Q: I've been taking an over-the-counter med (Prilosec) for heartburn every day for about six months. It's stopped the smoldering volcano, but is there a downside to taking it? -- Billy, B., Shreveport, Louisiana
A: You are smart to ask. Millions of people take OTC heartburn medications every day to control the production of heartburn-causing stomach acid, believing they are safe and effective. Some are proton pump inhibitors, such as Prilosec and Nexium; others are H2 blockers, such as Zantac and Pepcid. But the Food and Drug Administration has approved them to be taken for only 14 days at a time, because -- yes -- overuse can do a lot of harm.
You need stomach acid to break down foods and nutrients so that the body can absorb them, and to kill off harmful bacteria and other pathogens that you ingest. Reducing stomach acid can put you (especially if you're elderly) at high risk for gastrointestinal infections such as salmonella or C. diff. It also can deprive you of nutrients such as B-12 and calcium, make you more vulnerable to bone fractures and pneumonia, and cause acid rebound when you stop taking them -- making your heartburn even more of a problem.
If your heartburn is severe, you should be working with your doctor to identify and treat the cause. Your doc also should monitor and adjust your meds to the lowest effective dose. At the same time, you should adopt lifestyle changes to reduce your heartburn and wean yourself off these drugs. Kick food that's high in fat, chocolate, coffee, citrus, garlic, onions, pepper and even tomatoes off your plate. Also, ask your doc if any other medications you're taking could be triggers; if you smoke, quit; and lose weight if you need to. Then hopefully you won't need these potentially risky meds.
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Q: I just read that we should be taking 10 times more vitamin D-3 than the current recommendations. Is that true? And can it hurt you to take too much? -- Steven F., Boston
A: You must be referring to the new study that says the recommended dietary allowance for vitamin D (600 IU per day through age 70; 800 IU per day for those 71 and older) from the National Academy of Sciences/Institute of Medicine is 10 times lower than it should be.
Seems NAS/IOM made an error when they developed the standard, so the researchers are calling for a new guideline: 7,000 IU of D-3 daily for all ages. That, they say, is enough to prevent health problems related to vitamin D deficiency.
We can't tell you to take that dose, because some folks make that much (with sunlight) anyway. And there can be toxicity from too much vitamin D-2 or D-3. But we do know that most people don't get enough vitamin D-3 to maintain strong bones and a healthy immune system.
What causes D-ficiency?
• Too much indoor time.
• Being overweight: Body fat holds on to D and deprives other cells of the D they need.
• Aging: If you're over 65, you may have less ability to convert sunlight into D-3.
• A darker skin tone. A light-skinned person in a bathing suit may produce 10,000 to 20,000 IU of D by spending 10-12 minutes in the summer sun. Medium-toned skin takes about 30 minutes to make that much; dark skin can take up to 120 minutes.
Best bet: When you see your doc, get your vitamin D blood level checked and ask if taking a vitamin D-2 or -3 supplements is right for you.
Low levels of D are associated with depression, cognitive decline, osteoporosis, cancer, cardiovascular disease and Type 2 diabetes. And new research has found that taking vitamin D may help keep low-grade prostate cancer from becoming aggressive; when taken with metformin, it may prevent colon cancer; and it can help the body's immune cells prevent atherosclerosis and diabetes.
What we do: We each take 2,000 IU of vitamin D-2 or -3 every day; make sure to get out into the sun (walking, walking); and eat foods rich in D, such as salmon.
(Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at [email protected].)