DEAR DR. ROACH: I am an 83-year-old lady, and I have done many adventurous things in my life (skydiving, race car driving, zip-lining, etc.) — all fearlessly. But I have always been terrified of going to the dentist. My blood pressure skyrockets, and after even a simple cleaning, I have to sit in my car a while to calm down enough to drive home.

I finally spoke to my dentist about this, and he said that it wasn’t at all unusual and prescribed triazolam. I took it, and while I am told that I checked in, had the procedure done, checked out, paid my bill, and even called my husband to pick me up, I have no memory of doing any of it.

I’m not comfortable with this reaction, so I asked my family physician if there was something else I could try to ease my anxiety a bit that wouldn’t turn me into a zombie. His response? “All medications of this type will have the same effect. I would hold off on treatment.” What?! Any suggestions? — A.C.H.

ANSWER: You sound like a very interesting person. It is true that medications like triazolam, which are of the benzodiazepine type (like diazepam, lorazepam and alprazolam), can cause memory loss. The memory loss can include memories you already had but also events that happened after you took the medicine.

This effect is particularly strong when taken with alcohol, but as your experience shows, it can happen even when taken by itself. I am very glad that you had a ride home as it is not safe for people to drive in this state.

Your request was entirely reasonable. Benzodiazepines are the most common medication used to help allay anxiety around a medical procedure, but other options have been shown to be helpful without causing memory loss. One option is melatonin, which was shown to be about as effective as medicines like triazolam. The dose of melatonin used in these studies (3-10 mg) was much higher than the dose I recommend for sleep (0.5-1 mg).

Other drugs that have proven to be successful in this situation include gabapentin and buspirone, and although these may also have side effects, I recommend them above another benzodiazepine. Given your level of anxiety, they’re worth a try.

DEAR DR. ROACH: I am a healthy 68-year-old female. For the past three to four years, my B6 level has been elevated. Last year, it was 196 mcg/L. Now it is 293 mcg/L. I don’t take any supplements or use any energy drinks, protein shakes, or anything with additional B6. I eat a good, normal diet, and I stay hydrated. My other labs are considered to be within normal ranges. My doctors are stumped as am I. Any suggestions? — C.

ANSWER: Low B6 (pyridoxine) is an infrequent diagnosis in adults and can cause skin changes, especially around the mouth. High levels of B6 are even more uncommon and normally occur only when people are taking high doses of it, usually in supplements. Some energy drinks have very levels, but you are clearly aware of this.

High levels of B6 in people who are not taking excess B6 can be associated with a genetic issue in the ALPL gene. Polymorphisms in this gene cause an elevated vitamin B6 level that is independent of diet or supplement use. This may also cause low phosphate levels.

If you have low phosphate levels, it would provide support for this diagnosis, which can be confirmed if you have high levels of the active form of B6, called PLP, in your blood.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2025 North America Syndicate Inc. All Rights Reserved