Ask the Doctor—Healing After an Accident - Altitude Sickness - Depression - Cradle Cap

by Dan Lukaczer, ND

Q I just had a car accident and am feeling bruised and battered. What supplements, if any, may help?

A Of course, with any car accident, it’s important for a medical professional to examine you, since many injuries such as whiplash or other internal injuries are not always readily apparent. After this, my first choice is the well-known homeopathic standby Arnica Montana. Numerous clinical trials demonstrate arnica’s ability to reduce bruising and swelling, and I have found it to work well. Some controversy surrounds its use, because other studies show no demonstrable effect. Nevertheless, with its excellent safety record, enough positive trial results and my own encouraging clinical experience, I generally recommend it for this kind of accident.

I also would suggest you try bromelain (Ananas comosus), an extract from the pineapple plant. It is a sulphur-containing proteolytic enzyme often taken to help digest the protein in food. If taken without food, however, the enzyme is absorbed intact and can reduce some of the compounds that cause pain and inflammation. In particular, it breaks down fibrin, a compound that forms a matrix to wall off an inflamed area, potentially causing blocked blood vessels, inadequate tissue drainage and swelling—leading to that bruised and battered feeling you mention. Studies on bromelain go back 40 years, and most show positive effects.

You should keep two things in mind, however. First, if you are sensitive to pineapple, you may be sensitive to bromelain. Second, bromelain can act as a blood thinner: If you’re taking prescription blood-thinning drugs (e.g., warfarin), you probably shouldn’t use it. This is merely cautionary; to my knowledge no one has reported any adverse effects, but it’s always better to be safe than sorry.

My third recommendation is comfrey (Symphytum officinale), which is applied topically as a salve. A recent double-blind study found that the herb eased the pain and inflammation of ankle sprains, so it is reasonable to extrapolate that other sprains and bruises would respond as well. Comfrey should only be used topically since it can be toxic when taken internally.

Q I am planning to go hiking at high altitudes and was wondering about natural supplements to prevent high-altitude sickness.

A The technical term for this condition is acute mountain sickness (AMS), which can affect an unacclimatized hiker climbing to a higher altitude, especially one greater than 8,000 feet. AMS is relatively common and usually mild. Symptoms include pounding headache, light-headedness, dizziness, nausea and/or vomiting. The more severe the symptoms, however, the more serious the situation can become. First and foremost, it is essential to retreat to a lower elevation.

As far as preventing or minimizing AMS, two important protective measures are slowing your rate of ascent and drinking plenty of water. Also, there is some evidence—but not a definitive “yes”—that a standardized extract of Ginkgo biloba is effective. One placebo-controlled study suggested that 60 mg of gingko three times per day may help if taken one day before a rapid ascent.

Two other controlled studies indicate, however, that ginkgo was no better than a placebo. It is possible the dosing is important—three times per day versus twice per day. I also have seen recommendations for 200 mg standardized extract twice daily for two days before an ascent.

Q My son is 17 and has been troubled with a scalp condition since childhood. It looks like cradle cap but never goes away. What can I do?

A What you describe sounds like seborrheic dermatitis. Cradle cap is, in effect, the infant form of this condition, and it generally disappears after infancy. Adult seborrheic dermatitis can be a chronic condition, as your son is finding out. The hallmark is a dry, itchy scalp, typically with flaky “scales.”

Various reports indicate that eliminating food allergens or supplementing with high doses of B vitamins might help. Unfortunately, these reports are quite old and there is little recent research to support or refute their claims. You can try eliminating common food allergens such as wheat and dairy for three weeks and see if the condition improves. If it does, continue to stay away from those foods; if not, you’ve lost nothing. The same is true for the B vitamins. I suggest 250 to 500 mcg of B12, and 1 to 2 mg of biotin and folic acid. Try them and see if they have any effect. They are inexpensive, nontoxic and very important for other areas of health.

More recently, scientists found that infants with cradle cap appear to have an imbalance of essential fatty acids in their blood that returns to normal when their cradle cap resolves. In a preliminary trial, topical applications of borage oil (which contains the omega-6 gamma linoleic acid) twice daily to the affected area resulted in clinical improvement within two weeks. A later test, however, did not completely confirm borage oil’s proposed effect. As a practical measure, topical borage oil seems like an easy option to try.

Q I’ve taken St. John’s wort for the past few years, and it seemed to help. But recently I’ve experienced the same issues with depression I was having before. The St. John’s wort seems to have lost effectiveness. Any suggestions?

A There is a lot we don’t know about St. John’s wort (Hypericum perfolatum).
Although numerous trials attest to its efficacy for mild depression, I’m not aware of any studies that have followed patients long term—as in years. So we are left a bit on our own. I do have a few suggestions. To begin, sometimes even prescription antidepressants lose their effectiveness and require a higher dose. How much St. John’s wort have you been taking? I generally recommend 900 mg of a standardized extract.

Next, have you changed your medication routine? A number of other medications such as many oral contraceptives and some antibiotics, notably tetracycline, can both influence and be influenced by St. John’s wort. In addition, interactions undoubtedly exist between St. John’s wort and other medications that researchers don’t know about. Make a careful check of other prescription and nonprescription medications you’ve changed recently.

Last, have you changed the brand? Sticking to a brand you trust that uses a standardized extract is important. If you’re still using the same brand, check a new bottle against an old one and see if the formulation has changed (or, if you don’t have an old bottle, contact the company and ask if it changed anything).

With the warnings hitting the news about prescription antidepressants, you should take a careful look at these issues and see if you can uncover some clue as to what went wrong. St. John’s wort seemed to work well for you, and it’s possible it could do so again.