South Florida Sun-Sentinel (Sunday)
According to CDC, flu activity this year is below ‘baseline’
Q: I opted not to get a flu shot this year, because I have been staying away from people and wearing a mask when I go shopping. I figured that if I caught influenza, I could ask my doctor for one of the flu pills. Unfortunately, I cannot remember the names. What is the rate of infection like this year? A:
According to the Centers for Disease Control and Prevention, flu activity this year is below “baseline.” Last year, there was almost no influenza. That was probably a result of the measures people took to avoid COVID-19. The two oral antiviral drugs against influenza are oseltamivir (Tamiflu) and baloxavir (Xofluza). The CDC reports that both are effective against this year’s influenza strains. Taken soon after symptoms start, each can shorten the duration of flu by about a day or two.
Q: Have any studies been done about the safety of taking calcium for reflux? I take at least four 500 milligram generic tablets a day for my GERD. These keep the heartburn under control. Usually, I take two at bedtime so I won’t wake up with a bellyache. I’ve been doing this for years, since I do not want to take a drug like Nexium. Will I regret this?
A: The calcium carbonate you take is intended for short-term symptomatic relief. Each 500 milligram tablet supplies 200 milligram of elemental calcium, so four would provide about 800 milligram in a day. That is within the recommended dietary allowance of 1,000 milligram
for adult men up to 70 years old. (Women over 50 and men over 70 are advised to get 1,200 milligrams daily; to get this much, most people will need a supplement of some sort.)
What we don’t know is the long-term safety of calcium supplementation. A meta-analysis of
13 double-blind, placebo-controlled trials found that women taking calcium supplements were 15% more likely to develop cardiovascular disease (Nutrients, Jan. 26, 2021). A study published in the journal Gut (March 1,
2018) reported a connection between calcium plus vitamin D supplements and precancerous colon polyps.
The volunteers in this controlled trial were taking 1,200 milligrams of elemental calcium plus
1,000 IU of vitamin D3. It took six to 10 years for this complication to show up. You may want to consider some other strategies for controlling your heartburn.
Q: You probably saved my life with your article about lipoprotein Lp(a). All four grandparents and both
parents had a heart attack or stroke. I had never heard of Lp(a) and now I know it is an important risk factor for clogged arteries. In Robert Kowalski’s 2002 book “The New 8-Week Cholesterol Cure,” he quotes numerous studies where SR (sustained release) niacin lowers Lp(a). I have begun taking it. My husband has taken niacin for years under medical supervision. A:
Lp(a) is a serious genetic risk factor for heart disease and stroke. Cardiologists have known for almost 60 years that this blood lipid is probably as dangerous as LDL cholesterol.
Niacin is one of the few drugs that can lower Lp(a). Statins may actually raise this risk factor (European Heart Journal, June 21, 2020). A traditional “heart healthy” low-fat diet does not change Lp(a) levels. New research shows, however, that a low-carb diet can reduce this worrisome risk factor (American Journal of Clinical Nutrition, January 2022).