Question: What is phenylketonuria? An article I read on aspartame said people with this disease should not consume aspartame. But it didn't bother to explain the disease.
- M.S.Question: Please ease my mind. I drink diet sodas and use a lot of products containing phenylalanine. Is there any chance that this could damage the brain and memory of an individual who does not have phenylketonuria? Is aspartame known to be harmful to the body in other ways?
- G.A.
Answer: Phenylketonuria, PKU, is an inherited illness. The affected infant is born bereft of an important enzyme, one that digests phenylalanine, an amino acid. Without the enzyme, phenylalanine blood levels rise and phenylketones appear in the urine.
If the condition is not caught early, brain development suffers.
To escape brain damage in an infant with PKU, dietary phenylalanine is strictly limited.
Almost all states demand screening tests for PKU on newborns. PKU brain damage has dropped considerably since those laws were enacted.
The artificial sweetener aspartame is a composite of two amino acids, phenylalanine and aspartic acid. That's why it carries a warning label. It alerts all those with PKU to steer clear of it.
Apart from the PKU story, aspartame has been suspected of causing many ills. However, analysis of the information linking aspartame to any illness has exonerated the artificial sweetener. You need not fear using it.
Question: I take Coumadin. I'm told to be consistent with my diet. Can you tell me if that means to eat the same amounts each day or the same foods each day? I asked the doctor but did not get an answer. He just says I must be consistent.
- L.L.
Answer: Coumadin thins blood by blocking the action of vitamin K, which is intimately involved in clot formation.
The dietary consistency your doctor stresses has to do with your daily consumption of vitamin K foods, which include liver, broccoli, cauliflower, kale, spinach, cabbage, Brussels sprouts, lettuce and herbal and green tea. If you keep such foods and their portion sizes similar every day, you will not throw off the blood-thinning effects of the Coumadin.
On days you eat unusual amounts of those foods, the blood would not be thin enough. On days you skip the foods, your blood would be too thin.
If you really want to play it safe, avoid those foods altogether, and tell your doctor you plan to do that.
Question: I read your article on lichen planus. I have it in my mouth. It comes and goes. My doctor told me the lichen planus would go away when I quit worrying about whatever was bothering me. I find that anxiety brings it on. I take half a nerve pill and away it goes.
- A.M.
Answer: I have no doubts about the mind's role in aggravating illnesses. I must say, however, I had not heard of the value of tranquilizers for lichen planus.
My fellow doctors are likely to be out of sorts when they read of your treatment for lichen planus. Doctors favor standard treatments such as cortisone creams or pills. Cyclosporine, an immune-system regulator, is another popular choice.
Lichen planus appears on the skin, in the mouth and on the genitals. On the skin it looks like a flat-topped, purple, slightly elevated patch, which is extremely itchy. In the mouth and on the genitals, it looks more like white, lacy streaks, which might form ulcers.
In close to 70 percent of all cases, lichen planus disappears within a year. Sadly, it comes back to haunt about half of those who have had it in the past.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him at P.O. Box 5539, Riverton, NJ 08077-5539.
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