caffeine-insomnia
Juliette Borda
Dr. Raj answers your questions about caffeine, spider veins, and germs on public toilets.

Q: I drink four or five cups of coffee every day, then a cappuccino at night. Is that too much caffeine?

A: Yes and no. For most people, 200 to 300 milligrams of caffeine a day—about two or three cups of coffee—is fine. But more than that may cause anxiety, sleep difficulties, or irritability, as well as stomach ulcers, esophagitis (inflammation of the esophageal lining), a temporary rise in blood pressure, and reflux—all signature signs of an overdose.

Pregnant women should definitely try to avoid caffeine. If youre otherwise healthy and not having any problems, your caffeine intake is probably OK. Watch out for warning signs, though, and see a doc if you have restlessness or headaches or feel like your heart is beating too fast.

Q: How can I get rid of the spider veins on my legs? And am I doomed to get varicose veins, too?

A: Those blue and red squiggly veins that look like spider webs are smaller and closer to the surface of your skin than varicose veins. And, no, youre not doomed to get the varicose kind (created by a backup of blood in veins that are deeper and bigger) because you have them. The spiders pop up when blood in the tiny veins that carry blood upward to your heart seeps into surrounding tissue.



Causes and treatment for spider veins
There are lots of causes: hormonal changes brought on by pregnancy, menopause, or birth control pills, as well as obesity or weight gain, prolonged standing, or an inherited blood issue. Sun exposure can lead to spider veins on the face.

Most women who get spider veins during pregnancy find that they fade within three months of giving birth. For women who arent so lucky, there are ways to banish them. One option: sclerotherapy, a process in which saline is injected into the veins so they clot and disappear. Administered by a dermatologist or vascular surgeon at a cost of $150 to $550 per treatment, sclerotherapy could take from two to six sessions, one to two months apart, to show results.

Another doctor-provided option: laser therapy, in which strong bursts of light are used to slowly fade the vein. Multiple treatments, each costing about $300, are sometimes required. Dont want to visit the doc? Try some basic concealer, like Covermark Beauty Leg Magic in Almond ($18), which wont rub off on clothes.

Q: How bad is it to sit on a public-toilet seat? Could I catch something?

A: Its not as bad as you think. There are more germs on the floor in a public bathroom (hang up your purse!) than on the toilet seat. If the seat looks icky, use a paper cover, if available, or wipe it with toilet paper. But dont worry too much about STDs. The fact is, if you have a healthy immune system, you wont catch anything from a public-toilet seat.

Still worried about germs? Use stalls that have covers over the toilet paper rolls. When a toilet is flushed, it sprays germs and microscopic fecal matter into the air. If the toilet paper is protected, youre less likely to spread germs on yourself when you wipe.
Last updated: Nov 28, 2009