Three vitamin supplements reflux sufferers may need

By Karen Ansel, MS, RD


You’ve tried eating smaller meals, avoiding spicy foods and even losing weight. But if you’re one of the 15 million Americans who suffer from daily heartburn, chances are you’ve turned to medication as part of your anti-reflux regimen.

Sure, heartburn meds can help relieve acid pain and promote healing, but they have a downside too. When taken long term, many of these remedies can interfere with the absorption of key vitamins and minerals, eventually putting you at risk for nutrient deficiencies.

A little Digestion 101

When it’s not in your esophagus, that troublesome acid rising up from your stomach actually has a purpose. It helps your digestive system break down lots of important nutrients. Trouble is, many of the most popular reflux meds – like Zantac, Pepcid, Prilosec, Tagament and Nexium - work by zapping stomach acid. Good news for controlling your reflux, but potentially bad news for your nutritional health.



Is your reflux remedy a prime offender? Decide for yourself and find out the top nutrients you need to be concerned about.



Vitamin B12

What happens if you don’t get enough

Skimp on this B vitamin and you run the risk of developing serious neurological complications – like numbness in your arms and legs, trouble walking, disorientation, and even memory loss.


Why it’s a concern

B12 isn’t always easy to get. That’s because it’s only found in animal foods (crab, mussels, clams, beef and poultry are some of the best sources). What’s more, it’s not easily absorbed. In foods, vitamin B12 is tightly bound to a certain protein. The only way for our bodies to absorb it is to break it away from that protein – and that requires adequate stomach acid, something you might not have enough of if you’re popping anti-reflux meds every day. In fact, a University of Colorado study advises that people taking H2 receptor antagonists like Tagament and Pepcid or proton pump inhibitors such as Nexium, Prilosec and Prevacid for four years or more should be regularly monitored for B12 deficiency.



If these medications are part of your anti-reflux regimen, consider a B12 supplement. In supplement form B12 isn’t protein bound, so we can absorb it with or without acid. To make sure you’re getting enough, experts recommend 25 micrograms a day, the amount you’d find in a senior vitamin.



Iron

What happens if you don’t get enough

Iron’s chief role is to deliver oxygen throughout your body. Fall short and you’ll feel it mentally and physically. You’ll find you lack endurance, tire easily, and have difficulty thinking clearly.

Why it’s a concern

There are two types of iron: heme iron from animal foods and non-heme iron from plant foods. While our bodies easily soak up heme iron, non-heme iron requires acid for optimal uptake. If you eat few iron-containing animal foods (such as red meat, dark poultry and shrimp), talk to your doctor about blood tests to make sure you’re getting enough iron.



Calcium

What happens when you don’t get enough


Calcium is key for building strong bones. And it’s not just important for women either, with men accounting for 23 percent of osteoporosis cases in Americans over age 50.

Why it’s a concern


Like iron and vitamin B12, you need sufficient stomach acid to absorb calcium. Emerging research reveals that prolonged use of proton pump inhibitors may significantly weaken bones. Recently, a Journal of the American Medical Association study of nearly 150,000 people over age 50 found that taking proton pump inhibitors for more than one year increased a person’s risk of hip fracture by 44 percent. What’s more, the stronger the dose and the longer a person took these medications, the greater their hip fracture odds.



Because researchers found the link to be stronger for people getting their calcium from supplements than from food, they recommend relying on calcium from dairy products like low-fat milk, yogurt and cheese. Aim for at least 1,000 milligrams a day (that’s about three daily 8-ounce servings of milk or yogurt) if you’re under age 50 and 1,200 milligrams if you’re older.


Karen Ansel, M.S., R.D., is a freelance writer and dietitian in Long Island, NY. Her work has also appeared in Woman's Day, Cooking Light and Prevention.