Dear Dr. Roach: My 90-year-old mother lost her sense of smell several years ago. We think it was related to a new medication. I read that vitamin A deficiency can be responsible for this, and I have reason to believe she has a real deficiency. She also has poor night vision, dry eyes and skin problems.
Her doctor nixed the idea of taking any quantity of vitamin A or beta carotene. I am perplexed. Can you think of any reason why she shouldn’t try 5,000-10,000 IU daily for a month or two? Would moderate kidney damage preclude vitamin A in these doses? Is there a test for deficiency?
Vitamin A is important for eye, bone and skin health, and it is also necessary for a properly running immune system. But vitamin A is a fat-soluble vitamin, which means it is possible to get vitamin A toxicity. It’s also teratogenic at high doses — meaning, it can cause birth defects if taken by pregnant women. Doses greater than 6,000 IU should not be taken by women who might be pregnant.
I found an article from 1962 showing that healthy people who lose their sense of smell can improve the sense by treatment with vitamin A. More recently, there have been studies looking at using vitamin A preparations directly to the nose. So, there is some reason to believe that it might help.
There is a test for vitamin A deficiency. The blood level can be measured directly. Vitamin A deficiency is seen most frequently in people who have medical issues with absorption, such as celiac, but especially after gastric bypass surgery.
I don’t know why her doctor is flat refusing to consider the diagnosis. Either a therapeutic trial or measuring the level seems reasonable.
Dear Dr. Roach: I have the solution to prevent intertrigo under the breast. It is a properly fitted bra! The breasts must be lifted by the cups, and the circumference must be snug. A good bra is an essential part of a woman’s wardrobe.
I have 40 years of fitting women of all shapes and sizes in my lingerie shop, and have helped many women who were suffering needlessly.
I thank M.F.W. for writing. Many women wear bras that are not fit properly, and this can lead not only to intertrigo (inflammation, often complicated by bacterial or fungal infection) but also to pain in the breast. Even the medical boards I take every 10 years have questions on breast pain and the importance of getting a properly fitted bra. There are more brands now, with many more sizes available, or a woman can get custom fitted by a boutique with expertise in fitting women, such as M.F.W.’s.
Dear Dr. Roach: I had a tear in my gloves and got some paint remover solvent on my fingers. My skin looks shriveled up and dried. It was probably on my skin for half an hour before I realized I had a hole. Will this permanently affect my skin? I washed my hands with soap and water after I realized it, but the damage to my skin is done.
It is a bad idea to routinely expose your skin to solvent. The solvent damages the skin and can allow cancer-causing chemicals to enter the body. However, a small spot from a torn glove is very small risk. You did the right thing washing with soap and water.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu