Can vinegar reduce acid reflux?

Can vinegar reduce acid reflux?

Q. I was listening to your radio show and heard you wondering about the reason that vinegar works for reflux. As a physician, I was told that acid consumption causes the esophageal sphincter to contract, which helps prevent the reflux.

A. Reflux occurs when the sphincter at the junction of the esophagus and the stomach gets lazy. This muscle is supposed to allow food into the stomach but prevent stomach contents from splashing back into the esophagus.

Some medications can loosen the esophageal sphincter, which would increase the risk for heartburn. We like your hypothesis that acetic acid (vinegar) might have the opposite effect. We couldn’t find any research to support this approach, however.

Q. I am a woman who had a heart attack and bypass surgery two years ago. I was then prescribed three different statins, all of which caused me severe pain. Nevertheless, I had to continue taking them.

Last summer, I noticed that I could not use my right leg to get out of the pool. Holding the handrail did not help. I mentioned it to the cardiologist, but he did not appear concerned. I just let it go and only used my left leg to get out of the pool at the gym.

Then last summer I fell twice with no warning. And I fell again during our summer vacation this year. I believe these falls are related to the statin.

Finally the cardiologist agreed to place me on red yeast rice instead of a statin. So far, so good. I am regaining the strength in my right leg. I can now use it to get out of the pool.

My concern is that a friend took red yeast rice for a few months and lost the strength in his arms. He stopped it and is in recovery mode now. Is this a side effect of red yeast rice?

A. Statin-linked muscular damage appears to be, in part, related to dose. Red yeast rice contains lovastatin in lower doses than found in conventional prescription drugs. There is evidence that it can lower LDL cholesterol (Nutrition & Metabolism, Sept. 25, 2017).

One small trial found that many people who don’t tolerate statins do well on red yeast rice (Annals of Internal Medicine, June 16, 2009). That said, some people are so sensitive to statin side effects that even red yeast rice causes pain and muscle weakness (Therapie, Oct. 27, 2016).

Q. With the wide variety of brands of supplements available and, as far as I am aware, no Food and Drug Administration regulations, how does one choose a quality product? I need to take vitamin D, calcium and magnesium.

Sometimes when I think I have chosen a good product labeled “all natural” and I read the label, I find other added ingredients (such as mannitol and sorbitol) that I am not supposed to consume for my gut health. Where can I turn for advice?

A. There is no substitute for reading labels when you need to avoid certain ingredients. But it is very difficult to tell which supplements meet quality standards.

ConsumerLab.com is a good resource even though there is an annual subscription fee for its reports. It recently reviewed multivitamins and found that 46 percent fell short. Gummy multivitamins were especially problematic.