Have liver function checked if taking black cohosh

Q. You recently wrote about a link between black cohosh and liver problems. I have a friend who has had hepatitis C for 23 years. She had been taking black cohosh for menopausal hot flashes, but her liver enzymes were high, at 600. When I read your column, I e-mailed her, and she quit taking the herb.
Today she phoned to tell me her liver enzymes are now down to 60. She credits quitting the black cohosh for this dramatic improvement. We both thank you for perhaps saving her life.
A. We are delighted to learn that your friend had such a positive outcome. As far as we can tell, this reaction to black cohosh is quite rare. Nonetheless, it is so serious that women taking black cohosh might wish to have their liver function monitored.
Q. For many years, I suffered from heartburn and had to take Alka-Seltzer four or five days a week at bedtime. I had been advised to avoid fatty foods, so I ate a very low-fat diet with lots of rice, pasta and beans. I ate nothing fried.
Then last year, I made a New Year's resolution to lose weight, and I tried the Atkins diet. I worried that eating greasy food like sausage, eggs and hard cheese would aggravate my heartburn but decided to try the diet anyway. (I could no longer button my jeans.)
I managed to lose 25 pounds in 10 weeks and have kept it off for 15 months. I also lost my heartburn, even before the weight came off. I no longer need to take any antacid. Have others reported this benefit?
A. We have heard from some people that the Atkins diet helps relieve symptoms of heartburn and acid reflux. There is even a preliminary report in the medical literature documenting five cases of patients whose acid reflux disappeared when they adopted a carbohydrate-restricted diet (Alternative Therapies in Health and Medicine, November-December 2001).
Q. Do decaffeinated green and black tea have the same antioxidant content as regular green and black tea? We have read about the benefits but want to avoid the caffeine.
A. Jeffrey Blumberg, Ph.D., chief of the Antioxidants Research Laboratory at Tufts University, has assured us that decaffeinated tea contains a similar amount of antioxidants.
Q. I have trouble with insomnia and would like a natural remedy instead of a prescription sleeping pill. I take metoprolol and hydrochlorothiazide for high blood pressure, and sometimes I am awakened by a nightmare and cannot get back to sleep.
My doctor says I can take melatonin, but my pharmacist says there isn't any good research. Is this harmful, or is melatonin a safe sleeping aid?
A. Recent research from the Netherlands (Hypertension, February 2004) suggests that taking melatonin an hour before bed for three weeks can help control blood pressure in men with hypertension. Data suggest melatonin can be effective against insomnia, but longer-term studies are needed to answer your question about safety.
We list drugs that can contribute to insomnia (such as metoprolol) and discuss the use of melatonin and nondrug approaches in our guide to getting a good night's sleep. Anyone who would like a copy, please send $2 in check or money order with a long (No. 10), stamped (60 cents), self-addressed envelope to: Graedons' People's Pharmacy, No. I-70, P.O. Box 52027, Durham, N.C. 27717-2027. Metoprolol should never be stopped without medical supervision.
XIn their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features Syndicate, 888 Seventh Ave., New York, N.Y. 10019, or e-mail them at pharmacy@mindspring.com or via their Web site: www.peoplespharmacy.org.
& copy; 2004, King Features Syndicate Inc.