Forty-eight percent of America suffers from heartburn at least once every month. Forty-eight percent! Some seek over-the-counter remedies, and others get medical advice from their doctors. Heartburn is caused by stomach acid in the esophagus, so if we reduce stomach acid, we will have less heartburn, right? This circular logic has lead to a class of medications called proton pump inhibitors, and one of them Nexium, generates six billion dollars per year by itself!1

Proton Pump Inhibitors

Proton Pump Inhibitors stop acid production in the stomach. Proton pump inhibitors block the hydrogen/potassium adenosine triphosphate enzyme system of the gastric parietal cells. This enzyme system, or proton pump, is directly responsible for the secretion of hydrogen ions into the gastric lumen producing stomach acid. It this mechanism is reversed two to three days after the drug is stopped, and the stomach begins to produce new enzymes. Proton pump inhibitors work longer and are stronger acting compared to H2 antagonists.2 3

Short term (less than two weeks) usage of proton pump inhibitors are well tolerated and most side effects include headache, nausea, diarrhea, abdominal pain, fatigue, and dizziness.4

Long-term usage of proton pump inhibitors, on the other hand, have an increased risk of side effects, and they should only be used when all other options have been exhausted. After long term use, proton pump inhibitors cause magnesium deficiency,5 zinc deficiency,6 low B12 (from the lack of the stomach’s intrinsic factor),7 SIBO,8 increased risk of C. diff,9 accelerated skin aging,10 bone fractures,11 increased risk of community-acquired pneumonia,12 development of food allergies,13 chronic interstitial nephritis (leading to kidney failure), and even heart arrhythmias. 14

The risk of SIBO increases while taking proton pump inhibitors because the opportunistic bacteria that would usually be destroyed by stomach acid survive and colonize the small intestine. The survival of excessive amounts of bacteria is the reason for the increased risk of community-acquired pneumonia and the increased risk of C. diff in people who take proton pump inhibitors.

The risk of bone fractures and osteoporosis are increased because the disruption of acid production interferes with bone mineralization. I theorize that the increase of heart palpitations associated with proton pump inhibitor use is related to the decreased levels of magnesium in the body.

If I had to use a proton pump inhibitor, I would take some of the first originally developed proton pump inhibitors including omeprazole, and lansoprazole. There is a theory that some of the newer PPIs that are “active” forms of the originals (esomeprazole and dexlansoprazole) may have an increased side effect profile.15

If I had to use a PPI long term, or for certain medical reasons (Zollinger-Ellison syndrome), I would take a digestive enzyme with every meal. I would also take a good sublingual B12 supplement and use transdermal magnesium. I would also take certain supplements and change my lifestyle to stave off osteoporosis including getting proper sunlight exposure, following the Perfect Health Diet, vitamin K2, boron, and magnesium malate. Finally, I would follow my H. pylori protocol if symptoms occur for added protection.

I consider PPIs to be the most harmful medication to your overall digestive health because they are extremely over prescribed. Unlike Miralax and Reglan, both medicines that I believe should seldom be used, PPIs have medical circumstances where they should be used. Most doctors prescribe PPIs like candy if you have heartburn, hell you can get Prilosec over the counter at most pharmacies in the U.S. PPIs are just a bandage when it comes to GERD; therefore, they should only be used acutely.

If you are on proton pump inhibitors and want to correct the deficiencies and try to “fix” your digestive issues contact me for coaching so hopefully you will not have to be on them forever.

  1. http://www.newschannel5.com/story/24932574/overuse-of-the-1-prescription-drug
  2. Beers, Mark. The Merck Manual, Merck Research Laboratories, 2006.
  3. Dr. Brownstein, David. Drugs That Don’t Work and Natural Therapies that Do!, Medical Alternative Press, 2007.
  4. Beers, Mark. The Merck Manual, Merck Research Laboratories, 2006.
  5. http://www.fda.gov/drugs/drugsafety/ucm245011.htm
  6. https://goo.gl/RltGHN
  7. http://www.med.nyu.edu/content?ChunkIID=21781
  8. http://www.cghjournal.org/article/S1542-3565%2812%2901511-X/abstract
  9. http://www.fda.gov/drugs/drugsafety/ucm290510.htm
  10. http://www.arcmedres.com/article/S0188-4409%2810%2900013-5/abstract
  11. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm213240.htm
  12. http://www.ncbi.nlm.nih.gov/pubmed/23034135
  13. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2999748/
  14. Beers, Mark. The Merck Manual, Merck Research Laboratories, 2006.
  15. Dr. Brownstein, David. Drugs That Don’t Work and Natural Therapies that Do!, Medical Alternative Press, 2007.