|$6 Billion of Nexium was sold in the U.S. last year.|
Long-Term usage may cause vitamin B12 deficiency
and other serious health issues.
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Gastroesophageal reflux disease, also known as GERD, is near and dear to my heart. Through the years I've had my own issues with reflux and heartburn. Luckily I was able to finally control it with diet and some natural remedies that I will discuss later. But before that, my gastroenterologist had me take acid suppressant medications.
Acid suppressant medications are sometimes necessary but they are overprescribed and overused. Over 150 million prescriptions were written in 2012 plus many of these acid-suppressants are now sold over-the-counter and easier than ever to get. Unfortunately many of the people who take them continue to do so for an extended period of time.
Types of Acid Suppressant Medications:
Proton-pump inhibitors, or PPI's, are among the highest selling drugs in the U.S. with nearly $10 billion dollars in sales. Nexium alone sold $6 billion in 2013. Remember the commercial, "ask your doctor about the purple pill"? I guess they did.
PPI's reduce the amount of stomach acid made by the glands in the lining of your stomach. The most common ones are:
Histamine 2 Receptor Antagonists
Histamin 2 receptor antagonists, or H2RA's, block the action of histamine on parietal cells in the stomach, reducing the production of stomach acid by these cells. H2RA's include products such as:
They Work But.......
Medications that reduce stomach acid are very effective and are useful in giving the body time to heal esophageal tissue that has been damaged by reflux or to treat ulcers. The problem is people don't want to get off them. But long-term use can have serious consequences. Here's why.
Stomach Acid is Good
There is a reason you have acid in your stomach. Besides its role in digestion, it has some other very important functions:
Stomach acid kills bacteria and when acid is reduced, it does not. This could lead to quite a few problems. For example, when you lay down at night, stomach acid could travel up the esophagus and into your lungs. That stomach acid could harbor bacteria and, when it gets into your lungs, could cause aspiration pneumonia.
There has also been a connection between Clostridium difficile (a life-threatening bacteria), and PPI's. If a person consumes food contaminated with C. difficile, a low-acid stomach may allow it to take hold versus a stomach with a pH of 4 or less.
Stomach acid promotes the absorption of calcium. When stomach acid is reduced for a prolonged period of time, reduced calcium absorption could lead to osteoporosis and bone fractures. Research indicates a link between long-term use of PPI's and increased hip fractures.
Stomach acid uncouples vitamin B12 from food. Without stomach acid, the body cannot absorb vitamin B12 which could lead to B12 deficiency.
Recent Study Links Acid Suppressants to Vitamin B12 Deficiency
A recent study by Dr. Douglas A. Corley, published in The Journal of the American Medical Association, uncovered a serious problem for people taking PPI’s and H2RA’s for two years or longer. “People who are taking these medications are more likely than the average person to be vitamin B12 deficient."
Patients taking PPI’s for more than 2 years were 65 percent more likely to be deficient in B12. (Twelve percent of the patients with B12 deficiency used PPI’s two years or more vs. 7.2 percent of the non users). The risk of deficiency was smaller among the patients taking H2RAs, however, those taking H2RA's for more than 2 years were 25 percent more likely to be deficient (4.2% vs. 3.2%.)
Although most people associate vitamin B12 deficiency with seniors, this study showed the strongest association in adults younger than age 30!
The study also found a correlation between higher dosages and increased risk of B12 deficiency. Those taking an average of 1.5 PPI pills per day had almost double the risk of vitamin B12 deficiency compared to those averaging 0.75 pills per day.
Vitamin B12 is Critical!!
The average adult should get 2.4 micrograms per day.
Vitamin B12, or cobalamin, has some very critical functions:
* it's needed for the formation of normal red blood cells
* helps make nerves and is essential for the health of the entire nervous system
* important for the synthesis of DNA
* known as the "energy vitamin", as it increases your energy by supporting the metabolism of protein, fats, and carbohydrates
Early Deficiency Symptoms Include:
* weakness of the arms and legs
* difficulty walking or speaking
* numbness and "pins and needles" sensation in hands, feet or legs
* decreased sensory perceptions
* rapid heartbeat
* shortness of breadth
* easy bruising and bleeding gums
* mood changes and mental slowness
Long-Term, Untreated Deficiency can lead to:
* IRREVERSIBLE nerve damage
* memory loss
* deep depression
* paranoia and delusions
* loss of taste and smell
What to Do
If you have been on acid suppressant drugs for an extended period of time and exhibit any of these symptoms, get a blood test to confirm deficiency. If deficient, you can correct it with shots or daily high-dosage B12 pills. If you do this in time, you can reverse your symptoms. If you do not do this in time, you may not be able to reverse nerve damage so DON'T PUT THIS OFF!
Most importantly, work with a naturopath to determine the cause of your GERD. As an update to my post on Diet and Natural Remedies for GERD, Heartburn, and Indigestion, here's what eventually worked for me.
First my naturopath tested my stomach acid level. It's a simple test you can do at home by taking an increasing amount of Betaine Hydrocloride pills (Betaine HCL) until you feel stomach pain. If you can tolerate a lot of these pills, you have low stomach acid and your stomach problems are from not having enough acid to properly digest food, which is often the case. If you cannot tolerate many of these pills, you are producing too much acid. That was my problem - I make too much acid. Do not do this test without the knowledge of your doctor.
If your problem is too little stomach acid, your naturopath may recommend you take Betaine HCL with your high-protein meals.
|Betaine HCL aids digestion|
when you lack stomach acid
Since my GERD was not from low stomach acid, I had to go another route.
When I had severe GERD, I temporarily eliminated or greatly reduced my trigger foods. I say temporarily because today I can enjoy most of these things in moderation although I certainly try to avoid eating all of them in the same day.
My trigger foods are chocolate, spicy food, too much tomato sauce, too much caffeinated tea (green tea and Yerbe Mate), citrus fruits, peppermint, and alcohol. Trigger foods that I can never eat again include coffee and chamomile tea.
Here's are some of the natural products I take to control GERD:
* Heartburn Free by Enzymatic Therapy. For a severe GERD attack, this is my go-to treatment. I take one pill every other day until I've finished 10 pills total over 20 days, while avoiding my trigger foods. This usually does the trick. Its key ingredient is orange peel extract, which sounds like it would actually give you heartburn but, in fact, it works really well for up to 6 months.
* DGL by Enzymatic Therapy. I occasionally take these before I eat something naughty or when I get symptoms. This is an extract of deglycrrhizinated licorice and is widely used in Europe.
* GI-Encap by Thorne Research. I occasionally take these before I eat or when I get symptoms. This soothing botanical formula contains aloe vera, DGL, slippery elm bark, and marshmallow root.
* Essential Enzymes by Source Naturals, taken before meals, helps me digest food. I only take these with heavier, cooked meals and don't need them at all when eating raw salads or fruits. In addition to enzymes, I take a daily probiotic. Besides digestion, probiotics help create and support healthy microbiota which helps countless issues. See my post on The Microbes Within: How they Shape our Lives and Influence our Health.
Natural Cures take Patience and some Sacrifice
If you are taking acid suppressants, especially if you have been on them for a long time, I encourage you to seek a natural alternative. I especially encourage my vegan followers out there who are already having to make special efforts to get enough vitamin B12 (since it is not found in the plant kingdom.)
The hardest thing about giving up these drugs is that pills like Nexium or Zantac work quickly and so darn well. Who wants to give up chocolate and alcohol, even for a few weeks or a month? But these pharmaceutical cures come at a great price - bone loss, potential irreversible nerve damage, infections, anemia, and all the things I mentioned above. So the effort is well worth it. It worked for me and I truly hope it can work for you.