More than 50 million Americans are prescribed medication for acid reflux or GERD (gastroesophageal reflux disease). When acid reflux begins, the first place many people look for relief are the readily available, over-the-counter antacids such as Tums and Rolaids. When those remedies no longer seem to work, patients may turn to medications such as proton-pump inhibitors (PPIs). But the next time your acid reflux is acting up and you reach for your medication, I hope you think twice.
At first PPIs seem like a good choice, as they can easily relieve most symptoms. Proton-pump inhibitors are medications for constant acid reflux (referred to as GERD), peptic ulcer disease, and non-ulcer indigestion. Over the last several decades, PPIs have been one of the most widely prescribed drugs. However, are they truly safe and effective treatment options?
The range of PPIs available consist of both over-the-counter and prescription options:
- Omeprazole (Prilosec)
- Esomeprazole (Nexium)
- Lansoprazole (Prevacid)
- Rabeprazole (AcipHex)
- Pantoprazole (Protonix)
How Do PPIs Work?
PPIs work by reducing stomach acid, thereby reducing acid reflux into the esophagus and relieving heartburn symptoms. Short-term use of PPIs may not be an issue—based on an observational study, the risk of developing diabetes using PPIs for up to two years increases by 5%. PPIs used for more than two years, however, showed a marked increase in risk of 26%. Clearly, limiting the use of the medication to the short term is likely to reduce the risk of diabetes.
Long-term use of PPIs has been associated with vitamin B12 and zinc deficiency. Metformin, a widely prescribed drug for diabetes and prediabetes, is also known to inhibit the absorption of vitamin B12. Consider whether the combination of drugs increases the probability of absorption issues: data suggest that PPI users have a 40% higher risk of magnesium deficiency. After discontinuing use of the PPIs, levels appear to normalize within a couple of weeks; however, deficiency occurred again after restarting the medication.
Long-term and/or high-dose users may be at risk of a 41% reduction in calcium absorption, increasing fractures to the hip, spine, and wrist. Additionally, in a 2016–2017 study of omeprazole users in Brazil, it was found that there was a 70.6% progression of chronic kidney disease (CKD). Couple this with the effects of diabetes and it may exacerbate kidney issues.
Alarmingly, the risk of death increases with the amount of time a person is taking PPIs. It appears that the part of our cells, lysosomes, cannot function properly when taking PPIs. Lysosomes function in the following ways:
- they break down and digest carbs, lipids, proteins, and nucleic acids
- repair cell membrane
- respond against foreign invaders such as viruses and bacteria
If lysosomes are not functioning correctly, your digestive tract and immune system can become damaged and weakened over time.
The Importance of the Digestive Tract
Vitamins and minerals are absorbed and processed in the digestive tract. Stomach acid is designed to break down food so nutrients can be delivered. As with everything else in our metabolism it is a balancing act, and the food and beverages we consume have a direct impact on our digestive health. When that goes awry, you can experience stomach pain, bloating, irritable bowel syndrome, fatigue, difficulty in losing weight, joint pain, headaches, and migraines. Stomach acid is also needed to disable bacteria and viruses—when stomach acid is dramatically reduced by PPIs, there is an associated risk for intestinal infections.
Is Medication My Only Option?
First, it is important to get the proper diagnosis. Diabetic gastroparesis is a condition that can develop in which chronically high glucose levels damage blood vessels supplying nerves and organs with nutrients and oxygen. In this case, PPIs may not be your best choice. Understanding the cause of your heartburn or GERD can determine the proper course of action.
Lifestyle changes will most likely be your best option. What you eat, when you eat, and how much you eat has the greatest impact toward feeling better. Taking steps to heal your digestive tract should also be part of your resolution to improve acid reflux. This may be the most effective and the safest treatment for your long-term health. So, let’s get that balance back in your life!
Denise A. Pancyrz is a Diabetes Reversal & Holistic Lifestyle Coach, speaker, and best-selling author of The Virgin Diabetic, Reverse the Effects of Type 2 Diabetes, Reduce Medication, and Improve Your Glucose Levels. Diagnosed with type 2 diabetes, Denise was prescribed four daily insulin shots with oral medication for diabetes and heart disease. This protocol helped to bring her glucose levels down; however, she did not feel as healthy and vibrant as expected. After changing her protocol by learning to rest and preserve her pancreas, she was able to eliminate all medication and insulin and regain her health.