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PROBLEMS WITH PPIs, Part 2:Beyond the gut!


PPIs don’t just affect your gut! Because proton pumps are present in almost every cell of the body, inhibiting them in the digestive system also means they are inhibited in many other tissues. This can create unintended consequences:

Bone Density

We previously mentioned that the absorption of nutrients needed for making healthy bone is reduced with the use of PPIs. But the effect on bone density is not just due to nutrient deficiency. Osteoclasts, bone cells that are important for healthy bones, also have many proton pumps. The activity of these bone cells is reduced by PPIs.

Research has shown a 35% increased risk of hip fracture in postmenopausal women after two years of PPI use. If you are concerned about low bone density, PPIs may not be the best choice for you.

PPIs Increase the Risk of Cardiovascular Problems

Recent studies have shown that PPI users have increased risk of heart attack. One possible explanation for this is that PPIs reduce the body’s production of a natural cellular component called nitric oxide, a natural substance that promotes dilation of blood vessels and improves blood flow.

PPIs Can Harm the Kidneys

A study published in 2016 compared patients using PPIs to those using a different class of acid blockers. The study showed that over a five-year period, those in the PPI group were 28% more likely to develop chronic kidney disease. We know that proton pumps are present in kidney cells, and PPIs may interfere with their action.

PPIs Negatively Affect Cognition

Yikes! A study published in 2015 looked at cognitive function (that’s brain power!) in PPI users versus a control group. This study showed significant impairment in visual memory, attention and executive function in the PPI group. We do know that communication between brain cells requires the action of proton pumps. (remember, these proton pumps are present in many different cell types!) We also know that some commonly prescribed PPIs can cross the blood-brain barrier, which is there to protect our brain cells by keeping unwanted chemicals out.

Tinnitus

A study in 2022 showed a correlation between PPI use and increased tinnitus (ringing in the ears).

What Can You Do to Get Relief?

The development of GERD is a vicious cycle. Low stomach acid leads to carbohydrate malabsorption, which then leads to bacterial overgrowth, causing gas and bloating. This then increases intra-abdominal pressure, which is a main driver for reflux.

  1. Try a low-carb, paleo-style diet: a significant number of people experience relief from GERD after two weeks on a high protein, leafy vegetable-focused diet. Think grilled, steamed or roasted fish, chicken, turkey and lean grass-fed beef, with lots of raw and cooked green vegetables. No bread, no pasta, no rice, no sugar.

  2. Lose weight: As little as twenty pounds of extra weight can increase abdominal fat and put pressure on the upper digestive tract. See point number 1!

  3. Avoid alcohol, especially wine and beer, and especially during meals.

  4. Eat early (before 6 pm), eat lightly (never get overfull) and eat slowly (chew deliberately for every bite).

These self-help tips can help you manage your discomfort. But naturopathic medicine is about treating the cause, for lasting relief. There are many causes of GERD, and there can be more than one contributing factor, confusing the picture. If you’ve been on a PPI for a long time, and this now concerns you, seek out a naturopathic doctor to find and address the cause in your unique case.

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