Tuesday, May 11, 2010

Antacids a cause of bone fractures and infections, Vitamin D and Osteoporosis and more

I was reading in the Star Ledger about certain acid reducing medications  and their relationship to ones health (http://azstarnet.com/news/science/health-med-fit/article_247ef04b-9813-5d77-bbc8-fbeb497a226f.html).  For quite some time, if we have acid reflux, or heart burn or any other stomach complaint, antacid meds such as nexium have been given to relieve the complaint.  Commonly, most regular doctors are quite comfortable with the idea that if we have acid reflux or any other type of symptom representing overproduction of acid which have been thought in the past to cause ulcers and other gastro intestinal distress, these substances buffered the acid and reduced the amount we produced.  The symptoms may have been relieved, however, was it really the right thing to do?  As we age, we normally produce less acid.  This makes it more difficult to digest food, break down minerals such as calcium before it enters the intestines and even allows for increased likelihood of having infections in the stomach such as H Pylori which was treated with, you guessed it, nexium.  Years later, we have studies showing people with reduced calcium in their bones and more gastro intestinal infections as they get older.  This is what I call learning the hard way.  There are of course other treatments such as having a teaspoon of vinegar which has been known to calm the stomach.  Vinegar?  Sure vinegar because it has acetic acid and that helps digest food in older people.  As I have said, we need a paradigm shift, away from symptoms and more toward understanding what we are treating.  How can we treat something we do not understand and call it the science of health care?

The other article was on Vitamin D and osteoporosis (http://www.omaha.com/article/20100511/LIVING01/100519970).  For quite some time, vitamin D has been included in milk which has calcium because it helps assimilate calcium into the body.  Milk producers proudly state their milk has vitamin D added.  Vitamin D also is produced in the body naturally however, many seniors have skin sensitivity due to medications and some have fair skin which is a concern because of melanoma.  Because of this, many seniors stay out of direct sunlight which can cause a deficit of vitamin D.  The article suggests that many hip fractures and other fractures in the elderly may be avoided with vitamin D supplementation.  I agree.  I also believe it is more preventative than dexa scanners and using the results to talk people into taking drugs like boneva.

In healthcare, we are all consumers and in our office, educated consumers (as the Syms commercial says) is our best customer.  What do you think?