DR. ROACH: I'm hot -- but the doctors aren't bothered
DEAR DR. ROACH: I am a 66-year-old woman who usually is too hot. When I tell my doctors, they just sort of laugh it off. It is making my life miserable because if I keep the heat or air conditioning where it is comfortable for me, it is too cold for others. I hate summer and stay inside in the air conditioning. I keep the temperature in my house at 64 degrees Fahrenheit in the summer and winter. I know other members of my family do not tolerate being out in the sun when it's hot, but they aren't plagued with being too hot otherwise.
The sensation of being too warm comes and goes. I am about 40 pounds overweight, and have been for most of my life. The sensitivity has intensified as I've aged. I had a hysterectomy in my 30s, and I know some of my hormones were off. -- J.R.
ANSWER: Heat intolerance is common and has several possible causes. The short list includes excess thyroid hormones, loss of estrogen and being overweight. The long list includes, among many others, some serious conditions, such as polycythemia vera (a blood disorder of having too many red blood cells), inflammation of blood vessels, multiple sclerosis and tumors that secrete substances that can affect blood vessels, such as carcinoid or pheochromocytoma. These are uncommon to rare diseases and usually have other symptoms, and many would likely have progressed over time.
The part of your story that bothers me is that this has been bothering you for years and your doctors haven't taken it seriously. Even if it isn't a life-threatening condition, it's been bothering you, and they should have at least tried to help.
It's time to have a frank discussion with your current or a new doctor and explain that you are concerned about this, that it's affecting your life and comfort, and that you want to be taken seriously. I'm not saying your doctor needs to evaluate you for everything on the long list, but he or she does need to listen, think and explain.
DEAR DR. ROACH: Is it better to take Lipitor at night? Is that true for all statins? -- M.E.
ANSWER: The cholesterol in our blood comes from the food we eat and also by the cholesterol our body makes. Most cholesterol synthesis happens at night. So, it's better to take a statin at night, particularly for statins that don't stay in the body a long time (this is referred to as a short half-life). Lovastatin (Mevacor), pravastatin (Pravachol), fluvastatin (Lescol) and simvastatin (Zocor) have short half-lives, and data have shown better results with these taken at night. On the other hand, atorvastatin (Lipitor) and rosuvastatin (Crestor) have long half-lives, so it isn't so important to take these at night.
Naturally, if you are taking any statin, you should continue a careful diet as well. Taking a medication doesn't take away the harm of a poor diet.
DEAR DR. ROACH: Do peanuts (which are not nuts, but legumes) afford the same health benefits as nuts? -- A.
ANSWER: Most of the studies showing benefits of nuts included peanuts as well. Peanuts probably have the same benefits as tree nuts.
Unfortunately, many people are allergic to nuts, and many to peanuts. Those people can't get the benefits of eating nuts, as it is unsafe, even life-threatening on occasion.