ANSWER:

Most cases of diarrhea clear up on their own within a few days. There are things to help you cope with your signs and symptoms until the diarrhea goes away, such as:

• Drink plenty of clear liquids, including water, broths and juices, every day
• Integrate crackers, toast, eggs, chicken or rice (low-fiber foods) gradually as your bowel movements return to normal
• Avoid dairy products, fatty foods, high-fiber foods or seasoned foods for a few days
• Avoid caffeine and alcohol

There are anti-diarrheal medications available. Over-the-counter (OTC) anti-diarrheal medications, such as loperamide (Imodium A-D) and bismuth subsalicylate (Pepto-Bismol), can help reduce the number of watery bowel movements you experience. Certain medical conditions and infections may be made worse by these medications because they prevent your body from getting rid of what’s causing the diarrhea. Also, these drugs aren’t always safe for children. A pharmacist can help you decide which product is right for you or your child. If you still have diarrhea after a few days you should contact your doctor to ensure there isn’t an underlying health reason causing the diarrhea.

Do I need extra vitamin D? If so, how much should I take?

Vitamin D is needed in building healthy bones, preventing bone loss, and it can also make muscles stronger in people who don’t have enough. Having low vitamin D is becoming very common as up to 50% of adults who see their doctor have it.

Many factors limit the sun exposure to the skin. Clothing, sunscreen, time of day, season, regions with less sun, low altitudes, skin pigment, and age all affect the skin’s ability to produce vitamin D.

Vitamin D is available as an individual supplement and is included in most multivitamins and some calcium supplements. Milk is a good dietary source of vitamin D, with approximately 100 international units per cup, and salmon has 800 to 1000 units of vitamin D per serving.

Vitamin D2 and vitamin D3 are safe dietary supplements. Both can be taken once daily from 400 IU to up to 2000 IU or in larger doses available by prescription only (up to 50,000 IU) taken less often such as once a week or even once a month. Both vitamin D2 and D3 are best absorbed in the gut if taken with a meal containing fat.

The approach to testing and deciding on a need for supplementation is based on an initial assessment of your risk. For low risk adults, it is suggested not to test for vitamin D deficiency and to supplement 600 to 800 international units of vitamin D daily. Talk with your doctor about the need for testing your levels at your next appointment.

What can I take for a hard time falling asleep?

Having trouble sleeping is a common problem. A lack of sleep can cause people to be sluggish during the day which can affect your work, school, social life, and health.

Adults with sleep issues may use over-the-counter or prescription medicine to help with sleep. However, it’s best to look for the cause before starting treatment with medicine. Keeping a sleep diary for one to two weeks is great way to start.  Tracking sleep times, caffeine and alcohol intake, etc. can provide clues to what might be causing the problem. Changing these behaviors might be all that’s needed to help you sleep better. By maintaining good sleep habits, you may be able to avoid taking medicine.

Good sleep habits include:

• Stick to a regular bedtime
• Get regular exercise
• Go to bed only when you are sleepy, if you do not fall asleep within 15 to 20 minutes, get up and go to another room. Return to bed only when you feel drowsy.
• Avoid large meals just before bedtime
• Avoid alcohol, nicotine, and caffeine

Over-the-counter sleep aids are widely available. Common choices and the potential side effects include:

• Diphenhydramine (Benadryl, Unisom). Diphenhydramine is a sedating antihistamine. Side effects might include daytime drowsiness, dry mouth, blurred vision, constipation and urinary retention.
• Doxylamine succinate (Unisom). Doxylamine is also a sedating antihistamine. Side effects are similar to those of diphenhydramine.

(Diphenhydramine and doxylamine aren’t recommended for people who have closed-angle glaucoma, asthma, chronic obstructive pulmonary disease, sleep apnea, severe liver disease, digestive system obstruction, or urinary retention.)

• The hormone melatonin helps control your natural sleep-wake cycle. Some research suggests that melatonin supplements might be helpful in treating jet lag or reducing the time it takes to fall asleep — although the effect is typically mild. Side effects can include headache and daytime sleepiness.
• Supplements made from this plant are sometimes taken as sleep aids. Valerian generally doesn’t appear to cause side effects.

Start with your pharmacist or doctor. You don’t need your doctor’s OK to take an over-the-counter sleep aid. But it’s a good idea to ask your pharmacist if the sleep aid might interact with other medications or underlying conditions.