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Q. I have been using CBD salve on my arthritic knee for a year. I really wish scientists would study it. I cannot walk without it!
A. Scientists are beginning to look at this topic, although there are still very few studies. A review of transdermal cannabidiol (CBD) for pain and inflammation concluded that it offers a "potential novel treatment for chronic inflammatory pain" (International Journal of Molecular Sciences, May 28, 2024).
One study compared topical cannabidiol to diclofenac gel and placebo gel (Pain Management Nursing, February 2025). After two months, people using CBD and diclofenac gels felt significantly better than those using placebo gel; there was no difference between the two groups. In other words, CBD salve might work as well as Voltaren gel for some individuals.
Q. For several years now, I've been using a simple remedy for heartburn. If I start to experience symptoms, I eat a small apple and it works every time! Could it be the pectin?
A. We could not find any studies of apples for heartburn. However, one Australian study in which participants acted as their own controls found that an herbal formula containing pectin and other natural compounds alleviated many digestive symptoms, including heartburn (Nutrition Research, April 2020). Certainly this remedy will do no harm, and we have heard from other readers that it is helpful.
If you wish, you can learn more about natural remedies for heartburn in our "eGuide to Overcoming Digestive Disorders." This online resource is located under the Health eGuides tab at www.PeoplesPharmacy.com.
Q. High cholesterol runs in my family, and so does heart disease. I wanted to be tested for Lp(a), but my doctor didn't want to. I had to keep insisting, based on the family history. I am very physically active, eat mostly vegetarian and grow my own fruit in my orchard.
He finally said OK, but you have to pay for it. I did. I learned it is 140, which is very high. When I asked what I should do, my doctor avoided answering. Then he said, let's talk about statins and a Mediterranean diet. I replied statins make Lp(a) worse and I'm already on a Mediterranean diet.
I have asked some other doctors about niacin, aspirin and CoQ10. They said to just take CoQ10. I'm thinking about niacin and aspirin on my own. Do you have any suggestions?
A. You might want to continue your search for a more enlightened doctor who can help you with this challenge. Whether your Lp(a) measurement was in mg/dL or nmol/L, it is high. That means your high cholesterol is particularly dangerous, which could explain why your doctor seems set on statins. As you noted, though, statins often raise Lp(a) levels. Most of the medicines that cardiologists prescribe to prevent heart disease have little impact on Lp(a), except PCSK9 inhibitors like evolocumab.
One very old cholesterol-lowering drug, niacin, also lowers Lp(a). In addition, a review of the research found that losing excess weight, exercising intensely and following a low-carb, high-saturated-fat diet are linked to lower levels of this risk factor (Journal of Clinical Medicine, Jan. 28, 2024). L-carnitine, CoQ10 and flaxseed can also lower Lp(a) levels modestly.
You might also consider aspirin, which can help reduce heart attacks and strokes in those with elevated Lp(a) (Journal of the American Heart Association, Jan. 31, 2024). You will want to partner with a knowledgeable physician if you use aspirin, niacin or both, as well as any prescription medication.
In their column, Joe and Teresa Graedon answer letters from readers. Email them via their website: www.PeoplesPharmacy.com.