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Dear Doctor: Is there a link between multivitamin use and eye health and cataract prevention?

DEAR DR. ROACH: I’m writing in response to your comment that “for most people with a healthy diet, vitamins are probably unnecessary”. I eat five to six servings of vegetables and fruit a day, but I don’t know many people who eat more than one or two a day. I always take a multivitamin, because two ophthalmologists told me that there are two ways to delay the onset of cataracts: 1. Always wear sunscreen for your eyes (and he mentioned that all prescription glasses now have built-in sunscreen) and 2 Take a multivitamin for at least 10 years. I am 70 years old, have been taking multis for 30+ years and have no signs of cataracts, although both my parents had them. My husband, who is 72, had to have cataract surgery in his 60s and until recently had never taken multis.

Could you comment/clarify your multivitamin stand regarding eye health and cataracts? –SG

ANSWER: Although some individual trials have shown little benefit (9% fewer cataracts in one trial among multivitamin users), a recent review of nine clinical trials showed no benefit of multivitamins in preventing cataracts. Sunlight is a known risk factor for cataracts, so sunglasses and a wide-brimmed hat make sense. But the main risk factor for cataracts is age, and as one expert told me, if you live long enough, you will develop cataracts.

I would be the first to defend vitamins if they helped, but the fact remains that multivitamins have very limited proven benefits except in people with deficiencies.

DEAR DR. ROACH: In 2015, I was diagnosed with a myeloproliferative tumor, essential thrombocythemia. My question is simple: is it cancer or not? There seems to be a fundamental disagreement between my oncologist and my hematologist about the “c” label. Not that it makes a difference in terms of treatment, but I would like some clarification. — LFF

ANSWER: Cancer is the term given to hundreds of diseases that share uncontrolled cell division and the potential to spread to other parts of the body. Myeloproliferative neoplasms meet this definition and are therefore classified as blood cancers. However, as you say, whether or not it is cancer (it was not considered cancer) is not very important. There are many types of cancers that have very good prognoses, including essential thrombocythemia. The overall survival of people with ET is good and their life expectancy is normal.

The main problems with essential thrombocythemia (“essential” is an old term meaning “we don’t know why it happens”; ‘thrombocythemia’ means there are too many clotting cells, called platelets, in the blood ) are the blood clotting potential. , as you would expect with many wafers. However, bleeding is also a risk because the platelets don’t always function normally. There are symptoms, thought to be related to damage to small blood vessels, including headache and dizziness. The most feared complication is transformation into acute leukemia or myelodysplasia. The fact that they can transform highlights why they are considered Cancers. The prognosis for patients with TE that progresses to leukemia has always been poor, but new treatments are changing that.

Dr Roach regrets not being able to respond to individual letters but will incorporate them into the column where possible. Readers can send questions to [email protected] or mail to 628 Virginia Dr., Orlando, FL 32803.

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