Acid Reflux meds and Statins

[eliza]

I’m thinking both Zantac and Lipitor (simvastatin) are making my RLS terrible. I’ve searched the board and can’t find the info I need so here are my questions.

Regarding statins: Are there any that don’t exacerbate RLS, at least not as much as others? I was taking Vytorin. That wasn’t so bad, but with the recent negative reports on that drug my doc took me off it. Now I’m taking simvastatin. I’m sure it’s bad for my RLS. I’ve cut down to ½ pill every other night. I might as well give up on sleep the nights I take it. I have to take something. Doc said my cholesterol is “frightening.”

Regarding the acid reflux meds: Are there any that don’t aggravate RLS? I noticed Aiken’s post that said they interfere with iron absorption. So, yesterday I took the iron in the a.m. and Zantac before bedtime but the RLS was worse than ever. I only managed about 3 hours sleep.

Thanks for your insights.

Eliza :- )

[Polar Bear]

Eliza, I take simvastatin 20mg every night and haven't noticed any difficulty. It brought my cholesterol down from 7 to 3.9. I did read an article about how there can be a side effect of muscle discomfort (or something similar) soI sent an email to Dr B. who said there should be no effect of simvastatin on rls. The side effect mentioned on the simvastatin info, he says is entirely different.

Sorry, I don't know anything about acid reflux meds. Very, very occasionally I take peptobismal (sorry about the spelling) that horrible pink stuff, and haven't noticed any ill effects from it.

But who knows what will affect some of us ??

Betty

[Aiken]

Eliza--

Anything that reduces stomach acid inherently reduces iron absorption, because the one is required for the other. Depending on how much Zantac you take, and how often, this may not be an issue for you. Your RLS, or your low iron, may be caused by something else. I'm assuming by your name that you're a girl, so you may be losing significant iron if you have heavy flow during your period, for instance.

However, there are a few points to make.

First, if you haven't already, you should have your ferritin officially tested. If it's not at the high end of the range (maybe something like half again the typical value), then you're possibly going to benefit from iron supplementation. If it's below average, you'll almost certainly benefit. Sleep specialists like to see it higher than average in RLS patients, and that's worked well for me. However, if your iron is fine, you should not be taking significant supplements, as iron overload can be unhealthy (and in the extreme, fatal). Thus you should know what your levels are. You should also have them checked periodically if you're supplementing, to make sure you're not overdoing it.

Next, how are you supplementing your iron? A multivitamin, or a dedicated iron pill? How much elemental iron is in it? Do you take any other supplements at the same time that might interfere with its absorption? Calcium, for instance, will interfere and must be taken at a different time of day. That obviously includes antacids like tums or rolaids.

Also, how long have you been taking the iron? It takes a while to replenish lost stores, if yours are low. I wouldn't read too much into the fact that you didn't get relief the first day, if that was the first. You may need days or weeks of supplementation, depending on your current levels. You also may need a higher dose. Unfortunately, you can't do it all in one go, because iron is hard on the GI tract. In fact, if you're taking a significant dose, you may find you need to skip days to avoid nausea.

Finally, if your ferritin tested low and you've taken supplemental iron for a couple of months, but a second ferritin test still shows low levels, you may have something else inhibiting absorption. If so, you may need IV iron infusions. They're no fun, but they last a few months at a time.

[SquirmingSusan]

Eliza, I take acid reflux meds and I haven't noticed that they make my RLS worse, but they are antihistamines, and even though they aren't the sedating kind of antihistamines, some people still might have problems with them.

I do recall a discussion of statins in this discussion forum before, and that someone thought they were making the RLS worse. One thing you could do is send a private message to Josh, Fidgetboy, who is a pharmacist and see if he knows anything about that. You can search the member list for him.

[mackjergens]

I found this info on the web..

http://sleepdisorders.about.com/b/2007/ ... somnia.htm

Its about Statins causing insomnia.

[eliza]

Wow – thank you all for taking the time to send all this information. I think all of it may apply to me.

I have been watching my ferritan level. Iron does help me and my docs want it at 100 or over. I don’t have any trouble taking it and at last check it had gone from low to 65. I take 160 mg “slow release dried ferrous sulfate” pills on an empty stomach, with vitamin C and away from all other meds and supplements. I did back off though so I’ll start up again and get rechecked. Oddly enough, it tends to make my gums go bad. If I take an iron break they heal right up though.

I also think I’ll keep taking the zantac. Hopefully that isn’t the culprit because the reflux is a big problem all its own.

The link regarding insomnia and simvastatin is sure interesting. Maybe that’s part of the reason I have absolutely no REM sleep! I think I’ll switch to another statin ASAP.

Something has sure made my RLS go nuts. I hope my RLS bout after general anesthesia didn’t mess something up permanently. This RLS thing is sure a bummer. Oh well, I’ve got it and I’m very grateful to all you for helping me.

Thanks!
Eliza :- )

[Aiken]

Eliza--

That's interesting about your gums. You should see if your doctor/dentist have any idea why that might happen. I'm curious to know what the results are... sometimes my gums are bad for no reason, maybe it's the same.

I personally don't take iron on an empty stomach. It always upsets my stomach/intestines if I do, so I take it with plenty of food. It should be okay to take it with food. I'd think food would in fact promote acid production, which helps with absorption of iron.

I don't take time-release iron, as it's supposedly not as effective. However, you're taking nearly triple the dose I do, so perhaps that evens it out. If your ferritin has increased, I'll assume it's working well enough for you.

---

By the way, depending on your degree of reflux, you might now or later want to switch to a proton pump inhibitor (Prilosec, Protonix, Prevacid, Nexium, etc.). If Zantac still works fine, no biggie, but if you start needing more and more of it, the PPIs are definitely the preferred meds. You don't want to let it get bad, as acid in the esophagus over a long period can eventually lead to a pre-cancerous condition called Barrett's Esophagus, and esophageal cancer is baaad.

(You may already know this, but I always tell other reflux sufferers, in case they don't. Not many people with reflux ever see a doctor for it.)

[eliza]

Hi Aiken,

I'll try the Prilosec. Right now it seems like I have reflux trouble every night.

The other thing that made my gums bad was glycosamin (sp?). I took that for awhile for arthritis and it made a mess of my mouth. I read someplace that it could do that so I quit taking it. Fortunately, they healed right up. Isn't it strange how things affect us sometimes.

Eliza :- )

[ViewsAskew]

Eliza,

I have had some problems with reflux lately. I have looked into what could be causing it etc.

I realized that I initially created the problem when I started taking cinnamon tablets for blood sugar control. I am not diabetic, but it runs in the family so I thought it would be a good thing. Within 6 weeks, I had daily heartburn and reflux. I stopped the cinnamon, but it seems to have done some lasting damage, as I have to be very careful.

I found my triggers - everyone it different. For me it is alcohol, caffeinated beverages of any kind, decaf coffee, chocolate, fatty foods, acidic foods like tomatoes, peppers, onions, mint things, and spicy foods.

Yikes. So, what I've found is that I can have ONE of those things each day, but not multiple. As long as I eat lots of fresh fruits and veggies, prepare my fish or chicken without oily/fatty sauces, and limit the other things, I am fine.

DGL has also been very helpful, but not around the time I take me meds (it does reduce the acid so that the meds do not seem to absorb the same).

The end result is that I went from a daily acid blocker AND antacids to an occasional antacid, say once a week if I want to be sure because I had a bit too much spicy food, let's say.

I goofed last night...I ate a few pieces of chocolate with some mint crisps in it about midnight. I went to bed at 3 AM and was rudely awakened at 4 with acid reflux. I know better....and if I'd avoided it, I would have been fine. I spent the rest of the night sleeping sitting up

That's not to say that this will work for everyone. I am sure it won't. For me it was worth it to try, though, as I did wanted to see if I could control it with diet.

[Aiken]

Ann--

Not eating for four hours before bed also does wonders.

You just have to know four hours ahead of time when you'll be going to sleep...

...and there's the rub.

[ViewsAskew]

Yes, that does work, lol...if I knew when I'd be a goddess of some kind (omnipotence).