Your Tummy May Be Aching For Some B-12

If you are taking medication to reduce stomach acid, you should consider a B-12 supplement. I was inspired to write this entry after reading the “Top 200 Prescription Drugs of 2008” list in one of my pharmacy magazines. I wasn’t too surprised to find Nexium as the number 7 drug by number of prescriptions and number 2 by sales. Prevacid was number 31 and 9 accordingly. These are part of a class of stomach acid- blocking drugs known as proton-pump inhibitors (PPI’s for short). And clearly, lots of people are taking them! Several studies have uncovered that PPI’s deplete nutrients such as B-12, especially in long-term users. The good news is this can be minimized with proper B-12 supplementation.

Simply put, PPI’s decrease stomach acid and stomach acid is necessary for proper B-12 absorption. B-12 is an essential vitamin that is famous for supporting energy levels. Your body needs it for healthy nerve cells, red blood cells, and to make DNA. It actually takes years to develop B-12 deficiency, but you may have symptoms if your B-12 levels are just slightly below normal. These include irritability, weakness, numbness, low blood pressure, anemia, personality changes, and confusion. There is also an increased risk of birth defects, brain disorders, heart disease, and colon cancer associated with low B-12 levels.

As always, there are conflicting study results on the matter of PPI’s depleting B-12 levels. But this is my conclusion based on what I researched: Long-term use of PPI’s (greater than one year), especially in the elderly, increases the risk of a B-12 deficiency. Keep in mind that B-12 deficiency is already common in this group. But with more and more young folks taking PPI’s and for longer periods of time, I suspect this may become a bigger problem across all age groups. A B-12 supplement of at least 25-100 mg daily may be necessary to maintain B-12 levels.

Bottom line, it’s a good idea to have your B-12 levels checked if you’re on a high-dose and/or long-term treatment with a PPI (Nexium, Prevacid, Prilosec, Protonix, or Aciphex for example). A true B-12 deficiency may be underdiagnosed if you look at your B-12 levels alone because sometimes levels are within a normal range. Ask to have your homocysteine or methylmalonic acid levels checked too since these are also markers of your B-12 status. If you are looking for a B-12 supplement to balance your PPI therapy, feel free to consult with a Village Green practitioner for a recommendation.

NOTE: In theory, B-12 depletion may also happen with other stomach medications like Tums, Maalox, Mylanta, Alka Seltzer, Pepcid, or Zantac. I didn’t find a lot of good evidence at this point but I will keep you posted…

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Drug Interactions and Nutrient Depletions: Important information for your health

Americans are taking more prescription medications than ever before. As a result, people are experiencing more drug interactions. Adverse drug reactions can range from being mild to causing major injury or even death. Beyond interactions, medications can also deplete the body of vital nutrients, resulting in serious health concerns.

Combining pharmaceuticals with over-the-counter (OTC) medications, vitamins and herbal supplements, as well as certain foods can complement or interfere with a drug’s therapeutic action. For example, an interaction can occur if someone combines prescription blood thinners with aspirin, resulting in an increased effect of both drugs. Other combinations can result in a weakened effect of one or both substances, such as with fiber supplements preventing the absorption of certain medications.

Foods can also interfere with the effectiveness of medications. Two examples include grapefruit and dairy products. Grapefruit juice can interact with the enzymes that metabolize certain drugs, which can result in making the drug much more potent than it should be. And, dairy products alongside certain antibiotics (particularly tetracycline), can lessen its effectiveness.

It is estimated that roughly 30% of pharmaceutical side effects are the result of drug-induced nutrient deficiencies. The most common drugs linked to causing nutrient depletions are oral contraceptives, cholesterol-lowering medications (statins), nonsteroidal anti-inflammatory drugs (NSAIDs) and antibiotics. (Oral contraceptives can deplete the body of important B vitamins; statin drugs can inhibit the body’s production of coenzyme Q10, a potent antioxidant needed for energy production; and antibiotics can wipe out beneficial bacteria that your body needs function at its best.) These and many other prescription medications and OTC products can interfere with your body’s ability to digest, absorb, synthesize, or make use of certain nutrients, resulting in nutrient deficiencies.

How can you avoid potential drug interactions and nutrient depletions?

1) Tell your healthcare practitioner about everything you are taking, including prescription drugs, OTC medications, vitamins and herbal supplements. Be sure to mention topical medicinal creams and ointments, as well.

2) Carefully read the consumer information sheet that comes with your prescription. Ask your pharmacist about potential interactions or possible nutrient depletions.

3) Always read the label on OTC products, paying special attention to the “Warnings” section.

4) Before you buy a new vitamin or herbal supplement, talk to a nutrition advisor about potential interactions or depletions from your prescriptions. An advisor can also help suggest ways for you to replace depleted nutrients, whether through nutritional supplementation or through your diet.

The pharmacists and nutrition advisors at Village Green Apothecary are more than happy to help you with your prescription and nutrient questions. They are well versed in drug interactions and nutrient depletions and can provide you with the expert guidance you need to ensure your health and safety.

These charts listing the most common drug-nutrient interactions and nutrient depletions are also great reference tools.

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Don’t forget about CoQ10 with your Statin

If you’re taking a statin (Lipitor, Zocor, Pravachol, Mevacor, Crestor, etc) to lower your cholesterol or prevent cardiovascular problems, you should seriously consider taking a CoQ10 supplement. You have probably heard about the dangers of high cholesterol, particularly LDL (“bad cholesterol”). Statins work by blocking an enzyme in the liver responsible for creating cholesterol. In 2002, guidelines were published that recommended lower target levels for LDL. Since then, people have also started taking statins to prevent cardiovascular problems, even if they don’t have high cholesterol. Bottom line, lots of people are taking statins and higher doses are being prescribed. The problem is that this increases the chance of side effects. The good news is that taking a CoQ10 supplement can help balance things out. Continue reading “Don’t forget about CoQ10 with your Statin”

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Probiotics with Antibiotics

Are you about to start a course of antibiotics? Well don’t forget your probiotics. While the appropriate use of antibiotics does serve a role in fighting off unruly bacterial infections, it can also do a number on your gastrointestinal tract (and vaginal tract for females). As the public’s familiarity of probiotics increases thanks to the marketing of such products as Activia yogurt, the advice to supplement with probiotics while on antibiotics isn’t so “alternative” anymore. There is substantial research to support the use of probiotics for the prevention of antibiotic-associated diarrhea, as well as managing inflammatory bowel diseases and allergies (just to name a few of the other uses).

Simply put, probiotics are the good bacteria that keep potentially bad bacteria and yeast in check. When you take a course of antibiotics, it indiscriminately kills bacteria, including your normal flora of good bacteria. This sets the stage for antibiotic-associated side effects (gas, diarrhea, and yeast infections). It can take up to 3 months for your body to reestablish balance after a course of antibiotics. Foods rich in probiotics include yogurt, fermented cheeses, kefir, kombucha, and miso. But it is difficult to obtain enough probiotics for health benefits from dietary sources alone, since high-doses are required.

Quality probiotic supplements are available in capsules, powders, and liquids. I recommend that you support your body with probiotics for at least 2 weeks after your last dose of antibiotics. Remember to separate the probiotics from the antibiotic dose by at least 2 hours. Antibiotics will actually kill probiotics if you take them too close together. And did you know that your gut contains about 60-70% of your immune system cells? So supporting a healthy gut supports a healthy immune system – an added bonus! Here are some quick tips to help you select a quality probiotics supplement:

• Should have several strains of Lactobacillus and/or Bifidobacterium species
• Should be stocked in the refrigerator, even if it is stable at room temperature
• Should be freeze-dried in capsules, not tablets
• Capsules should be enteric coated, so they will open in your intestines

• Container should be dark and moisture-proof
• Ideally the product should have been tested for live bacteria levels at the time of manufacture and at the expiration date (this will be noted on the label)

As always, feel free to ask for recommendations from any of the Village Green staff.

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Not All Supplements Are Created Equal – How Do I Choose?

With the overwhelming amount of nutritional supplements available on the market, it can be a confusing process figuring out which health products are the best for you. When it comes to choosing the most beneficial products, there are four important things to look for:

1. Quality ingredients

    Patented, trademarked ingredients (examples: Ester-C®, Suntheanine®)
    Vitamin and mineral forms that are highly absorbable (examples: calcium hydroxyapatite or calcium citrate, rather than calcium carbonate)

2. Purity

    Products that are free of wheat, gluten, corn, dairy products, eggs, yeast, heavy metals, preservatives, and artificial colors or flavors
    Products that do not contain any unnecessary binders and fillers

3. Scientific Validation

    Ingredients and formulas demonstrated to be effective in clinical trials and research studies
    Independent third-party testing

4. Careful Manufacturing

    Meticulous quality assurance procedures followed
    Products tested to ensure proper breakdown by the body

Different supplement lines have different values regarding these four aspects of product quality. At Village Green Apothecary, it is our passion and commitment to provide our customers with premium products, and to this end, we created the Pathway line, which has over 120 single nutrient and combination formulas. Pathway products meet all of the criteria listed above – they are carefully formulated to contain the finest raw materials in forms that are well absorbed and assimilated into the body, as well as being 100% natural and hypoallergenic, designed with our customers’ health in mind.

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  • Paula Gallagher
    Paula Gallagher
    Paula is a highly qualified and experienced nutrition counselor on the staff at Village Green.
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December 2023