Q: Which type of calcium supplement is best absorbed? How many milligrams do you suggest for a woman in her 60s?

A: Most calcium supplements sold are either calcium carbonate or calcium citrate, and either one is reasonable in people who need calcium supplementation. I prefer dietary calcium when possible: Calcium supplements increase the risk associated with kidney stones, while calcium mineral in food (dairy products and fish with tiny bones, such as sardines, are excellent sources) decreases kidney stone risk. Further, there will be some suggestion that calcium supplement supplementation may increase heart disease risk, and while the evidence is conflicting, calcium through food seems safer than calcium dietary supplements to me.

The standard recommendation is 1, 200 mg of elemental calcium a day from a combination of food and supplements with regard to a lady over 50 or a man over 70. (Read labels carefully: A one, 250 magnesium serving, which may be one or more tablets of calcium supplements carbonate, contains 500 mg of much needed calcium. ) Calcium carbonate is best absorbed with meals, while calcium citrate is usually well assimilated with or without foods. Calcium carbonate is not well-absorbed by people taking proton pump inhibitor medicines like omeprazole (Prilosec).

Queen: I am the 72-year-old male in good health who was told this week that my eyes have shown the beginning of glaucoma. There is no change in my 20/20 vision yet. In 2014, I had cataract surgery in both eyes. Is there any evidence that AREDS 2 vitamins (special eye vitamins) will do anything to moderate the effects of glaucoma?

A: Although there are many vision diseases, three of the most important ones in older adults are glaucoma, cataracts plus age-related macular degeneration. There can be some confusion over what these are usually.

Glaucoma is a disease of the retina that is usually (but not always) associated with high pressure in the particular eye. A person can get glaucoma with normal eye pressures, and some people with high eye pressures never get glaucoma. But , we often treat individuals with higher pressures to prevent glaucoma from developing, and will certainly treat people with glaucoma and normal attention pressures along with medication — eye drops are almost always used to reduce eye pressure. Some people with glaucoma, or those who are at risk due to eye pressure or even anatomy, benefit from laser surgery rather compared to medication. Eye doctors screen for glaucoma with a comprehensive eye exam, including a careful look at the retina, plus by measuring eye stresses. Vision loss in glaucoma is gradual and is definitely often not really noticed, since it is in the peripheral vision. Vitamins have no effect on glaucoma.

Age-related macular degeneration (AMD) is a very different condition. It’s not clear exactly how the condition starts, but it can be “wet” (with abnormal blood vessels) or “dry” (more common, with atrophy of the particular macula, the part of the retina in the center where our vision can be sharpest). AMD is diagnosed by an eye examination. Wet AMD has treatment options, such as injections into the eyes of medications to stop abnormal blood vessels through growing. Dry AMD is certainly treated with the AREDS or AREDS 2 nutritional vitamins, which slow progression associated with the disease.

You know all about cataracts, having had surgical treatment. They are opacities within the lens from the eye, causing gradual cloudiness of the vision. If a person live long enough, you will develop cataracts. Surgery is the treatment regarding cataracts.

Q: A doctor friend suggested I purchase a nitric oxide nasal spray from Israel. She suggested using it when eating out or hanging out with friends maskless. Do you have an opinion about its efficacy? I got the most recent booster and the flu shot. The reason I’m concerned is that I see an uptick in individuals around me getting COVID for possibly the first or second time. And I spend a lot of time along with my grandchildren.

The: There are some reasons to become optimistic about this treatment. Two studies have shown improvement that individuals with COVID-19 using the nose spray, but there are usually no published data I can find to show that the spray prevents infection in the first place. We did find an ongoing study within people along with asymptomatic COVID-19, but the particular results are not yet available. Unfortunately, the kind associated with study needed to show effectiveness at preventing the disease is extremely large and expensive. Getting your booster, choosing wisely whether to go maskless and avoiding large crowds remains the particular best way of not really getting sick.

Queen: Am I actually taking too many vitamins and are there benefits in taking all these nutritional vitamins? I started taking seafood oil intended for my coronary heart; 2, 000 IU of vitamin D3 was recommended by my gastroenterologist; a multivitamin because my mom has macular degeneration; and I began taking zinc and vitamin C due to the fact I heard it will certainly help with COVID symptoms.

A: Vitamins inside reasonable doses are seldom dangerous, although some can be at very high doses. Let’s take a look at each associated with your questions.

Fish oil has been demonstrated to modestly improve bloodstream pressure plus cholesterol, and a prescription version reduced heart attack risk in people with high triglyceride levels in one study. In another study that individuals getting statins and fish oil had no additional benefit.

Vitamin D has been very controversial. Recent studies have found that vitamin D did not “prevent cancer or even cardiovascular disease, prevent falls, improve cognitive function, reduce atrial fibrillation, decrease migraine frequency, decrease age-related macular degeneration or reduce knee pain. ” Of course, there are some people who still benefit from vitamin D, such while people with osteoporosis who cannot absorb supplement D well, or that live where they never get sun exposure. The 2, 000 IU you are usually taking will be safe.

People with the dry form of macular deterioration take advantage of the particular multivitamin (called the AREDS or AREDS 2 formulation) to slow progression of this condition that will affects central vision. However, studies designed to display prevention associated with macular degeneration with the particular same formulation could not show a benefit. Again, though, there is no harm through these supplements, except that smokers should not take the original AREDS formulation, given that they had a higher danger of lung cancer.

Multiple correctly looked to see regardless of whether vitamin C, zinc or even calciferol may prevent COVID-19 or decrease its severity; unfortunately, the particular preponderance of the proof shows simply no convincing advantage. Taking supplements is no substitute for vaccination and prudent behavior. Scientists have not proven that will vitamin plus mineral health supplements benefit a person for the conditions you are concerned about, but it is still possible that there is an advantage that will be too small to find within the types of studies already done. The downside of these particular capsules at reasonable doses is usually small.

Dr. Roach regrets that he is unable to answer individual letters, but may incorporate them in the column whenever possible. Readers may email questions in order to [email protected] cornell. edu or send mail to 628 Virginia Dr ., Orlando, FL 32803.

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