DEAR DR. ROACH: In a recent column, you wrote, “Being anxious all the time isn’t good for you.” What damage can it cause, other than just an unpleasant feeling? — J.
ANSWER: The mind affects the body, and vice versa. In the case of anxiety, continuous levels of strong emotions trigger the release of stress hormones, including epinephrine (adrenalin) and cortisol. These can cause high pulse rate, blood pressure and blood sugar levels, which increase risk of heart disease and stroke. Reduction of anxiety reduces this excess risk.
I strongly prefer to start with non-pharmacologic treatment of anxiety. Simple techniques like mindful breathing, yoga and tai chi can go a long way toward reducing anxiety levels. Cognitive behavioral therapy by a psychologist may be the most effective treatment for anxiety disorders.
DEAR DR. ROACH: I am a 72-year-old woman, and I have been told by various doctors that I have pancreatitis and, some said, pancreatic insufficiency. Can you explain the difference? I have never been told to avoid alcohol, as you mentioned in a recent column, although I do not drink alcohol in any form. I did have ulcerative colitis for more than 25 years, and finally had it removed, and I was doing great. After a few more years I started having severe gas pain and diarrhea, and discovered that I needed a prescription of Creon and a diet with a very low intake of fats. Recently my sugar level has been borderline, so when I can, I use sugar substitute. — H.H.
ANSWER: The pancreas has two main jobs: making enzymes that help digest food, especially fat, and making insulin. Pancreatic insufficiency is when the pancreas can’t do its job, and the first job to go is making the digestive enzymes. The symptoms may include bloating or loose stools, and many people notice fat in their stools, which has a peculiar odor and floats.
Recurrent or chronic pancreatitis, an inflammation of the pancreas most commonly caused by alcohol or by gallstones, is the most common cause of pancreatic insufficiency. However, there is a type of pancreatic insufficiency related to ulcerative colitis, which may be autoimmune, and this may be why you developed pancreatic insufficiency. Creon is a brand of replacement pancreatic enzymes, which can dramatically improve the symptoms of insufficiency.
It is possible that you are now developing diabetes due to ongoing damage to the pancreas. It is said that 90 percent of the pancreas needs to be damaged to get loss of enzymes and 99 percent to develop diabetes.
DEAR DR. ROACH: For 20-plus years, I have been mixing butter half and half with olive oil to use in place of plain butter. I read somewhere that this is healthier than butter alone, and I do not like the taste of margarine. The bonus is that this spreads like a dream right out of the fridge! Am I deluding myself that this is good or better for me? Thank you! — K.B.
ANSWER: You are not deluding yourself. Olive oil has much more healthy monounsaturated fat than butter and much less unhealthy saturated fat, so using a mixture of olive oil and butter is much healthier than butter alone. As I have said before, a little butter isn’t the end of the world, but substituting healthier alternatives, like olive oil, is better. You’ve found a way that works for you.