Friend or Foe? Let’s Discuss Proton Pump Inhibitors

Proactive Health

By Joy Stephenson-Laws, JD, Founder

Pharmaceuticals serve a critical role in our healthcare delivery system. They are responsible for controlling a myriad of diseases and even preventing death. However, it is important to remember that all drugs—every  last one of them—have side effects, especially if they are taken for long periods of time. And as consumers, we need to be aware of these side effects and determine how much we can reduce or eliminate them so we can enjoy our healthy lives.    

One popular class of drugs are proton pump inhibitors (PPIs). About 10% of the general population take them. Popular brand names for over the counter (OTC) PPIs include Prilosec, Nexium and Prevacid. They are used to treat frequent complaints like heartburn, acid reflux or gastroesophageal reflux disease (GERD), a more severe form of acid reflux.  

Green Bay Packers’ Brett Favre often suffered from chronic heartburn. You might recall he became a spokesman for Prilosec. He is reported to attribute the disappearance of his heartburn to OTC Prilosec.

These drugs work by reducing the amount of stomach acid made by glands in the lining of your stomach. We need stomach acid to digest our food and kill harmful bacteria and other parasites that we may swallow with our food. But sometimes the stomach acid backs up into the tube that connects the throat and stomach (esophagus). Heartburn occurs as the result of the refluxed stomach acid coming in contact with the lining of the esophagus.

Left untreated, heartburn may eventually lead to more serious health problems. And the PPIs are used to reduce the stomach acid.

Recent studies have linked PPIs to a range of potential health risks including dementia, stomach infections, kidney disease, pneumonia and bone fractures.

The most recent study was published yesterday and suggested that PPIs may promote the growth of a type of bacteria associated with chronic liver diseases.

Scientists found "that the absence of gastric acid promotes growth of Enterococcus bacteria in the intestines and translocation [transfer] to the liver, where they exacerbate inflammation and worsen chronic liver disease." These scientists were also able to confirm the bacteria's role in contributing to the “buildup of excess fat in the liver, which marks fatty liver diseases.”

For these reasons, it was recommended that "clinicians should consider withholding medications that suppress gastric acid unless there is a strong medical indication."

PPIs have also been associated with an increased risk of vitamin and mineral deficiencies.  For example, nutrients like calcium, which require an acidic environment to be effective, may not be efficiently absorbed if you take PPIs. Other nutrients that may be impacted include vitamin B12, vitamin C, iron and magnesium.  And these deficiencies may be more pronounced in elderly patients.  

All of these nutrients which may be affected by prolonged PPI use are important for keeping us healthy for various reasons:

  • Calcium is important for building and maintaining strong bones and teeth. This mineral is also important for maintaining hair and nail health in perimenopausal and menopausal women. Adequate calcium intake may also decrease your risk for colorectal cancer.
  • Vitamin B12  is important for a healthy nervous system and blood cells, and it helps make DNA. It’s often touted for energy-boosting benefits; this may be because B12 helps prevent a type of anemia that leaves people feeling tired and weak.
  • Vitamin C is important to protect our immune systems. To check out additional benefits, particularly for older women, click here.
  • Iron is an essential component of many proteins and enzymes. It is vital in the formation of red blood cells and lean muscle. If you are low in iron, you may find that you feel very tired.
  • Magnesium is necessary for a myriad of body functions. For example, it may help with depression,  regulate blood pressure, bone metabolism and has antioxidant functions. Magnesium is also great for pain management. Many people use magnesium as a safe alternative to ibuprofen or acetaminophen. Magnesium may even help alleviate leg cramps women may experience during pregnancy.

So how can we be proactive about PPIs?

  • Assume responsibility for our health. Educate ourselves about each medication we are prescribed.
  • Understand that nutrient deficiencies can be the price of effective drug therapy. Be knowledgeable about the important role each nutrient plays in the body, and discuss ways of replenishing those nutrients with a competent physician.
  • Consider a comprehensive nutrient test if you have been taking medications for a long period, to determine how they affect your body. And once you find out, discuss with a competent health care professional the best way to get those nutrients back in your body.  
  • Always discuss with your doctor any alternative medications, which might exist with less side effects.

Enjoy your healthy life!

The pH professional health care team includes recognized experts from a variety of health care and related disciplines, including physicians, health care attorneys, nutritionists, nurses and certified fitness instructors. To learn more about the pH Health Care Team, click here.