - and managing your cholesterol and other heart risks in other helpful ways.

Q. I have overactive thyroid showing an enlargement on both sides and my doctor advised me to choose between removing the gland and x-ray therapy. WHICH ONE IS BETTER REMEDY AND ARE THERE OTHER SOLUTIONS TO MY CONDITION?.

A. Surgery to remove the overactive thyroid gland is rarely recommended unless you are pregnant and can't be exposed to any radiation. Surgery has potentially more immediate and long-term risks. Believe it or not - the biggest risk (and benefit) of radiation is the likelihood you will develop an underactive thyroid in a few months or longer and then need lifetime replacement with thyroid hormone. This is by far considered the least invasive way to go for most people.

Q. Was able to see the segment on excessive sweating on ABC. Was wondering why you did not have Mon Ray Antiperspirant as an option. Based on your statement, Aluminum Chloride is the ingredient that stops the sweat; they claim to have the most active ingredient outside of prescription.

Based off their website, they have the most Aluminum Chloride (17.1), was wondering why you did not mention them.

Outside Drysol, Mon Ray offers the most active ingredient and also does not have alcohol, which they claim to reduce the irritation that you see with Drysol. Would like to get your comments on this. I am planning on purchasing this product, after seeing your segment, I think I have answered my own questions, but was wondering why you did not have that as an example.

A. Thank you for alerting me to the Mon Ray antiperspirant. I was not previously aware of the product. It is not my intention to promote a specific product, but rather to present an array of available ones. As you heard me say, the aluminum salt is the active ingredient, which crystallizes in the sweat duct when it comes into contact with the sweat, temporarily blocking off the sweat duct and sweat production. Stronger brands can be irritating - and alcohol is more irritating yet can active as an astringent too. There are so many products and the added ingredients can be soothing, help with odor etc. so personal preference and an individual's response is important too.

Thanks again for the heads up.

Q. I am a pharmacist..with osteoporosis A book by an MD noted that Actonel, fosomax dont add bone They dont work on trabecular bone just cortical bone ( I hope I have that right) So why should I take this..with stomach side effects and the problems with the injection that can cause worse problems.

A. You have asked a number of tough questions. What we do know is that the bisphosphonates (such as Actonel and Fosamax) interfere with the osteoclasts (the cells that are constantly breaking down bone) so that the bone building cells take over leading to a gradual increase bone density and proven lower fracture risk. Trabecular bone is the spongy bone in the vertebrae and inner hip area that is already more "porous" and is lost first in women as they lose estrogen at menopause. It is also the bone that is most actively breaking down and building up so it is most affected by bisphosphonates. All men and women lose both cortical bone and also trabecular bone as they age - and this leads to a greater risk of fractures to long bones and of course the hip. The drugs can reduce bone fractures in both hip and vertebral sites but there are a number of long term safety concerns too. Short term they irritate the esophagus if directions aren't followed closely, and diffuse bone aches and pains. Long term there is a rare risk of bone death, especially in the jaw. That said, I do think that in addition to calcium, lots of vitamin D and exercise, bisphosphonates can be life saving for elderly with severe risk of fracture. I am hesitant to routinely recommend it in younger people with bone loss as I am concerned about taking this drug for many many years.

Hope this is of some help to you.

Q. I am a male 60 years of age and have the following conditions: Type 2 Diabetes A1C 7.9 take 5 mg glipzide 1 X a day and 500 mg metformin 3 X's a day. Hypothyroid for many years taking 122 mcg Levothyroxine Psoriasis for many years and psoriatic arthritis taking Diclofenac 50 mg 2 X's a day and Prednisone 2.5 1 X a day Use Mg 217 tar based ointment for psoriasis patches and demorest for face patches. Have vitiligo for many years and have not had too many flare ups Thank God! Take 50mg Metoprolol 2 X's a day for high blood pressure. Have osteopsorsis but stopped taking Actonel because it interacts with Diclofenac according to my rheumatologist and when it was taken away I experienced too much swelling and pain so I stopped actonel and asked my rheumatologist to put me back on diclofenac. Also take 7.5 mg Methotrexate once a week for arthritis. Have high cholesterol and take 40 mg of pravastatin and 10 mg zetia 1 X a day before I go to sleep. Take isosorb for clogged artery disease 30 mg 1 X a day and have a stent implanted LAD in Oct 2007. Had a stress test in Dec 2008 and passed it. Take a multivitamin once daily and folic acid and calcium and vitimin D tablets. Oh I also have gerd and a hyiatal hernia diagnosed in 5/09 and take 20 mg aciphex 1 X a day.

All of that to ask you the following: In your article about the effects of statins I am always tired and fatigued I can sleep eight to ten hours and feel refreshed but fall asleep at work constantly if it wasn't because my boss knows my illnesses I think I would have lost my job a long time ago. I have spoken to my PCP about this and she says that it can't be the statins as I have been taking them for a long time. In your opinion might not the statins be causing this tiredness or perhaps sleep apnea? Sometimes I feel like I am being dismissed. If you need more information to better make some kind of informed comment please feel to email me and request same at my email address below. Thank you for your time and I know that you get many emails and that perhaps you won't be able to answer this immediately but appreciate your time and thoughts whenever you are able to do so.

A. Thanks for your question and helpful medical summary. I think you are right to be concerned about sleep apnea in view of the fact you fall asleep so much during the day yet get what seems to be plenty of sleep at night. Have you ever had a sleep study? I recently wrote about research suggesting that up to 80% of patients with diabetes may have sleep apnea - and most go undiagnosed. Untreated sleep apnea could further increase your blood pressure and risk for heart disease.

Although statins are recognized to cause fatigue, low energy, etc. the typical description is more a tiredness/achiness in the muscles and perhaps some mental changes. That doesn't quite sound like what you are experiecing. On the other hand, the only way to exclude pravachol as the culprit would be to try a period of time without it. I suspect your physician may be concerned however if you stop it. A patient with diabetes and high blood pressure and cholesterol has a pretty high risk of heart disease and statins have been clearly shown to help reduce this risk. Other treatments such as red rice yeast has been shown to be effective in lowering bad cholesterol, but there is no evidence they prevent heart attacks as statins do.

If you have a sleep problem, treatment such as using a breathing apparatus can be very effective.

Q. I recently had a triple bypass and have been put n the Mediterranean diet, so will be listening for Dr. Marie's advice. The problem is - I was already being careful with my diet - I feel like - what more can I do???

A. I was surprised to learn about your bypass surgery. Did you have a family history of premature heart disease? Your lipids okay? did you smoke when young? or have high blood pressure? Obviously diet (plant based with some omega 3's/fish oil) is hugely important - but almost certainly there were other factors - maybe genetic/hormonal and somewhat beyond your control. I presume you are now on aspirin, a statin, fish oils, etc.?