Hello, dear readers, and welcome to the winter edition of our monthly letters column. The weather has changed, and so have your concerns, moving from the ticks and mosquitoes of summer, to colds and the dreaded flu. Speaking of which:
• Many of you have asked whether it’s time for a flu shot, and the answer is an emphatic YES! After vaccination, it will take your body a few weeks to build up immunity. Considering all the travel and shopping and visiting the holidays bring — much of it in crowded and under-ventilated spaces — we need all the help we can get in staying healthy.
• In a recent column about age-related insulin resistance, we cited research that links a decrease in a gut bacterium known as A. muciniphila, or Akk, to an increase in insulin resistance. A reader from Pennsylvania asked how levels of Akk in the gut can be restored. Unfortunately, as with many gut bacteria that have been revealed to play important roles in health and metabolism, we don’t yet have a way to affect specific populations. The best course at this time is to “eat for your gut.” That is, choose from a wide range of fresh fruits and vegetables, beans, grains, legumes, healthy fats and fermented foods to provide a diverse range of nutrients for the trillions of microscopic organisms that make our guts their homes.
• We heard from a reader who has begun to struggle with leg cramps at night. “The outside muscles of my leg from the knee to the ankle abruptly harden for a few minutes while I am sleeping, which wakes me up several times during the night,” she wrote. “None of the meds I take list this as a side effect. What can I do?”
Nocturnal leg cramps, which become more common as we age, affect up to 60% of adults. They tend to be more common in women than men. For most people, the condition is occasional, but some experience leg cramps on a nightly basis.
The onset of the cramp is sudden, and the experience is quite painful. It can take anywhere from a few seconds to several minutes for the muscle to finally relax. For immediate relief, try gentle massage and topical heat at the site of the cramp. Many of our readers swear by drinking a spoonful of apple cider vinegar mixed with a glass of water. For the long term, strength and stretching exercises have been shown to be beneficial. There is some evidence that supplements like magnesium, calcium, potassium and coQ10 may help, but the results are still unclear.
Thank you for all of your letters, your kind words and, yes, the occasional criticism. We love hearing from you and are always working to make this column more useful. Just a reminder that while we can address the big picture on medical issues, news and conditions, we can’t offer a diagnosis or second opinion. For comments, tips or other suggestions, our mailbox is always open.
Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.
Send your questions to email@example.com, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.