I went on a visit to Israel and ate a salad in Jerusalem with my family. I was surprised that while no one else complained, I felt a strong smell from green stuff that looked like parsley; it also tasted like soap to me. The restaurant told me that it was cilantro, which I had never eaten before. Can you explain why I had this reaction that no one else in my family had? P.V., Portland, Oregon USA

Prof. Mel Rosenberg, emeritus professor and expert on smells and tastes at Tel Aviv University, replies:  

You have no reason to worry. About 10% to 15% of the population have this soapy reaction to coriander, and it is genetic. There is even a website called IHateCilantro.com with some 4,000 registered members.

The journal Nature published an article on this phenomenon a few years back:

“Now, researchers are beginning to identify genetic variants behind the mixed reception for the herb Coriandrum sativum, which North American cooks know as cilantro, and their British counterparts call coriander. A genetic survey of nearly 30,000 people … has identified two genetic variants linked to perception of coriander, the most common of which is in a gene involved in sensing smells. There is clearly sympathy for this stance – 21% of east Asians, 17% of people of European ancestry and 14% of people of African descent say they dislike the stuff, according to a paper published this year in the journal Flavor. By contrast, 3% to 7% of south Asians, Latin Americans and Middle Eastern subjects disapproved of the herb, which is more common in their native cuisines.”

Dislike of coriander has long been thought to be a partly inherited trait and not just an artefact of cultural practices and exposure to the herb. Charles Wysocki, a behavioral neuroscientist at the Monell Chemical Senses Center in Philadelphia, Pennsylvania, says that surveys of hundreds of twins he conducted beginning in the early 2000s at the annual Twins Days festival in Twinsburg, Ohio, suggests that coriander preference is influenced by genes. He found that about 80% of identical twins shared the same preference for the herb,” the article continues. “But fraternal twins (who share about half their genome) agreed only about half the time. “Strong evidence suggests there’s a heritable component to the reactions that people have to cilantro, whether you’re a hater or a lover.”

I am wondering if there has been any new treatment for “wet” age-related macular degeneration instead of injections into the eyeball. I also have cataracts and was told that I should not have them removed because it could make the AMD worse. R.L., via email

Prof. Anat Loewenstein, head of the ophthalmology department at Tel Aviv Sourasky Medical Center, advises:

Age-related macular degeneration (AMD) is the most common cause of serious and irreversible vision loss in people 60 years and older. It happens when the macula, the small central portion of the retina (which is the light-sensing nerve tissue at the back of the eye) breaks down. Because the disease develops as a person gets older it is often referred to as age-related. Although macular degeneration is almost never a totally blinding condition, it can be a source of significant visual disability.

There are two main kinds, the “dry” kind and the “wet” kind. In the first, there are yellow deposits, called drusen, in the macula. As they get bigger and more numerous, these deposits can cause reduced vision – distortion or dimming – that patients notice especially when they read.

When the disease advances, the light-sensitive layer of cells in the macula begin to die.In the advanced stages, patients lose central vision. There is, unfortunately, no cure.

The “wet” form of AMD is characterized by the growth of abnormal blood vessels from the choroid underneath the macula that leak fluid into the retina, causing vision to be distorted. The result is blind spots and loss of central vision, and straight lines look wavy. Looking at a special graph and reporting that the lines are not straight can lead to a diagnosis.

The only proven treatment at present for “wet” AMD us intravitreal injections of an anti-vascular endothelial growth factor agent. These injections must be given frequently and consistently, and monthly monitoring and frequent treatment are necessary to achieve good visual acuity outcomes.

However, I just saw a report on a phase II study showing the efficacy of a slow-release device that is surgically put into the eye and needs to be refilled only once or twice a year. So there is hope for the future.

Is auriculotherapy being used to treat post-traumatic stress disorder in Israel? P.F.K., via email

Dr. Menachem Oberbaum, director of the Center for Integrative Complementary Medicine at Jerusalem’s Shaare Zedek Medical Center, answers:

Auriculotherapy is a complementary healthcare procedure in which the auricle of the external ear is stimulated in an attempt to alleviate medical conditions in other parts of the body. While originally based upon the ancient Chinese practices of acupuncture, the somatotopic correspondence of specific parts of the body to specific parts of the ear was first developed in France.

I am not aware of any therapist in Israel using auriculotherapy. In the past it was popularized by Dr. Edward Dvorkin, but it “died” slowly seems to have disappeared.

I’m 67 years old and have been retired for two years. I was a librarian and on my feet all day. During the last few years, my ankles and left knee were very stiff when I first got up from a chair. After that, the problem improved after I walked for a bit. Now, it has returned and is sometimes painful. My left knee feels weak, and when I go downstairs I feel like I have sand in my knee. When I walk down a slope, the knee feels weak, even a little like a loose hinge. I wonder if this is just normal aging. J.S., via email

Dr. Amir Rubin, a foot and knees specialist at Shaare Zedek Medical Center in Jerusalem, replies:

It’s very hard to diagnose such a problem without examining the patient, but it sounds to me that you have a cartilage problem. You should go to a physiotherapist to be examined so he or she can decide on a treatment regimen. Most problems of this kind require regular physical activity.

If you want an Israeli expert to answer your medical questions, write to Breaking Israel News health and science senior reporter Judy Siegel-Itzkovich at judy@israel365.com with your initials, age, gender and place of residence.