Citrus bergamia, the bergamot orange, acts on the same enzyme as red yeast rice and statins to lower cholesterol, but the results aren’t conclusive. Also: concave fingernails and bad reaction to ACE inhibitor blood pressure medicine.

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Q. I have had success taking red yeast rice to lower my cholesterol. However, it’s not quite as effective now as in the beginning.

My nutritionist suggested trying citrus bergamot. Is there research to back this up?

A. We were surprised to learn that Citrus bergamia, the bergamot orange, acts on the same enzyme as red yeast rice and statins to lower cholesterol (Fitoterapia, April 2011). Scientists have conducted a handful of studies to determine if this fruit or its extract would be effective for treating high cholesterol. One study of 80 individuals found that a bergamot extract (Bergavit R) lowered cholesterol significantly during the six-month study (Frontiers in Pharmacology, Jan. 6, 2016). This trial was not placebo-controlled, however. And some other studies have not confirmed the lipid-lowering benefits of bergamot.

Some people complain that drinking Earl Grey tea can trigger muscle cramps. Since bergamot provides the distinctive flavoring for this tea, you should be alert for this complication.

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Q. Seven of my fingernails have become concave. The nails have always been quite thin. Is there a cure for this? Are there any special foods or vitamins that might help?

A. You are describing what may be “koilonychia.” One way to test for this condition is to put a drop or two of water on the affected nail. If the water does not run off immediately, you could indeed have this condition.

Concave or spoon-shaped nails may indicate iron deficiency. Other causes include lupus, Raynaud’s disease or diabetes. You should ask your doctor to test for anemia or other potential contributors. Correcting the underlying problem should improve your nails.

If you are deficient in iron, you probably will need an iron supplement. Foods high in this mineral include clams, mussels, oysters, sardines, liver, red meat, beans and spinach.

Q. My brother took lisinopril for nearly three years to lower his blood pressure. It did make him cough, but that didn’t bother him too much.

One morning, he woke up with his tongue so swollen that he couldn’t keep it inside his mouth. He went to the emergency room, and they called emergency triage.

The ER doctor came out, rushed him into the ER, stripped off his clothes on the way and gave him epinephrine. He said if he had been five minutes later, he might not have lived.

I’ve never had that kind of reaction, luckily. When I took Vasotec, though, it caused an awful cough.

A. Your brother was smart to get to the emergency department in time. He experienced angioedema, a rare but life-threatening reaction to ACE inhibitor blood pressure medicines like lisinopril.

Vasotec (enalapril) also is an ACE inhibitor. All such drugs may cause uncontrollable cough in susceptible people.

Our “Guide to Blood Pressure Treatment” outlines the pros and cons of various classes of medicine to treat high blood pressure and some nondrug options. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (70 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. B-67, P.O. Box 52027, Durham, North Carolina, 27717-2027. It also can be downloaded for $2 from our website: