Ask Dr. Frita: Medical Questions and Answers

Have you ever had a medical question and just couldn't figure out the answer, or were you too scared to ask? Fear not, because today I'm going to answer your burning questions about all things health and medicine related from some of my past YouTube videos. And if you have any pressing questions or concerns, please put them in the comment section below, and who knows, I may just feature your question next. Trust me, we all have questions, and so today, let's get some answers. Join me as I dive into Ask Dr. Frita: Medical Questions and Answers. These are questions and comments that have come from past YouTube videos, and I'm going to answer them now.

1. "How Do You Feel About Sea Moss?"

(Question from my YouTube Video: How To Reduce Blood Pressure At Home)

That's a great question because sea moss has been all the rage, right? And sea moss is actually seaweed, it's red seaweed, and there have been lots of claims about sea moss like it's good for your complexion, digestion, breathing, clearing up mucus, and for getting rid of toxins. Here's the issue. We don't have any steady, large, randomized controlled trials, and so there really is limited data to prove the benefits of sea moss.

That being said, sea moss has been used for centuries. So if you look at some of the nutrients and minerals, we know that sea moss has calcium, magnesium, chromium, and it has vitamin B2. And so, it definitely has some antioxidants, lots of things with health benefits. But here's the flip side. Sea moss can also have certain substances that aren't good for everyone. It can have a lot of potassium. And if you're someone who has chronic kidney disease for example, then it's important, in most cases, that you limit your potassium.

Also, it can have some heavy metals like lead, mercury, and even arsenic. And because a lot of the sea moss products come in gels, pills, and powders, many of them, or most of them I should say, are not FDA-approved. And so you don't exactly know if you're being introduced to dangerous levels of heavy metals. It's a possibility.

And the other thing about sea moss is that it has iodine, which definitely can be good, but if you're taking iodine in excess, then that can affect your thyroid function. So here's the bottom line. I do believe that sea moss does have some health benefits, but sea moss is not going to have the same benefits for everyone. And sea moss in excess can be toxic to people. In fact, if you look at some of the recommendations, some say that you should only have two tablespoons of sea moss, but a lot of people out here eating sea moss think that "more is more".  That's not necessarily so. So what you should do is consult with your physician, take the sea moss, the brand that you're actually wanting to use, and find out if sea moss is safe for you.

2 . "I Am A Vegan Who Eats A Lot Of Canned Beans, Corn, and Diced Tomatoes. I Rinse Everything. A Lot Of Sodium Is In The Liquid That They Come In, and Can Be Deadly. So Tell Me This, Am I Correct?"

(Question from my YouTube Video: 15 Foods to Avoid If You Have High Blood Pressure!)

That's a great question.  So you're a vegan, congratulations! Having a plant-based lifestyle is definitely heart healthy, kidney healthy, and it's just good for you. As far as canned vegetables, the best choice would be fresh vegetables, right? Fresh vegetables, organic vegetables with no pesticides.

But we also know that's the most expensive choice, and not always the most convenient choice, because fresh vegetables can go bad quickly in a lot of cases. So, if you can't do the fresh vegetables, the next choice would be frozen vegetables which tend not to have the added sodium. But again, if you don't have the space, a huge freezer to store the frozen vegetables, that might not be feasible either.

The next best choice is going to be canned vegetables with low or no sodium added. But if you're having canned vegetables that do have sodium added, that's definitely better than not having a plant-based diet, and rinsing them is the best thing to do. You want to dump out that salty stock that's in there, and you want to replace it with rinsed vegetables.

That being said, some of the salt will have been soaked into the vegetables. That's just inevitable. But this is the best-case scenario when eating canned vegetables. So you are doing the right thing for canned vegetables by rinsing them. Remember that the recommendation for most people is to have less than 1,500 milligrams of sodium per day because if you have higher than that, that could increase your risk for hypertension.

3. "A Nephrologist Is Not An Expert In High Blood Pressure, There Is No Such Thing As A Doctor Of High Blood Pressure. Frita Is A Kidney Doctor, Period."

(Question from my YouTube Video: 15 Foods to Avoid If You Have High Blood Pressure!)

Are you for real? Okay, so yes, I am Dr. Frita. I am a Nephrologist, I am a kidney specialist, but I'm also a high blood pressure specialist. I don't even know if this is a joke or not. So here's what you may not know, the kidneys are responsible for regulating your blood pressure. In fact, when I get patients and referrals, they come from other specialists like Gastroenterologists who are stomach doctors. They come from Endocrinologists, like diabetes doctors. They come from Hematologists, Oncologists, Blood doctors, and Cancer doctors.

And do you know what they tell their patients? "I'm referring you to Dr. Frita who is a Nephrologist, and a high blood pressure specialist." I'll just give you a couple of things. We talk about salt, and how sodium controls blood pressure in a lot of ways, right? Too much sodium can lead to high blood pressure. Well, guess where your salt is regulated? In your kidneys.

In one of my videos, we discuss how a high-potassium diet can help to lower blood pressure. Where's the potassium regulated? In the kidneys. There are also other things, you're renin-angiotensin system. And when you have low blood pressure your kidneys kick in to help your blood pressure to be at a proper level.

When you have high blood pressure and excess fluid in your body, guess what organs help to get rid of that fluid, the kidneys. So yes, I'm a Nephrologist, I'm a kidney specialist, and I am a hypertension high blood pressure specialist. Why? Because it's the kidneys that help to regulate high blood pressure.

4. "What If You Are Unable To Burp or Fart? Is That A Sign of Kidney Failure?"

(Question from my YouTube Video: 10 Kidney Failure Symptoms)

If you are unable to burp or belch, or if you're unable to fart or have trouble with flatulence, that is not necessarily a sign of kidney failure. I want you to watch my video on some of the signs and symptoms of kidney Failure after you finish reading this article. Now, if you're having digestive issues like that, which it sounds like you're describing, that could be an issue with your digestive system. You could be constipated, or you can have an autoimmune disease like Crohn's disease, or ulcerative colitis. You could also have reflux disease. There's a long list.

And in some cases, especially in advanced kidney disease, you may also get some stomach gastrointestinal problems. But if you are not able to "burp or fart," as you say, that is not necessarily a sign of kidney failure. I thank you for your support.

5. "Lately, I've Been Smelling Ammonia, Especially At Night While Sleeping. My GFR Is 50. I've Been In Stage Three CKD For Over Five Years Now. Is Smelling Ammonia Normal?"

(Question from my YouTube Video: 10 Signs of Kidney Disease)

Thank you for that question. Okay, so you have a GFR or a glomerular filtration rate of 50. And you've been in CKD stage three. I want everyone to watch my video on CKD stages after you finish reading this article to better understand. Now, that's a moderate stage of CKD, it's not very advanced. And when you talk about this ammonia, sometimes people who have more advanced kidney failure, especially when you get to CKD stage five, will have a breath that smells like ammonia, or that actually smells like urine.

If you are having a sensation or smell of ammonia, that's not necessarily a sign of kidney failure, but I certainly would recommend that you go to your nephrologist to get some updated kidney numbers and to be sure that you don't have something else going on. But yes, the ammonia or urine smell of the breath can be associated with kidney failure.

Also, if you have kind of a sweet, or ammonia smell on your breath, it could be associated with diabetes. So I recommend that you go to your primary care physician, and to your nephrologist to make sure that you have updated numbers and that you get a full physical exam to find out what this means for you. Thank you for the question.

6. "Is This Safe For Someone To Stop Medication For Diabetes and High Blood Pressure When The Measurements Go Back To Normal For Two To Three Months?"

(Question from my YouTube Video: 10 Signs of Kidney Disease)

Ooh, this is a great question. And if you're talking about yourself, congratulations on those numbers going down. With that being said, I don't recommend that you stop diabetes, high blood pressure, or any medication without consulting with your physician. Now, if for example, you've had lifestyle modifications, I do have patients who are able to come all the way off of diabetes medication, and off of insulin. Also, for patients with lifestyle modifications such as weight loss, many can come off of high blood pressure medication. But I always recommend that you do it under the consultation of your physician. I don't recommend just stopping yourself at home.

7. "How About That Tingling Sensation and Numbness of the Left Leg To Buttocks? Is It Also A Sign and Symptom of A Heart Attack?"

(Question from my YouTube Video: Heart Attack Symptoms: 7 Warning Signs You Should Never Ignore!)

Thank you for that question. And this one came under, The Heart Attack Symptoms, Seven Warning Signs you Should Never Ignore. We know more classically we think of one of the symptoms as being a tingling of the left arm or shoulder, or jaw, but we know it could be both shoulders, both arms, and you can have all kinds of symptoms that aren't typical. A classic one is not a tingling of that left leg or buttock, and you want to make sure that you consult with your physician 'cause you could have some type of a neurological issue. For example, you could have sciatica, or you could have an issue with your spine, like your lumbar spine or something going on in your vertebrae. You could also have a circulation issue as well. Make sure you consult with your physician, because that is not a classic heart attack symptom, but you definitely want to make sure you have all of your updated heart tests and evaluations completed.

8. "What’s Your Take On Statins? I Am Afraid To Take Them Due To Adverse Side Affects (Loss of Muscle and Brain Function)."

(Question from my YouTube Video: How To Keep Your Kidneys Healthy)

- Jodi, your question is right on time about statins, because the US Preventive Services Task Force (USPSTF) just came out with some new guidelines for statins which are cholesterol medicines, but they also have benefits to prevent heart disease and stroke. In the study, they actually reviewed 26 studies, and they looked at over 500,000 patients. So it was a really good data set. And what they found time after time, is that the patients who used statins, and took the statins had a decreased risk for heart attacks and strokes. And those risks were minimal.

The risks that you're talking about did not outweigh the benefits. And so now the recommendation is, that if you're between the age of 40 and 75, and you have at least one risk factor for heart disease like diabetes for example, and if you have a 10% chance of having a heart attack or a stroke in the next 10 years, it's recommended that you take a statin.

Now actually, the American College of Cardiology and American Heart Association also recommends statins, but they're even a little bit more strict than the USPSTF. And they recommend that if you have even a 7.5% as opposed to a 10% risk of having a heart attack or stroke in the next 10 years, you take a statin. And if you have diabetes, for example, they say don't bother calculating the risk, just go ahead and take the statin. And so my stand on statins is that their benefits far outweigh the risk, especially if you're between the ages of 40 and 75.

9. "Do You See Patients In NYC? I Would Love To Have An Appointment With You."

(Question from my YouTube Video: How To Lower Blood Sugar Levels Naturally)

- Marie, thank you for asking. Yes, I see patients in New York City, The Big Apple. I have a telemedicine practice, so please make sure that you click my link and get the information, and I'd love to set up an appointment, and to meet you. Thank you.

10. "How Long After Changing To A High Blood Pressure Diet Will I Start To Feel Better and See Consistency?"

(Question from my YouTube Video: 15 Foods to Avoid If You Have High Blood Pressure!)

Thank you, Shirley, and I see that you've put this question under my video on, 15 Foods to Avoid if You Have High Blood Pressure. If you make this lifestyle change, the answer is going to vary from patient to patient. It depends on how far along you've already been in having a healthy lifestyle. But for most people, within two to three weeks of being consistent, they will start to see results. They will start to see the blood pressure lower. And beyond just having foods that are low in sodium and that are heart healthy, and high blood pressure friendly, you also want to make sure you have the exercise, and you are trying to get toward a healthy weight. All of these things in combination will help you, but within two to three weeks you will start to see results in most cases, but it could take longer. Don't give up, because definitely having these heart-healthy diets, it's going to help you in the long term.

11. "What About Your Pulse Reading? What Role Does It Play with Blood Pressure?"

(Question from my YouTube Video: Systolic vs Diastolic Blood Pressure)

Oh, that's a good question. So, when you say pulse reading, you're talking about the heart rate. And yes, on that blood pressure machine, you often will see the heart rate. Now, it's going to vary from person to person, make sure you consult with your physician. But for most adults, a normal heart rate or pulse reading is between 60 and 100.

If it's well over 100, that's too fast, Tachycardia, and well under 60, that's too slow, Bradycardia, especially if you have symptoms. Here's the real key. For a person who is taking blood pressure medications or who may need to take blood pressure medications, some of these medications will affect your heart rate. And so it's important when you're reporting your blood pressure to your physician, that you let them know your pulse reading number as well. Because depending on the pulse reading, they may or may not be able to give you certain medications. The other thing is that if you have very low blood pressure or hypotension, you may have a high pulse rate, and having that information will help your physician.

12. "Are You From Nigeria?"

(Question from my YouTube Video: Uterine Fibroids Symptoms)

Juliet, I get asked that question all the time, and the answer is no, I'm not from Nigeria. I get asked if I'm Nigerian, specifically if I'm Igbo. But to be honest, I only know my history back so many generations. So it is quite possible that my roots could be in Nigeria. I need to do a DNA, I've never done a DNA test before. But no, I'm not Nigerian. I was born in the south, Augusta, Georgia. So I'm one of the GRITS, "girls raised in the south".

13. "What Causes One Number To Be Higher Than The Other?"

(Question from my YouTube Video: Systolic vs Diastolic Blood Pressure)

Systolic blood pressure is the pressure within the blood vessel walls when the heart is contracting. And so that's when you're gonna have a higher pressure, a greater force. That number's going to be higher. Diastolic blood pressure is the pressure or the force within the blood vessel walls when the heart is relaxed. So there's less pressure. So that number is lower, and that's why. And which number is more important? Well, it actually depends on your age group. And so if you make sure that you listen to that video, Systolic versus Diastolic Blood Pressure, Which One is More Important? I go into detail about which one is more important for you, but spoiler alert, they're both important. You want them both to be within a normal, and healthy range.

14. "Can Congestive Heart Failure Be Cured/Reversed?"

(Question from my YouTube Video: Congestive Heart Failure Overview Part 1)

Stasha, this is such an important question, because amazingly in many cases, yes. In fact, I was just talking to one of my patients with congestive heart failure, and he was at a point where the way that his heart pumped was so low, that he actually had to get a defibrillator. He had severe congestive heart failure. But, after going through certain things, like getting on the proper medications, getting to a healthy weight, having a low salt diet, and doing other various things that his heart failure specialist has had him do. And doing different treatments that I've had him do for his high blood pressure, his congestive heart failure has improved immensely. He has not totally corrected, but he's gotten to a much, much safer stage. And so congestive heart failure can be improved, and some of those really, really low numbers can be reversed. Will you have a 100% cure? Not necessarily. But please, if you have heart failure, make sure that you consult a cardiologist and specifically, a heart failure specialist.

15. "How Do I Get Your Book, "Under Pressure?"

(Question from my YouTube Video: Systolic vs Diastolic Blood Pressure)

You can get my book, "Under Pressure: a Guide to Controlling High Blood Pressure," by going to Amazon, or you can go to my website.

16. "What If You Have Some of These Symptoms But Your Blood Work Says Your Kidney Levels Are Within Normal Range?"

(Question from my YouTube Video: 10 Kidney Failure Symptoms)

That's such a good question because here's the thing, a lot of the symptoms of kidney failure are non-specific, meaning, you can have them from kidney failure, or something else. For example, you can be nauseated with kidney failure. You can also be nauseated if you're pregnant, or nauseated if you have reflux disease. So the point is, to see your physician and rule out the things that it is not. Now, if they've done your complete kidney workup, your BUN, creatinine, and your GFR, all of those things, and they're sure that you don't have kidney disease but you're still having symptoms, then talk to your primary care physician about looking for other things that can cause some of these overlapping symptoms.

17. "What Happens If You Choose To Do Nothing?"

(Question from my YouTube Video: Stages of Chronic Kidney Disease [CKD])

If you choose to do nothing about your kidney disease, a few things can happen. One, you can continue and just progress through all the stages of CKD, and go all the way to CKD stage five, which is the level where your kidneys are functioning at less than 15%. If you get to this level and your kidneys are not functioning, if they completely fail and stop working, you stop making good urine and your electrolytes become out of whack, you cannot live with kidney failure unless you have some form of kidney replacement therapy, such as dialysis or a transplant.

You have to have at least one functioning kidney in order to live. And so I do have patients who choose to do nothing. Patients who get to the point where it's time for a transplant or dialysis and they say, "you know what? I don't want it." We talk about it, I make sure that they're of a good mindset, and if that's truly their decision I support them, and we ultimately transfer them to hospice.

You have other patients who have acute kidney injury, meaning it's just a temporary kidney disease and sometimes it can reverse. I don't recommend sitting around and kind of waiting for luck, or just kind of trying to see if it's gonna change. I recommend that you go to your physician, and your nephrologist, and if there are ways to reverse it, I recommend that you reverse it so that you can live. But ultimately the answer to the question is if you truly do have kidney failure and if that kidney failure progresses and your kidneys stop working, you cannot live unless you have some form of kidney replacement therapy, dialysis, or a kidney transplant.

18."Is A Cucumber Considered A Fruit?"

(Question from my YouTube Video: 7 Low Sodium Foods To Combat High Blood Pressure )

This is an age-old question. "Is a cucumber considered a fruit?" And I was taught that if a fruit, vegetable, as some may call it, if it has seeds, then it's a fruit. And so a cucumber has seeds, and so I would think it's a fruit. A tomato has seeds, it's a fruit. Even though they're not sweet, we don't think of them as fruit. That is really a good question. What I can tell you, is that cucumbers are an excellent source of nutrition, a wonderful plant-based food. And it's one of the foods that can help to lower your blood pressure naturally. It's a low-sodium food. Is a cucumber a fruit? I think, yes

19. "I Know High Blood Pressure Can Contribute To Kidney Problems, But Can It Work In Reverse Also? Can Kidney Dysfunction Create High Blood Pressure?"

(Question from my YouTube Video: 10 Kidney Failure Symptoms)

What came first, the chicken or the egg? High blood pressure can cause kidney failure as you stated, and kidney failure can cause high blood pressure. You're absolutely correct. And sometimes it's hard to know which came first, but I can definitely tell you that if you control your high blood pressure then that can decrease your risk of progressing to kidney failure. And if you do progress to kidney failure, if you do things to try to improve that kidney failure, that can help with your high blood pressure. But you got it just right. What came first, the chicken or the egg?

20. "What Are Your Thoughts On Adding Flax Seed Supplements To Your Morning Diet?"

(Question from my YouTube Video: How To Lower Blood Pressure Naturally)

That's a good question. Flax seed, that's something I talk about because that's a way to help you lower blood pressure naturally. Flax seeds are a pretty healthy supplement or food. But here's something that you have to be careful of. Flaxseed can contain a lot of phosphorus, and if you are a person with CKD or chronic kidney disease, and if you're a person who has end-stage renal disease on dialysis, it's important that you limit your phosphorus in most cases to less than 800 milligrams a day. So bottom line, flaxseed can definitely be a healthy choice, but you want to consult with your physician because flaxseed is not for everyone.

Conclusion

This was fun. I hope you all enjoyed it, I certainly did. And if you found this article to be helpful and informative, please be sure to share it with the people you care about. If you have any questions, or comments, please put them in the comment section below, and I just might feature your question or comment in the next episode of Ask Dr. Frita Medical Questions and Answers.