DEAR DR. ROACH: I have a friend whose daughter has an egg allergy. She said her daughter will break out in a rash if she eats anything that even has trace amounts of egg in it. Another friend of hers told her to use CBD oil to prevent reactions, but I am skeptical. I cannot find anything credible to support the claim. What are your thoughts? — E.B.P.
ANSWER: Almost every day I hear another claim that cannabidiol, the major nonpsychoactive component of cannabis, is effective for some medical condition. Unfortunately, the evidence of effectiveness of CBD is very limited. The sole Food and Drug Administration indication for CBD is for the treatment of two uncommon childhood seizures: Dravet syndrome and Lennox-Gastaut syndrome.
There is preliminary evidence that CBD may be useful for anxiety disorders, some types of sleep disorders and chronic pain. There is active research on other conditions, including asthma, multiple sclerosis and contact dermatitis. I believe it is likely that CBD will be proven effective for other conditions, but until there is better evidence of effectiveness, I cannot make a recommendation to use CBD (outside of the two forms of childhood epilepsy for which it is indicated).
Although there are laws in all 50 states legalizing CBD, the federal government’s position is still that cannabis extracts are Schedule I controlled substances, although they do not seem to be enforcing action against CBD at present. Unfortunately, independent laboratory analysis of available CBD products show that about a quarter of them have less CBD than advertised, and another quarter contained the psychoactive component THC.
For food allergies, I would recommend strongly against using any unproven treatment. Egg allergies have a broad range of severity in children, from mild rash to life-threatening airway swelling and anaphylaxis. Although many children outgrow egg allergies, your friend should listen to her daughter’s doctor, not her CBD-supporting friend.
DEAR DR. ROACH: I recently changed primary doctors, and I saw the report of my echocardiogram. It said I have “mild left ventricular hypertrophy with some diastolic dysfunction.” Could you tell me what this means and if it is serious? — C.B.
ANSWER: An echocardiogram uses sound waves to take precise images of the heart. The cardiologist interprets those images to make statements about the anatomy of the heart, including thickness of the walls of the heart, as well as its function. The left ventricle is the chamber of the heart that pumps blood to all of the body, having received oxygenated blood from the lungs.
Consequently, it is the thickest of the chambers. “Hypertrophy” means “too much growth” — that the wall is too thick. “Diastole” is the part of the cardiac cycle where the ventricles fill up. This should happen at very low pressures. In diastolic dysfunction, which commonly accompanies left ventricular hypertrophy, the left ventricle requires higher pressure to fill that thickened and stiffer wall. LVH and diastolic dysfunction are most commonly results of high blood pressure.
Some of the many medicines we use to control high blood pressure are good at helping the heart fill at lower pressure. Not everybody with these findings on an echo needs treatment. The key word in your report is “mild,” which generally indicates no need for treatment beyond careful blood pressure monitoring.