Living Well

Folks around the office were dragging a little more than usual...

Last week, the U.S. and 70 other countries around the world switched to daylight saving time.

I love doing my taxes.

Most people don't believe me when I tell them, but I really do enjoy it.

The problem might start with a sleepless night...

Then it morphs into terrible indigestion, shortness of breath, and a pain in your back that won't quit. It persists over the next few days, so you go to the doctor.

One of the world's most deadly epidemics has already hit...

It claims hundreds of thousands of American lives each year... and causes millions of deaths in China, India, and other emerging economies.

It's one of the most common – and embarrassing – conditions that comes with age...

More than 30 million American men experience this significant health problem, but a staggering 75% don't seek treatment. They typically don't want to talk about it... or even hint at it... even though it's often treatable with some simple lifestyle changes.

More than 30% of Americans will be diagnosed with shingles... The pain from shingles can last for years. And your risk of getting it increases as you age. So it's no wonder that our issue on shingles brought in dozens of questions and comments from our readers.

This topic clearly resonated with you all and we appreciate the feedback. Educating yourself is crucial. That's why we're dedicating this week's Q&A to more questions about both shingles and its vaccine.

I'll never forget the day my friend Porter told me his face was on fire.

He was on his way back home from a trip to Zurich, Switzerland, when huge, bright red blisters appeared on his cheek and ear. The lymph nodes in his neck swelled, and he was in so much pain, he passed out... twice.

"Heartburn medication raises risk of dementia by 44%," read a recent headline...

That's the gist of a study that's getting a lot of attention right now.

But here's the problem: It's mostly hype. Don't let these big numbers scare you.

The news comes from a research paper in the leading journal JAMA Neurologyabout heartburn medications called proton-pump inhibitors, or PPIs.

PPIs work by shutting off a pump that releases protons into the stomach. Left unhindered, these protons turn to acid. We need stomach acid to help break down food, but too much of it can cause heartburn or other gastrointestinal problems.

According to a new study, people taking PPIs were 44% more likely to develop dementia in the seven years of the study.

You know that I always tell my team to trust, but verify. That's why I let out a groan whenever I see an outrageous headline about a new medical "breakthrough."

We've talked about the dangers of PPIs before, but when you take a deeper look at this particular study, there are several concerns.

First, only 2,950 of the 73,679 people in the trial took PPIs. That's 4% of the entire study group taking the pills we're concerned about... a smaller sample size than we'd want to see.

Another concern is the many confounders. The problem is that the older folks get, the more medications they tend to take. The interactions of these medications can change the way PPIs are processed. And other drugs that a person takes might also increase the risk of dementia. With all of these variables, it's difficult to track if there's just one single drug causing the problem.

JAMA Neurology also published an editorial about these concerns. As the author pointed out, in the studies reviewed, many of the people taking PPIs had angina (chest pains), depression, and in general were in poorer health.

Angina's connection with dementia makes sense as it signals trouble with your cardiovascular system. It happens when your heart doesn't get enough blood because your vessels are damaged. That means the blood vessels elsewhere – including your brain – could also be damaged.

Depression has a strong connection with dementia. Not only can depression be an early symptom of dementia, but having depression also increases your risk ofdeveloping dementia. Worse, as a study in the Journal of the American Geriatric Society demonstrated last year, having both depression and cardiovascular problems (like high blood pressure) increased that risk even more.

I suspect that dementia, much like cancer, is multi-factorial. You can't point to someone who took PPIs for years and say that's the sole cause of their dementia.

But there's one really interesting point made in this study... PPIs could cause amyloid plaques, one of the hallmarks of Alzheimer's.

The researchers cited several studies (all done on mice) that demonstrated how taking PPIs led to the development of amyloid plaques in the brain.

The theory is that since PPIs lower acid and can cross the blood-brain barrier, they might also lower the acid levels in your brain. Without that acid, your brain can't break up the normal chunks of amyloid plaques and, over time, these unbroken plaques cause dementia.

This is just a theory. The evidence of this trial only points to an association between these things. It's not cause-and-effect.

What we really want to see is a clear, randomized, controlled trial. These are the gold standard in medical research. You carefully take two groups of people with no confounders and give half the drug in question (in this case, PPIs). The other half receives a placebo.

Then you follow up with lab results over a long period of time. That way, you control the results instead of asking participants to self-report. By randomly assigning people to the drug group, you have a much better sense if the drug alone causes dementia.

Until this happens, we won't jump to the conclusion that PPIs cause dementia. At best, they are probably one of many co-factors. But we still urge you to think carefully about your heartburn medicine.

I've recommended not taking PPIs before because of their link to heart attacks. Many other studies have also shown correlations between taking PPIs and increased incidences of chronic kidney disease, along with an increased risk for hip fractures.

Bottom line... these drugs are not as safe as we thought.

Do what I do and combat heartburn naturally. Carry a piece of sugar-free gum with you for when you start to feel heartburn coming on. And cut back on common heartburn triggers like cigarettes, alcohol, caffeine, and foods like pepper, garlic, and raw onions. Antacids – like Tums – are also a popular, safe way to fight less frequent heartburn.

If none of these work or you need medication for something more severe than heartburn, ask your doctor about switching to an H2-blocker drug (these include Zantac, Tagamet, and Pepcid). H2 blockers do not have the same heart-attack risk and haven't shown the same link to dementia.

Below, we have a list of common dangerous PPIs and safer H2 blockers listed by their brand name and their generic name.

PPI H2 antagonist Nexium (esomeprazole) Deprizine (ranitidine) Prevacid (lansoprazole) Pepcid (famotidine) Prilosec (omeprazole) Tagamet (cimetidine) Zegerid (omeprazole/sodium bicarbonate) Zantac (ranitidine)

A good way to tell which kind you're taking is to look at the generic name. Many PPI generic drug names end in "-prazole" (like omeprazole). Many H2 antagonists end in "-tidine" (like ranitidine). You can also check which category your drug falls under at Drugs.com.

What if humans could match the lifespan of Ming, the world's longest-living animal... Ming was an ocean quahog – a type of clam – who holds the current record at 507 years old.

That's more than seven times longer than the average 71-year life expectancy of humans.

Watch out for tax thieves this time of year... I don't mean the folks at the Internal Revenue Service (IRS). The law allows them to take our money.

I'm talking about imposters who call you up claiming to be from the IRS.

According to fraud-awareness firm Fraud.org, tax season is prime time for thieves targeting taxpayers.

Last year, fake IRS fraudsters targeted more than 366,000 people with harassing phone calls demanding payments and threatening jail. Part of the largest nationwide tax scam in history.

These swindlers demand immediate payment using a prepaid debit card or a wire transfer via a service like Western Union or MoneyGram. (If you send money this way, it's extremely difficult to trace the funds or get them back.)

And if you refuse or act uncertain, they'll threaten you with arrest.

Worse, last year some of these callers even knew the last four digits of the taxpayer's Social Security number, which made them appear more legitimate.

So this tax season, if you get a call from someone who claims to be from the IRS and threatens you with jail time, hang up immediately.

The IRS doesn't initiate contact through the telephone. If you really owe money, it will send a notice in the mail first. And real IRS agents never demand immediate payment by credit card or wire transfer.

We had a tip from reader Dave in Tennessee. When receiving scam calls...

My solution is simple. I ask them to hold on, get my police whistle, and blow hard. They rarely call back and my unwanted calls have dropped off significantly.