Q: As a dental hygienist, I was intrigued to read your article about a connection between statin use and susceptibility to soft tissue infections. I wish the researchers would do a study of statins and the mouth microbiome.

Gingivitis is an inflammation caused by bacteria. People with diabetes or heart disease are more susceptible to this condition. Could statin use contribute to gum disease?

A: You have asked a challenging question. There is very little research to answer it precisely.

The study you refer to was conducted by Australian researchers (British Journal of Clinical Pharmacology, Oct. 8, 2019). Using a database of veterans and war widows that covered 12 years, the scientists found that people taking statins were 40% more likely to develop skin and soft tissue infections (SSTIs) due to Staphylococcus aureus. They suggest that cholesterol-lowering statins inhibit crucial immune system cells, leaving patients more vulnerable to infection.

Any connection between statins and gum disease (gingivitis) is complicated and controversial. Drugs like atorvastatin reduce blood levels of the essential nutrient coenzyme Q10 (CoQ10) (JAMA Neurology, June 2004). CoQ10 deficiency has been linked to gingivitis (Journal of Clinical & Diagnostic Research, August 2015).

Statins are also associated with increased blood glucose and diabetes. Higher blood sugar seems to promote bacterial overgrowth in the mouth, which could also contribute to gum disease. One study noted a link between statins and periodontitis (International Journal of Environmental Research and Public Health, Jan. 18, 2021).

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On the other hand, statins also reduce inflammation. A recent review found that statins appear to improve oral health, including gum disease (Journal of Translational Medicine, April 6, 2020). Although the final word on this topic is not yet determined, taking a CoQ10 supplement might be helpful and is unlikely to do harm.

Q: Many years ago, in 1997, I fell to the floor with arthritic pain in my hips and back upon getting out of bed. A few days later, I heard your program on the radio. I think Dr. Tieraona Low Dog was discussing Boswellia for pain relief. That very day I bought some Boswellia.

After taking it for two weeks, I had notable relief. Over a four-week period, my pain lessened remarkably. Actually, for about five years I felt no arthritis pain.

Today, almost 25 years later, my pain has increased but I continue to take Boswellia. In the past several years, I’ve added turmeric and ashwagandha. Is there any research on these herbs for arthritis?

A: All three of these botanical medicines have a long history of use for joint pain. Each has proven anti-inflammatory activity. Ashwagandha, for example, affects some of the same compounds in the body as powerful arthritis medications.

A systematic review of the active ingredient in turmeric (curcumin) concluded that this spice is safe and effective for osteoarthritis (Bioscience Reports, June 25, 2021). To learn more about these natural products and other nondrug approaches to managing joint pain, you may wish to consult our 104-page booklet, The Graedons’ Guide to Alternatives for Arthritis. It can be found in the Books section of the store at www.PeoplesPharmacy.com.

People on anticoagulant medicines should not take turmeric or curcumin, as they could increase the risk for bleeding.