People's Pharmacy answers reader queries about caffeine pills; the side effects of Fosamax; and irritable bowel syndrome.

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Q: You’ve written about the health benefits of coffee. I don’t like the taste, so I get my caffeine from tablets (NoDoz). Am I getting the same benefits as those who drink coffee?

A: Coffee is much more than a caffeine delivery vehicle. There are at least 1,000 different compounds in a cup of brewed coffee, and it’s hard to tease out the effects of caffeine from all the other chemicals.

Epidemiological studies have shown that coffee consumption is linked to a lower risk of type 2 diabetes (American Journal of Clinical Nutrition, April 2010) and heart failure (Circulation: Heart Failure online, June 26, 2012).

Regular coffee can delay Alzheimer’s disease progression (Journal of Alzheimer’s disease online, June 5, 2012). Other chemicals in coffee may enhance the effects of caffeine on the brain (Journal of Alzheimer’s disease, July 2011).

A recent study found serendipitously that regular coffee reduced neck and shoulder pain triggered by computer work (BMC Research Notes online, Sept. 3, 2012). Whether the subjects would have gotten the same results from a caffeine tablet is unknown.

Q: My sister (60 years old) just broke her femur without any trauma. She simply stepped down, and as she stepped, her femur snapped.

She had taken Fosamax for five years and stopped last year when she heard of possible side effects such as broken femurs and deteriorating jaws. What can you tell us about this problem in otherwise healthy women?

A: The Food and Drug Administration approved Fosamax in 1995 to treat osteoporosis. A decade later, the first reports of unusual thighbone fractures began to surface. These breaks often occurred without a preceding fall or other trauma.

Someone who is exposed to this type of drug (bisphosphonates such as alendronate, ibandronate or risedronate) for more than five years may be at risk. Because the drugs linger so long in the body, the danger may persist even after the medication has been discontinued.

Q: For more than 30 years, my husband dealt with IBS (irritable bowel syndrome). He came to suspect that the problem might have been triggered by overprescription of antibiotics.

We tried medical treatment, home remedies, herbal remedies and dietary changes, to little effect. Ironically, this year he caught Lyme disease and was fortunate that a very visible bull’s-eye rash led to an expeditious prescription of doxycycline for 21 days. (He hadn’t had any illness requiring an antibiotic in decades.)

Within a few days of beginning treatment, the IBS symptoms disappeared and have remained gone for months now. Could IBS be cured by treating intestinal bacteria?

A: Overuse of antibiotics may indeed contribute to disruption of intestinal microbes. Paradoxically, there is some evidence that targeted antibiotic treatment might help restore a better balance of belly bugs and control symptoms of IBS (Current Gastroenterology Reports online, Sept. 4, 2012).

In their column, Joe and Teresa Graedon answer letters from readers. Write to them c/o King Features Syndicate, 300 W. 57th St., 15th floor, New York, NY 10019, or via their website: