Q. I'm trying to lose 10 pounds and thought of using a nonprescription diet pill. I bought a five-capsule trial packet of Dexatrim, which came with a 1,250-calorie diet and other helpful suggestions on how to lose weight. What is the active ingredient in these pills? Are they safe? Can you become addicted to them? Do they have any bad side effects? A. The active ingredient in Dexatrim is phenylpropanolamine, or PPA. PPA is the main ingredient in most over-the-counter diet pills. It's also the main decongestant in many cold and allergy medicines. PPA doesn't cause any problems for most people, but for some, PPA can spell trouble. PPA acts like adrenaline, the natural stimulant that gives you an extra burst of energy when needed. For example, adrenaline pumps into your bloodstream when you're startled, or at the sound of the starting gun in a race. Like adrenaline, PPA is a chemical cousin of amphetamine, the drug known as "speed". And like these two stimulants, PPA can make your heart beat faster and your blood pressure shoot up. Because of these actions, PPA has led to some potentially serious side effects, such as hypertension. In a few people who are sensitive to it, or especially in overdoses, PPA has been related to strokes, seizures and even death. However, you're more likely to have less serious but more common side effects, such as headaches, nausea, anxiety, restlessness, insomnia, palpitations (heart pounding) or tremor. Some people have developed hallucinations, confusion or out-of-control behavior. This reaction is more likely to happen in people taking too much PPA, such as when they mix it with street drugs to get high. In addition, caffeine seems to make PPA reactions more likely. You should be especially careful about taking PPA if you have high blood pressure, hyperthyroidism (overactive thyroid gland), diabetes, a kidney problem or a heart condition. As always, it's a good idea to check with your doctor when starting a new medication, even a nonprescription one. An over-the-counter drug may not mix well with a prescription medicine you're taking, or it may aggravate a medical problem you have. Although you can't become addicted to these pills, they do carry the risk of side effects. I think you'd be better off if you simply followed the diet and other instructions on how to lose weight, and exercise more. Diet pills are not a long-term solution to being overweight. Q. I've been getting weekly allergy shots for three years for an allergy to pollen. So far, I've had no apparent relief from my hay fever symptoms. Does this mean that the shots just aren't going to work for me, or should I give them more time? A. If the shots haven't helped you by now, chances are they aren't going to help you in the future. For about 6 million Americans, allergy shots relieve the aggravating symptoms of hay fever and other allergies. But they don't work for everyone. Allergy shots help about two out of three people who try them. In your case, I would guess that either you're someone who isn't helped by the shots, or the mixture you're getting doesn't cover the things you're allergic to. Before giving up on them altogether, you might have your doctor test you again to make sure the shots are designed for your particular allergy. There's a chance you're allergic to something else that the shot isn't covering. Normally, allergy shots start with very small doses of the substance you're allergic to. This tiny amount gives your immune system a chance to build up a tolerance to the offending substance -- in your case, pollens. The dose is gradually increased, until you can take full doses without having a reaction. It can take anywhere from three months to two to three years to build up to the full amount. Once you've developed some immunity to that substance, you'll only need "maintenance" shots every two to six weeks. Some people will need to take the shots year-round. Others just need to start them before the hay fever season, for example. Side effects of allergy shots include itching, swelling or rashes, especially at the site of injection. Rarely, you might develop a more serious reaction, such as wheezing, shortness of breath or even shock. Because of these potential complications, many physicians will have you wait in the office for 20 minutes or so after the shot. Jay Siwek, a family physician from Georgetown University, practices at the Fort Lincoln Family Medicine Center and Providence Hospital in Northeast Washington. Consultation is a health education column and is not a substitute for medical advice from your physician. Send questions to Consultation, Health Section, The Washington Post, 1150 15th St. NW, Washington, D.C. 20071. Questions cannot be answered individually.
ncG1vNJzZmivp6x7uK3SoaCnn6Sku7G70q1lnKedZK6zr8eirZ5nnJ6zpr%2FTsqOeZ6eaua26xKyqaGlpbYZwfJdoaG5np52utb%2BMoqVmnJmawW68yKWjrGWnnbKvecClo56ql656tLTOrapmnpGeuXCyxW1ua2qWa3qmsZaaZG1tYpp6oq%2BYmmRwbmFlsXWtwJ%2BYamhf