Herald-Tribune

Multivitam­in change leads to painful constipati­on

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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-thecounter 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 very 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, FL 32803, or email them via their website: www.PeoplesPha­rmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”

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Joe Graedon and Teresa Graedon
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