Q: I’ve been taking a biologic (infliximab) for five years for psoriatic arthritis. I have to get an IV every six weeks. I’m pretty tired of it, and my symptoms seem to be all gone. My doctor says I have to keep taking it, but what if I just stopped? -- Christian B., Dallas
A: You should listen to your doctor. If you stop taking your infliximab, your psoriatic arthritis symptoms almost certainly will return. You have an autoimmune disease, not the flu, and while it sounds like you are in remission, it is not a disease that can be completely cured.
Infliximab was the first biologic, and it has helped lots of people. If you’re tolerating it well, then, like they say, “If it ain’t broke, don’t fix it.” We know the idea of being on a medication for the rest of your life can be unsettling for you, but medications like infliximab can really put the brakes on joint damage caused by your psoriatic arthritis.
One thing you might talk to your doctor about is if you could safely reduce the dosage or cut back on the frequency of your IVs. Infliximab is generally prescribed for an infusion every four or eight weeks, so you might have some wiggle room there. I’m sure your doctor’s answer will have to do with your age, weight, overall health and your diet and exercise habits.
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We understand that no one is happy taking a medication for the rest of his or her life, but around 75 percent of patients can achieve low disease activity with continued treatment, and about 20 percent will achieve remission with or without treatment (although you cannot predict if that is you). So clearly, these medications are the key to leading a full, healthier life. For you and millions of others, they have been a game changer.
Q: Buying all organic food for my family is very expensive. When does it matter and when doesn’t it? -- Bridgett K., Daytona, Florida
A: You’ve asked a question that millions of folks want an answer to, because like you they want to eat as healthfully as possible and stretch their food dollars. The most important thing to know about buying food is to keep it fresh, lean and unprocessed. You want your family to eat five to nine servings of fresh produce a day, along with healthy proteins, including beans, 100 percent whole grains, and skinless poultry and salmon or ocean trout. Also, stick to one 4-ounce serving of red meat a week or two egg yolks a week, and cut down on saturated fats from dairy too. If you do that, you will be providing your family with the fuel they need to stay healthy, keep their brains sharp and avoid everything from depression to diabetes and many cancers.
But if you want to go a step further, you can avoid what the Environmental Working Group calls its Dirty Dozen (the produce with the most pesticide residue), and opt for organic apples, celery, cherry tomatoes, cucumbers, grapes, nectarines, peaches, potatoes, snap peas, spinach, strawberries and sweet bell peppers, especially during pregnancy and the first three years of a child’s life.
And you might want to consider going organic for dairy products and for that one weekly serving of meat. According to a new study done by an international team and published in the British Journal of Nutrition:
--Organic milk and meat contain around 50 percent more beneficial omega-3 fatty acids than conventionally produced products.
--Organic meat has slightly lower concentrations of two saturated fats (myristic and palmitic acid) that are linked to an increased risk of cardiovascular disease.
--Organic milk contains 40 percent more conjugated linoleic acid (CLA).
--Organic milk contains slightly higher concentrations of iron, vitamin E and some carotenoids.
Either way, remember that the most important steps to take are to avoid processed foods and opt for fresh produce and lean proteins.
Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at firstname.lastname@example.org.