Q: When I was a kid, I used to get horrible canker sores. My mother treated them with silver nitrate, which hurt like heck.

After my braces came off, I took better care of my teeth and brushed more frequently. I didn’t have as many canker sores and thought it was because of the brushing.

When I hit menopause though, the canker sores were back with a vengeance. Doctors didn’t have any suggestions, but I read in your column that toothpaste without sodium lauryl sulfate might help. I tried it, and it did reduce the canker sores, but I never liked the toothpaste I was using. It had no fluoride, and it didn’t foam.

My daughter and I went to Europe a few years ago. We traveled lightly, and I figured I would use her toothpaste. I got a canker sore right away, but when we were in Paris, our hotel was down the street from a pharmacy. There I found a toothpaste with fluoride but no SLS. It worked perfectly to clean my teeth without causing canker sores. When we got home, I checked online and found it. It’s called Elmex Sensitive Toothpaste.

A: Many readers have reported that toothpaste containing SLS triggers their canker sores. A systematic review of the medical literature concludes that people with frequent mouth sores “may benefit from using SLS-free dentifrices for their daily oral care” (Journal of Oral Pathology & Medicine, May 2019).

Q: I would strongly suggest that anyone taking the diuretic hydrochlorothiazide for high blood pressure have the doctor monitor sodium and potassium levels regularly. My sister suffered from extreme nausea for months before it was discovered that her sodium level was extremely low. Her hydrochlorothiazide was discontinued, and the nausea abated.


A: Most people with high blood pressure have been told to avoid excess sodium. To do so, they may follow a strict low-salt diet.

While too much sodium can drive blood pressure up, diuretics such as hydrochlorothiazide can lower it, sometimes too much. Beyond nausea, symptoms can include headaches, cramping, weakness and even confusion or seizures in extreme cases.

Other medications may also contribute to low sodium levels (hyponatremia). They include some antidepressants, antipsychotics and PPI-type heartburn medicines (Journal of Medical Case Reports, June 29, 2020). Because low sodium levels can become dangerous, prescribers should monitor sodium as well as potassium levels with regular blood tests.

To learn more about hydrochlorothiazide and other medications for high blood pressure, you may want to consult our eGuide to Blood Pressure Solutions. This online resource can be found in the Health eGuides section of PeoplesPharmacy.com.

Q: I am a pharmacist and I recommend over-the-counter cold and allergy products every day. I had a stuffy nose recently, and I took everything I recommend to my patients (e.g. NyQuil, Sudafed, antihistamines, etc.). NOTHING worked.

An old friend told me I should put Vicks VapoRub on the soles of my feet. I was desperate, so tonight I did. Within five minutes my nose UNCLOGGED! It’s amazing.

A: We’ve heard about using Vicks VapoRub on the soles of the feet to stop a persistent nighttime cough. Using it for nasal congestion is new to us, but it may work in the same way. We suspect that the menthol, camphor, eucalyptus oil, thymol and other essential oils in Vicks trigger special receptors in the skin. These TRP channels may activate nerves that affect congestion and cough.