DEAR DR. ROACH: I had a very frustrating experience getting a prescription filled. This happens often, though I consistently follow the instructions of my pharmacy and doctor — phoning to have my prescription renewed a week before I run out, and going as often as is required. Last time, I had to call the doctor on two consecutive days after the pharmacy’s faxes failed to get a response.
I would like to know your thoughts on this problem. We who pay our insurance premiums, doctor bills and pharmacy fees seem to be left out of the equation. — N.H.
ANSWER: I understand your frustration. People who take multiple medications often end up in the pharmacy several days per month (if not per week) getting medications. And if the physician doesn’t have the prescription ready so the pharmacist can fill it, it is frustrating. Worse, it is an abuse of your time.
The best advice I can give is to ask the doctor for a three-month supply. Almost all medications can be filled that way, and most insurance companies will allow this. Sometimes it is cheaper to do it that way as well. This can be done through your local pharmacy or through a mail-order pharmacy, depending on the insurance and your preferences. That significantly cuts down on frustration for everybody.
Many physician offices are now using e-prescriptions, which allows the doctor to send the pharmacy the information instantly and with less trouble than a written prescription or fax.
DEAR DR. ROACH: In today’s column on osteopenia, you recommend dairy products. Besides leaching out more calcium than is used, dairy is not a “healthy food,” according to the Department of Agriculture. — K.E.
DEAR DR. ROACH: Calcium needs vitamin D and magnesium to be absorbed by the bone. If you don’t have these co-factors, the calcium will settle somewhere in your body, just not your bones. A human body can absorb only about 500 mg of calcium at one time. If a person tries to take the full recommended dose all at once (1,200 mg to 1,500 mg), some of that calcium is not going to be absorbed. — D.B.
ANSWER: The hypothesis that protein leaches calcium from bones — once scientific dogma and still prevalent on Internet sites, — recently has been proven untrue. Animal protein increases calcium absorption, so dairy products increase net calcium uptake. The question of whether dairy reduces fracture risk in people with osteoporosis is not completely settled, with inconclusive evidence on both sides. A diet high in dairy calcium and vitamin D did increase bone density in several studies.
Dairy products certainly are not perfect foods. All milk has sugar, and whole milk and most cheeses have relatively high amounts of fat, so it is wise to limit intake. Dairy products are a good source of calcium, but there are other good dietary sources of calcium, such as dark-green, leafy vegetables. I recommend diet rather than calcium supplements due to concerns about cardiovascular health, as well as the known increase in kidney stone risk. If, because you can’t get enough calcium in the diet and you do take calcium supplements, I agree with D.B. that 500 mg is the most you should take at one time. I also agree that magnesium is necessary, but most people get adequate magnesium from the diet and do not require supplementation.
Vitamin D is necessary for calcium metabolism, so a vitamin D supplement is necessary for many people with osteoporosis, especially those living north of Atlanta or Los Angeles. It is hard, but not impossible, to get adequate vitamin D through diet.
TO READERS: The booklet on constipation provides useful information on the causes and cures of this common malady. Readers can obtain a copy by writing: Dr. Roach — No. 504, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.
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