Many individuals with MECP2 Duplication syndrome have gastric reflux. As a result, many are receiving GERD (Gastroesophageal Reflux Disease) medications such as antacids, for example, Mylanta or Tums; H2 blockers, for example, ranitidine (Zantac), cimetidine (Tagamet) or famotidine (Pepcid); or proton-pump inhibitors, for example, lansoprazole (Prevacid), omeprazole (Prilosec), or esomeprazole (Nexium). It is important to consider what these drugs actually do. There primary purpose is not to actually reduce reflux, but they do reduce the the acidity of the stomach.
Since these medications make the stomach contents are less acid, reflux causes less burning and therefore less pain and damage. Those things are important. However, reducing acidity in the stomach also can have a downside because stomach acid plays an important role in absorption of certain nutrients, such as Vitamin B12 and Calcium. In addition, stomach acid helps to keep some bacteria in check, so the use of these medications can slightly increase the risk of certain kinds of infection.
The effect of these drugs on calcium absorption is a particular concern for individuals with MECP2 Duplication Syndrome because many have been shown to have poor bone density and this may result in susceptibility to fractures. There are probably a number of contributing factors to this susceptibility, but these medications can contribute to the problem. Genetic factors, a lack of exercise and weight bearing, other medications, and reduced sun exposure may be some of the other contributing factors. Calcium and vitamin D supplementation may be useful to reduce this problem. Whether supplementation is advisable and how much should be used should be discussed with the individual’s physician or nutritionist. If supplementation is used, calcium citrate supplements are typically recommended over calcium carbonate supplements because these drugs have been shown to reduce absorption of calcium from calcium carbonate to a greater extent than they affect calcium citrate.