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Warning: FDA Says Heartburn Meds Can Increase Your Fracture Risk

heartburn medicines, increase fracture riskThe FDA has mandated that proton pump inhibitor heartburn medications must carry a label warning of increased fracture risk.  This group of drugs include Prevacid, Prilosec, and Nexium.

The FDA suggests those taking these drugs should consult with their doctors, and those using such drugs over-the-counter limit their use to no more than three 14-day periods a year.

According to the FDA website:

"... [The decision is] based on the Agency's review of several epidemiological studies that reported an increased risk of fractures of the hip, wrist and spine in patients using proton pump inhibitors."

Dr. Mercola's Comments:

One of the most commonly prescribed drugs for heartburn and acid reflux are proton pump inhibitors (PPIs). These drugs, which include brand names like Prevacid, Prilosec and Nexium, VERY effectively block your stomach’s ability to produce acid.

While that may sound like a good thing, in most cases it is the absolute worst approach for the problem, as typically your stomach is producing too little stomach acid, not too much.

That, coupled with the fact that the drugs are horrendously over-prescribed and riddled with side effects, and you’ve got a veritable prescription for disaster. The issue is so serious that even the FDA has spoken up on this one.

Heartburn Drugs Wreck Your Bones

It’s been known for years that people who take proton pump inhibitors for a year or more have a greater risk of fractures. It’s thought that the drugs may make it more difficult for your body to absorb calcium, leading to weaker bones and fractures.

Now, after the FDA reviewed several epidemiological studies that showed an increased risk of fractures of the hip, wrist and spine in people taking the drugs in high doses or for one year or longer, the FDA is requiring PPI drug labels to warn of the fracture risk.

“Epidemiology studies suggest a possible increased risk of bone fractures with the use of proton pump inhibitors for one year or longer, or at high doses. Because these products are used by a great number of people, it’s important for the public to be aware of this possible increased risk …,” Joyce Korvick, M.D., deputy director for safety in FDA’s Division of Gastroenterology Products said in the FDA’s press release.

The risk of a bone fracture has been estimated to be over 40 percent higher in patients who use these drugs long-term.

The Risks Greatly Outweigh the Benefits

Before taking any medication, you’ve got to ask yourself this fundamental question: do the benefits outweigh the risks?

In the case of heartburn drugs, the answer is rarely.

These drugs are actually designed to treat a limited range of severe problems.

According to Mitchell Katz, director of the San Francisco Department of Public Health who wrote an editorial on this topic, proton pump inhibitors (PPIs) are only warranted for the treatment of:

  • Bleeding ulcers
  • Infection with the ulcer-causing bacteria Helicobacter pylori
  • Zollinger-Ellison syndrome (a rare condition that causes your stomach to produce excess acid)
  • Severe acid reflux, where an endoscopy has confirmed that your esophagus is damaged

PPIs were never intended for people with heartburn, and according to Katz, "about 60 to 70 percent of people taking these drugs have mild heartburn and shouldn't be on them."

However, I believe the number may be even higher than that, because there are over 16,000 articles supporting the fact that suppressing stomach acid does NOT treat Helicobacter pylori infection, which Katz included above. Suppressing stomach acid is also not the solution to treating heartburn.

Heartburn is Usually Caused by a Lack of Stomach Acid

One of the reasons why common heartburn and ulcer drugs are such dismal failures is that they suppress stomach acid … which is actually the opposite of what you want if you have heartburn. As Dr. Jonathan Wright explained in detail in an interview I did with him a couple years back, heartburn and GERD are almost always caused by a LACK of stomach acid, rather than an overproduction thereof.

Further, acid reflux (of which heartburn is the primary symptom) is commonly related to hiatal hernia -- a condition in which the acid is coming out of your stomach, where it’s supposed to remain.

After food passes through your esophagus into your stomach, a muscular valve called the lower esophageal sphincter (LES) closes, preventing food or acid from moving back up. Gastroesophageal reflux occurs when the LES relaxes inappropriately, allowing acid from your stomach to flow (reflux) backward into your esophagus.

An organism called helicobacter pylori (initially called campylobacter) can also cause a chronic low-level inflammation of your stomach lining, and is responsible, or at least a major factor, for producing many of the symptoms of acid reflux.

Suppressing stomach acid does not treat the problem; it only treats the symptoms. And one of the explanations for this is that when you suppress the acid in your stomach, you decrease your body’s ability to kill the helicobacter bacteria. So it actually makes your condition worse and perpetuates the problem.

Pneumonia, Food-borne Infections and MORE Heartburn, Anyone?

Reducing acid in your stomach, which again proton pump inhibitors do very well, diminishes your primary defense mechanism for food-borne infections, which will increase your risk of food poisoning.

PPI drugs are also fraught with other serious side effects, including pneumonia and infection with Clostridium difficile, a harmful intestinal bacteria.

You’ll also develop both tolerance and dependence on them, so unfortunately you can’t stop taking them without suffering repercussions.

In fact, you should NEVER stop taking proton pump inhibitors cold turkey. You have to wean yourself off them gradually or else you might experience a severe rebound of your symptoms, and the problem may end up being worse than before you started taking the medication.

In one study, more than 40 percent of healthy volunteers experienced heartburn, acid regurgitation and dyspepsia (pain and fullness in your abdomen) in the weeks after stopping the drugs. These were symptoms they did NOT have before!

The drugs lead to what’s called “rebound acid hypersecretion,” which is an increase in gastric acid secretion above pre-treatment levels within two weeks of stopping the drugs.

Essentially, because these drugs slam the brakes on the acid-producing pumps in your stomach, when you stop taking them that built-up acid can be unleashed with a vengeance.

It’s a vicious cycle and one you’re far better off avoiding in the first place.

Are You Taking PPIs for Symptoms of Heartburn?

There are far better ways to resolve the problem than with drugs that could destroy your bones and make your heartburn even worse. Here are the top steps to relieve heartburn symptoms, naturally:

  • Restore your gastric balance and function with probiotics

    Consuming enough probiotics will help balance your bowel flora, which can help eliminate helicobacter bacteria naturally. It will also aid in proper digestion and assimilation of your food.

    Ideally, you’ll want to get your probiotics from fermented foods. One of my favorites is natto, but there are many other food products that are excellent choices for natural probiotics, such as fermented vegetables, and kefir, a fermented milk drink made from RAW milk and yogurt.

    Another option is taking a high quality probiotic supplement. The one I use personally contains the Bacillus Coagulans strain, which has been proven highly effective. It’s also the one we recommend in my Natural Health Center.

  • Eliminate food triggers and modify your diet

    Food allergies can be a problem, so you’ll want to completely eliminate items such as caffeine, alcohol, and all nicotine products. Eating large amounts of processed foods and sugars is also a surefire way to exacerbate acid reflux as it will upset the bacterial balance in your stomach and intestine.

    Instead, you’ll want to eat a lot of vegetables, and high quality, organic, biodynamic, and locally grown foods.

  • Increase your body’s natural production of stomach acid

    Like I said earlier, heartburn/acid reflux is not caused by too much acid in your stomach -- it’s usually a problem with too little acid. One of the simplest strategies to encourage your body to make sufficient amounts of hydrochloric acid (stomach acid) is to consume enough of the raw material.

    One of the most basic food items that many people neglect is a high-quality sea salt (unprocessed salt), such as Himalayan salt. Not only will it provide you with the chloride your body needs to make hydrochloric acid, it also contains over 80 trace minerals your body needs to perform optimally on a biochemical level.

    Another option is to take a betaine hydrochloric supplement, which is available in health food stores without prescription. You’ll want to take as many as you need to get the slightest burning sensation and then decrease by one capsule. This will help your body to better digest your food, and will also help kill the helicobacter and normalize your symptoms.

  • Optimize your vitamin D levels

    As I’ve mentioned many times in the past, vitamin D is essential, and it’s essential for this condition as well because there’s likely an infectious component causing the problem.

    Once your vitamin D levels are optimized, you’re also going to optimize your production of 200 antimicrobial peptides that will help your body eradicate any infections that shouldn’t be there.

    You’ll want to make sure your vitamin D level is about 60 ng/ml. As I’ve discussed in many previous articles, you can increase your vitamin D levels through appropriate amounts of sun exposure, or through the use of a safe tanning bed. If neither of those are available, you can take an oral vitamin D3 supplement.

  • Implement an exercise routine

    Exercise is yet another way to improve your body’s immune system, which is imperative to fight off all kinds of infections.

    Remember, too, that if you’re already taking proton pump inhibitors you cannot go off of them cold turkey. Ideally, you’ll want to get a lower dose than you’re on now, and then gradually decrease your dosage from there.

    Once you get down to the lowest dose of the proton pump inhibitor, you can start substituting with an over-the-counter H2 blocker like Tagamet, Cimetidine, Zantac, or Raniditine, and then gradually wean off the H2 blocker over the next several weeks.

    I would also encourage you to read natural health pioneer Dr. Jonathan Wright’s excellent book, Your Stomach: What is Really Making You Miserable and What to Do About It, for more information on how to relieve heartburn and acid reflux symptoms by addressing the root of the problem.

+ Sources and References