Dr. Marie Savard Answers Your Questions: GMA Medical Contributor Weighs in on Diabetes, Acid Reflux and More
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QUESTION: “I take medications for acid reflux. How is this going to affect my bones?”
DR. MARIE SAVARD: I’m getting this question all the time. There is a lot of research that shows that’s exactly the point. The more you take, the stronger the medication, it lowers your bone density and raises the risk of fracture. Why is that?
It turns out that when you block all that acid, which is important, you’re not absorbing important vitamins, including calcium.
[Medications such as] Prevacid, Prilosec, Nexium, those are strong and they’re meant to be taken for short periods of time — six to eight weeks. So if you have an ulcer or a bad reflux, that’s fine. But beyond that time, use lifestyle and other ways to kind of get rid of the heartburn.
… It’s not the magic bullet to get rid of that heartburn and indigestion when you ate too much and drank before you went to bed. … That has to be lifestyle. Don’t eat late at night, minimize the alcohol at night. And if you need it for short periods, that’s fine. Or try the over-the-counter antacids or even Pepcid AC. They’re milder, don’t block as much acid.
There’s a rare condition, Barrett’s Esophagus — that really does raise your risk of cancer. In that case, maybe you need lifelong medications. But, then, maybe you need to double up on calcium and vitamin D with it.
Dr. Marie’s advice? Acid reflux medications are short-term solutions.
QUESTION: “I’m interested in finding out more about the injectable contraceptive Depo-Provera. Does it work the same as the pill or is it completely different?”
SAVARD: The injectable form, obviously, is a shot. It lasts for three months and I guess that’s the easy part of it. And the active ingredient is progestin. … It’s very similar to what’s in birth control pills. The difference is this. The difference is, there’s no added estrogen. Estrogen was put in birth control pills to kind of even out the lining so that you would have a more even [menstrual] flow every month.
… It’s absolutely just as effective. The progestin is the active ingredient in all hormone pills and it works by thinning the lining of the uterus so that you can’t have a successful pregnancy, and it also stops an egg from forming every month.
Type II Diabetes Is Controllable
When you’re getting the shot, you’re much more likely to have breakthrough bleeding, some bloating, some of the other side effects that the pill can cause. And one heads up: Long-term, if you’re getting the shot, there is a concern about lower bone density. So, you’re at greater risk for osteoporosis. The good news is, if you stop the shot, your bones can come back. But, on the other hand, I would say that any woman who’s at increased risk for osteoporosis — women with eating disorders, women with a family history — this may not be the right contraceptive for you.
Dr. Marie’s Advice? Depo-Provera is as effective as traditional birth control pills, but may not be the best contraceptive for those at increased risk for osteoporosis.
QUESTION: “I have Type II diabetes. I know some people who say they control it with diet instead of medicine. How do you do that?”
SAVARD: Well, this is complicated. So to start from the beginning, anyone who has Type II diabetes, what’s happening in the beginning, their pancreas is working overtime to make extra insulin. Usually, they’re overweight or sometimes obese, and the insulin in that case doesn’t work very well.
So the pancreas is working overtime. At that stage, diet and exercise can do a lot to help that insulin be more effective. Gradually, the longer you have it, your pancreas tires out and produces less insulin. Then you switch to the oral medication that kind of boosts the insulin or lets the insulin work a little bit better.
In the final stages of Type II diabetes, what happens is eventually, your pancreas really fails. It can no longer produce enough insulin and, in that case, you’re going to even need insulin injections.
Dr. Marie’s Advice: Diet can control Type II diabetes in the early stages. Click here for Dr. Marie Savard’s diabetic diet tips.