Prior to ordering vitamin and mineral supplementation for patients with macular degeneration, ask about smoking history. Individuals who smoke or have ever smoked should avoid high-dose vitamin A supplementation due to a high correlation between smoking, vitamin A and lung cancer. As an alternative, prescribe a formulation that does not contain vitamin A. — Debra Hunt, ARNP, Orlando, Fla. (166-6)
These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it, here.