I just thought that all you Sleevers would want to know that Prevacid (Lansoprazole) and other Proton Pump Inhibitors (PPIs) such as (omeprazole [prilosec], lansoprazole, pantoprazole, esomeprazole, and rabeprazole) which block acid production in your stomach can significantly interfere with Calcium absorption. Turns out that you need stomach acid to dissolve and absorb calcium, Iron, and potentially other Vitamins. I have been racking my brain trying to figure out how I could possibly need more calcium and realized that I take my multi with calcium, drink my premier Protein with calcium, AND take my calcium supplement in the morning along with my prevacid. Argh! I knew not to take calcium and iron at the same time, but I did not realize that the prevacid could be interfering.

In May 2010, the US food and Drug Administration issued a warning of the: “possible increased risk of fractures of the hip, wrist, and spine with high doses or long-term use of a class of medications called proton pump inhibitors. The product labeling will be changed to describe this possible increased risk”(US. FDA News Release, May 25, 2010).

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2974811/pdf/nihms239233.pdf

I have been on prevacid for 4 months now, which my Dr. prescribed initially to reduce acid and prevent GERD (which hopefully I don't have). My Dr. said I "could" go off it after 3 months. But now I am definitely going off of it (and calling my Dr. to confirm that its ok to do so). However, if you do have GERD or otherwise please contact your Dr. before discontinuing. Apparently even with PPIs "calcium citrate" absorbs MUCH better than calcium carbonate and other calcium supplements. Bariatric Advantage vitamins are calcium citrate, nearly every supplement I found in Walmart had calcium carbonate (and so does Premier Protein, my almond milk, most gummies, etc). Also I don't know for sure but perhaps if you don't actually take your prevacid and calcium TOGETHER (like I was doing) it might improve your absorption as well. In any event, please discuss with your Dr. if you have concerns. Most of these studies looked at long term PPI therapy for years (not for 3 months like my Dr. suggested), so the benefits may outweigh the risks in the short term.

I have done so much research, I feel like a fool that I did not know this. I thought that all of you might want to.

I hope this information is helpful.

Thanks for the info. That is why my surgeon's team did not want me to take PPIs for the long term.

Everyone is different, some people may have severe GERD or prone to ulcers.

In their case the risk of an ulcer outweighs the possible risk of bone thinning due to PPIs. They can do a bone density scan periodically and take other actions to mitigate the chance of this.

I'm one year out of surgery and have taken protonix twice a day. My calcium has been fine throughout the year.

I've been on omeprazole for 2+ years and my calcium and other Vitamin levels are completely normal.

The deal about the the use of PPIs and calcium absorption / osteoporosis is that it increases the odds of those issues -- it doesn't lead to those issues in everyone -- not by a long shot.

That having been said, my surgeon had me on a PPI (Protonix) for 3-4 months, but no longer.

I still use it (maybe for a day or two every two months) when I have a big flare-up of reflux. And it solves the problem immediately. I think that's a fairly safe way to use the medication long-term.

The larger point the OP makes is excellent: We all need to be aware of the side effects and drug interactions of all the meds we're taking (including herbs, supplements, over-the-counter meds, etc.) There are some great online apps that help us with this, including:

http://www.drugs.com/drug_interactions.html

http://www.webmd.com/interaction-checker/

... and others out there.

Also, folks should know that blood tests are not going to reveal calcium levels that are too low in your bones. If your body needs additional calcium for its functioning, it will simply leach the calcium from your bones and add it into the bloodstream, meaning that your blood calcium levels will look great while your bones are thinning away to nothing. The only way to know about your state of bone health is by getting some sort of bone scan.

PPI's do have risks -- do does taking calcium long-term, and there is little evidence that it does anything to prevent fractures, which is supposedly why we are taking calcium in the first place:

http://well.blogs.nytimes.com/2013/04/08/thinking-twice-about-calcium-supplements-2/?_r=0

Personally, I have thought it over and decided to discontinue calcium supplements. I rely on dietary intake and lots of strenuous exercise to prevent osteoporosis and fractures, plus I am relatively low-risk for osteoporosis (no children, life-long non-smoker, almost life-long obese person). So interfering with a calcium supplement is not the reason I am cautious about long-term PPI use risk. But messing with body chemistry for that long just seems to me like it cannot be without consequences, so if I don't have to, I won't.

I'm surprised your NUT or surgeon didn't tell you this from the very beginning. I was told early on that it was one of the reasons I needed to take extra calcium, despite eating a lot of dairy.

Huh. Was not aware of this. I'm more than 2 years out, and take 40mg Omeprazole 2xday. The second dose with a single time release calcium supplement. Labs have always been perfect. Just another reason not to neglect your lab checkups! You never know!

@@FocusOnMeNow - I knew about the calcium carbonate vs the calcium citrate. I know a lot of people don't realize the difference and opt for a chewable/cheaper one that may NOT be calcium citrate.

Thanks for taking the time to post this - hopefully of them will read and understand the difference.

I have a GF who is about 2 months post-op behind me and she opts for the chewable (non calcium citrate) and also the whey Protein (instead of whey isolate protein) and she is always bragging about how easy it is to find and how mush less expensive than what I pay...I quit trying to explain

@@JamieLogical - no one said a word

@@Bufflehead - there is an intact parathyroid hormone test, which if elevated either indicates that your blood calcium is in fact being maintained by leaching from your bones OR that you might possibly have a parathyroid tumor, which is extremely rare. Much more likely that blood levels of calcium are being supplemented by bones. Also be careful relying on "dietary" calcium alone. I am the "dairy queen" and also at "low risk" but I have figured out that they tell you to take the vitamins for a reason.

Just a little shout-out here for the efficacy of a new treatment to ward off osteoporosis - Prolia shots, taken every six months by "old folks" like me (I'm 70).

My PCP strongly recommended these, and I've had 3 treatments thus far.

Here's a recent report on a long-term study of Prolia's efficacy in strengthening bones (up to 8 years of treatment):

http://www.medscape.com/viewarticle/812577#vp_2