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DEAR DR. ROACH: A New Age friend of mine claims that our food (meat, fish, and even highly processed foods) is full of unspecified parasites, so regular cleansing of the digestive system is desired. Absinthe was mentioned as a treatment. Is it true? Do we need regular “dewormers”? – KO
REPLY: Parasitic infections are rare in the United States and Canada. Many parasites diagnosed in the United States come from international travel. Others, like Giardia, are found in contaminated (untreated) water. Foodborne parasitic infections, such as tapeworms, can be found in beef, pork, and fish, but they are rare. Parasitic infections caused by highly processed foods are said to be extremely rare, which may be the best thing you can say about consuming ultra-processed foods.
Symptoms of intestinal parasitic infections can include nausea and weight loss. Vitamin B12 deficiency is common in fish tapeworms. People may notice part of the worm passing through the stool.
Absinthe is used as a flavoring in alcoholic beverages (wormwood) and is known to be hallucinogenic, although the dose needed for this toxicity is much higher than what one can drink without getting very sick from alcohol. The name comes from ancient descriptions of the use of Artemisia absinthium as a treatment for worms. Interestingly, a recent trial showed wormwood extract to be effective for schistosomiasis in Africa, which is caused by a type of worm that is not found in the United States.
Medicines to treat worms are unnecessary and potentially toxic and therefore not recommended. Since these infections are rare, neither screening nor prophylactic treatment is necessary.
DEAR DR. ROACH: I am 79 years old, male and in great shape. The only medicine I take is 20 mg of Lipitor per day. About five years ago I fell off a small ladder. The fall was caused because I lost my balance. From that moment on, my balance deteriorated. I notice that when I lose my balance most of the time I fall backwards. I consulted an otolaryngologist, whose results came back negative. I met a neurologist, who arranged for an MRI of my brain, which came back normal. Do you have any suggestions? – G.
REPLY: Balance problems are extremely common in older people, and often a single cause cannot be found. Falls occur each year in about a third of the elderly in the community.
A full assessment is appropriate. This includes not only the balance and strength studies that your ENT and neurologist have done, I’m sure, but a vision assessment, heart check, and blood pressure check both while standing and lying down, a foot inspection and medication review (Lipitor is NOT one of the many medications commonly associated with falls). A blood level of vitamin D may be helpful, with supplementation for people with low levels.
If the assessment does not reveal any identifiable cause for the fall, my personal practice is to refer to physiotherapy and / or occupational therapy. These professionals have the expertise to help prevent recurring falls. They may also recommend strength and balance exercises. Tai chi, in particular, has been shown to reduce the risk of falling.
Geriatricians have particular expertise in preventing falls, as well as improving overall function in the elderly.
Dr Roach regrets not being able to respond to individual letters, but will fit them into the column whenever possible. Readers can send questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.
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