ASK THE DOCTORS: Readers' feedback on kefir and migraines

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From the mailbox:

- We always learn from your letters, and this time it's food scientist Bob Hutkins from the University of Nebraska-Lincoln who helped out. Writing about the finer points of kefir production, he explained that it's actually an added enzyme, lactase, that works the magic of making kefir lactose-free. The enzyme turns lactose into a different type of sugar, and thus allows those who are lactose-intolerant to enjoy the benefits of kefir without gastrointestinal discomfort.

- In response to the column about ocular migraines, we heard from Kurt in nearby Thousand Oaks, Calif. Although Kurt experienced the visual disturbances of an ocular migraine, a brain scan led to a different diagnosis:

"The cause of the vision loss was TIAs from microemboli," he wrote. A TIA, or transient ischemic attack, is a temporary blockage of blood flow to the brain. In Kurt's case, tiny particles, which can often be blood clots, caused the blockage.

"Upon initiation of low-dose aspirin therapy, the visual symptoms immediately resolved," he wrote. "Although migraine is a serious condition, it is not life-threatening in contrast to the possible outcome of TIAs. I would encourage you to inform readers of other possible causes of transient vision loss and the need to have a thorough workup to diagnose."

- The recent changes to blood pressure guidelines prompted more than a few of you to write, both in confusion and frustration. We agree that it can be unnerving when the same blood pressure reading that was considered normal one day is classified as elevated the next.

At this time, a reading of less than 120/80 is the new normal. A top (systolic pressure) number between 120 and 129 is now considered "elevated" blood pressure. When the bottom (diastolic pressure) number exceeds 80, and the top number is 130 or greater, the results are considered high blood pressure.

If it's any consolation, the updated blood pressure guidelines have caused quite a bit of conversation in the medical world, and no small amount of controversy. The reason given for the changes is to promote increased vigilance by physicians and patients in dealing with high blood pressure before it causes harm.

- To the reader who is worried that his newly diagnosed prostate cancer might be contagious, please be reassured that it is not. We quote no lesser authority than the American Cancer Society when we say there is no evidence that close contact of any type can result in the spread of cancer from one person to another.

As ever, thank you for your letters. We are grateful for your interest in this column and realize how fortunate we are to have readers like you.



Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.

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