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People’s Pharmacy: Papaya enzyme cools hot flashes from niacin

Q. My wife and I have found that papaya enzyme is a quick solution for heartburn and upset stomach, and calms the effects of niacin. I have been in a heart study for the past 13 years. I started with four tablets of niacin, but the hot flashes and rash were so miserable, I had to cut my dosage to two tablets.

When I started taking papaya enzyme, the result was fantastic. Besides not suffering heartburn, I could return to four tablets of niacin.

Last year, I was switched to Niacin CR, which is not as drastic. If I start to get hot flashes, I chew a couple of papaya tablets, and the flashes fade away quickly.

A. Papaya is popular in tropical countries, and papaya extracts are sometimes used as digestive enzymes. A modest, double-blind, placebo-controlled trial in Vienna found that papaya extract eased symptoms of bloating and constipation (Neuroendocrinology Letters, January 2013). We’ve not heard that it can provide relief from the itching and flushing associated with high-dose niacin. Thanks for sharing your experience.


Q. I had been taking glucosamine for a few years to keep my joints from aching. My cholesterol level was 229, over the recommended 200 threshold.

A month ago, I switched from glucosamine to turmeric. At my annual checkup, I found that my cholesterol level has dropped to 124.

I made no other changes in my diet or regimen. I read on your site that glucosamine can raise cholesterol, so I assume that is what was pushing my cholesterol up.

A. We are quite puzzled that glucosamine sulfate has been proven beneficial for arthritis pain in Europe (Lancet, Dec. 22, 2007), but studies in the U.S. have shown that glucosamine hydrochloride supplements are no better than placebo for knee osteoarthritis (Arthritis and Rheumatology, April 2014). Two long-term studies of six months’ and three years’ duration investigated whether glucosamine (sulfate) raised blood pressure or cholesterol and found it did not (Open Rheumatology Journal online, Nov. 29, 2011).

Your experience is quite intriguing, however. If others are interested in the use of turmeric or other botanical medicines to ease joint pain, we suggest our Guide to Alternatives for Arthritis. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (70 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. AA-2, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website:


Q. Your recent radio show on chocolate and its health benefits was appreciated. We start our day with granite-stone-ground cacao with chiles and cinnamon in coconut milk as our morning beverage. This has eased inflammation and cut sugar cravings throughout the day.

A. We appreciate your unusual recipe and notice that your hot morning beverage does not contain sugar. Susanna Larsson of the Karolinska Institute in Sweden has reported that both tea and cocoa help relax the blood vessels. In addition, cocoa improves sensitivity to insulin. These physiological mechanisms may help explain why cocoa consumption is associated with a reduced risk of stroke (Stroke, January 2014).

The compounds in cocoa also reduce oxidative stress in the body and keep platelets from clumping together to form clots, as well as fighting inflammation (Molecular Nutrition and Food Research, June 2013).

In their column, Joe and Teresa Graedon answer letters from readers. Write to them via their website: