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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

May take more than milk to overcome low level of vitamin D

Joe Graedon and Teresa Graedon The Spokesman-Review

Q. My physician recently found that my vitamin D level is very low. I find this hard to believe since I drink nearly a gallon of milk weekly and take a multivitamin and supplement of calcium plus D each day.

I also take prednisone, tramadol, gabapentin, methotrexate and leucovorin. Could one of these drugs interfere with vitamin D absorption?

A. Many Americans have low vitamin D levels, especially in winter when they don’t get regular sun exposure. A glass or two of milk daily combined with vitamin supplementation does not always correct the imbalance for healthy people.

Your medications are likely making the situation much worse. Prednisone, gabapentin and methotrexate all can interfere with vitamin D.

You may need at least 2,000 International Units daily, which is much more than you are getting from your supplements and diet. Have your doctor monitor your progress. Vitamin D is crucial for immune function, muscle strength, balance and blood pressure control, as well as bone density.

Q. I had a wart surgically removed, but it came back. I then spent a nine-month period seeing a dermatologist and trying many different treatments he recommended. I had finally given up and told him I would not be returning.

Upon hearing this, he suggested I try Tagamet, the heartburn medicine. I began taking generic cimetidine (200 mg per day). The wart went away in less than two weeks and has never returned.

A. This unconventional use of the acid-suppressing drug cimetidine has been known for more than a decade. You may have been exceptionally lucky that your wart responded so well. A recent review of studies of this therapy concluded that “Current data do not support the use of H2-antagonists 1/8 cimetidine and ranitidine 3/8 for the treatment of common warts” (Annals of Pharmacotherapy, July/August 2007).

Q. I have been battling statin side effects for years. My doctor has prescribed Lipitor, Crestor, Pravachol, Lescol and Zocor, but I cannot tolerate any of them because of muscle pain and weakness.

It is imperative for me to keep my lipids under control because of coronary artery disease. What can you tell me about niacin and other ways to control LDL cholesterol? I would also like to know how to raise HDL cholesterol.

A. Although statin-type drugs are extremely effective at lowering LDL cholesterol, many people cannot tolerate side effects such as muscle problems, nerve damage (neuropathy) or memory impairment. There are other ways to lower cholesterol, however.

Niacin can be a very effective way to lower LDL and raise HDL cholesterol. It also reduces triglycerides. A doctor must supervise niacin use, since it can cause liver toxicity as well as uncomfortable side effects (flushing and itching).

Other strategies include fish oil and the soluble fiber psyllium. Nonstatin prescription drugs that can help control cholesterol include WelChol, Tricor and Zetia.

We are sending you our Guides to Heart Health and Cholesterol-Lowering Drugs with more information about niacin, fish oil and other strategies. Anyone who would like a copy, please send $2 in check or money order with a long (No. 10), stamped (58 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. CL-75, P.O. Box 52027, Durham, NC 27717-2027. They also can be downloaded for $2 from our Web site: www.peoplespharmacy.com.