New Report Says PPI Acid Blockers May Raise Risk of Stroke
Most of you assume that if a medication is sold over-the-counter (OTC) it’s safe, but that is simply not true. OTC medications are big business, especially drugs for stomach discomfort. An estimated 20 million Americans buy OTC drugs to get quick relief from indigestion, esophageal burning, belching, chest (sternum) pain and other symptoms of excessive stomach acid or gastroesophageal reflux (GERD).
I bet you take these drugs without batting an eye. In fact, most of you think harder and longer about what you’ll to record on TV tonight, than you do popping an OTC medication. But even OTC drugs are drug muggers of nutrients that you need to prevent blood clots, keep your heart beating rhythmically and your bones strong.
Most of you know I am not fond of using medications to eat, especially the acid blockers.
The sheer mechanism of action of antacids and acid blocking drugs will negatively impact your microbiome (probiotic status) which over time, leads to a reduction in neurotransmitters which are needed for sleep, self-esteem, appetite, mood stability, happiness and passion. That may sound weird to you but there are more neurotransmitters a.k.a. “happy brain chemicals” in your gastrointestinal tract than in your brain. So a reduction in those probiotics (by PPIs) means there will be a ‘reduction’ in mood as far as I’m concerned.
All these happy brain chemicals go kaput over time when you lose neurotransmitter balance. Balance is essential. You may over time develop anxiety, phobias of all sorts, anhedonia, agoraphobia and insomnia, nightmares, greater pain and dozens of other neurological symptoms that are hard to pin down to a medication because they develop over time. These symptoms can develop from the chronic intake of dozens of different medications that affect your probiotic status, and antibiotics would be the worst of all because those cause severe microbiome shifts. But back to acid blockers, here are some of the most effective popular ones:
Drug Categories to Help You Reduce Stomach Acid
Basic antacids- Maalox, Mylanta, Tums and others H2 (histamine 2) antagonists- Pepcid, Zantac and others
PPI (proton pump inhibitors)- Nexium, Prevacid, Protonix, Prilosec, Aciphex and others.
More About the PPIs
Proton Pump Inhibitors or PPIs, are reduce your gastric acid production. This category of drugs is the most powerful acid secretion inhibitors available today because they block acid almost 24/7. Acid blocking drugs called “PPIs” (proton pump inhibitors) indefinitely such as:
Omeprazole (Prilosec)
Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Pantoprazole (Protonix)
Rabeprazole (Aciphex)
Others in combination with H2 antagonists
PPIs are prescribed by doctors (or sold OTC) and are used for various conditions including gastroesophageal reflux disease (GERD), Barrett’s esophagus, dyspepsia, gastrinomas (tumors in the pancreas or gut that secrete acid) and other conditions that cause an excessive secretion of stomach acid. The PPIs are used to treat laryngopharyngeal reflux, peptic ulcer disease, and even for the “prevention” of stress gastritis, as well as Zollinger-Ellison syndrome.
Some of the strongest medications are sold OTC, and are safe for short-term use, in fact the label says 14 days only. But because many antacids and potent acid blocking drugs sold OTC, everyone can self-treat and therefore there is the potential for misuse and abuse. Worse, some doctors advise a patient to stay on them forever without addressing underlying cause or doing special stool or blood tests to find out the problem. This is real scary because if you are suppressing acid 24/7 with one of the potent PPI drugs, then you may experience the problems associated with a ‘leaky gut’ which is where undigested food particles exit your ‘tube’ and leak into your bloodstream. This annoys your immune system and induces food allergies, including gluten sensitivity, whether or not you have the gene SNP for Celiac.
Now you have to go gluten-free.
Taking acid blockers beyond the recommended time frame of 2 weeks will increase your risk for developing food sensitivities and sudden food allergies. As I said, it could cause sudden problems digesting gluten and dairy, or fruits, or anything. Your immune system sits on guard analyzing all the undigested food particles that leak into the bloodstream and land in your thyroid gland, myelin, cartilage, skin cells and so forth.
So as much as you don’t want to hear this, there is a dramatically higher risk for food allergies if you use acid blocking medication inappropriately. Lots of people have become sensitive to gluten but they are non-celiac.
We also know the rate of celiac disease is steadily rising, we’ve seen it in a study that compared stored blood of soldiers with people today, and Celiac is rising about four times higher than it used to be 50 years ago. I feel like lately, the use of PPI drugs (as well as H2 receptor antagonists) play a role due to their well-documented interference with the digestion of your food. How are you supposed to fully digest your meals without your stomach acid? It’s not really a question, I’m saying you can’t.
PPIs increase intestinal permeability allowing gliadin and wheat glutenin proteins to get absorbed into the body which makes you vulnerable to what looks like celiac disease. It could be better termed non-celiac gluten sensitivity, and it could be related to your antacids and acid blocker use. The PPIs would have a higher risk of triggering a food allergy in my opinion because they impact gastric acid levels 24/7.
Maybe you’re not really losing your mind!
The PPIs could be associated with neurological dysfunction due to the vicious depletion of vitamin B12 which is manufactured by your microbiome. Your probiotics are making your B12, so when you reduce your probiotics, your endogenous production of B12 stops too. If you don’t have an appendix, your situation could be even worse because that’s the garage or warehouse for probiotics in your body. Sadly, I’ve heard from some of you that your surgeon cut out your appendix as if it was a useless piece of meat, even when it wasn’t inflamed… “but since I’m operating close by, let’s get that appendix out because it’s useless, and you could get appendicitis one day.”
Taking a PPI drug long-term (more than 3 or 4 months) means you’ll become deficient in B12 (and in fact, the whole entire B complex) and this can lead to new “diseases” like dementia, Alzheimer’s, confusion, chronic fatigue syndrome and peripheral neuropathy. I’m saying you could be healthier than you think, maybe it’s just a B12 or B complex deficiency since that can present as dementia in case you didn’t know.
PPIs are also known to produce cardiac arrhythmias due to the strong magnesium depletion. The FDA has actually strengthened warnings for the PPI drugs to warn doctors of hypomagnesemia, so strong it can damage your heart. My question is has your doctor pass this information along to you YOU about this? Over 100 million prescriptions are written for these drugs each year, I worry that not too many of you are told of the strong magnesium depletion.
Acid blocking drugs are sold OTC in the United States and other countries. The label clearly will say they are intended for a 2 week course of treatment, up to 3 times per year.
At this dosage, the magnesium depletion is possible, but should not be dangerous. But unfortunately, many users do not stop after 14 days, they stay on the drugs for months, sometimes forever!
Magnesium deficiency
Asthma- Magnesium deficiency may cause dozens of symptoms including bronchospasms or full-blown asthma. This little known fact is important because asthma sufferers need to know the following information, the inhalers don’t correct low magnesium.
Intravenous magnesium can abort attacks sometimes, and there is debate about nebulizer magnesium (but it might work). The point is magnesium helps with asthmatic attacks. We also know that low serum magnesium is associated with more severe asthmatic attacks. Now, here we have this class of drugs called the PPIs used for GI disorders (unrelated to your lungs) and if you have asthma or are prone to bronchospasm, overuse of PPIs could make you worse due to the potent ‘drug mugging’ effect (depletion of magnesium by drugs).
Bone loss and fractures- A magnesium deficiency can cause such a potent depletion of minerals (including magnesium) that bone integrity is compromised. Fracture rates are higher in people with low mag.
The depletion of magnesium in and of itself may cause fibromyalgia-like pain, spasms, muscle cramps and depression. How awful. In today’s sick-care system, becuase it’s not a health-care system, you’ll be given all kinds of new drugs to deal with those side effects unless you understand the drug mugger facts. It’s not my theory, it’s a fact.
A drug is mugging (depleting) the magnesium out of your body, causing the side effects, but they mistakenly get diagnosed as a new disease. You keep adding more and more medications to your regimen for years and years. So sad. Do you feel any better with all of them? I’ve been trying to help you with this for years, that’s why I wrote the book.
PPI drugs are making headlines again.
Acid suppressing drugs by their very nature cause you to become deficient in every single vitamin and mineral due to the fact that they upset the natural pH in your gastrointestinal tract. So these drugs are drug muggers of everything.
When acid blocking drugs essentially suck your body dry of every important mineral and B vitamin (and all of these are needed for healthy cardiac conduction and vascular health) well then, it’s obvious, you will ultimately pay the consequences for blocking every natural metabolic pathway in your body. Very few brave souls have been willing to tell you just how dangerous the side effects of PPIs could be (when misused or abused) I am 100% okay with the recommended guidelines set by the pharmaceutical manufacturers. I’m talking about long-term use that even THEY warn against.
I am aware some of you have a true medical necessity for long-term use, but these are the third most popular class of drugs in our country (New York Times), and millions are sold without prescription from jiffy stores, pharmacies, gas stations and online… honestly any 12 year old can buy these drugs from any place, any time, they are pervasive and yet, they come with genuine warnings including severe hypomagnesiumia (which could precipitate a heart attack) and now the newest warning is stroke! Please, please do not OVERUSE them, misuse them (ie higher dose than recommended) or abuse them (ie combining two or three of them, taking them for longer than you should, taking them for more than 14 days or 3 times a year, etc).
These are the problems that raise your risk for catastrophic consequences.
Symptoms of Stroke
Strokes occur as the result of a blood clot. Basically, a stroke is caused by an obstruction within a blood vessel that normally supplies blood to your brain. If something gets in the way of blood flow to the brain, it’s a bad thing, the brain starves. The underlying problem of clots have to do with fatty deposits lining your blood vessel walls, termed atherosclerosis. But what if you don’t have atherosclerosis, what if you took a drug that raised risk of a stroke through some other mechanism? It happens with certain medications.
Symptoms happen quickly! Acting fast can save a life.
* Sudden numbness or weakness of the face
* Weakness or numbness in the extremities like an arm or leg (usually unilateral- one side of the body)
* Sudden confusion trouble speaking – friends may think you’re drunk
* Difficulty with language- people cannot understand your speech
* Eyesight problems- sudden trouble seeing from one or both eyes
* Sudden trouble walking due to loss of balance or coordination
* Dizziness
* Severe and sudden headache
If you believe someone near you is having a stroke call 911 immediately.
Should I continue?
If you’re blown away and worried about continuing your acid-reducing medicine, I totally understand. I can imagine how awful it feels in your chest to have heartburn so severe you feel you’re on fire, or you feel like you’re having a heart attack. So I’m not telling you to stop your medication because that’s not my place.
Maybe you need them for a while longer while you clean up your diet or have a procedure done. It’s not my place to say what’s right for you, this is between you and your physician. My role as a pharmacist is to be your drug information specialist, that’s where my education is. Pharmacists all over the world are always available to tell you more about the medications you take, about interactions, side effects, proper dosing, new drugs on the horizon, natural options, we give alternatives to physicians who need options… we give out drug information, that’s what we’re here for. We don’t prescribe or advise what’s right for you specifically, that’s between you and doc.
We just want to keep you safe and it wouldn’t hurt to restore missing nutrients; put back what the ‘drug mugger’ stole. Restoring essential nutrients allows you to stay compliant on medication if you need it. The nutrients listed above are a start, and there’s others listed in my Drug Mugger book which most of you have by now.
If you use a PPI drug, use them with caution. Wouldn’t it be nice to control acid and gastrointestinal discomfort with natural remedies? It would be huge for you to put back all the missing nutrients that are mugged by your drugs.
Also, consider the following:
GI-friendly herbs
Demulcents (marshmallow, slippery elm)
Herbal teas
Calendula or chamomile herbal extracts or teas
Probiotic strains that are natural to your own flora fingerprint, especially lactic acid bacteria and bifido strains.
Gentle exercise
Diet restrictions
Stress-reducing and joy-provoking activities
Alcohol and nicotine restriction
The scientific paper that I’m basing today’s warnings on is not from America, the statistics and data was compiled in Denmark. So read on if you are interested in the details of the latest Proton Pump Inhibitor (PPI) to stroke data, it is as follows:
Denmark researchers conducted a study led by Dr. Sehested where reviewed patient records for 244,679 Danish patients, who had an average age of 57. These people had undergone a procedure called an endoscopy (I’m sure many of you reading this have had this done too). The endoscopy is a procedure that is helpful in identifying stomach pain, ulceration, perforations and bleeding ulcers. After about 6 years, almost 10,000 people (9,489 to be exact) had suffered an ischemic stroke for the first time in their lives. Researchers determined if the stroke occurred while patients were using one of four popular PPIs in their country:
- Omeprazole (Prilosec)
- Pantoprazole (Protonix)
- Lansoprazole (Prevacid)
- Esomeprazole (Nexium)
Risk is there regardless of the drug you take.
According to this research, the overall risk of stroke increased by 21 percent when the person was taking a PPI drug.
Higher doses are worse.
They found that at the lowest doses available for each PPI, there was slight or no increased stroke risk. So the higher the dose, the more dangerous. This makes sense because the more you take, the stronger your drug nutrient depletions (drug mugging).
Some medications appear to be more risky than others.
While it’s hard to conclude this from the Denmark research because it’s just one trial, the researchers said: “At the highest dose for these 4 PPI’s, stroke risk increased from 30 percent for lansoprazole (Prevacid) to 94 percent for pantoprazole (Protonix).”
What about the H2 Antagonists?
Several other drugs are sold OTC in America, for heartburn including famotidine (Pepcid is one popular brand, and there other derivatives) as well as ranitidine (Zantac). These medications were NOT found to have an increased risk of stroke associated with their use. If you are suffering with basic heartburn or reflux from something spicy, I’d recommend these drugs over the PPIs for a first-line treatment. Why shoot a fly with a shotgun? Even better would be something like a simple antacid such as Maalox or Tums, or something natural like mastic gum or slippery elm lozenges.
The Denmark study accounted for age, gender and medical factors, including high blood pressure, irregular heart beat (atrial fibrillation), congestive heart failure and the use of certain pain relievers that might have been linked to heart attack and stroke.
Dr. Sehested noted that most PPIs in the United States are now available over the counter and hope that their research, along with prior studies will encourage more cautious use of PPIs.
Since this research is from another country, you might be wondering what our United States FDA might have to say. I could not reach a human being, can you imagine? Everything is an automated response. So from that I’ll just say an interview with me was more or less declined (not a surprise), but I did find this is on the FDA’s website:
Additional Information for Patients
* Seek immediate care if you (or your child) experience an abnormal heart rate or rhythm, or symptoms such as a racing heartbeat, palpitations, muscle spasm, tremor or convulsions while taking a PPI drug. In children, abnormal heart rates may cause fatigue, upset stomach, dizziness and lightheadedness.
* Tell your healthcare professional if you have ever been told you have low magnesium levels in your blood, or if you take the drug digoxin, diuretics, or other drugs that may cause hypomagnesemia.
* Your healthcare professional may occasionally check your serum magnesium level (a blood test) while you are taking your prescription PPI drug.
* Do not stop taking your prescription PPI drug without talking to your healthcare professional.
* Discuss any questions or concerns about your PPI drug with your healthcare professional.
* If you take an over-the-counter (OTC) PPI drug, follow the directions on the package carefully.
* Make sure your healthcare professional knows if you have been taking an OTC PPI drug for a long period of time.
Summary and Final Recommendations
I totally understand that some of you reading this are worried about your condition, as well as the safety of your medication. I don’t mean to alarm you, my intention is to keep you safe, and it’s pretty easy to restore essential nutrients mugged by PPI drugs and other acid blockers. Consider lowering the medication dose because stroke risk appears to be dose-dependent.
I am aware how alarming this article may be to you so I wanted to leave you with some options to discuss with your practitioner.
Testing- Because I’m running out of time and space, we can discuss the GI tests available today but there are LOTS of new specialized and comprehensive GI tests on the market. One that I want to mention today is The GI Effects Microbial Ecology Test through Genova.
This is so much better than a basic stool test which may be all you’ve been offered. Do what you can do so you can avoid medications, especially those that have a high risk to benefit ratio. Any physician can order it for you, they may just need to fax their license in so they can be a ‘provider’ of that test. Many practitioners can do this, they don’t even have to be an MD. As a pharmacist, I am also a provider so if you just prefer to buy the test kit outright, they will ship it to your home directly, click here. It’s called “The GI Effects Gastrointestinal Function Comprehensive Profile” (One Day Collection)-Genova Kit
What I like about this test is that it’s a one-time collection, you do it at home, ship it from your home and it tests for various fungus, bacteria, probiotic status, fats, butyrate levels, and so much more. At the site you can click on a Sample Report which will blow your mind. The specialized panel is different than a typical doctor’s office stool test. The GI Effects test I’m suggesting combines DNA Analysis, Gas Chromatography/Mass Spectrometry, Microscopic, Colorimetric test for the presence of enzymes, specific compounds, antibodies, hormones and many more substances.
This next list are items that are sold OTC and online. These are the nutrients I recommend if you take a PPI drug- it’s a start!
Probiotics twice daily
B12 about 1000 mcg daily
B complex one daily (to keep the B12 from tilting you out of balance)
Magnesium 300 – 800 mg daily in divided doses
Trace Minerals one daily (to keep the magnesium from tilting you out of balance)
Papain supplements may help you with digestion of meals. The pH is great for those, compared to other digestive enzymes.
Marshmallow root infusion daily see my video CLICK HERE
Slippery Elm, you can buy commercially-prepared lozenges or make a gruel. You can make the gruel thick or thin, as thin as you want it: See my video CLICK HERE
Folate supplements may be needed, although this is in a good B complex supplement.
Suzy Cohen, has been a licensed pharmacist for over 30 years and believes the best approach to chronic illness is a combination of natural medicine and conventional. She founded her own dietary supplement company specializing in custom-formulas, some of which have patents. With a special focus on functional medicine, thyroid health and drug nutrient depletion, Suzy is the author of several related books including Thyroid Healthy, Drug Muggers, Diabetes Without Drugs, and a nationally syndicated column.
