I find it quite offensive when medicine uses cutesy, trendy titles when writing about serious health issues. “Adverse Effects of Proton Pump Inhibitors: Fact or Fake News?” on Medscape is one such travesty. This title is telling patients, who are suffering debilitating magnesium-deficiency symptoms from using PPIs, that their PPI adverse effects are just Fake News! It’s demeaning and disgraceful.
Even the Pharma-friendly FDA, in 2011, warned that PPIs deplete magnesium. “Use of proton pump inhibitors (PPIs) regularly for a year or longer may lead to low levels of circulating magnesium, which may increase the risk of leg spasms, arrhythmias, and seizures, read the FDA warning.”
Take Dana, who I wrote about in The Magnesium Miracle 2017. Dana’s wife, Lynn, wrote that he was able to replace his three-per-week IV magnesium drips with ReMag and improve his magnesium blood test results and his health. That was back in 2012. Even though I told Dana in 2012 that his PPI was draining his magnesium, it wasn’t until 2018 that his doctor urged him to get off this drug. It seemed like a miracle when Dana’s magnesium levels went to normal after being diagnosed with hypomagnesemia in 2007. He had been on a PPI since 2001, which probably set him up for magnesium deficiency and all the symptoms that go with that condition.
According to this Medscape article, proton pump inhibitors are the most widely prescribed and overprescribed medications worldwide. In the US 15% of adults have used a PPI within the last year, with even greater use in the elderly. In Customer Service we hear about PPIs being used for infants, instead of burping them!
The authors make the statement that they are “generally considered well tolerated, epidemiologic studies mining large databases have reported a panoply of purported serious adverse effects associated with proton pump inhibitors, including chronic kidney disease, cognitive decline, myocardial infarction, stroke, bone fracture and even death.”
Another section of the article says:
“There is now a long list of dozens of potential serious adverse effects associated with PPI therapy, including alterations in gut microbiome, enteric infection, micronutrient deficiencies, fundic gland polyps, gastrointestinal malignancy, chronic kidney disease (CKD), cognitive dysfunction, myocardial infarction (MI), bacterial overgrowth, bacterial peritonitis, pneumonia, bone fracture, drug interactions and death. There is relatively strong evidence, including biologic plausibility, linking PPIs with alterations in gut microbiome, micronutrient deficiencies (e.g. magnesium, vitamin B12, iron and calcium), fundic gland polyps and enteric infection. Increasing basic science data suggest a possible association with carcinogenesis that is mediated by PPI-induced hypergastrinaemia.”
Then they proceed to debunk the studies saying that since they are poorly designed that we can’t trust them. They offer about 35 studies done in the past year to debunk all the other studies. Sounds kind of suspect to me! Why all the ‘good’ studies all of a sudden.
They conclude that “Most of the recent highly publicized serious adverse effects ascribed to proton pump inhibitors are not based on demonstrable evidence. Nevertheless, when proton pump inhibitors are prescribed long-term, they should be used at the lowest effective dose and the need for their use periodically reassessed.” BOOM! In one review of a 13-year period, they found that PPI prescriptions doubled and patients were treated with higher and higher doses for longer durations than recommended by clinical guidelines.
Do you see the double-speak here? They say the drugs are OK, then they agree that long-term high doses are NOT OK. But that’s exactly how they are being prescribed – LONG TERM and they use more and more because lower doses seem ineffective!
Guess what doctors hail as the best use of PPIs? Giving them along with NSAIDs to mitigate the side effects! So, they really want these drugs so they can keep prescribing pain pills.
The article gives a good overview of the importance of gastric acid. They say:
“Gastric acid secretion is precisely regulated to maximize benefits and minimize harms. Acid kills ingested microorganisms, renders the stomach and small intestine relatively sterile, modulates the gut microbiome, assists in protein digestion and facilitates the absorption of nonheme iron, calcium and vitamin B12, and enhances the bioavailability of certain medications (e.g. ketoconazole, itraconazole, thyroid hormone and atazanavir). However, when levels of acid (and pepsin) overwhelm mucosal defense mechanisms, gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD) may occur.”
However, alternative medicine doctors who do Heidelberg Gastric Analysis of stomach pH find that most people with a diagnosis of acid reflux actually have alkaline stomach pH from alkaline juices refluxing into the stomach from the small intestine. Articles by Dr. Jonathan Wright can be helpful to understand this paradox.
So, even though gastric acid is extremely important, doctors don’t test stomach acid contents before choosing to block stomach acid, which can cause insurmountable problems.
The Medscape article goes on for 5,000 words trying to justify the use of PPIs, beyond their desperation to use PPIs for the side effects of NSAIDs.
You can read the whole article if you can ‘stomach’ it. Quite frankly, it makes me kind of sick and I’m finding myself writing in a disjointed fashion as I try to ferret out the scientific double-speak.
Bottom line: these drugs are only suited for short term use. When I was in medical school, short term meant 2 weeks but that’s long been forgotten. Look to the cause of your digestive disturbances. I have several sections in my Future Health Now Encyclopedia that give you safe alternatives. Any medicine is going to have side effects so you have to be clear that the side effects of the drug do not offset the benefits.
Of course there are people with horrible gastric conditions that depend on the PPIs, so if that’s the case, please ramp up your intake of ReMag.
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Carolyn Dean MD ND
The Doctor of the Future®
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