Archive 2006 2007 2008 2009

Q: Should I wipe my kitchen counters and bathroom surfaces with bleach? I’ve seen ads saying I should, especially to combat flu viruses.

A: Bleach is an effective sanitizer—that is, it kills germs (bacteria and viruses). But for most people, plain soap or detergent and water will get rid of dirt on kitchen counters, utensils, and floors. This won’t kill most germs, but they won’t survive long if surfaces are clean and dry. A clean kitchen or bathroom does not need to be disinfected.

You may have read about research, some sponsored by Clorox, suggesting that bleach should be used for everything in the kitchen and elsewhere. Bleach does kill a wider range of microorganisms than ammonia, vinegar, and detergents. And it does not contain any free chlorine, so properly diluted bleach is not corrosive and does not cause environmental harm.

Undiluted bleach, however, should be handled with care. The fumes are unpleasant and can irritate your eyes and skin. If you do use bleach, one teaspoon in a quart of warm water is plenty. Don’t mix it with ammonia-containing compounds, toilet bowl cleaners, or similar products—that can produce chloramine gas, which can be harmful.

The #1 infection fighters: The best way to prevent the spread of most germs is to wash your hands well with plain soap and water, especially before and after preparing food. When water is not available, use alcohol hand gel. Use common sense in the kitchen—clean up well after handling raw poultry, for instance, and keep sponges and dishcloths clean. For the flu virus, the key preventive is to avoid close contact with a person who is coughing or sneezing.

Q: What do you know about Amberen, a supplement that claims to treat hot flashes and other menopausal symptoms? Supposedly it restores the natural estrogen cycle but is not a hormone itself.

A: The claims on the manufacturer’s website are carefully designed to sound highly scientific, but they are deceptive, and we advise you not to take this supplement. Amberen, it’s claimed, consists mainly of succinate, a chemical the body produces as part of the complex cycle of energy production. This is called the Krebs cycle, and it takes place inside certain cellular structures called mitochondria. The website says that succinate plays a role in resetting the body’s hormonal system, stimulating the production of estrogen so that hot flashes go away. Changes in estrogen levels (a normal part of menopause) cause hot flashes, but there is no evidence that Amberen restores the estrogen cycle. Even if it did, we now know that this could have a downside—an increased risk for breast cancer.

Advocates of Amberen often point to studies on rats, which have supposedly been rejuvenated by succinate, and some Russian researchers have come up with some highly debatable theories about this. But according to Dr. Nanette Santoro, Director of the Division of Reproductive Endocrinology at Albert Einstein College of Medicine in New York City, there is no evidence for these claims. Addressing the claims that Amberen can reverse menopause and cure hot flashes, Dr. Kathryn Martin of Massachusetts General Hospital adds that the reproductive system and hormonal cycle of rats are different from those of humans, so even if succinate helps rats, it would not help women. There is no known way to reactivate menopausal ovaries so that they produce more estrogen.

Given the lack of evidence for benefit and the potential for harm, as well as the high price, we think you should stay away from Amberen.

Q: If someone swallows poison, should I induce vomiting?

A: Call the national Poison Control Center—800-222-1222—which will connect you to a center near you. Most calls to poison centers can be managed over the phone.

Do not induce vomiting (by using syrup of ipecac, for instance) unless you are instructed to do so. If the substance swallowed is caustic (such as drain opener, bleach, or detergent), vomiting can further damage the esophagus and throat. If it is a petroleum product (kerosene, gasoline, furniture polish, or paint thinner), vomiting can make the person inhale the substances and cause a serious lung problem. Never induce vomiting if the person is unconscious or has convulsions, or if you don’t know what was swallowed.

Q: What is trichomoniasis? Can it be spread by a toilet seat?

A: It is one of the most common sexually transmitted diseases, with an estimated 7 million new cases annually in the U.S., most often among sexually active women. The cause is a protozoan, Trichomonas vaginalis, which infects the vagina and sometimes the urethra and is transmitted during unprotected sex. It is not spread by toilet seats, since the organism can’t live long on objects.

Most people who have trichomoniasis do not know it. As many as half of infected women have no symptoms. Common symptoms in women are vaginal itching, irritation, smelly greenish/yellowish vaginal discharge, and pain and itching during intercourse or urination—which can be mistaken for symptoms of other vaginal or cervical infections. The great majority of infected men have no symptoms; the most common symptom in men is a burning sensation when urinating.

The most serious risks of trichomoniasis are complications during pregnancy, reduced fertility, and increased risk for women becoming infected if exposed to HIV.

If you have symptoms of a vaginal infection for the first time, or notice any abnormal vaginal discharge, consult your doctor. And if you’re taking medication for a yeast infection and there’s no improvement in three days, get medical advice.

There are one-dose prescription drugs that can cure trichomoniasis. Your sexual partner also has to be treated in order to prevent re-infection. For more information, go to the CDC website.

UC Berkeley Wellness Letter, December 2009