Sherry - RE: Refluxkids: beware of zinc deficiency due to use of PPIs (Prilosec etc.)

[Guest guest]

Sherry,

May I put this on my website? I have someone who I was going to forward it to, but was wondering if I could put this on my site, since I may be referring people to this more than once .

Qadoshyah

*Got Down Syndrome?

www.gotdownsyndrome.net

From: Down Syndrome Treatment [mailto:Down Syndrome Treatment ] On Behalf Of gldcstSent: Tuesday, July 04, 2006 8:10 AMDown Syndrome Treatment Subject: Re: Refluxkids: beware of zinc deficiency due to use of PPIs (Prilosec etc.)

Acid-Reducing Drug Nutrient Depletion

Proton Pump Inhibitors1

Omeprazole (Prilosec®)

Lansoprazole (Prevacid®)

Pantoprazole (Protonix®)

Rabeprazole (Aciphex®)

Esomeprazole (Nexium®)

Histamine2 Antagonists

Cimetidine (Tagamet®)

Famotidine (Pepcid®)

Nizatadine (Axid®)

Ranitidine (Zantac®)

Vitamin B121, 10,11,12

Depletion of vitamin B12 includes: Fatigue, Peripheral Neuropathy, Tongue and mouth irregularities, Macrocytic anemia (abnormally enlarged red blood cells), Depression, confusion and memory loss (especially in the elderly), Poor blood clotting and easy bruising, Dermatitis and skin sensitivity, Loss of appetite, Nausea, and Vomiting.

Beta-Carotene1, 13

Beta-carotene depletion may cause a weaker immune system, and cancer.

Vitamin B12 1, 2

Anemia, tiredness, weakness, peripheral neuropathy, tongue and mouth irregularities, enlarged red blood cells (macrocytic anemia), depression, confusion, memory loss, poor blood clotting or easy bruising, dermatitis, skin sensitivities, loss of appetite, nausea, vomiting

Folic Acid 1, 3

megaloblastic anemia, birth defects, cervical dysplasia, elevated homocysteine, headache, fatigue, hair loss, anorexia, insomnia, diarrhea, nausea, increased infections

Iron 1, 4

Menstrual bleeding, pagophagia (consuming large quantities of ice), hypochlorhydria, diarrhea, intestinal inflammation, hair loss

Calcium 1, 6, 7

Rickets, osteoporosis, magnesium deficiency, intestinal inflammation increased phosphorus ingestion (with soft drinks etc.), increased caffeine intake, excess dietary fat and fiber, lack of exercise.

Vitamin D 1, 8

Rickets, low dietary Vitamin D intake, limited sun exposure, kidney or liver malfunctions, osteoporosis, osteomalacia, hearing loss, muscle weakness, severe tooth decay, phosphorus retention

Zinc 1

Acne, impaired sense of taste and smell, delayed wound healing, anorexia, decreased immunity, frequent infections, depression, photophobia, night blindness, skin, hair, and nail problems, menstrual problems, joint pain, involuntary eyeball movements (nastagmuas).

Beta-Carotene1,5: No RDA has been established. Most common supplemental dose is 25,000 IU/day. Dosage range is 5000-30,000 IU/day. Sources include colored fruits and vegetables (yellow, orange and red). No known toxicities; carotenosis, orange coloring of the skin, appears at large doses.

Vitamin B12: 100-2000 mcg/d; Oral supplements are not well absorbed. Intramuscular injection is best. Food sources include organ meats, clams, oysters, beef, eggs, milk, chicken, and cheese. Contraindicated in patients with hypersensitivity to cyanocobalamin, cobalt, or a hereditary optic nerve atrophy. Avoid use in premature infants. An intradermal test dose should prior to initial dose. Use IM shots only when treating pernicious anemia.

Folic Acid: 200-800 mcg/d; severely deficient need 5000-10000 mcg/d. Food sources include Dark green leafy vegetables, brewer’s yeast, liver, eggs, beets, broccoli, Brussel sprouts, orange juice, cabbage, cauliflower, cantaloupe, kidney and lima wheat germ, whole grain cereals and breads. Contraindications are pernicious, aplastic, or normocytic anemias. Pernicious anemia may be masked and irreversible nerve damage may progress with doses >0.1mg/day. Alcoholism, depressed hematopoiesis, and other vitamin deficiencies may cause resistance to treatment.

Iron: 10-50 mg/d elemental iron; Sources include LIVER, organ meats, fish, poultry, dried beans, vegetables, dried fruits, nuts, whole grain cereals and breads. Contraindications are hemochromatosis and hemolytic anemia. Avoid administration of iron >6 months in patients with bleeding, monorrhagia, repeated pregnancies. Caution in patients with peptic ulcer disease, enteritis, or ulcerative colitis.

Calcium: 800-2000 mg/d of elemental calcium; Milk and dairy products, dark green leafy vegetables, broccoli, legumes, nuts, and whole grains are excellent sources of calcium. Contraindications are hypercalcemia, renal calculi, and hypophosphatemia. Absorption may be altered in achlorhydria. There is an increase in gastric acid with in two hours following administration.

Vitamin D: 200-800 IU/d; No significant amount in many foods. There are small amounts in butter, cream, egg yolks, and liver. Milk with added vitamin D is the most common source in the United States. Contraindications are hypercalcemia or evidence of vitamin D toxicity. Administer with great caution in patients with decreased renal function, heart disease, renal stones, or atherosclerosis. Maintain good fluid intake.

Zinc: 10-50 mg/d; Sources include lean meats, liver, eggs, seafood (especially oysters), and whole grain cereal and breads An undiluted injection into a peripheral vein will result in phlebitis, tissue irritation, and increased renal loss of minerals. Zinc administration without copper may result in decrease plasma levels. HDL may increase and immune system function may be impaired with excessive doses.

__________________________________________________________________________________________

1. Pelton R., La Valle JB, Hawkins EB, et al. Drug Induced Nutrient Depletion Handbook. 1999-2000. Lexi-Comp,Inc. pp. 250-53, 262-69, 294-97, 300-07, 404-410, 426.

2. Force RW, Nahata MC. “Effect of H2-Receptor Antagonists on Vitamin12 Absorption.” Ann Pharmacotherapy. 1992. 26(10): 1283-86.

3. Russel RM, Golner BB, Krasinski SD, et al. “Effect of Antacids and H2 Receptor Antagonists on the Intestinal Absorption of Folic Acid.” Journal of Laboratory and Clinical Medicine. 1988. 112(4): 458-63.

4. NR, Hasinoff, Meddings JB, et al. “Ferrous Sulfate Reduces Cimetidine Absorption.” Digestive Disease and Sciences. 1993. 38(5): 950- 54.

5. Partlow ES, NR, Chan SC, et al. “Ferrous Sulfate Does Not Reduce Serum Levels of Famotidine or Cimetidine After Concurrent Investigation. Clinical Pharmacology and Therapeutics. 1996. 59(4): 389-93.

6. Bo-Linn GW, GR, Buddrus DJ, et al. “An Evaluation of the importance of Gastric Acid Secretions in the Absorption of Dietary Calcium.” Journal of Clinical Investigation. 1984. 73(3): 640-47.

7. Merenich JA, Georgitis WM, and JR. “Failure of Cimetidine to Reduce Postoperative Hypocalcemia in Patients With Primary Hyperparathyroidism Undergoing Neck Exploratory Surgery.” Surgery. 1993. 133(6): 619-23.

8. Bengoa Jm, Bolt MJ, and Rosenberg IH. “Hepatic Vitamin D 25-Hydroxylase Inhibition by Cimetidine Isoniazid.” Journal of Laboratory and Clinical Medicine. 1984. 104(4): 546-52.

9. Lacy CF, Armstrong LL, et al. Drug Information Handbook. 1999-2000. Lexi-Comp, Inc. pp. 174, 424, 480, 512, 585, 1239.

10. Bellou A, Aimone-Gastin I, De Kowin JD, et al, “Cobalamin Deficiency With Megaloblastic Anemia in One Patient Under Long-Term Omeprazole Therapy,” J Intern Med, 1996, 240(3):161-164.

11. Mercuard SP, Albernaz L, and Khazanie PG, “Omeprazole Therapy Causes Malabsorption of Cyanocobalamin,” Ann Intern Med, 1994, 120(3):211-5.

12. Termanini B, Gibril, Sutliff VE, et al, “Effect of Long-Term Gastric Acid Suppressive Therapy on Serum Vitamin B12 Levels in Patients With Zollinger-Ellison Syndrome,” Am J Med, 1998, 104(5):422-30.

13. Tang G, Serfaty-Lacrosniere C, Camillo ME, et al. “Gastric Acidity Influences the Blood Response to a Beta-Carotene Dose in Humans,” Am J Clin Nutr, 1996, 64(4):622-6.

[Guest guest]

Yes of course...I wish more people would take this seriously. I keep getting brushed off whenever I mention it. So funny because we got jamie off of prevacid and I was really sick for awhile so my dh "forgot" to give her her calcium supplements for 2 weeks. She then had bloodwork done and the doc called to congratulate us on getting her calcium levels up to almost normal after 5 years. I tried to tell her we weren't giving the calcium- only removing the prevacid but she still couldn't get her medical head around it.

Oh well...get the info out!! Good luck

Sherry

[Guest guest]

Thanks. I'll put it up on our site probably tomorrow or later tonight.

It is really serious info - especially with Down Syndrome when you look at the facts that they can have a tendency to be prone to zinc deficiency, B12 deficiency & folic acid deficiency!!

Thanks again!

Qadoshyah

*Got Down Syndrome?

www.gotdownsyndrome.net

From: Down Syndrome Treatment [mailto:Down Syndrome Treatment ] On Behalf Of gldcstSent: Monday, August 07, 2006 1:58 PMDown Syndrome Treatment Subject: Re: Sherry - RE: Refluxkids: beware of zinc deficiency due to use of PPIs (Prilosec etc.)

Yes of course...I wish more people would take this seriously. I keep getting brushed off whenever I mention it. So funny because we got jamie off of prevacid and I was really sick for awhile so my dh "forgot" to give her her calcium supplements for 2 weeks. She then had bloodwork done and the doc called to congratulate us on getting her calcium levels up to almost normal after 5 years. I tried to tell her we weren't giving the calcium- only removing the prevacid but she still couldn't get her medical head around it.

Oh well...get the info out!! Good luck

Sherry