Monday, January 15, 2007
Warning! Reflux drugs thin bones and may cause... reflux!
First published January 15, 2007 - last revised January 21, 2007
A recent, well-publicized study found that all common reflux drugs, including Nexium, Prevacid and Prilosec make hip fractures far more likely. Nearly 50% more hip fractures occurred after just one year of taking the most effective "proton pump inhibitor" drugs! 17190895 This is shocking news, because one in five people dies after a hip fracture, according to Dr. David Forcione; and it can be presumed that the risk becomes greater with every year that reflux drugs are taken. It now seems that reflux drugs, which act by limiting the acid we produce, thereby limit the amount of calcium we absorb (calcium reacts with acids), imperiling our bones to a startling degree.
Note that both the new and old drugs don't stop reflux, heartburn, or GERD since reflux is "primarily a motor disorder"; 15729198 they only reduce the amount of acid within the fluids that come up. Also, older drugs were found to thin bones less only insofar as they were less effective in reducing acid in the first place – so switching back to such drugs as Zantac doesn't help any more than does reducing the dosage of the more recent drugs.
But there may be worse news hidden in this new study. It may even be that the most profound and common long-term side-effect of reflux drugs is... worse reflux over time! This is because calcium is essential in controlling reflux, not just neutralizing the acids in it – possibly for reasons we do not yet fully understand including better gut mobility 15628717 and anti-inflammatory action 17201221 as well. So if modern reflux medications are indeed reducing our calcium intake, more and worse reflux may be an all-too predicable consequence of taking those drugs for long periods. These drugs may actually be helping to cause the problem they are being prescribed to cure.
Calcium is a common treatment for reflux, and not just because the calcium we've just eaten combines with acid to neutralize it in the stomach. The calcium available in our body also helps us to deal with stomach acid in reflux by being released and neutralizing it, as well as improving gut mobility. Therefore, taking calcium well before an episode of reflux happens helps - but only if it's absorbed, of course, and our reflux medications are helping to prevent that. If over time we have less calcium in our body thanks to reflux drugs such as proton pump inhibitors or older drugs such as Zantac, still worse reflux months or years later may be a likely result. Sadly, the new finding about hip fractures may also explain why so many people who start taking reflux drugs end up staying on them year after year, and even decade after decade.
Other conditions can also be strongly affected by calcium deficiency, including epilepsy, anxiety, and muscle spasms. Combining reflux medication with these conditions may not be advised. It is also known that low acid interferes with B-12 absorption.
So what to do if you have reflux? The first thing - take all the calcium and B-12 you should (which for almost everyone means taking calcium/magnesium supplements). Note, however, that if you are still taking reflux drugs, these may prevent you from absorbing any calcium from these supplements, as well. At a minimum, it's worth finding out, in consultation with your doctor, whether taking substantial calcium supplements will allow you reduce your dosage of reflux drugs such as PPIs. If these drugs are indeed addicting, only being off them for some time, during which calcium can be replaced, will tell you if they are either necessary or truly helping you, over time. You should expect a transition period during which reflux is more noticeable because it's more acidic, before things get better.
Consider the possibility that your reflux is being caused by other medications you are taking. Asthma medication, anti-depressants and aspirin-class NSAID painkillers can all cause reflux, and taking female hormones may do so. Any drug which is a sedative or tranquillizer may slow the peristaltic waves within the esophagus that clear food. Lose weight if you can, since extra pounds worsen reflux.
Other things to try: make sure you're getting enough fiber, since this also helps motility. Raise the head of your bed a few inches, and make sure you drink a glass of water after taking any medication, to limit damage to the esophagus. Also limit smoking, alcohol, chocolate, coffee and tobacco and if you do take them, try to do so only in the morning, since these stimulants may possibly cause reflux by altering the stomach and intestine's daily cycles. (PhotoperiodEffect.com describes some of our daily rhythms and new knowledge about how to optimize them.) The good news is that if you've improved these habits since you started taking reflux drugs, the only thing now causing your reflux, might be the drugs themselves!
A recent, well-publicized study found that all common reflux drugs, including Nexium, Prevacid and Prilosec make hip fractures far more likely. Nearly 50% more hip fractures occurred after just one year of taking the most effective "proton pump inhibitor" drugs! 17190895 This is shocking news, because one in five people dies after a hip fracture, according to Dr. David Forcione; and it can be presumed that the risk becomes greater with every year that reflux drugs are taken. It now seems that reflux drugs, which act by limiting the acid we produce, thereby limit the amount of calcium we absorb (calcium reacts with acids), imperiling our bones to a startling degree.
Note that both the new and old drugs don't stop reflux, heartburn, or GERD since reflux is "primarily a motor disorder"; 15729198 they only reduce the amount of acid within the fluids that come up. Also, older drugs were found to thin bones less only insofar as they were less effective in reducing acid in the first place – so switching back to such drugs as Zantac doesn't help any more than does reducing the dosage of the more recent drugs.
But there may be worse news hidden in this new study. It may even be that the most profound and common long-term side-effect of reflux drugs is... worse reflux over time! This is because calcium is essential in controlling reflux, not just neutralizing the acids in it – possibly for reasons we do not yet fully understand including better gut mobility 15628717 and anti-inflammatory action 17201221 as well. So if modern reflux medications are indeed reducing our calcium intake, more and worse reflux may be an all-too predicable consequence of taking those drugs for long periods. These drugs may actually be helping to cause the problem they are being prescribed to cure.
Calcium is a common treatment for reflux, and not just because the calcium we've just eaten combines with acid to neutralize it in the stomach. The calcium available in our body also helps us to deal with stomach acid in reflux by being released and neutralizing it, as well as improving gut mobility. Therefore, taking calcium well before an episode of reflux happens helps - but only if it's absorbed, of course, and our reflux medications are helping to prevent that. If over time we have less calcium in our body thanks to reflux drugs such as proton pump inhibitors or older drugs such as Zantac, still worse reflux months or years later may be a likely result. Sadly, the new finding about hip fractures may also explain why so many people who start taking reflux drugs end up staying on them year after year, and even decade after decade.
Other conditions can also be strongly affected by calcium deficiency, including epilepsy, anxiety, and muscle spasms. Combining reflux medication with these conditions may not be advised. It is also known that low acid interferes with B-12 absorption.
So what to do if you have reflux? The first thing - take all the calcium and B-12 you should (which for almost everyone means taking calcium/magnesium supplements). Note, however, that if you are still taking reflux drugs, these may prevent you from absorbing any calcium from these supplements, as well. At a minimum, it's worth finding out, in consultation with your doctor, whether taking substantial calcium supplements will allow you reduce your dosage of reflux drugs such as PPIs. If these drugs are indeed addicting, only being off them for some time, during which calcium can be replaced, will tell you if they are either necessary or truly helping you, over time. You should expect a transition period during which reflux is more noticeable because it's more acidic, before things get better.
Consider the possibility that your reflux is being caused by other medications you are taking. Asthma medication, anti-depressants and aspirin-class NSAID painkillers can all cause reflux, and taking female hormones may do so. Any drug which is a sedative or tranquillizer may slow the peristaltic waves within the esophagus that clear food. Lose weight if you can, since extra pounds worsen reflux.
Other things to try: make sure you're getting enough fiber, since this also helps motility. Raise the head of your bed a few inches, and make sure you drink a glass of water after taking any medication, to limit damage to the esophagus. Also limit smoking, alcohol, chocolate, coffee and tobacco and if you do take them, try to do so only in the morning, since these stimulants may possibly cause reflux by altering the stomach and intestine's daily cycles. (PhotoperiodEffect.com describes some of our daily rhythms and new knowledge about how to optimize them.) The good news is that if you've improved these habits since you started taking reflux drugs, the only thing now causing your reflux, might be the drugs themselves!
Labels: reflux health calcium photoperiod darkness
