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Heartburn Drug Leads to Deficiencies

Powerful acid-suppressing drugs such as omeprazole can ease heartburn but over the long term they may create nutritional deficiencies.

Proton pump inhibitors (PPIs) are enormously popular drugs to treat acid reflux or heartburn. While they can be very helpful for symptom control in the short term, they may lead to important deficiencies if they are taken for a long time.

Deficiencies That Developed While on Prilosec:

Q. I was on Prilosec for nearly two years to combat persistent heartburn. When my fingernails started to fall apart and my feet and legs starting getting numb, I did a bit of homework and discovered that this drug greatly inhibits the absorption of vitamin B12.

I started to wean myself off of the Prilosec. That was rather unpleasant because prolonged use of proton pump inhibitors makes your gastric acid glands work overtime to compensate. I took lots of Tums and DGL (deglycyrrhizinated licorice) to stave off the worst of the acid blow-back. It took nearly six weeks, but my stomach got back to normal.

Beware of High Fructose Corn Syrup:

I discovered that sweets, especially soda or anything with high fructose corn syrup (HFCS), were the main cause of my misery, so I cut them completely out of my diet. I ate smaller meals and kept taking my vitamin B12 supplements.

Magnesium Deficiency Following Long-Term PPI Use:

The strange tingling in my feet eventually went away after I added magnesium to my nightly supplements. Now I rarely have heartburn that I can’t handle with Tums. My fingernails, although not perfect, are much better.

Other sufferers might consider eliminating carbonated beverages and foods sweetened with HFCS from their diets to see if that helps alleviate their heartburn.

A. Thanks for sharing your experience. Other readers have told us that a low-carb diet can sometimes alleviate heartburn.

Long-term use of acid-suppressing drugs may reduce vitamin B12 levels. That can lead to nerve pain such as tingling or numbness.

The FDA has just issued a warning about low magnesium levels linked to powerful acid-suppressing drugs like esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec) and pantoprazole (Protonix). Using such drugs for more than a year could lead to dangerously low levels of magnesium that a supplement cannot reverse. A case report published recently shows that seriously low magnesium levels from chronic PPI use might have no symptoms until a person develops a life-threatening heart rhythm disturbance (Magnesium Research, Dec. 1, 2015). When people take such medications for an extended period, they should have their magnesium and vitamin B12 levels checked regularly.

To help others wean themselves from such drugs under medical supervision, we offer our Guide to Digestive Disorders.

Revised 4/14/16

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
Digestive Disorders

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I started having acid reflux to varying degrees about two years ago. I hesitate to take PPI’s (thanks to the information gleaned from your program) but I also don’t want it to continue and progress into esophageal cancer. I am experimenting with Zantac which is not a PPI and therefore (I hope) less dangerous in the long term. Even so, I try to take no more than necessary and am sometimes able to go without any for several days at a time. I find that the main help for me is reducing carbs. So hard to do! But if I consistently eat a modified Atkins diet (just a reduction of carbs, not a severe cutback) I do improve considerably. If I get careless it will take me 2 or 3 days of “good” eating to get back in line again. Cutting carbs (not just sugar) and eating less processed food does the trick.

Dr took me off omeprozole an prescribed generic for zantac. Does this have the same side effects?

I recently got off omeprazole. I had an endoscopy & it found a hiatal hernia. While I didn’t take the ppi that long – only 4-5 months – it wasn’t even doing the trick.

After starting to read about all the problems associated with it, I knew I had to get off it. The solution that has worked for me is a 100 BILLION probiotic (needs chilling) first thing in the morning, watching what I eat, eating smaller meals, avoiding REALLY spicy foods like jalapenos, watching my posture (weeding while seated & bent over is guaranteed to bring on some reminders of how it used to be) and another 20 BILLION probiotic at night.

I also take quite a bit of magnesium citrate. I can honestly say I’m 98% heartburn free doing these things – I usually forget I ever had it. I don’t want to take tums or similar otcs as I’m concerned about their type of calcium going to my arteries, rather than my bones. When even the omeprazole wasn’t completely controlling my heartburn, I never dreamed I could feel so good again with these “simple” steps. But I do, and I’m thankful.

Oh, swell, now there’s a possible connection with PPI’s & low Magnesium & B12 levels; people are reporting Osteoporosis, & their nails are splitting – I wondered why my always healthy nails were splitting & breaking off. That’s minor compared to my recent bone density results – Osteopenia, meaning I’m at risk for Osteoporosis & fractures. This is getting scary.

Several weeks ago, my Doctor told me to get off of the PPI I take. I’m alternating the PPI with Pepcid, gradually using less PPI & more Pepcid. It seems to be working out so far. I’ve lost weight, quit smoking 18 yrs ago, stopped drinking soda a year ago, raise the head of the bed, & checked labels for foods containing high fructose corn syrup long before reading about a connection between PPI’s & health problems. I refuse to knowingly purchase anything containing HFCS & never used artificial sweeteners.

My Doctor wants me to cut back on the supplements I take, but I’m staying with B-Complex & Magnesium, along with a Calcium-rich diet plus Calcium & vitamin D supplements. I’m working to lose more weight – I’d never paid attention to warnings about the health risks associated with being overweight. Trust & respect for one’s Physician is fine; however, I’m the one ultimately in charge of my health, and so are all of you who’ve read and commented on this article. My thanks for the article & to all who commented; best wishes for your improved health & well-being.

Acid reflux drugs were never ever meant to be taken forever. If certain foods cause it for you, stop eating those foods. LISTEN TO YOUR BODY. GET off the pop. Eat whole food, not processed food, and learn to cook it yourself. I realize this is hard, demanding, time-consuming work. Take probiotics to feed your good bacteria.

Good health starts in your guts, not in the drug store. There doesn’t seem to be anything that humans hate worse then CHANGE, but changing what you ingest is the first thing to do when your tummy rebels at what you are putting in it.

My tummy doesn’t like food cooked in commercial cooking oil, which is full of preservatives, so I fry in bacon fat and butter. Is that going to kill me? It doesn’t matter because no one is getting out of Life alive anyway.

Aged 73, I consumed various antacids and acid inhibitors in substantial quantities for five decades.

Six months ago, I started taking Turmeric capsules, one in the morning and one in the evening (for other reasons) and found that I no longer have a need for any kind of acid relief. My digestion is heartburn free, better, and I feel better.

After being on Nexium for over five years (all the other PPis, gave me headaches or stomach pain), I suddenly developed a serious heart arrhythmia. I wore a heart monitor for 48 hours and found I was having an average of 8500 irregular ventricular beats a day. This just came out of nowhere. My cardiologist was thinking I’d eventually need ablation surgery on my heart, but because of my serious allergies to antibiotics (which are used with the surgery), the doctor said to wait awhile and just “live with it.”

It was very uncomfortable. Imagine my surprise when my doctor called and said there was some new research on Nexium and other meds like it. Not only did they deplete B12 and calcium, but also magnesium. He said that muscles needed enough magnesium to function properly, and that my heart was a muscle. He advised me to taper off Nexium and within four or five weeks, the serious arrhythmia was gone!

I now eat more carefully (avoiding trigger foods like tomatoes, other acidic fruits, chocolate, coffee, etc., and I take a generic “antacid” from the drug store. Doctor said to use an antacid with calcium and magnesium (similar to generic Rolaids), not Tums, which do not contain magnesium. I only need a tablet a day, as long as I don’t eat trigger foods, and I’ve done very well with this for several years. If I get a little heartburn from something, I take a second tablet. I don’t need anywhere near the eight tablets a day I could take, and there are some days when I don’t need any tablets at all. Another thing that helps is smaller, more frequent meals. Heartburn is no longer much of a problem. Hope this helps someone.

For me, the best anti-gerd medicine was to raise the head of my bed 8 inches, sit upright during the day and not bend over for any length of time.

hi, I’m 70 yo,. and have taken omeprazol for more than 10 years, always had a funny tummy, but Dr put me on them because I take medication for arthritis artrosis ect,. so I trusted him, but he never gave me exact instructions, and from what I read none do, take the ppi 15 t0 30 min before breakfast, if you don’t eat breakfast, the before lunch, you must eat after the food is the starter motor, s a,.

Ok I was taking glucosamine and chondroitin, + ibuprofen and paracetamol when in pain, but I just took them all in the morning, thanks to the readers an blogs i found out about taking the ppi first, the others latter. So I was visiting Argentina and decided to have the PRP, plasma rich plaquette injections, and yes its slowly working, and no more pills, but I was getting pain in my back right side of my hip and down my leg, stopped me in my tracks. Fortunately my dear friend here was a nurse, and she said that looks like sciatica, so asked me what meds I take, when I said omeprezol she smiled and said I probably have a Vb12 problem, she popped off 10 minutes later came back with a box of b12 amphils 3mls, I could not believe the relief I felt- and so quickly, why aren’t our Drs warning us about the side effects of drugs? So I stopped taking them and felt so ill, had to start them again, so now I’m cutting down from 20 mg to 10 mg and hoping I can get off them and a good diet, thanks the the blogs I know why my leg goes numb, thank you all for the help.

I had been taking Omeprazole – slow release for about a month, and developed numb feet. The Dr. Never said it could be from the medicine, so I brought it up. Now he prescribed Lanzoprazole, but if this medicine is in the same family as the other one, how will this be better for me. I have Barrets, so I’m supposed to be on some type of medicine to prevent more damage. I’m not so sure I want to take this medicine.

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