Q: I experienced a problem with “frozen” medication. Combivent Respimat inhalation spray was shipped to me during an unusually cold spell. I noticed I was not getting the same relief for my breathing, and the relief I did get didn’t last the expected six hours.

I called Boehringer Ingelheim, the manufacturer. The representative I spoke to instructed me to stop using the inhaled meds immediately. They shipped me a replacement right away. Is it safe to get mail-order medicine in the winter?

A: You raise a fascinating question. Most medicines are supposed to be maintained within a relatively narrow temperature range (68 to 77 degrees Fahrenheit). For short periods of time, it is generally OK if temperature fluctuates between 59 to 86 F.

During either winter or summer, shipped medications may spend hours outside those parameters. One woman wrote:

“My husband was sent some AndroGel by mail order, but we had to go out of town for a funeral at the last minute. The meds spent eight days riding around in a truck before they could be delivered.

“Routine blood tests revealed that the meds were no good. The manufacturer was so concerned that it tracked down exactly where the drugs had been and at what temperatures. Apparently, they spent too much time in temps over 85 degrees, so the company refunded our money.”

Q: My doctor recommended psyllium for double duty: to lower my cholesterol and to keep me regular. How does this laxative lower cholesterol?

A. Psyllium is fiber from the plantago plant. The soluble fiber binds to bile acids in the digestive tract, allowing you to eliminate excess cholesterol. While psyllium won’t lower total cholesterol as much as statins can, it can lower this blood lipid anywhere from 9-15 points (Journal of Chiropractic Medicine, December 2017). Taking psyllium also may reduce levels of triglycerides and blood sugar.

Q: I have read that high blood sugar can contribute to erectile dysfunction. My wife died more than two years ago, but I now have a lady friend. I want to be able to perform if called upon.

Can you tell me about natural ways to reduce my blood sugar levels? I do use a lot of sugar in my morning coffee, and I drink more soda pop than water.

A: Elevated blood sugar can affect blood vessels that are essential for erections, just as it affects blood vessels in other parts of the body (Journal of Sexual Medicine, December 2015). So you are wise to look for ways to control your blood sugar.

If you have been diagnosed with diabetes, we urge you to follow your doctor’s advice and take the medications that have been prescribed. If, however, you are trying to keep your blood sugar down though it isn’t yet at the level of diabetes, there are several things you can do.

You might want to experiment with stevia instead of sugar to sweeten your morning coffee. Adding some cinnamon to the coffee grounds also could be helpful.

Try to change the ratio of water to soft drinks. Sugar-sweetened beverages provide a lot of empty calories. To get blood sugar down, you’ll want to reduce the amount of sugar and refined carbs in your diet. Exercise also is crucial for good blood sugar control. Certain herbs may be helpful: bitter melon, fenugreek or nopal cactus could help you maintain normal blood sugar.

In their column, Joe and Teresa Graedon answer letters from readers. Send questions to them via www.peoplespharmacy .com.