DEAR DR. ROACH: I recently read about turmeric for osteoarthritis. I’m on a limited income. Please tell me more about it, like how much it costs and where I can get it. — W.C.

ANSWER: Turmeric, a spice that has been used for millennia, is the source of curcumin, which has been shown to improve symptoms of osteoarthritis, at least in short-term studies. It is generally thought to be safe, as most people have no side effects or only occasional stomach upset, nausea or diarrhea.

A theoretical concern is bleeding, in combination with anticoagulants, but this appears to be rare. I have had many patients try curcumin, and it has improved symptoms in about half of those who tried it.

Turmeric is easy to find at any grocery store, but when curcumin is used as a supplement, it is usually combined with other supplements to help with absorption. A common one is piperine, derived from black pepper. It’s difficult to use turmeric from food to get a pharmacologic effect. The usual dose is 400-500 mg two or three times daily. A month’s supply from a reliable online retailer I found cost about $10.

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DEAR DR. ROACH: My husband has psoriasis on his hands, and he thinks it’s from stress. He had psoriasis a long time ago, and now it reappeared. He is stressed because I am sick. Please tell me what cream he can use. Before, he used some good Yugoslavian cream called Vipsogal. — M.A.M.

ANSWER: Psoriasis is a common skin condition thought to be caused by abnormalities in the immune system. There are several forms, but most people with psoriasis notice plaques or papules on the skin.

Treatment depends on the type and severity of the psoriasis, but the important part is that it needs evaluation before treatment, both to determine the correct diagnosis and assess severity. This includes at least a joint exam for psoriatic arthritis and a careful history to look for other associated conditions, such as in the eye. Severe disease may need systemic therapies, including biological ones.

I looked up Vipsogal and it is a combination of several medicines, especially high-potency steroids. These are the mainstay of treatment for most people with mild to moderate psoriasis and are available in the U.S. and Canada only with a prescription. It’s a powerful medicine with the potential for real harm if used incorrectly. Your husband should see a dermatologist.

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1. ROACH WRITES: A recent column on fructose malabsorption in adults may have been confusing. I also mentioned the condition hereditary fructose intolerance, which is very different from the fructose malabsorption I discussed.

HFI is a potentially serious disease, which is usually diagnosed in children and is often unrecognized. It is caused by deficiency of an enzyme called fructose-1-phosphate aldolase, isozyme b. This disorder is diagnosed through sophisticated testing or by genetic analysis. Treatment is complete elimination of fructose from the diet, which is a difficult task.

Fructose malabsorption in adults is a much milder condition. It’s treated by avoiding large amounts of fructose by itself (such as in honey, fructose-sweetened foods and fruits containing high net amounts of fructose, such as apples, pears, sweet cherries, prunes, and dates), and avoiding the artificial sweetener sorbitol.

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

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