Recently there have been a couple of rather major reversals in healthcare standard recommendations: it's been suggested, rather strongly, that people over the age of 70 may derive no health benefit at all from taking cholesterol-lowering drugs; and it's been suggested, rather strongly, that women under the age of 50 may be doing themselves more harm than good with annual mammograms.
But I'm not going to talk about those things right now. What I have in front of me is something that hasn't really been in the news much - though I found out about it in my newsmagazine, The Week.
It was just a little two-paragraph bit on an interesting - make that frightening - correlation between longterm use of common antacids and three guarantees of a miserable old age: depression, nerve damage, and dementia.
Note: correlation does not mean causation. It just means Thing 1 was found to be associated with Thing 2. But if Thing 2 is dementia, I tend to pay attention.
The mechanism is an inhibition of vitamin B-12. A study of 26,000 patients (obviously, this is not one of those back-office one-time surveys with fourteen subjects) "found that those who took a class of drugs known as proton pump inhibitors - sold over the counter as Prilosec, Prevacid, and Nexium - for two years or more had a 65 percent higher than normal risk of B-12 deficiency. Those who took the acid-inhibiting drugs called histamine-2 receptor antagonists, contained in brands such as Pepcid and Zantac, also experienced an increased but more modest risk."
And vitamin B-12 deficiency is associated with ... depression, nerve damage, and dementia.
Call me crazy, but I'd rather use diet and exercise modifications to cope with indigestion, heartburn, or even GERD than take the risk of torpedoing my brain.
Now, it's possible to moderate the risk by adding a vitamin B-12 supplementation program to your regimen. But again, I'd rather use diet and exercise modifications than add another pill to my daily routine.
It's easy for me to say this at 48. I may feel differently at 78. But I doubt it. The more studies like this that come out - those indicating that the longterm side effects for lifestyle medications may be worse than the condition the medication is meant to treat - the more determined I am to keep my temple clean.
Here is a link to the NPR story cited by The Week: http://www.npr.org/blogs/health/2013/12/10/249975706/popular-antacids-increase-the-risk-of-b-12-deficiency
and here is a link to the journal article (abstract) based on the original study: http://jama.jamanetwork.com/article.aspx?articleid=1788456