DEAR DR. BLONZ: When taking pills -- vitamins, supplements, prescriptions, whatever -- is it important to swallow one pill at a time? Or is it OK to do as I do and take three, four or five in one gulp? As you might imagine, my wife and I have (cordially!) debated this point, and hope you can settle our differences. Don't worry; we very much love each other, so there's no chance of serious domestic strife. -- F.S., via email
DEAR F.S.: It makes no significant difference to our bodies if pills and supplements arrive in the stomach after one swallow, or multiple. The issue is whether your preference for the multi-pill method overtakes your ability to safely swallow the entire bunch at one time.
An overload could present a danger of choking and pill aspiration, which increases with each additional pill. The size, shape and coating of each pill can also affect the risk. The tone of your message suggests some experience at this, but all it takes is an unexpected shock, noise, bump or other distraction at a vulnerable time, and something can go down that "wrong pipe." Another issue is that swallowing difficulties become more prevalent as we age; check the National Foundation of Swallowing Disorders (b.link/buhqds) for more information.
Sorry for the mini-lecture, but multiple-pill swallows represent an avoidable risk. Here's hoping the debate with your partner goes down without a hitch.
DEAR DR. BLONZ: Both copper and zinc are in the mineral supplement I am taking, but I have read it is not a good idea to combine them. What is the problem here? -- S.F., San Francisco
DEAR S.F.: We understand the amount of nutrients needed to prevent a deficiency. Still, we have only begun to tackle the complexities of how they interact -- particularly if disease conditions are in play.
Zinc plays a role in many enzymes, including those involved in detoxification, sex hormone production and wound healing, and it is also involved in our senses of taste and smell. Copper helps form red blood cells, is essential for normal hair and skin, and is needed for normal respiration and the production of certain antioxidant enzymes.
Both are essential, but an excess of zinc can deplete the level of copper in the body. Likewise, if the copper intake is excessive, zinc can suffer. While uncommon, the odds of an imbalance can increase with environmental conditions -- such as toxic levels in drinking water, elevated levels in certain foods, or cooking acidic foods in poorly maintained copper pans -- or with certain health conditions. Taking supplements that overload one nutrient over the other can also be an issue.
The Daily Value for zinc is 15 milligrams, and the tolerable upper limit is 40 milligrams per day. For copper, the Daily Value is 2 milligrams, and the tolerable upper limit is 10 milligrams per day. (These figures are for adults 19 years of age or older.)
While there is no problem with the recommended amounts, even if taken together, take care not to overdo it with either one unless there is a medical reason to do so. Read more from the National Institutes of Health on zinc at b.link/pnnsvv and copper at b.link/66d6km.
Send questions to: "On Nutrition," Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.