Judy Foreman

Nationally Sindicated Fitness, Health, and Medicine Columnist

Is there a new way to check yourself for melanoma? How does it work?

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Yes, and dermatologists call it the “ugly duckling” test.

Until recently, dermatologists recommended that people use the so-called “ABCDE” guidelines for checking moles for melanoma, the deadliest form, which kills more than 8,000 Americans a year.

In the “ABCDE” system, A stands for asymmetry, B stands for border irregularity, C for variegated color, D for large diameter and E for evolving, or changing, said Dr. Hensin Tsao, director of the Massachusetts General Hospital Melanoma and Pigmented Lesion Center, in an e-mail. Moles with these characteristics may be an early melanoma in disguise.

The trouble is, “ABCDE is a mouthful, and people can’t remember what it stands for,” said Dr. Mathew Avram, director of the Dermatology Laser and Cosmetic Center, also at Mass. General. Moreover, the ABCDE system doesn’t catch all suspicious moles.

Enter the “ugly duckling” test. Using diagrams available on the website of the Skin Cancer Foundation (skincancer.org/early-detection), you can check yourself for weird moles – dubbed “ugly ducklings” because they don’t look like other moles.

Sometimes, amid a scattered group of moles, one “ugly duckling” stands out as being darker and larger than its neighbors. Sometimes, in a group of moles, one mole, often a small one, stands out because it lacks pigmentation. Sometimes, one mole is all by itself in a large area of skin such as the back; it’s a potential problem if this mole is changing, asymmetrical or otherwise atypical.

The goal of this new system is to catch more suspicious moles early, said Dr. Allan Halpern , chief of dermatology at Memorial Sloan-Kettering Cancer Center in New York. “If melanomas are caught early enough,” he said, “they are almost 100 percent curable.”

It only takes a few minutes to do the “ugly duckling” and ABCDE tests, so check your moles monthly. If any look suspicious, see your doctor. These simple tests aren’t guaranteed to catch every cancer, but they could save your life.

Does preeclampsia put women at higher risk of cardiac problems later?

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Yes, there is definitely a correlation between preeclampsia – high blood pressure and protein in the urine during pregnancy – and cardiovascular problems in later life. But it’s not clear whether preeclampsia itself is the culprit or whether women who get preeclampsia were already at risk of future cardiovascular problems before they got pregnant, said Dr. Richard J. Levine, an epidemiologist at the National Institute of Child Health and Human Development at the National Institutes of Health.

Preeclampsia almost always occurs about halfway through a normal, 40-week pregnancy. It’s quite common, occurring in roughly 5 percent of pregnancies, and accounts for about 15 percent of premature births as well as the death of several hundred Americans per year, according to the Preeclampsia Foundation.

Recent research shows that preeclampsia is caused by an imbalance between two kinds of factors, those that turn on and those that shut down new blood vessel growth, said Dr. Benjamin Sachs, formerly the head of obstetrics at Beth Israel Deaconess Medical Center and now dean of the Tulane University School of Medicine.

At the beginning of pregnancy, a woman has to create more blood vessels to increase the blood supply to a growing baby, a process called angiogenesis. At the end of pregnancy, this process needs to be reversed, otherwise a woman could bleed heavily. In preeclampsia, the shutdown of blood vessel growth occurs too early which can lead to damage to blood vessels, the kidneys, liver, and brain, Sachs said.

The bottom line is that women who have had preeclampsia should be extra careful throughout their lives to monitor blood pressure and cholesterol, control weight, and take blood pressure-lowering medication if necessary.

It’s not clear yet whether the babies of women who have preeclampsia are also at increased risk of cardiovascular problems later in life.

Does growth hormone improve strength and athletic performance?

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You might think so, given all the publicity about the use of growth hormone and other drugs by professional athletes. But in fact, injections of growth hormone do not appear to improve strength or build muscle, and they may actually decrease athletic performance.

That’s the conclusion of a scientific review published last week in the Annals of Internal Medicine. The leader of that study, Stanford University endocrinologist Dr. Hau Liu, looked at data from 27 randomized, controlled studies involving 440 mostly young, physically fit men, 303 of whom took growth hormone. Although the studies varied in design – some gave just one injection of the hormone, while others used longer-term doses – the overall finding was striking, Liu said in a telephone interview: “Based on the current scientific literature, we found no evidence that growth hormone improves athletic performance.”

Growth hormone did increase lean body mass by an average of 4.6 pounds, said Liu, but that may reflect water retention, not muscle growth. The people taking growth hormone also had more swelling in soft tissues and more fatigue than those who didn’t. Furthermore, in two of the three studies that looked at lactic acid levels – a measure of muscle exhaustion – people who took growth hormone had higher lactic acid levels than those who did not, a sign of worse muscle fatigue.

“I am not surprised at all” by these findings, said William J. Evans, a physiologist at the University of Arkansas for Medical Sciences. A number of studies over the years have come to the same conclusion, he said in an e-mail.

The US Senate is considering a bill that would prohibit the sale of human growth hormone for illegitimate purposes. While parents of children with growth hormone deficiencies support stiffer penalties for abusers, they worry their access to the drug may be limited, according to the Magic Foundation, a group dedicated to helping children with growth disorders.

Are those new thermometers for the forehead more accurate?

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I spent some time one recent afternoon (I know: Get a life!) taking my temperature with the ($50) home version of the new Exergen scanner, a little wand that you swipe across your forehead. I took my temperature four times this way and four times immediately afterward with a ($7.33) Medline oral thermometer from the drug store.

The two thermometers agreed on only two of the four trials, both saying my temperature was 98.2 Fahrenheit. On one other trial, the scanner registered 99, while the oral thermometer read 98.1; on the remaining trial, the scanner said 97.9, the oral thermometer, 98.1.

The scanner works by detecting heat in the temporal artery, which runs from the heart right below the skin in the forehead, but I gather it takes some practice to get consistent readings. You have to hold the button down while you are scanning the forehead and release it only when you are done, which takes a little getting used to.

According to Francesco Pompei, a scientist and engineer and CEO of the Watertown-based Exergen, which makes the scanners, the devices are now used in 30 percent of US hospitals. One advantage of the scanner, he noted, is that it is fast (a reading took 3 seconds, compared to 45 with the oral thermometer); another is that you don’t have to put it in your (or anyone else’s) mouth, rectum, or ear, a big plus for dealing with kids or elderly people.

In one study published last year in the American Journal of Critical Care, both oral and temporal artery thermometers were more accurate and precise than temperatures taken in the ear or under the armpit. The temporal artery method may also be quicker than rectal thermometers at detecting rapid changes in temperature, such as occurs when children with fevers are given fever-reducing drugs – though more research is needed.

As for me? I’m sticking with the oral thermometer. It’s cheaper, and I found the readings more consistent. If I had young kids and $50 to spare, I might switch to the scanner. But I’d be sure to take more than one reading – at least 30 seconds apart.

Is there anything I can do to stop grinding my teeth at night?

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Yes. You can see a dentist and get fitted for a “night guard” that you wear, like an orthodontic retainer, while you sleep. Custom-made night guards are pricey ($200 to $600, for more complex devices), but they are covered by some insurers. Alternatively, you could try the cheapo over-the-counter drugstore versions. I did this, but despite trimming it down according to the instructions, it was so bulky and uncomfortable that I threw it out.

Tooth grinding, technically called bruxism, is very common, affecting about 50 percent of adults and children at some point in their lives, said Dr. Stephen DuLong, associate dean for clinical services at the Boston University Goldman School of Dental Medicine. It seems to strike more when people are stressed, and it may actually relieve stress, though it’s not clear why. “The good news is that people tend to outgrow the tendency to grind their teeth as they get older,” DuLong added.

Grinding one’s teeth at night (people tend to inhibit the tendency during the day) can lead to TMD, temporomandibular joint disorder, or pain in the jaw joint and difficulty opening the mouth wide. That’s because sliding your teeth around at night and clenching them hard “torques” the jaw joint, said Dr. Luke Matranga, a dentist an associate professor at the Creighton University School of Dentistry in Omaha and a spokesman for the Academy of General Dentistry. It also causes the teeth to wear down significantly, and raises the risk that teeth will develop cracks or even break.

The easiest way to tell if you grind your teeth at night is to ask your bed partner – grinding can be fairly noisy. You probably grind your teeth if you wake up with tight, sensitive jaw muscles. And look in the mirror – if your teeth look shorter than they used to, you’re probably grinding them down.

What are the best treatments for male pattern baldness?

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There are two main approaches — hair transplantation or medications such as Rogaine and Propecia — but the best choice for an individual man depends on his age and the speed and degree of hair loss.

In general, it

Are oats really as good for you as we are told?

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Well, they won’t make you immortal, but short of that, oats are one of the best foods you can eat, particularly if your goal is to lower your cholesterol

David Jacobs, a professor of epidemiology at the University of Minnesota School of Public Health, said he believes oats really do deserve a “thumbs up.”

Because they are hard to refine (they get so sticky that they gum up the machinery) most of the oat products available are whole grains, precisely the type of carbohydrate that nutritionists say we should eat more of. Jacobs and his team, in a 2007 study of more than 27,000 post-menopausal women followed for 17 years, concluded that eating whole grains such as oats was linked to a lower risk of death from diseases that are triggered by inflammation, including heart disease and diabetes.

One of the reasons oats are so good for you is that they contain an ingredient called beta-glucan, a natural anti-inflammatory agent that suppresses the body’s production of certain cytokines.

An analysis of data pooled from 10 studies published in 2007 by the Cochrane Collaboration, an international group that evaluates health research, touted the benefits of whole grains for lowering both LDL (“bad” cholesterol) and total cholesterol in people diagnosed as being at risk for coronary heart disease. Eight of the 10 studies involved only oats, and seven of those found a clear, beneficial effect. The researchers cautioned, however, that even though studies show a consistent, positive effect, most are short-term and are paid for by companies that sell oat products.

Dr. George Blackburn, director of the Center for the Study of Nutrition Medicine at Beth Israel Deaconess Medical Center, said that 6 grams of oats eaten daily for a month can lower LDL by about 10 percent in people whose LDL levels are very high, say 200 milligrams per deciliter. That means that if your LDL is very high to start with, you might still have to take a cholesterol-lowering drug such as Zocor, even if you eat oats. Doctors say that optimal LDL is 100 or lower.

The take-home lesson is a no-brainer: Eat more oats.

Why does your appetite decrease when you get sick?

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When a person gets sick, especially from an infectious agent like a bacterium, the body mounts a vigorous inflammatory response, said Dr. Clifford Saper, chief of neurology at Beth Israel Deaconess Medical Center. Among other things, the immune system pumps out hormones that end up in the brain, triggering fever, changes in the sleep-wake cycle (that’s why you get so sleepy when you get sick), and appetite.

Losing your appetite during a bacterial infection is actually a good thing, Saper said. Bacteria live on a type of sugar called glucose. When a person gets sick and stops eating, there is less glucose around, which means bacteria essentially starve. The person, luckily, does not, because humans are well-adapted to use an alternate fuel, fat, to keep metabolism going.

Losing your appetite doesn’t help fight viral infections, because viruses don’t live off glucose in the same way as bacteria.

Losing your appetite temporarily may seem like good news for the weight-conscious – at most, you’ll lose about a half a pound a day, said Dr. Mark Pasternack, chief of the pediatric infectious disease unit at Massachusetts General Hospital. But once the infection is over, appetite – and the scale – usually rebounds with gusto.

“For the short-term illnesses that most of us encounter, diminished food intake has no prolonged effect,” he said.

Should I be concerned that the soles of my feet feel itchy all the time?

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No. The only time you should worry is if you feel itchy all over your body, not just the soles of your feet, and if this itchiness is nonstop and is not accompanied by a rash, said Dr. Robert Stern, chairman of the department of dermatology at Beth Israel Deaconess Medical Center. This kind of pervasive itchiness can be associated with an illness such as lymphoma or kidney or liver disease.

Itchy feet can be annoying, though, and can have many causes. Athlete’s foot, a fungal infection, is the main culprit. This can be treated by keeping your feet (and socks) clean and dry and use antifungal medications if necessary. The soles of the feet can also get itchy if your feet sweat and you don’t let them dry properly, or if you have eczema, an inflammation of the skin. Feet can also get temporarily itchy with changes in temperature – both from hot to cold and vice versa. People with Raynaud’s disease, in which cold or emotional stress can trigger discoloration of the extremities, may also get itchy feet.

Occasionally, itchy feet can result from a nerve injury, said Dr. Clifford Saper, chief of neurology at Beth Israel. This can be treated with medications that reduce the frequency of nerve firing, including some anti-epileptic drugs.

Overall, though, itchy feet are a mild hassle, not a serious medical problem.

Is there any way to tell whether you are getting enough vitamin D?

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Yes – a blood test called 25-hydroxyvitamin D, which, though expensive ($20 to $100 a pop), is covered by insurance. Your level should be at least 30 nanograms per milliliter of blood and not more than 100. If your level is way below that, say around 18, you need to take 1,200 international units or more a day of vitamin D supplements, either the type called D2 or D3, said Dr. Michael F. Holick, an endocrinologist and leading vitamin D researcher at the Boston University School of Medicine.

“Everyone should be tested,” said Holick, who consults for a lab that conducts the tests but does not get royalties. Many doctors hesitate to order the test because they still believe that rickets, a serious but now, extremely rare bone disease in children, is the only manifestation of vitamin D deficiency.

But even mild levels of vitamin D deficiency have been linked to cancers of the breast, prostate, and colon, as well as to multiple sclerosis, both type 1 and type 2 diabetes, heart disease, and stroke. A meta-analysis involving data on more than 57,000 people in 18 studies showed that those taking vitamin D supplements had a lower risk of dying for any reason during the study.

Vitamin D is a steroid-like hormone that the body makes after skin exposure to UV-B radiation from sunlight. After an inactive form of vitamin D is made in the liver, it is transformed in the kidney to an active form.

Many studies show that people, especially African-Americans and those in northern latitudes like New England, are at high risk of being deficient in vitamin D. A 2004 study of 307 healthy teenagers led by Dr. Catherine M. Gordon, an endocrinologist at Children’s Hospital in Boston, showed that 42 percent were vitamin D deficient.

Many doctors assume that because vitamin D is important for calcium metabolism, if blood levels of calcium are normal, vitamin D must be sufficient, too, said Holick. But this is not true.

Usually, Holick said, it’s only when doctors begin testing themselves for vitamin D deficiency that they “get religion” and begin taking vitamin D testing seriously. A growing number of researchers now recommend that everyone take at least 800 to 1,000 international units of vitamin D a day. It takes 10,000 IU’s a day for vitamin D to become toxic.

For what it’s worth, I take at least 1,400 IU’s a day.