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House Calls, April 5, 2012

Posted on April 6, 2012April 6, 2012 by Staff

Practicing family physicians from the UNC Department of Family Medicine have teamed up with The Carrboro Citizen to bring you a weekly feature responding to your questions about health and medicine. Send your questions or comments to yourhealth@unc.edu

This week we respond to questions about tonsil stones and B12 causing acne.

Dear HOUSE Calls, I keep getting white spots on my tonsils and have to scrape them out with a toothbrush. It makes my breath bad. What can I do?

These are little stones filled with bacteria. About 3 percent of people who go to a doctor concerned about bad breath turn out to have these stones. These tonsil stones are really calcium deposits. If they are bothering you (i.e., they feel irritated or you have recurrent bad breath), it is important to know there are treatment options. Some people will actually get their tonsils removed because these become such a nuisance. Getting tonsils removed as an adult can be a bit of an ordeal. Other options include laser treatment and water irrigation. You can irrigate these yourself with a dental water pick, which may also prevent recurrence. Another easier approach is gargling with warm saltwater.

Dear HOUSE Calls, I started getting B12 supplemental shots several months ago, and I noticed that my face started breaking out. I changed to the B12 pill supplement, and I still look like a teenager. Is there an association between B12 and adult acne?

We had not previously heard about a link with acne and B12, but apparently there is one, and it is more common in women than men. The first thing you should do is talk with your doctor about how much you need the extra B12. Was your level very low or borderline? Perhaps cutting back on the dose would help. If you stop the B12 and the acne goes away, that will show the B12 as the likely cause. If you absolutely do need the B12, your doctor may need to start treating the acne too. The most important thing is just to talk to your doctor about coming up with the best plan for you. We should mention that B12 shots were once quite common. We now know that with high enough doses, almost everyone can get enough B12 by taking extra in the form of a pill.

House Calls is a weekly column by Dr. Adam Goldstein, Dr. Cristy Page and Dr. Adam Zolotor on behalf of Your Health and the UNC Department of Family Medicine.

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