Heartburn has been in the news a lot lately — and I’m not talking about the heartburn you get from watchingthe news. All those stories about COVID 19, peaceful protests, looting, and the upcoming presidential election are certainly enough to cause indigestion. But before you reach for that “little purple pill” to relieve your heartburn, consider its potential impact on your overall health.

As highlighted in a number of recent reports, prescription and over-the-counter drugs commonly used to alleviate symptoms associated with heartburn, gastroesophageal reflux disease (GERD), acid reflux, and ulcers, may increase the risk of numerous health conditions, some of which can be fatal. Among these risks are cardiovascular disease, chronic kidney disease, and cancer.

Most recently, the news buzzed about the U.S. Food and Drug Administration’s (FDA’s) recall of all prescription and over the counter (OTC) ranitidine medications, commonly known by the brand name Zantac. The FDA discovered a contaminant called N-Nitrosodimethylamine (NDMA) in some ranitidine products that “increases over time and when stored at higher than room temperatures and may result in consumer exposure to unacceptable levels.” NDMA is a probable human carcinogen (a substance that could cause cancer).

Ranitidine is a histamine-2 (H2) blocker, a class of heartburn medication that’s normally not nearly as harmful as another class of medications commonly used to treat heartburn (I should say commonly overused) — proton pump inhibitors (PPIs). One study of PPIs — Estimates of mortality associated with proton pump inhibitors among US veterans — was published in May of 2019 in the British Medical Journal. In that peer-reviewed study, researchers from the Department of Veterans Affairs-Saint Louis, Saint Louis University, and Washington University School of Medicine in Saint Louis concluded that taking proton pump inhibitors (PPIs) is associated with a small excess of cause-specific mortality, including death in 45 out of every 1,000 people. Another study published in 2006 in the Journal of the American Medical Association, concluded that long-term PPI therapy is associated with an increased risk of hip fracture.

Other potential adverse side effects associated with PPIs include pneumonia, Clostridium difficile diarrhea, hypomagnesemia, vitamin B12 deficiency, iron deficiency, chronic kidney disease, and dementia. Possible drug interactions are another concern.

Understanding Heartburn and Proton Pump Inhibitors

Heartburn — also referred to as acid indigestion — is that uncomfortable experience wherein the contents of the stomach reverse course and back up into the esophagus. And, because the stomach’s strong digestive mechanism produces acid, the influx of partially broken-down foodstuff results in a sour, unpleasant taste in the back of the mouth or even the tongue.

Proton pump inhibitors (PPIs), first developed in the 1980s, were designed to treat acid-related disorders such as acid indigestion/heartburn and related discomfort in the upper gastrointestinal tract. According to data from the U.S. National Institutes of Health, 15 to 20 million adults in the United States now use prescription PPIs to reduce the excessive production of acid.

Technically speaking, PPIs inhibit active parietal cell acid secretion, meaning they’re designed to reduce the production of acid in the wall of the stomach, thereby preventing ulcers and helping to heal ulcers of esophagus, stomach, and small intestine. A number of different PPIs are currently on the market:

  • Aciphex (Rabeprazole)
  • Dexilant (Dexlansoprazole)
  • Nexium (Esomeprazole)
  • Prevacid (Lansoprazole)
  • Prilosec (Omeprazole)
  • Protonix (Pantoprazole)
  • Zegerid (Omeprazole and sodium bicarbonate)

Additionally, research has revealed that more than 50 percent of the people taking PPIs did so without a documented medical need. Researchers also found that approximately 80 percent of people who take PPIs consume low doses of the prescription medication, roughly equivalent to dosages commonly found in over-the-counter versions of those same medications.

The Problem with Proton Pump Inhibitors

The problem with PPIs and other medications used to reduce stomach acid is that they work — they reduce stomach acid. Trouble is, stomach acid is generally a good thing. That’s why we have it. It helps to digest food, it kills harmful bacteria and viruses, and it improves absorption of certain nutrients.

Reducing stomach acid inhibits the absorption of key nutrients, including B vitamins, which play a key role in keeping homocysteine levels in check. Homocysteine is a common amino acid in blood that you get mostly from eating meat. High levels of homocysteine are associated with dementia, stroke, depression, anxiety, estrogen-related cancers, and other disorders. And high levels of homocysteine are caused by low levels of vitamins B6, B12, and folate (another B vitamin). PPIs also reduce the absorption of certain minerals, including calcium and magnesium.

Functional Medicine’s Approach to Heartburn

As a functional medicine practitioner, I take a different approach to treating indigestion — an approach that identifies and addresses the root cause(s) of indigestion while promoting whole health. I’m hesitant to prescribe medical-grade PPIs or even recommend taking over-the-counter versions. Taking PPIs, especially for longer than a couple weeks, just isn’t safe, especially when other approaches that address the symptoms these drugs are supposed to alleviate are readily available.

The 5 Pillars of Health — which account for the role of detoxification, nutrition, hormones, nervous system, and exercise in a healthy system — play a significant role in how I uncover and treat the underlying causes of heartburn, acid reflux, and GERD. Within three months of treatment, most of my patients who previously relied on PPIs to manage their heartburn, no longer require these over the counter or prescription medications.

Some of the areas I test for and treat include:

  • Low levels of acid production. I realize that’s counterintuitive, but acid reflux can be caused by not enough stomach acid, especially in older patients.
  • Hypothyroidism, which can often lead to heartburn and reflux symptoms.
  • Patients often self-report a correlation between stress and their stomach issues.
  • Gut dysbiosis — an imbalance of beneficial bacteria and other microorganisms that live in the digestive tract.
  • Diet or overeating.
  • Weak stomach lining.
  • Poor bile production.
  • Issues with the gallbladder.

The bottom line on PPIs should now be clear. Using PPIs to treat chronic heartburn, acid reflux, or GERD is questionable at best and potentially dangerous. Personally, I think the FDA should mandate a black box warning about the potential for fatal health risks when taking PPIs for two weeks or longer.

If you’re ready to ditch your heartburn medication and address the root causes of your stomach and GI disorders, please call visit the appointments page here on my site and schedule a visit for us to discover what may be ailing you. During your initial intake, I’ll spend time with you to fully understand all of your health concerns, discuss testing, and work with you on a plan to eliminate any dependence you may have on heartburn medication.

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Disclaimer: The information in this blog post about antacid making you sick is provided for general informational purposes only and may not reflect current medical thinking or practices. No information contained in this post should be construed as medical advice from Dr. Matt Lewis, D.C., DACBN, CFMP®, nor is this post intended to be a substitute for medical counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate medical advice on the particular facts and circumstances at issue from a licensed medical professional in the recipient’s state, country or other appropriate licensing jurisdiction.

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About the Author: Dr. Matt Lewis, D.C., DACBN, CFMP®, specializes in diagnosing and treating the underlying causes of the symptoms related to chronic and unexplained illness through nutrition, lifestyle, chiropractic, and other natural approaches to whole-health healing in Tampa, Fla. Dr. Lewis has 20 years of experience practicing nutritional and holistic medicine. He earned his B.S. in Biology from Shenandoah University, his Doctorate in Chiropractic from Life University, his Diplomate status in Clinical Nutrition from the American Clinical Board of Nutrition, his CFMP® from Functional Medicine University, and his certification as a Digestive Health Specialist (DHS) through the Food Enzyme Institute. Dr. Lewis’ passion for health and wellness stems from his own personal experience. With a family history of autoimmune conditions and diabetes, and his own lab tests showing his genetic susceptibility to Hashimoto’s thyroiditis (autoimmune thyroid), he has learned how to restore his own health and vigor to prevent the onset of these and other illnesses and live an incredibly active life. Through this process, he acquired a deeper understanding of health and wellness, which he now offers his patients in Tampa.