Antacids and Mineral Depletion - Milk of Magnesia,Tums, etc.

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Antacids and Mineral Depletion - Milk of Magnesia,Tums, etc. JoAnn Guest Apr

28, 2005 21:36 PDT

 

Folate - Supplementation Possibly Helpful

Calcium Citrate - May Increase Aluminum Absorption

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The term " antacid " is used to describe certain compounds that directly

" neutralize " stomach acid.

Tums, Maalox, and Mylanta all fall into this category.

The active ingredients in most antacids are various forms of calcium,

magnesium, and aluminum. Antacids are used for symptomatic relief of

uncomfortable " acid stomach " and for heartburn.

 

Many antacids are available today, including-

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aluminum carbonate (Basaljel)

aluminum hydroxide (ALternaGEL, Alu-Cap, Alu-Tab, Amphojel, Dialume,

Nephrox)

aluminum hydroxide/magnesium carbonate (Duracid)

aluminum hydroxide/magnesium hydroxide (Alamag, Almacone, Aludrox,

Gaviscon Liquid, Gelusil, Kudrox, Maalox, Magalox, Magnox, Mintox,

Mylanta, Rulox)

aluminum hydroxide/magnesium hydroxide/calcium carbonate (Tempo)

aluminum hydroxide/magnesium trisilicate (Alenic Alka, Gaviscon,

Genaton, Foamicon)

calcium carbonate (Alkets, Amitone, Chooz, Equilet, Gas-Ban, Maalox

Antacid Caplets, Mallamint, Mylanta Lozenges, Titralac, Tums)

calcium carbonate/magnesium carbonate (Marblen, Mi-Acid Gelcaps, Mylanta

Gelcaps, Mylagen Gelcaps)

magnesium hydroxide (Milk of Magnesia, Phillips' Chewable)

magaldrate or aluminum magnesium hydroxide sulfate (Iosopan, Riopan)

magnesium oxide (Mag-Ox, Maox, Uro-Mag)

sodium bicarbonate (Bell/ans, Bromo Seltzer)

sodium citrate (Citra pH)

 

Other drugs work by reducing the stomach's production of acid. These are

discussed separately in the articles on H2 Blockers (e.g., Zantac

[ranitidine], Axid [nizatidine], Tagamet [cimetidine], Pepcid

[famotidine]) and Proton Pump Inhibitors (Prilosec [omeprazole],

Prevacid [lansoprazole]).

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Folate

Supplementation Possibly Helpful

 

Research suggests that antacids physically bind to folate and reduce its

absorption by the body.

 

However, this interaction may be clinically significant only in

individuals who take antacids regularly and whose diets are low in

folate content.

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Minerals

Supplementation Possibly Helpful, but Take at a Different Time of Day

 

Different types of antacids can interfere with the " absorption " of

various minerals.

 

Supplements containing the U.S. Dietary Reference Intake (formerly known

as the Recommended Dietary Allowance) of these minerals should be

helpful, especially if you take them at a different time of day from

when you take antacids, at least 2 hours before or after taking your

antacid.

 

Any antacid can interfere with the " absorption " of iron, zinc, and

possibly other minerals by " neutralizing " stomach acid.

 

Aluminum-containing antacids can " bind " with phosphorus and interfere

with its absorption, and this can further lead to calcium depletion.

 

 

 

Antacids that contain calcium may also compete for absorption with iron.

 

 

Although calcium antacids may alter the absorption of magnesium, the

clinical importance of this effect appears to be minimal.10,11

 

Calcium-containing antacids, when taken with zinc supplements, might

substantially decrease zinc absorption.12–16

 

However, the presence of a meal appears to mitigate this effect.

 

Finally, calcium antacids might also impair the absorption of manganese

and chromium.

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Citrate

May Increase Aluminum Absorption

 

Concerns have been raised that the aluminum in some antacids may not be

good for you.20

 

Since there is some evidence that calcium citrate supplements might

increase the absorption of aluminum,

it might not be a good idea to take calcium citrate at the same time of

day as aluminum-containing antacids.

 

Another option is to use other forms of calcium, or to avoid antacids

containing aluminum.

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References

 

1. Russell RM, Golner BB, Krasinski SD, et al. Effect of antacid and H2

receptor antagonists on the intestinal absorption of folic acid. J Lab

Clin Med 112: 458–463, 1988.

 

2. Sturniolo GC, Montino MC, Rossetto L, et al. Inhibition of gastric

acid secretion reduces zinc absorption in man. J Am Coll Nutr 10:

372–375, 1991.

 

3. Spencer H and Kramer L. Antacid-induced calcium loss. Arch Intern Med

143: 657–658, 1983.

 

4. Lotz M, Zisman E, and Bartter FC. Evidence for a phosphorus-depletion

syndrome in man. N Engl J Med 278: 409–415, 1968.

 

5. Hallberg L, Brune M, Erlandsson M, et al. Calcium: effect of

different amounts on nonheme- and heme-iron absorption in humans. Am J

Clin Nutr 53: 112–119, 1991.

 

6. Cook JD, Dassenko SA, and Whittaker P. Calcium supplementation:

effect on iron absorption. Am J Clin Nutr 53: 106–111, 1991.

 

7. Dawson-Hughes B, Seligson FH, and Hughes VA. Effects of calcium

carbonate and hydroxyapatite on zinc and iron retention in

postmenopausal women. Am J Clin Nutr 44: 83–88, 1986.

 

8. Read MH, Medeiros D, Bendel R, et al. Mineral supplementation

practices of adults in seven western states. Nutr Res 6: 375–383, 1986.

 

9. Sokoll LJ and Dawson-Hughes B. Calcium supplementation and plasma

ferritin concentrations in premenopausal women. Am J Clin Nutr 56:

1045–1048, 1992.

 

10. Lewis NM, Marcus MS, Behling AR, et al. Calcium supplements and

milk: effects on acid-base balance and on retention of calcium,

magnesium, and phosphorus. Am J Clin Nutr 49: 527–533, 1989.

 

11. Andon MB, Ilich JZ, Tzagournis MA, et al. Magnesium balance in

adolescent females consuming a low- or high-calcium diet. Am J Clin Nutr

63: 950–953, 1996.

 

12. Argiratos V and Samman S. The effect of calcium carbonate and

calcium citrate on the absorption of zinc in healthy female subjects.

Eur J Clin Nutr 48: 198–204, 1994.

 

13. Dawson-Hughes B, Seligson FH, and Hughes VA. Effects of calcium

carbonate and hydroxyapatite on zinc and iron retention in

postmenopausal women. Am J Clin Nutr 44: 83–88, 1986.

 

14. Hwang S-J, Lai YH, Chen HC, et al. Comparisons of the effects of

calcium carbonate and calcium acetate on zinc tolerance test in

hemodialysis patients. Am J Kid Dis 19: 57–60, 1992.

 

15. Pecoud A, Donzel P, and Schelling JL. Effect of foodstuffs on the

absorption of zinc sulfate. Clin Pharmacol Ther 17: 469–474, 1975.

 

16. Crowther RS and Marriott C. Counter-ion binding to mucus

glycoproteins. J Pharm Pharmacol 36: 21–26, 1984.

 

17. Freeland-Graves JH and Lin PH. Plasma uptake of manganese as

affected by oral loads of manganese, calcium, milk, phosphorus, copper,

and zinc. J Am Coll Nutr 10: 38–43, 1991.

 

18. Davidsson L, Cederblad , Lnnerdal B, et al. The effect of individual

dietary components on manganese absorption in humans. Am J Clin Nutr 54:

1065–1070, 1991.

 

19. Seaborn CD and Stoecker BJ. Effects of antacid or ascorbic acid on

tissue accumulation and urinary excretion of chromium. Nutr Res 10:

1401–1407, 1990.

 

20. Gaby AR. Aluminum: The ubiquitous poison. Nutr Healing 4: 3, 4, 11,

1997.

 

21. Walker JA, Sherman RA, and Cody RP. The effect of oral bases on

enteral aluminum absorption. Arch Intern Med 150: 2037–2039, 1990.

 

22. Anonymous. Preliminary findings suggest calcium citrate supplements

may raise aluminum levels in blood, urine. Family Practice News 22:

74–75, 1992.

 

23. Weberg R and Berstad A. Gastrointestinal absorption of aluminum from

single doses of aluminum containing antacids in man. Eur J Clin Invest

16: 428–432, 1986.

 

24. Nolan CR, Califano JR, and Butzin CA. Influence of calcium acetate

or calcium citrate on intestinal aluminum absorption. Kidney Int 38:

937–941, 1990.

 

25. Slanina P, Frech W, Bernhardson A, et al. Influence of dietary

factors on aluminium absorption and retention in the brain and bone of

rats. Acta Pharmacol Toxicol (Copenh) 56: 331–336, 1985.

 

 

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Last reviewed March 2002 by HealthGate CAM Medical Review Board

_________________

 

JoAnn Guest

mrsjo-

DietaryTi-

www.geocities.com/mrsjoguest/Genes

 

 

 

 

AIM Barleygreen

" Wisdom of the Past, Food of the Future "

 

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