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Earl Grey linked to cramping

The Baltimore Sun

Is it Earl Grey or English breakfast tea that can cause sore muscles?

There is one case report of a man who developed significant muscle pain and cramping in reaction to Earl Grey tea (The Lancet, April 27, 2002). We have also heard from a few readers who had similar problems.

Earl Grey tea is flavored with oil from the citrus fruit bergamot. This oil contains bergapten, a natural compound that can block the flow of potassium in and out of cells. Muscle cells rely on potassium flow, so that might explain the connection. Most people do not seem to have this kind of reaction, so those who do may be exceptionally sensitive.

I had a wart surgically removed, but it came back. I then spent a nine-month period seeing a dermatologist and trying many different treatments.

He finally suggested I try Tagamet, the heartburn medicine. I began taking generic cimetidine (200 milligrams per day). The wart went away in less than two weeks and has never returned.

This unconventional use of the acid-suppressing drug cimetidine has been known for more than a decade. You may have been exceptionally lucky that your wart responded so well. A recent review of studies of this therapy concluded that "current data do not support the use of H2-antagonists [cimetidine and ranitidine] for the treatment of common warts" (Annals of Pharmacotherapy, July/August 2007).

My physician recently found that my vitamin D level is very low. I find this hard to believe since I drink nearly a gallon of milk weekly and take a multivitamin and supplement of calcium plus D each day.

I also take prednisone, tramadol, gabapentin, methotrexate and leucovorin. Could one of these drugs interfere with vitamin D absorption?

Many Americans have low vitamin D levels, especially in winter when they don't get regular sun exposure. A glass or two of milk daily combined with vitamin supplementation does not always correct the imbalance for healthy people.

Your medications are likely making the situation much worse. Prednisone, gabapentin and methotrexate all can interfere with vitamin D.

You may need at least 2,000 International Units daily, which is much more than you are getting from your supplements and diet. Have your doctor monitor your progress. Vitamin D is crucial for immune function, muscle strength, balance and blood pressure control.

I tried making a cinnamon extract with hot water to help with blood sugar as described in your column. I ended up with a gooey glob. Please provide exact proportions of spice to water so I don't have to deal with the mess.

Research shows that 1/4 to 1/2 teaspoon ground cinnamon before a meal can reduce the rise in blood sugar after eating. We worry, however, that the spice could contain coumarin, a compound that occurs naturally in cinnamon. Regular intake of coumarin could damage the liver.

We suggested putting 1/4 or 1/2 teaspoon cinnamon in a paper coffee filter and pouring a cup of hot water over it. The resulting liquid contains the active ingredient without coumarin.

One reader has a slightly different technique: "I put about 2 teaspoons cinnamon in my coffee filter and then put my coffee grounds on top so I get the benefits of the cinnamon and it cuts any bitterness from the coffee. I turned all my family and friends on to this, and my mother-in-law was able to go off her diabetes medicine that she'd been on for years!"

We imagine that 2 teaspoons of cinnamon is enough for a whole pot of coffee. Anyone who uses cinnamon to lower blood sugar should be under medical supervision and should monitor blood glucose regularly.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or e-mail them via their Web site: peoplespharmacy.com.

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