People’s Pharmacy: Multivitamin leads to painful constipation

Q. Why do I get constipated when I take a new multivitamin? My most recent attempt resulted in four days of constipation. I had to take Ex-Lax to recover.

A. A lot depends on the ingredients in your multivitamin. Minerals such as calcium or iron in high enough doses could lead to constipation. You may wish to look for a formula without those minerals.

Our “eGuide to Controlling Constipation” describes many medications that can cause irregularity and what to do about it. This online resource can be found under the Health eGuides tab at www.PeoplesPharmacy.com.

Q. As the mother of two Type 1 diabetics who are now both in their 40s, I’ve been watching technology and equipment become much easier to use. My daughter was diagnosed in 1983 at age 4. We used a clunky Accu-Chek machine and pricked her fingers and toes multiple times a day.

Today, 40 years later, she can just put her phone to her CGM arm patch and get an instant reading. She has no signs of diabetic complications and has had three healthy pregnancies.

Insulin pumps used to have tubing that clogged frequently. Today, pumps have no tubing and connect directly to the monitor patch to deliver the right amount of insulin.

A. Thank you for reminding us how challenging it was to monitor blood sugar levels. Today, continuous glucose monitors (CGMs) are about the size of a quarter and are both easy to use and accurate. The typical CGM stays on the arm for two weeks and can transmit data to a smartphone or insulin pump. This makes it possible for people with diabetes to track how food and activity affect their blood glucose.

This summer, the over-the-counter Dexcom Stelo Glucose Biosensor System will become available for people with Type 2 diabetes who do not use insulin. People without diabetes will also be able to use this technology to track their own blood sugar.

Q. A lot of people take over-the-counter pain medicines, but I suspect most don’t know about side effects. Tylenol can cause serious liver damage, even liver failure, but the public is not adequately warned.

All of the NSAIDS, including OTC drugs like ibuprofen and naproxen, have ominous warnings about serious bleeding in the digestive tract as well as the risk of stroke or heart attack. The public trusts these OTC medicines and some people overuse them.

In my opinion, they should be prescription drugs with limits on the dosage. What do you think?

A. You have identified a serious problem with the way people think about medications. Most consumers perceive prescription drugs as strong and potentially hazardous. Virtually every TV commercial lists frightening adverse drug reactions.

Many people assume that OTC medications, however, are safe. If they bother to read the warnings on the packaging, they might be surprised to learn that pain relievers that contain ibuprofen or naproxen are inappropriate for many people. Both drugs state that consumers should ask a doctor if warnings about bleeding ulcers would apply. The labels also suggest checking with a health care professional before using if the patient takes other drugs or has high blood pressure, heart disease, cirrhosis of the liver, kidney disease, asthma or has had a stroke.

Many people are opposed to the idea of restricting access to these pain relievers, even though they can cause very serious complications.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, Fla., 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”