Keep your potassium levels up when taking a diuretic 

Q. I have high blood pressure and was put on medication plus hydrochlorothiazide. I started to lose potassium and had to come off the HTZ. Now I can’t get my blood pressure down. Any suggestions? — Pamilia, via email

A. HTZ is a diuretic, or “water pill,” that’s a frontline treatment for lowering blood pressure. It works by triggering your kidneys to flush out excess water and salt, but potassium often gets flushed, too — right down the toilet.

Usually it’s a mild deficiency that can be cured by eating potassium-rich foods and taking a supplement. But there’s a conundrum: A solid amount of potassium (plus calcium and magnesium) may be important for keeping your BP down.

There’s a great diet that’s swimming in these minerals and that will lower not only your BP (eight to
14 points) but also your cholesterol and — drum roll, please — heart attack risk (almost 20 percent). It’s called DASH, for Dietary Approaches to Stop Hypertension. On the menu: six servings of whole grains; three to four of vegetables; four of fruit; two to three of low/no-fat dairy foods; three to six of lean poultry, fish and meat; three of nuts, seeds or beans; and two of healthy monounsaturated fats (such as olive, flaxseed and canola oils).

That’s a lot of food. Just try to slip in a bag of chips or a cruller! You won’t have room, so you’ll likely lose weight. Particularly if you follow DASH’s parallel Rx: Do 30 minutes of moderate exercise a day (arise and walk!). Expect almost immediate gratification: DASH should start to nudge your numbers down in only 14 days. By the way, if that fails, there are many other medications that will get your BP down. It’s important!

Q. Are there vitamins that help macular degeneration? I’ve been diagnosed with it. — Evelyn, Haymarket, Va.

A. If you have early age-related macular degeneration, we recommend frequently grazing at the salad bar to protect your sight. AMD is a leading cause of blindness, but good nutrition can help hold it off. Make a beeline for the carrots, spinach and other dark, leafy greens. You want their lutein, zeaxanthin and betacarotene; all fight AMD. Omega-3 fatty acids also are vision-savers; find them in wild or canned salmon, trout, canned tuna, some nuts (particularly walnuts) and supplements. We recommend 900 mg a day of algae-based omega-3s in their DHA form (the form your body likes best).

If you have intermediate AMD in one or both eyes — or advanced AMD in one eye but not the other — there’s good evidence that taking specific amounts of vitamins C, E, A (or beta carotene), copper and zinc can keep it from becoming advanced. This powerful combo is called the AREDS formula (for Age-Related Eye Disease Study). Just “don’t try this at home.” Talk to your ophthalmologist about it. By the way, there’s no evidence that AREDS helps early AMD. Only lutein (10 mg twice a day) and those omega-3s (900 mg a day) do that.

Q. My doctor put me on 81 mg of daily aspirin after I developed a blood clot in my lung. Since then, I get small, purply bruises on my arms and legs almost daily. I’m 66. Is this dangerous? My doctor doesn’t seem concerned. — Karen, via email

A. Like gray hair, wrinkles and the ability to remember your second-grade teacher’s name but forget how you banged your shin this week, it’s normal to bruise more frequently as you age. Your skin gets thinner and your capillaries (itsy-bitsy blood vessels) become more fragile, so a tiny bump can cause a bruise.

Yep, aspirin’s blood-thinning effects intensify this, but thinner blood that doesn’t clump up and clot easily is what you need and what your doc is after.

That said, alert your physician if the bruising increases. Normally, frequent bruising can signal more serious conditions, including leukemia and other blood disorders. But yours is likely a not-unexpected result of a treatment that’s otherwise good for you.

Eat more fish and live longer

Chowing down on 6 ounces of omega-3-rich fish twice weekly cuts your risk of dying from heart disease by 36 percent. Even if the fish is high in mercury.

Still, don’t start tossing any old seafood in your grocery cart, especially if there are infants, young children or pregnant moms in your household. Mercury can still cause brain and kidney disorders. Use these fish facts to reel in the healthiest benefits:

1. Small is beautiful.
When you can’t recall which fish are safest, just remember this: Young, pint-size fish have the shortest exposure to mercury in the water.

2. Go for the winners. Salmon and trout get the gold for omega-3s but herring, sardines, flounder, haddock, cod and canned light tuna also deliver.

3. Pair fish with fruit, seeds and nuts. Polyphenol-rich tropical fruits, such as mango, pineapple, banana and papaya reduce the amount of mercury your body absorbs.

4. Avoid heavy-metal losers. Swordfish, shark, tilefish, king mackerel, marlin, orange roughy and mahi mahi are mercury depots.  Red snapper just came off the list!

The YOU Docs — Mehmet Oz, host of “The Dr. Oz Show,” and Mike Roizen of Cleveland Clinic — are the authors of “YOU: Losing Weight.” For more information go to

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