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Heartburn Medicines May Thin Bones

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Q. I have been on omeprazole for years. It relieved my severe reflux, but unfortunately, it caused my bones to thin. My hip socket cracked and I needed hip replacement surgery. I am worried about another fracture.

A. There is growing evidence that long-term use of powerful acid-suppressing drugs may increase a woman's risk of a fracture by 35 to 45 percent. These data from the Nurses' Health Study were presented at this year's Digestive Disease Week conference (May 9, 2011).

Getting off such medications can be challenging, however. When people stop drugs like esomeprazole (Nexium), lansoprazole (Prevacid) or omeprazole (Prilosec), the rebound reflux can be very uncomfortable.

We discuss the pros and cons of acid-suppressing drugs and ways to stop taking them in our Guide to Digestive Disorders. You will be glad to learn that the risk of fracture drops within two years of stopping such drugs.

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17 Comments

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Your article on omeprazol and bone loss left out a bit of information.

Gerd can be more than just an uncomfortable annoyance.
I am 70 years young. I had been on OTC omeprazol for, at least, 12 years and I was also taking extra calcium at that time. My last bone density in '09 showed mild osteopenia.

When I became anemic 6/10, they did an esophagoscopy, they found an ulcer and Barretts esophagus with high grade displasia, probably due to the NSAIDs [for arthritis] and GERD.

After multiple treatments I am now on omeprazol 40 mg BID and CA citrate 1000 mg QID till the end of '11, and no NSAIDs. I don't want the GERD, I don't want the bone loss, and I don't want the Barretts to return. If I had not had the anemia, I probably would have been diagnosed too late for easy treatment.

Letting people know that GERD can cause esophageal problems with a possibility of cancer, is an important piece of information.

[I am being well followed by UCLA physicians.]

When I have heartburn I chew on a stick of gum for a while.
Another thing I do is simmer about a cup of sliced ginger root in about 2 qts. of water for several hours. Save the liquid after draining it, and while it is still hot add about a cup of sliced persimmon, dried or fresh. Leave the persimmon in the liquid, refrigerate, and sip about an ounce every evening or when you have heartburn.

As a new nurse, I find the info from your show, tweets, & website extremely helpful & relevant. While in nursing school, ironically most of what you discussed was being taught and/or tested on simultaneously. This info on omeprazole is a prime example: Tons of clients are on this seemingly harmless RX, and don't realize the side/adverse effects. Thanks for sharing. Allows me to share with clients- evidence based is the best back-up.

does this info also have the same degeneration for men as for women? I give my husband Omeprosole 40 mgs daily as well as Calcium 1000 mgs. When he stopped these medications, he was very ill, with constant belching so bad that they sounded like coughing. The Dr put him back on Omeprozole 80 mgs until the belching stopped, dropping to 40 mgs thereafter,and I put him back on the Calcium. He is 89 yrs old.

From my reading of many alternative health newsletters and helping a friend successfully get off the reflux meds I can safely say that many people, especially the middle aged and older, can solve their problem by taking digestive enzymes.

Unfortunately this problem is hitting much younger adults and children. Our Dr was concerned that my young son was low in his minerals and it indicated a pattern that was from lack of digestive enzymes/acid. I started him on chewables (he was too young for pills) and then as he got older the pills. His numbers all improved and he finally grew! He was the shortest kid in his classes-even smaller than the Asian kids. He is now 6'1" as an adult thanks to proper digestion.

Yes, we all still take digestives. One must do a challenge test every few years to make sure one is getting enough. Increase to the point of acid stomach then back off to the last good dose.

I used to have problems with fingernails breaking, splitting and peeling. Also terrible split ends on my hair-even when short. My Dr had me take the digestives and I still have no split ends or fingernail problems 31 years later.

I was having trouble with GERD several years ago. Once a day before a meal
I took an over the counter acid depressor, not the stronger prescription pill.
I did not have any trouble stopping this regimen.

I have been taking 300 mg of ranitidine (zantac) for gerd for many years. A little over a year ago, concerned about the possibility of bone density issues from long term usage, I decided to try a tablespoon of apple cider vinegar in a glass of water each morning, Monday through Friday instead of the ranitidine. This has worked extremely well. I rarely experience gerd during the week while on this regimen.

I still take the ranitidine on the weekends when I am less careful about my diet. Only taking an acid suppressant 2 days a week has greatly reduced my concerns about possible bone density issues from the drug.

Splitting nails, brittle hair, poor digestion all sounds very familiar. My thyroid tests in the normal range every year. What is the name of the digestive enzymes that you take?

About 3 weeks ago I decided to try getting off of Nexium. While I suffered some discomfort the first week, I could calm it with digestive bitters whenever it surfaced. I thought I was home free! However, the second week, the GERD really kicked in; to the point that swallowing anything; food or liquids, caused pain about 2" below my throat (esophagus?) The bitters (and Tums) couldn't control this and after about 3 days of extreme discomfort I took a Nexium.

The GERD was gone in a couple of hours. I'm very discouraged, as I'm aware of the long term effects of taking acid suppressants. I'm thinking of taking Nexium every 2nd or 3rd day. Any helpful comments?
thanks
m.c.

I suffer from a condition called Gastric Antril Vascular Ectasia, commonly known as watermelon stomach. I have been taking Omeprazole, iron and vitamin C for the last six or seven years. A recent bone scan showed no problems, so at age 82 I think I'm o.k. for a while

About 10 years ago, with no symptoms at all, I was put on Nexium 2x/day,after an upper GI test. Later, I was allowed to lower it to 1/day. But after reading about all the bone density side effects, I was determined to get off the medication. After my GI doctor (who prescribed it) said he didn't know why I was taking it, and he didn't care if I stopped taking it, I stopped the doses, with the same results as everyone else.

So I began to skip just one dose/week, for a 2 weeks. Then I skipped just Mon. and Fri. for 2 weeks, Mon. Wed and Fri., for 2 weeks, etc. until I was down to taking it just one day a week. Yes, it took a long time, but I didn't have the withdrawal side effects. I also added ginger capsules and Digestive Advantage (lactose intolerance because I have a dairy allergy, but there are other formulations). I no longer use the ginger because it seemed to upset my stomach. If I need something , I find that OTC antacids work well.

MC, my advice is the same. Try some digestive enzymes. Start small with one that has only 200 or so mg. of betaine HCL and as you increase the enzyme decrease your Nexium.

Rantidine was not mentioned in the list. Should this medication be listed? I only have occasional heartburn--that's why I take this and not the other ones.

I am taking Panoprazole Sod 40mg for my bleeding ulcer, which has been under control since I started taking it since 4/2009. I also take calcium daily and eat leafy veggies and milk and yogurt.

Thank you for any comments.


Jessie F.

I have been on GERD medicine for many years, first, Nexium, and then, with a push from my insurance company, omeprazole. Not liking to continue on this medicine when the said you should only be on it for 90 days, I tried to very systematically wean myself off of it, but the stomach pain and throat burning came back.

Recently, having read about the bone density effects, I tried again, but was not having much success, taking a pill every other day, but even on the days I took the medicine, I felt poorly. Then, I read in your column, I believe, a brief comment that almonds and broccoli sometimes help.

Sounded odd, but since I had almonds, I tried 6-7 raw, waited about 5 minutes and my symptoms were gone. I could hardly believe it, so I tried it again the next evening, which is when I have always taken my pill, with dinner. After dinner, I munched a few dry roasted almonds. I am now on day 4 or 5 without omeprazole and even when I lie down to sleep, I have no reaction or symptoms. It truly seems to be a miracle. Thank you so much!

My 75-year-old husband, who had taken omeprazole for years for hiatal hernia and chronic reflux, successfully weened himself off by not eating starches and refined sugar. After several weeks of no potatoes, pasta, rice, breakfast cereals, etc. he doesn't miss them. By combining this regimen with exercise he has been able to stop taking several other prescription meds also.

I would like to get updates on this post.

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