Is a ketogenic diet beneficial for diabetes?

Dr. Riley: A ketogenic diet is a diet that’s very high in fat and contain almost zero carbohydrates. You might think of it as sort of the Adkins diet on steroids. This type of diet has been shown to reduce the number of seizures in children with epilepsy and that’s really the best medical indication for it at this point. It’s a highly regimented diet that most people would find to be very difficult to stick to. Diets that are recommended for people with diabetes usually contain a low amount of simple sugars and a modest amount of complex carbohydrates like starches. If weight loss is desired, there is evidence to support a modestly low carbohydrate diet as one option—things like the Adkins plan. But we don’t have good evidence to support using a true ketogenic diet in the treatment of diabetes.


What are some things that cause thyroid failure?

Dr. Riley: By far the most common cause of thyroid failure is a glitch in the immune system where the body decides incorrectly that the thyroid gland doesn’t belong there and begins to destroy it. This is one of a number of diseases that we call autoimmune diseases because they’re caused by the body’s own immune system getting confused. Viruses can attack the thyroid gland, too, but in those cases the thyroid gland is almost always able to recover its function at some point. Fortunately, we have the ability now to make thyroid hormone that’s identical to the hormone the body makes naturally, so we can replace the thyroid’s function with medication, but people whose thyroids glands no longer function will need to stay on that medication for the rest of their lives.


Bold What’s the best thing to do for a persistent cough?

Dr. Riley: Many of the viral illnesses that people get this time of year include cough as a symptom, including influenza. And oftentimes, cough is the last symptom to get better. For adults, we advise staying well-hydrated. And some people will get some relief from the over the counter cough medications like Robitussin. We have a prescription medication that doesn’t contain any opioids called Tessalon that I’ll sometimes prescribe for people. There’s some evidence in children that a teaspoon of honey at bedtime can reduce nighttime cough, and there’s no harm in adults trying that, too. Most of these coughs that hang on, though, will get better within a month, so if your cough is persisting longer than that without improvement, it’s time to see your doctor. A chest x-ray may be in order to make sure everything’s OK.