The fact that a drug is purchased ‘over the counter’ doesn’t change the fact that it is a drug. Take, for example, that class of drugs that stop the production of acid in the stomach, widely taken for GERD (acid reflux). The symptoms of acid reflux include heartburn, wheezing, and tightness or a feeling of food caught in the throat. The solution is to take just one of those harmless little pills every day, stopping the production of acid in the stomach. Voila! No symptoms of acid reflux! Life is now good, right?
Wrong! There is actually a very good reason for that acid in your stomach. Like, digesting food! Without the acid, the protein you eat can’t be broken down. The pH has to be very much on the acid side before the valve that lets the food out of the stomach is triggered to open, and without acid the only way that can happen is for the food in your stomach to rot (a process that doesn’t take terribly long at body temperature). If you can still taste the food you ate for breakfast in a burp before lunch, that food is still sitting in your stomach, rotting away.
Let’s set that part of digestion aside, and look at some of the longer term problems. Without an acid environment, calcium cannot be broken down or absorbed, no matter what food or supplement you ingest. You need a certain level of calcium in your blood for muscles, including your heart, to relax, so your body is very good at keeping enough calcium in your blood – it steals it from your bones!. No calcium in the diet = calcium stolen from the bones = osteoporosis. Using this class of medication more than one year causes measurable loss of bone density.
Need more? A recent article in JAMA (The Journal of the American Medical Association) associates long term (2 years) use of proton pump inhibitors (like Prilosec, Prevacid and Nexium, and their generic and OTC equivalents) with a 65% increased risk of vitamin B12 deficiency, since the cells that make the stomach acid also make intrinsic factor, a protein that helps vitamin B12 be absorbed. As you’d expect, the higher the dose of inhibitor, the higher the risk of B12 deficiency.
So, why should we worry about B12 deficiency? Not enough B12 can lead to some very troubling ailments. These include anemia, nerve damage, psychiatric problems and dementia, just for starters. As we age we naturally lose the ability to produce hydrochloric acid and intrinsic factor and to absorb B12 – which means if you are over 50, you should consider B12 supplementation even if you haven’t been on an acid blocker.
How do we get B12 in our diet? Almost exclusively from animal tissues (vegans beware). And, unlike most B vitamins, your body stockpiles B12, sometimes enough for 7 years – so a deficiency may not show up for a while. If you decide to supplement B12, make sure you do so by injection or an oral spray that’s absorbed through your mouth. B12 is the largest vitamin molecule known and isn’t passively absorbed from the digestive track. Taking B12 in a pill is simply not effective.
So, you have GERD and knowing all of this, don’t want to take those acid blockers anymore. While I cannot recommend that you stop taking anything that your medical doctor has prescribed, I can help you stop the acid reflux, so that you and your medical doctor together can decide to reduce or stop that medication. Call me. Let’s talk.