Treatment of heartburn can interfere with vitamin and mineral absorption


DEAR DR. DONOHUE: Doctors don’t give me a definite answer to this question, so I hope you can.

 Since Aciphex reduces stomach acid, is it true that such a reduction could interfere with the absorption of vitamins and other nutrients in my diet? The insert that comes with Aciphex says it may interfere with the absorption of B vitamins.

 Two years ago, after a scope exam of my esophagus showed I had esophageal erosions, the doctor prescribed Aciphex. She commented that this would be for an indefinite time. What does this mean for my nutrition? — T.S.

 ANSWER: Aciphex is one of the five proton pump inhibitors. In this instance, “proton” is a synonym for “acid.” These medicines have been true breakthroughs in the treatment of GERD, gastroesophageal reflux disease (heartburn) and ulcers. No other medicines equal them in decreasing acid production. The other members of this family are: Prilosec (omeprazole), Prevacid, Protonix and Nexium.


 Stomach acid facilitates the absorption of iron, vitamin B-12 and calcium carbonate, the kind of calcium often chosen as a supplement.

 Interference with iron absorption is a theoretical possibility that hasn’t been proven. The suppression of vitamin B-12 absorption is an issue if the only supply of this vitamin comes from what’s obtained in foods. Vitamin B-12 in pill form can still be absorbed. If your body level of B-12 is low, take a B-12 supplement. Calcium carbonate has to have some stomach acid in order for adequate amounts of calcium to enter the blood. This problem can be avoided by taking another kind of calcium, calcium citrate. It is not dependent on stomach acid for absorption.

 DEAR DR. DONOHUE: I am 57. I have developed a swollen testicle. I have no pain. It’s about three times the size it used to be. I was seen by a urologist and had an ultrasound. I was told there is fluid around the testicle but not to worry about it. What causes this? — L.L.

 DEAR DR. DONOHUE: I am 47. My testicle has grown to the size of a medium apple. I am not in any pain, and have sex without any problem. I am scared to have this looked at and don’t know what kind of doctor takes care of this kind of thing. Any help is appreciated. — Anon.

 ANSWER: Making a diagnosis without seeing the patient is fraught with danger. What I am about to say is a guess. For Anon, who hasn’t seen a doctor, you should. The family doctor or a urologist is the one to consult.

 What you both describe fits the description of a hydrocele (HI-drow-seal). In a darkened room, light from a flashlight applied to the back of the scrotum can be seen coming through the front. The liquid in the scrotum is clear fluid. It comes either from the abdominal cavity or from the double-ply lining tissue that covers the testicles. The fluid accumulates between the two plies of tissue. Most hydroceles are idiopathic. That word means the cause isn’t known. If they are not too large and if they aren’t painful, they can be left alone. Draining the fluid almost always is followed by a repeat accumulation of it. Surgical removal is the only way to get rid of a hydrocele completely. In younger men, a hydrocele can result from a testicular tumor. Such tumors are found between the ages of 15 and 40.

 DEAR DR. DONOHUE: I take Plavix for carotid arteries that are partially blocked. In a whirlpool with a water temperature of 103, I lie back so the water jet massages my neck in the region of the carotids. Will the hot water dilate these arteries and get rid of the buildup? — B.G.

 ANSWER: The short answer is no. In fact, it could be dangerous. The water jet might dislodge pieces of the obstructing buildup, and they could find their way to smaller brain arteries and cause a stroke.

 The booklet on stroke discusses this common malady in detail. To obtain a copy, write: Dr. Donohue — No. 902, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from