Two recent warnings serve as important reminders for us (and our doctors) to always carefully weigh the risks as well as the benefits of taking medicines and dietary supplements.

Calcium Supplements for Bones

Controversial research linking calcium supplements to an increased risk of heart attack published in a leading British medical journal is raising eyebrows around the world.

“A paper published in the July 2010 issue of the prestigious British Medical Journal found from 11 randomized studies (around 12 000 participants) that healthy women treated with calcium supplements (without vitamin D) had about a 30% increase in the incidence of heart attacks compared with those treated with placebo,” explains heart rhythm expert Dr. Douglas Zipes. “Studies on dietary calcium intake do not show such an increase so the risk appears to be due to the calcium supplements alone. Calcium supplements reduce the risk of bone fractures by only about 10%, so the benefits of taking them may not outweigh the risks for most individuals.”

Researchers say that even a small increase might translate into large numbers of women at risk because of the widespread use of calcium supplements. Others note that the findings are not based on studies designed to prove cause and effect.

PPIs Reduce Stomach Acid

In May, the FDA reported that high doses or long-term use of popular proton pump inhibitor (PPI) medicines for chronic heartburn may increase the risk of hip, wrist, and spine fractures.

PPIs effectively reduce stomach acid to treat heartburn, gastroesophageal reflux, and ulcers—conditions that, left untreated, can have serious consequences.

As a precautionary step, however, revised labels on prescription and over-the-counter PPIs will reflect the increased risk of broken bones, say federal health experts.

Prescription PPIs are Nexium, Dexilant, Prilosec, Zegerid, Prevacid, Protonix, Aciphex, and Vimovo.

Over-the-counter PPIs are Prilosec OTC (omeprazole), Zegerid OTC (omeprazole), and Prevacid 24HR (lansoprazole).

“Because these products are used by a great number of people, it’s important for the public to be aware of this possible increased risk,” said Joyce Korvick, MD, deputy director for safety in the FDA’s Division of Gastroenterology Products, in an FDA press release.

Advice for Consumers

“Before discontinuing any medicine and supplement, individuals should first check with their provider about specific risks and benefits,” advises Dr. Zipes.

Future research will better clarify the risks associated with calcium supplements and PPIs.

In the meantime, read and follow all product labels and talk to your health care professional about any concerns you have about using dietary supplements and drugs.

Click here for more from Dr. Zipes and his new book. The Black Widows | Saturday Evening Post

Drug Alerts The Saturday Evening Post

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Urbana, Missouri

Strontium (STRON-tee-um) is a naturally occurring mineral that is closely related to calcium. At best, foods contain a minimal amount of the mineral, but different versions of strontium—used to improve bone health, unlike radioactive strontium, which treats bone cancer—are widely available online and in stores. In the U.S., strontium citrate is sold as a supplement, not a drug, which means data about its long-term safety and optimal dosage are lacking, and the purity of specific products is questionable. Still, evidence suggests that strontium preserves existing bones and helps build new bone tissue. Usually, strontium citrate is taken at bedtime, at least four hours after consuming calcium.

Prescription-strength strontium ranelate is available in Europe for treating osteoporosis. Osteologix, a biopharmaceutical company in Richmond, Virginia, is planning additional studies of its osteoporosis drug, NB S101 (strontium malonate). Assuming testing is successful, the prescription product could be FDA approved and available for use in the U.S. in early 2015.

Strategies for Bone Health The Saturday Evening Post

Both of your doctors could be right. It depends on where the calcium is, how much is there, and whether it is buried in the heart muscle or mobile, like in a valve leaflet. If it is immobile, it may not be necessary to remove because it is anchored in place and may not be causing any problems.

If it is moving, it may be susceptible to breaking off into the bloodstream, and its removal might be a priority. Be bold and ask both doctors to explain their positions. Having a significant leak in your valve could be a reason for operating to try to fix it.

Two Views on Calcium Deposits in Heart The Saturday Evening Post