Forget bottled water; tap water is better

#Middlebury #alopecia

DEAR DR. ROACH: Bottled and purified water sales have increased over the years. I often see advertisements showing filters attached to faucets that “take out all impurities.”

My parents had a water softener, and my father, professionally involved in weight-bearing physical activity, experienced demineralization of his skeleton and a broken hip. It has been suggested that the water softener took minerals, including calcium, out of the water that my parents used to cook and drink.

I drink tap water, but is a large percentage of the U.S. population headed for demineralization and malnutrition because they drink only “purified water”? – C.D.

ANSWER: Most water softeners work by exchanging sodium for the “hard” minerals, especially magnesium and calcium, present in most tap water, to greater or lesser extent. If the water in your area is naturally very hard, then a significant amount of sodium may be added, and calcium and magnesium removed.

However, this is very rarely a problem, and almost certainly had nothing to do with why your father had a hip fracture. We get our minerals mostly from food, not from water. The major risk factors for osteoporosis in men are smoking, alcohol, low testosterone levels and low vitamin D, although there are many other causes.

I don’t recommend bottled water or water purifiers because in most of the United States and Canada, the water quality is excellent. Bottled water is 1,000 times more expensive than tap water where I live. I have been to places where the tap water doesn’t taste so good, in which case I would recommend a filter over bottled water.

DEAR DR. ROACH: Could you please discuss the use of Propecia for female hair loss?

I am a female in my late 50s, and I have suffered from hair loss for many years. After numerous blood tests, a biopsy and exams, my dermatologist determined that I have androgenic alopecia. I have been on Aldactone, and have used minoxidil for quite a while, with minimal results, if any.

For the past eight months, I have been taking Propecia, 2.5 mg daily. My hair doesn’t seem any better or worse, but I worry about its side effects. Can you please give me your opinion on the use of Propecia by women? Do the benefits outweigh the risks? – R.M.

ANSWER: Male pattern hair loss will occur in up to 80 percent of men and 40 percent of women, with age being the primary risk factor. Hair loss can affect self-image and self-esteem significantly, probably even more in women than in men. Diagnosis usually is made by appearance, but a biopsy is sometimes necessary to rule out less-common causes.

Finasteride (Propecia) is a blocker of dihydrotestosterone, and although it frequently is used in men, is not approved for use in women. It should not be used by women who could become pregnant. Women (and men) should not donate blood while taking finasteride. However, it is sometimes used “off-label,” and one study showed that although it did not cause regeneration of hair, it did slow further loss. Side effects of weight gain, loss of libido, depression and fatigue are listed as possible. I have no personal experience of women using this medication.

Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

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