Diseases & Conditions Archive

Q. For years, I have had recurrent cold sores and took antiviral drugs to treat the outbreaks. A friend suggested that I take daily lysine.  What's the evidence that it works?

A. Cold sores (sometimes called fever blisters) are painful fluid-filled lesions on or near the lips that are caused by the herpes simplex virus (HSV). There are two kinds of HSV: HSV-1, which causes most cold sores, and HSV-2, which is mostly responsible for genital herpes. HSV-1 infection is very common and easily transmitted by kissing or other contact with saliva. Once you're infected, the virus lays dormant in the nerve cells that supply sensation to the skin. When the virus becomes active, it travels to the skin surface and multiplies, causing an outbreak.

Ask the doctor

Q. A friend says that the worst disease of all is ALS. What is it?

A. What makes a disease the "worst?" For many, it would be a disease that robs them of their mind. For others, it would be a disease that creates constant pain. For still others, it would be a disease that makes them unable to care for themselves or to control their bodily functions — in full view of their family and closest friends.

It might be orthostatic hypotension, a condition that can be challenging to catch and treat.

You stand up and suddenly feel unsteady on your feet. It's easy to brush off this experience as a fluke or a bug, but don't. You may have a condition called orthostatic hypotension, a temporary drop in blood pressure when you stand. It's tricky to catch.

"Blood pressure is highly variable, and depends on position, timing, the method of measurement, and circumstances associated with its measurement," says Dr. Lewis Lipsitz, chief of gerontology at Harvard-affiliated Beth Israel Deaconess Medical Center and director of the Marcus Institute for Aging Research at Hebrew SeniorLife. "It may take multiple blood pressure measurements at different times of day, lying and standing, in order to detect orthostatic hypotension," Dr. Lipsitz says.

On call

Q. Lately, my eyelid has begun to twitch for no reason. It comes and goes, but is this a sign of a serious problem?

A. I suspect you are referring to the situation in which a few of the muscle fibers of the eyelid seem to contract in an irregular and random fashion. While it feels strange, it is almost never a sign of a serious problem.

Here's how to prepare for the coming allergy season.

Spring is in the air, and so are millions of pollen particles, the tiny grains that fertilize plants. Seasonal allergies — also known as hay fever — can affect almost anyone and at any time in life. Although most people begin to experience allergies in childhood or early adulthood, sometimes the symptoms become more problematic later in life, especially if their living environment changes.

"Even if you have never suffered from allergies — or used to when you were much younger but not anymore — there is a good chance you will become more sensitive to pollen as you reach your 60s and 70s, although it's not clear why," says Dr. Mariana Castells, of the Department of Allergy, Rheumatology, and Immunology at Harvard-affiliated Brigham and Women's Hospital.

But these remedies aren't the best choice if you have frequent heartburn.

You feel the familiar sensation in your chest: heartburn. Again, you find yourself reaching for the bottle of antacids in the medicine cabinet. It's something you've done a few times a week for the past six months. Is it okay to keep popping over-the-counter acid reducers, or is it time to see a doctor?

We asked two experts, Dr. Jennifer Nayor and Dr. Molly Linn Perencevich, both instructors in medicine at Harvard Medical School, for their thoughts on heartburn, including when it's okay to use over-the-counter antacids and when you should seek other treatments. Below are their responses.

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Q. I recently had diverticulitis. I'd like to avoid a recurrence. Is there anything I can do to prevent this painful condition in the future?

A. As people age, small pouches often form in the wall of the large intestine, a condition called diverticulosis. If food or bacteria become trapped in these pouches, they can become inflamed or infected, which is known as diverticulitis.

Research we're watching

If you have an arthritis-related condition called Heberden's nodes, you may be at higher risk for arthritis-related knee problems, according to a study published online January 9 by Arthritis & Rheumatology.

Heberden's nodes develop when cartilage in the fingers wears away, causing the bones to rub against one another. This prompts new bone to form, creating bony nodules in the knuckles closest to the fingertips.

There are many types of yoga. One of the most popular forms practiced in the United States is known as hatha yoga, a style that focuses on maintaining specific poses. What sets yoga apart from most other exercise programs is that it places as great an emphasis on mental fitness as on physical fitness, what's known as the mind-body connection.

Studies suggest that yoga has benefits for people with Chronic Fatigue Syndrome (CFS), arthritis, fibromyalgia, migraines, low back pain, and many other types of chronic pain conditions. It can also improve mood, which can be helpful to people with CFS who are depressed.

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Q. My teenaged granddaughter was diagnosed with mono. Is that just a kids' virus or can older people get it?

A. We need to distinguish between the illness, mononucleosis (mono), and the virus that most often is the cause of the illness, Epstein-Barr virus (EBV). Most human beings become infected with EBV early in life, typically in their teenage years. Once we are infected, the virus remains in our bodies for the rest of our lives. It lies "asleep" inside some of our cells, periodically "reawakening" to multiply and go on to infect other cells, and then it settles down again.