By Joy Stephenson-Laws, JD, Founder

Back in 2015, former speaker of the House of Representatives, John Boehner, stated that we “spend more money on antacids than we do on politics.”

The actual facts suggest that Boehner got his numbers wrong. Reportedly, we spend close to $2 billion on antacids -- “less than the $3.8 billion Americans spent on federal elections (per the Center for Responsive Politics) and much less than we spent on all federal and state elections -- a sum closer to $6 billion,” according to the Times' calculations.

Although Boehner’s comment may have been just another ‘off the wall’ comment we often hear from politicians, the truth is Americans do spend a lot of money on antacids. Two billion is quite significant, and the antacid market continues to grow.

In 2015, it was reported that 100 million Americans were estimated to be taking prescription antacid and heartburn medications. Furthermore, it was also reported that more than $10 billion is spent worldwide each year on antacids.

“Increasing geriatric population around the world is the key factor driving the global antacid market. According to data from World Population Prospects 2017, the number of older persons those aged 60 years or over are 962 million globally in 2017 comprising about 13 percent of the global population, which is expected to be more than double by 2050 accounting for nearly 2.1 billion in 2050. In addition, sedentary lifestyle, increasing incidence of gastroesophageal reflux disease (GERD), changing food eating habits are leading to increasing adoption of antacid.”

So what exactly are antacids and why do so many people take them?

In a nutshell, antacids neutralize stomach acid. Stomach acid causes heartburn. So antacids reduce heartburn.

To break this down a bit further, our stomachs naturally produce an acid called hydrochloric acid which helps break down proteins. The contents of our stomach are acidic with a pH level of 2 or 3 (the lower the number, the more acidic).

(The National Institutes of Health (NIH) says that normal volume of the stomach fluid is 20 to 100 mL and the pH is acidic (1.5 to 3.5)).

“The stomach, duodenum [first part of the small intestine], and esophagus are protected from acid by several protective mechanisms. When there is too much acid or protective mechanisms are inadequate, the lining of the stomach, duodenum or esophagus may become damaged by the acid, giving rise to inflammation and ulcerations and their various gastrointestinal symptoms such as nausea, abdominal pain, and heartburn (due to gastroesophageal reflux disease or GERD).”

Most over-the-counter antacids usually contain at least one of the following ingredients:

• Calcium Carbonate. Not only is this used as a dietary supplement to treat a calcium deficiency, but it is also used to neutralize acid in the stomach.
• Aluminum Hydroxide and Magnesium Hydroxide. Used together to treat heartburn, acid indigestion and upset stomach.
• Sodium Bicarbonate. Helps relieve heartburn and acid indigestion. Also may be used to make your blood or urine less acidic due to having certain health conditions.

Some brand names of antacids you may be familiar with include:

• TUMS®
• Rolaids®
• Mylanta®
• Maalox®
• Nexium®
• Gaviscon®

Now, it’s great that we can take antacids to help relieve the very uncomfortable symptoms of heartburn and indigestion, but as with many medications, there are unwanted side effects.

One problematic side effect of antacids

With antacids, a very problematic side effect may be the depletion of certain nutrients that we need an adequate intake of to maintain our health.

One study found evidence which suggested that antacids may cause a deficiency in vitamin B12. We actually need an acidic stomach to absorb B12. So if antacids are frequently used to  block acid production, we may not have enough acid in our stomachs to properly absorb this essential nutrient.

B12 serves many purposes in the body, such as helping make DNA and red blood cells (that carry oxygen to your organs and give you energy and help prevent fatigue). B12 also helps keep the brain and immune system healthy and plays a role in preventing a type of anemia called megaloblastic anemia, which may leave us feeling tired and weak.

Not only is having sufficient B12 important for preventing and fighting disease and giving the body energy, but it may also play a major role in our mental health.

What is especially concerning about the relationship between antacids and B12 is that increasing B12 intake will not result in greater absorption. This is because the stomach does not have enough acid to absorb it. And despite this, some people take antacids for years and pop antacid tablets like breath mints, without knowing that this could be very detrimental to their balance of nutrients.

There is also evidence that antacids may deplete the body of folate (vitamin B9), another key nutrient we all need.

“Antacids may bind to folate and reduce its absorption, according to New York University's Langone Medical Center. You are more likely to suffer from folate deficiency if you take antacids on a regular basis and have an existing medical condition that affects nutrients absorption,” according to this article.

“However, if you are healthy, taking antacids on a short-term basis is not likely to have an adverse effect on folate levels in your body.”

But the problem is that many people, especially older people who are already at a greater risk of nutrient deficiencies due to their age, are not taking antacids on a short-term basis. According to the Cleveland Clinic, prescription antacids are generally meant to be used for eight weeks but some people end up taking them for years.

In addition to this, antacids that contain aluminum may cause calcium loss which could lead to weak bones and osteoporosis, reports the NIH.

How can we be proactive?

• Get to the root of the issue, don’t just treat it.

Many times the reason why we may suffer from heartburn is due to our diet. If we eat too many fatty, oily  or fried foods (pro-inflammatory foods), this may contribute to heartburn and indigestion. So take a look at your regular diet and see if you need to make some changes. The majority of your diet should consist of nutrient-dense foods, including fruits, vegetables, lean protein like fish, legumes and whole grains. Drinking sufficient amounts of water is also important in balancing the acid in your stomach.

There are also some situations where people have underlying health issues that may be causing heartburn and indigestion.

For example, people with diabetes may suffer from gastroparesis (also called delayed gastric emptying), a condition in which the stomach cannot normally empty itself of food. So preventing diabetes and controlling your glucose levels if you already have diabetes may help prevent gastric upset and, as a result, reduce your need for antacids.

And gastroesophageal reflux disease (GERD) in some cases may be caused by being overweight or obese (by putting increased pressure on the abdomen). So maintaining a healthy weight may reduce your need for antacids.

• Try natural remedies

Consult with a competent healthcare professional first, but there may be some natural remedies for heartburn and indigestion.

• Alkaline Water. According to the NIH, alkaline water may have good acid-buffering capacities.
• Probiotics. As we have discussed many times, probiotics help keep the gut microbiome healthy. And having a healthy, diverse gut microbiome may help prevent any digestive issues and inflammation that can contribute to gut issues.
• Ginger. “The root of the ginger plant is another well-known herbal digestive aid. It has been a folk remedy for heartburn for centuries,” (Harvard Health).
• Chamomile Tea. May also help soothe the digestive tract.

And this source lists foods that may specifically help with acid reflux symptoms.

For example, melons are naturally rich in magnesium which may balance acid in the stomach.

Furthermore, “Asparagus, spinach, kale and brussels sprouts all are highly alkaline, meaning they’re good for your stomach and digestive system. Being naturally low in fat and sugar, vegetables also help lessen stomach acid.”

So eat healthily, maintain a healthy weight and consider getting a GI Effects Test which can look into whether your digestive system is functioning properly.

Enjoy your healthy life!

The pH professional health care team includes recognized experts from a variety of health care and related disciplines, including physicians, attorneys, nutritionists, nurses and certified fitness instructors. This team also includes the members of the pH Medical Advisory Board, which constantly monitors all pH programs, products and services. To learn more about the pH Medical Advisory Board, click here.