B 6

Question
I am seeing a chirpractor and wanted me to get off tylenol and take Ultra Cal-m.  It has been working but my GI dr says that it isn't good for my stomach.  Now the pain is coming back.  The chirpractor suggested B6.  Is this okay?

Answer
Hi Amy,

First, let me say that the issue of what to do in arthritis pain for gastric bypass patients is not that easy.  Most surgeons want you to avoid aspirin and NSAIDs (ibuprofen, cox-2 inhibitors, etc) due to the risk of ulceration of the pouch.  Tylenol is usually the the only allowable conventional medication for pain, but regular and/or long term use is really bad for your liver - and if you ever had fatty liver in the past, it may be worse.  The Ultra Cal-M product from Anabolic Labs, has magnesium salicylate.  This is an over-the-counter drug related to aspirin (methyl salicylate) that is also found in Nuprin and Doan's Pills.  You should not take this.

Some studies have shown that a select group of rheumatoid arthritis patients have low levels of vitamin B6.  If you have non-rheumatoid arthritis, it's probably not going to be of benefit.  Studied levels showing some efficacy in rheumatoid arthritis are 10 to 50mg/day.  Interestingly, a higher dose of 100mg/day did not show benefit in a 6 month trial.  Since higher doses are associated with toxicity (liver, nerve), if you do try it I'd go for something in that lower range.  Remember to look at what your multivitamin already contains (some have a lot).

What your e-mail does not tell me is anything about the kind of pain you have.  I would welcome you to write back with more information.  I might also be able to help steer you towards some other effect treatments if I know what you are struggling with.

In Health,

Dr. Jacques

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