WOMEN’S HEALTH PAGE

The “Pap” (more info here)

How Often to Have a Pap?
It should be done annually. When a woman is monogamous with one partner who is also monogamous, and has had 3 normal Paps with that partner, she can reduce these to every 2-3 years. However, if her immune system is suppressed she may need them as often as every 6 months. Women who have had their uterus and cervix removed, as in the case of a Total Abdominal Hysterectomy, for something other than cancer, can stop Pap Smears.

Vitamins
All menstruating (in other words, still having periods) Women should take a vitamin with iron, at least every few days. This can be 2 “Flinstone complete” vitamins or a chewable Centrum. The “Silver” vitamins don’t have much iron. The “A-Z” vitamins don’t all have iron, so please check your label.

Non-menstruating women should take a multivitamin withOUT iron. My favorite of these are the “Flinstones Gummy” vitamins. To get enough, however, an adult should take 2-3 of these. The “Silver” vitamins are OK. There is a Chewable Centrum Silver vitamin too.

Why Chewable Vitamins?
Many people don’t digest vitamins well. People with stomach problems, particularly ulcers, gastritis, esophagitis, just don’t have good absorption of vitamins. People on stomach medicines don’t absorb vitamins - like zantac, pepcid, and especially acid blockers like Prilosec, Prevacid, Nexium, Protonix, and Aciphex.

People who have had Gastric surgery, especially Gastric Bypass or Stomach Stapling Bariatric surgery don’t absorb vitamins well. They must take chewables in higher doses. Dr. Stiles recommends a Centrum Chewable and Calcium plus D chewable, twice a day. They sometimes need B12 shots as well. We check multiple vitamin levels annually in folks who have had Bariatric surgery.

People who have had Gallbladder removal or who have chronic diarrhea may not absorb fat-soluble vitamins well – especially Vitamin K, A, D, and E. They must take extra vitamin D sometimes, like in the chewable Calcium plus D tablets.

The chewable vitamins help by breaking down in the mouth and utilizing the mouth enzymes and acids.

Some medicines especially Metformin (Glucophage) inhibit B12 absorption.

B12 is now available as a sub-lingual dissolving tablet. There are liquid vitamins. Calcium plus Vitamin D is available in a chewable tablet.