Dr. John Day, Cardiologist

Podcast: Play in new window | Download

Subscribe: RSS

5 Reasons To Get Off Acid Reducing Meds

Worldwide headlines reported that the popular acid reducing medications, such as Prevacid (iansoprazole), Prilosec (omeprazole), and Nexium double your risk of dying from a heart condition.  What should you do if you are part of the 60% of Americans who has heart burn, or acid reflux symptoms, each year?

What is worse, acid reflux or a heart attack?

In this article, I will share 5 reasons to get off acid reducing meds.  I will also give you 5 natural strategies to prevent acid reflux in the first place so that you will never miss these medications.

Acid Reducing Medications and Heart Attacks

As a cardiologist, I see a lot of patients on acid reducing medications.  In my experience, most of the patients I see with chest pain have chest pain due to acid reflux.

The study which got the world talking about the dangers of proton pump inhibitors (Prevacid (iansoprazole), Prilosec (omeprazole), and Nexium) came from Stanford University.  In this study, researchers reviewed the records of 2.9 million Americans taking these medications.

Dr. Nigam H. Shah and colleagues found that people taking these acid reducing medications were twice as likely to die from heart related conditions.  Interestingly, if people took the older acid reducing medications, such as Tagamet (cimetidine), Zantac (ranitidine), Pepcid (famotidine), or Axid (nizatidine) they did not see this risk.

There are many possible reasons why proton pump inhibitors may cause heart attacks. For example, these medications are known to alter gut bacteria.  These medications also block the absorption of key nutrients like, magnesium and vitamin B12, which are critically important for heart health.  In addition, these medications may increase the risk of blood clots.

If you are on a proton pump inhibitor, don’t panic.  This study was not confirmatory and there are certainly many limitations of this study.  For example, the people included in this study tended to have more chronic medical conditions.

Also, this was an observational study.  Just because proton pump inhibitors are associated with dying from heart disease does not mean that the proton pump inhibitors caused their deaths.

I Was Once Dependent on Prilosec (Omeprazole)

Yes, it is true.  I used to buy the large Costco pack of Prilosec (omeprazole).  I could not survive without this medication.  Sometimes my chest would hurt so much I had to take Aleve with my Prilosec.

Interestingly, after I completely changed my lifestyle several years ago, my acid reflux seemed to have mysteriously gone away.  In fact, I can’t remember the last time I had acid reflux.

I’m not sure the exact reason why my acid reflux resolved.  It probably had something to do with eliminating dairy (I have a dairy food allergy), losing weight, and eliminating most processed foods from my diet.

Acid Reflux Is Rarely Seen In The Developing World

In 2010, Americans spent 14 billion dollars on medications like Prevacid (iansoprazole), Prilosec (omeprazole), and Nexium.  Each year more and more Americans are getting heart burn symptoms.

Historically, heart burn symptoms were rarely seen in the developing world.  For example, in a review of 36 published studies, the risk of having acid reflux symptoms in China was less than 5% in any given week.  The risk of acid reflux is also extremely low in Africa.

The fact that acid reflux is rarely seen in the developing world is reason for hope.  It suggests that there is something about the American lifestyle which contributes to this condition.  Based on these studies, if we can change our lifestyles then most people can avoid acid reflux.

5 Reasons To Get Off Acid Reducing Meds

Proton pump inhibitors, or PPIs, such as Prevacid (iansoprazole), Prilosec (omeprazole), and Nexium) were never meant to be taken long term.  The problem, is that so many people become “addicted” to PPIs.  While these medications are effective in reducing symptoms from acid reflux, the long term consequences of these medications may far outweigh any potential short term benefits.

PPIs can be very helpful for short term episodes of severe acid reflux.  Indeed, the 5 reasons I list to get off acid reducing medications all tend to occur with long-term use.

Please note that I am not recommending that you stop these medications on your own.  This is a shared decision you have to make with your physician after carefully weighing the risks and benefits of these medications.  This shared decision should also take into account that most people can control heart burn symptoms with simple lifestyle changes.  Also, these risks may not apply to the older acid reducing medications such as Tagamet (cimetidine), Zantac (ranitidine), Pepcid (famotidine), or Axid (nizatidine).

1. To Prevent Heart Disease

As discussed above, proton pump inhibitors (PPIs) such as Prevacid (iansoprazole), Prilosec (omeprazole), and Nexium may double your risk of dying from a heart condition.

2. To Prevent Dementia

Proton pump inhibitors (PPIs) block the absorption of vitamin B12 in the gut.  Vitamin B12 is critical to keep homocysteine levels low.  When homocysteine levels are high, dementia, strokes, and heart attacks are much more common.

3. To Prevent Fractures

In addition to blocking the absorption of vitamin B12, PPIs may also block calcium absorption.  Thus, people taking these acid reducing medications long-term are at a 78% higher risk of breaking their hips.

4. To Prevent Anemia

PPIs are well known to block iron absorption.  If your iron levels are too low you may become anemic.  This is especially dangerous for menstruating women as they already tend to be low in iron.

5. To Prevent Magnesium Deficiency

Fully 60% of Americans are deficient in magnesium.  This problem is magnified in people taking PPIs.  Magnesium is critical for proper heart function and to prevent DNA mutations which could cause cancer.  To learn more about the symptoms of magnesium deficiency, please read this article I wrote.

Do PPIs Prevent Esophageal Cancer?

One reason why your physician may put you on a PPI is to prevent the potential risk of acid reflux causing cancer of the esophagus.  While Prevacid (iansoprazole), Prilosec (omeprazole), and Nexium certainly block acid production in the stomach, it is unclear how much benefit there may actually may be when it comes to preventing esophageal cancer.

It is interesting to note that even though 119 million prescriptions are written every year in the U.S. for PPIs, esophageal adenocarcinoma has increased more than 350% since the mid-1970s!  Once again, do not stop PPIs on your own as your physician may be using this medication to prevent cancer of the esophagus for you.

6 Ways to Prevent Acid Reflux Without Meds

1. Avoid Your Food Triggers

Food allergies can be a big cause of acid reflux.  I know that was the case with me.  Eliminating dairy helped me tremendously with symptoms of acid reflux.  Another common cause of acid reflux is gluten sensitivity.

Outside of food allergies, the main triggers of acid reflux are pizza, soda pop, alcohol, chocolate, fried foods, fatty meats, citrus fruits, tomatoes, or spicy foods.  The key is to figure out your own triggers.  While I listed the most common culprits, your triggers may be different.

2. Keep Your BMI Below 25

Our Western Diet and our expanding waist lines are the primary reason why the U.S. is the acid reflux capital of the world.  Interestingly, we don’t even know when we are overweight anymore.  For example, in a recent study, 78% of parents of obese children thought their child was at a normal weight.

I see this in my cardiology practice as well.  Many of my patients have no idea what their ideal weight is.  Here is a BMI calculator to see if you are overweight.  The goal is to keep your BMI below 25 to help with acid reflux.

3. Eat Early and Light Dinners

The bigger your meal the more likely you will have heart burn.  Also, eating before bed is a recipe for acid reflux.  As soon as you lie down, and gravity no longer keeps your stomach acid in your stomach, you may start to feel the heart burn.

In fact, I routinely tell my patients to stop eating after 7 pm for a variety of reasons.  According to studies, eating late at night may also cause weight gain, strokes, and heart attacks.

4. Review Your Medications with Your Doctor

Many medications can cause acid reflux.  The most common medications to cause heart burn include the following: calcium channel blockers, antibiotics, anti-inflammatory medications, bisphosphonates, pain medications, and sedatives.  It is critical to always review your medication list with your doctor as you may be taking a medication you may no longer need.

5. Don’t Constrict Your Stomach

Wearing tight clothes can be a mechanical cause of acid reflux.  If you suffer from frequent heart burn, see if loose fitting clothing helps.

6. Consider an Older Acid Reducing Medication

If you absolutely must take an acid reducing medication long-term, you could talk with your doctor about whether one of the older medications, such as Tagamet (cimetidine), Zantac (ranitidine), Pepcid (famotidine), or Axid (nizatidine), might be safer for you.

Do you take acid reducing medications?  Is there anything you have found which helps to prevent acid reflux?