Studies Link Some Stomach Drugs To Alzheimer's Disease and Kidney Problems (scientificamerican.com) 102
While the recommended dosage for Nexium, Prevacid and Prilose is just two weeks, doctors often advise patients to continue taking them for years. But now Scientific American reports that "Chronic use of popular heartburn medicines may be riskier than was thought," citing two papers linking the drugs to an increase risk of dementia, including Alzheimer's disease, and a greater risk of kidney problems.
schwit1 quotes their report:
The papers did not prove that PPIs cause the problems. But some researchers have nonetheless suggested possible mechanisms by which long-term use of the drugs could trigger dementia or kidney problems. A reduction in vitamin B12, for example, might leave the brain more vulnerable to damage, says Britta Haenisch, an author of the JAMA Neurology study and a neuropharmacologist at the Bonn campus of the German Center for Neurodegenerative Diseases. Last spring clinicians at the Houston Methodist Research Institute reported another plausible explanation for how PPIs might lead to these unexpected health issues: they picked up signs that the drugs act not only in the stomach but elsewhere in the body, too.
The article ends on an ambiguous note. "Without conclusive data, physicians and patients have to balance the need to prevent the ill effects of excess stomach acid and reflux with the desire to avoid potentially serious -- if theoretical -- side effects from long-term use of PPIs."
The article ends on an ambiguous note. "Without conclusive data, physicians and patients have to balance the need to prevent the ill effects of excess stomach acid and reflux with the desire to avoid potentially serious -- if theoretical -- side effects from long-term use of PPIs."
Recommended dose is two weeks for OTC (Score:3, Informative)
The recommended dose is two weeks for the over the counter (OTC) versions of the medications. That's so you don't keep taking it by yourself when you have symptoms that need an evaluation by a doctor.
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So what's wrong with supplementing vit B12 methylcobalamin? Problem 1 solved. Cheaply.
Nothing. But most people don't know to do this.
Re:Recommended dose is two weeks for OTC (Score:4, Informative)
Because that's only one problem.
The PPIs also slow down acid production in the lining of blood vessels, meaning they can't clear out damaged proteins. This is the cause for the kidney problems, as mentioned in the article.
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...acid production in the lining of blood vessels...
Never heard of that!
I think I know however that adequate amounts (12+ g/day) of ascorbic acid can make your blood vessel linings more healthy, and that if you combine that with 3 -5 g/day L-lysine, your plaque will disappear in the course of a few months because the lipoprotein(a) that carries the cholesterol around get's 'caught' by the L-lysine, instead of by the lysil groups sticking out of your stressed arterial walls where it would 'patch' a stressed part of the lining, leading to the build-up of pla
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So apparently it goes like this:
"Let's use the useless stuff, because the real deal is more expensive." Sigh..
Re:Man, what a concept! (Score:4, Insightful)
Surgery isn't healthy, either. If you have a hiatal hernia, you can go drug-free and get esophageal cancer, get surgery, or take a pill every morning. Guess which one I do?
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Not Doctors. They'd fucking make you mainline heroin just to shut you up.
They went back to morphine [wikipedia.org] long ago in most countries.
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If those work, they are cheaper as well. They don't work for me - I need all the acid to go away.
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For the benefit of the acronym-annoyed, PPI=Proton Pump Inhibitor.
PPIs suppress acid generation, but don't do anything for acid that's already present. So you either have to take them in advance or use one of the products that combines a traditional antacid remedy with them to neutralize what's there and keep new acid from coming in. Or take your own antacid + PPI inhibitor (check with your doctor, though).
PPIs are wonderful. They allow me to eat and drink things that taste great but have a prohibitive acid
Re: Don't use a PPI (Score:1)
There is not proof of causation, it may be that people who develop renal problems and dementia may be predisposed to gerd
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They did tests on cultured cells in a lab. There were no people involved in those experiments.
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Yup, I have a hiatal hernia, so while diet can help, my physiology will eventually give me esophageal cancer if I don't either take a PPI or have surgery. Even without the cancer, waking up every night with a mouth full of stomach acid and a constant pain in my eroded esophagus was getting old.
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No:
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You can develop a resistance to H2 antagonists. My gut says you're probably better off with an antacid that directly neutralizes the root cause. That way, you can reduce the acid in your stomach only at night when you're most likely to experience reflux, while leaving it fully acidic during the day when that acid is actually playing a crucial role in digestion.
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No solution is totally safe, and some acid neutralizers themselves have had warnings - for example, Rolaids was using an aluminum-based ingredient that came under fire during the Great Aluminum Alzheimer's Scare. I'm not even sure what simple calcium carbonate can do to you if you overdo it.
Also, in many cases, you have to chain-pop antacids, especially in cases where it's not a single acid hit but an ongoing self-renewing onslaught. PPIs are often 1 pill for 12-to-24 hour relief and that can make a big dif
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Or, better yet, find out what's actually causing your stomach to produce excess acid and eliminate it from your diet. Oh, no. Can't do that, it's too hard and crap food is sooo fucking delicious you just have to eat it, and in excess to boot. Big brother parma will fix it.
This insane idea we have (fed to us by food industry marketing, no doubt) that we can eat what we want and let the pharmaceutical companies fix what we screw up with improper diets is going to continue to kill while funneling billions o
Re:Don't use a PPI (Score:4, Informative)
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Re:Don't use a PPI (Score:4, Interesting)
I used to sneer at the filtered-water crowd and the mere idea of buying water - in plastic bottles no less - at a cost per gallon higher than gasoline repels me.
But I got a filter pitcher once as part of my emergency preparedness kit and was amazed to discover that my heartburn rate went way down.
The chlorine in my tap water was doing it to me.
So even just drinking lots of water isn't totally risk-free.
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So even just drinking lots of water isn't totally risk-free.
The water is fine. Chlorinated water, not so fine. Stop using rivers as sewers, then you can drink the water without chlorine.
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I saw three doctors about acid reflux that suddenly got very bad out of nowhere. Found out I had a hiatal hernia. One doctor told me I'd have to take one of these type of medicines the rest of my life. It kept making my digestive system extremely uncomfortable, plus I am scared to death of side effects of anything long term.
Turns out, all I had to do was not eat dinner (or anything) at 6:30 PM to solve 95% of my problems. Other things I do to manage the 5% of it are avoid alcohol (especially after 6 PM), av
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Some folks eat quinoa and twigs and still have risky acid reflux
Indeed. I have relatives in this position, more or less - careful attention to diet and regular exercise, but still chronic reflux. It's not always "lifestyle".
I, on the other hand, am somewhat less careful about diet (though I do eat a wide variety and probably hit all of the nutritional targets that have any actual evidence behind them), and while I do exercise it's decidedly irregular, but my weight and waist size haven't changed in a couple of decades and I don't think I've ever had so much as heartburn
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I wake up with it or sometimes even taking the pill with some water causes reflux. So at this point water and and/or my stomach being empty causes reflux.
This is your stomach so accustomed to being full of hard to digest 'food' that it constantly overproduces acid, even when empty. I used to be the same way -- daily anti acid pills with a scattering of chewables here and there, and one right before bed to keep the night reflux in check. After my diet change I haven't had any problems at all. No more daily pills and I only need a chewable on occasion when I eat too many onions. I use less anti acids in a year than I used to in a week before.
By they way,
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Or, better yet, find out what's actually causing your stomach to produce excess acid and eliminate it from your diet.
Tomatoes, wheat, cheese. Yep, but sometimes I just gotta have a pizza or pasta.
Or swap for acidic fruit juice and you have a Continental Breakfast as supplied by most hotels and conferences.
Only a masochist or an idiot would consume this sort of stuff daily, but on days that I do, I bless Big Brother Pharma.
Though I wouldn't have downvoted you on your use of that term.
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Or, better yet, find out what's actually causing your stomach to produce excess acid and eliminate it from your diet.
Sometimes the problem is not due to diet, but other things like hiatal hernia, weak lower esophageal sphincter, pressure on mid-section, H, Pylori infection, etc.
I start having problems once I go over a certain body weight, but the symptoms go away when I lose the excess weight.
Re: no clear evidence (Score:1)
He told me omeprazole lowers your acidity (increases pH) very effectively. Even so effectively that with prolonged use polyps can develop due to the almost total lack of acid. Lansoprazole, as he told me, didn't reduce the acidity that much, and so prevented way better those polyps to form.
Uh, whaaa? (Score:3)
The dosage for most drugs is measured in mass (mg, often)/time, not time alone. How does one meter a dosage in the time domain with no regard to mass (homeopathic medicines excepted, of course)?
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I was on a PPI for ~3 years. My doctor told me the main reason they suggest the 2 week duration of use is because the drug may allow someone with a much more serious condition, say an ulcer or possibly cancerous lesions, to "get by". They don't want a person with those kinds of symptoms to "get by", they want them to see the doctor.
After 3 years, I was tired of getting a solid bout of the stomach flu about every 6 weeks, so I lost 40lbs and dropped the meds as I didn't need them anymore.
PPI troubles (Score:4, Interesting)
Proton pump inhibitor have been known to be troublesome for a long time
By reducing stomach acidity, it increases the amount of bacteria that pass alive in the intestine, increasing the odds of Small intestine bacterial overgrowth (SIBO) [wikipedia.org]. It also increase the odds of proliferation of some bacteria such as heliobacter pylori [wikipedia.org] in the stomach itself.
All that pathogens overload the immune system, and degrade digestive functions.
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Well supposedly they're taking an inhibitor because they have too much acid. Thus they attempt to reduce it to the proper amount. People who are well don't need to take it at all. For the occasional indigestion some Tums or some such anti acid remedy would seem like a better solution.
Correlation or Causality? (Score:2)
I mentioned this association to my doctor. She advised caution in interpreting these results because these PPIs are routinely prescribed to patients at risk for the linked diseases. Anyone know more on this?
Of course, the older H2 blockers can be effective for those who want to avoid PPIs. Better still, some people, including myself, get complete relief by finding a healthy diet that does not trigger acid reflux. (For me, that means cutting down on grains and starchy vegetables, YMMV).
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Did you read the article? They performed tests directly on cells in a lab, rather than on patients.
Anyone can suggest an alternative ? (Score:2)
Anyone can suggest an alternative that actually works for them long term ? I have heard of apple cider ? does that actually work ?
I have been taking PPIs for 8 years now. Though I have reduced the dosage as much as possible but stopping them altogether gets really difficult in 1-2 days.
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When you have quit, have you tapered off the drug in a controlled manner to prevent a rebound effect?
I suggest reading Chris Kresser's six-article series on GERD starting with the article What Everybody Ought To Know (But Doesn’t) About Heartburn & GERD
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Thanks, good article.
Since the PPIs work so perfectly in stopping acid reflux I never really got motivated to search around for options i guess.
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Haven't tried Ranitidine yet. Let me try that, thanks.
I have always been on Lansoprazole 30mg and shifted 6 months back to Pantoprazole 40mg then 20mg.
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Correlation is not what it seems (Score:3)
I would think that PPI use is also strongly associated in many case with certain lifestyle choices. Stuff like poor diet, lack of excercise, alcohol use. And also stress. PPI use and dementia could both be symptoms of the same underlying cause.
Re: I fear cyanocobalamin (Score:1)
It is true however that, although maybe the cheapest, cyanocobalamin isn't the best form of vit B12 to take.
I found methylcobalamin much more effective. As in immediate relief from tingling sensations in the extremities.
Papers did not prove that PPIs cause the problems. (Score:2)
The papers did not prove that PPIs cause the problems.
So, click-bait, then ?
Complex issue (Score:4, Informative)
First:
It is unwise to immediately and completely change ones medications or prescription habits just based on one study. These large observational multivariate studies are always hindered by bias, though trying hard to compensate for them.
On the other hand, these kind of findings should not be ignored.
Proton pump inhibitors are already known for a long time to cause trouble. The article already mentions several, like the bacteria get a change of growing in the changed environment of the stomach, a defensive barrier is removed, certain vitamins and drugs need the acidity to get absorbed etc etc. Kidney issues are also not news. Other weird side effects, like I'll never forget a patient with an extreme hypomagnesia, like 0.10 mmol/l or so. She did not feel well.
But not forget the number of patients who have gained significant quality of life and the reduction of severe gastric bleeding. Remember the time where Bilroth gastrectomies were as common as cholecystectomies. The two week maximum advise for the over the counter drugs is because of the risk of patients masking a serious condition like malignancies.
But there is no denying that most people at some point start their PPI for some discomfort, and continue to swallow them for the rest of their lives. (Ideal drug for pharmaceutical companies.) The majority should just quit them, change their food habits and posture and get on with their lives.
The use of these drugs should be reserved for those who really need them. Right now it is prescribed more or less as a luxury drug
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Perhaps you know the answer to this: is it a misconception to think that GERD is caused by excess stomach acid? Isn't the problem that certain foods (primarily acidic food and carminitives) cause the LES to fail to close properly? Therefore tackling GERD either by neutralising acid or reducing its production is tackling the problem from the wrong end, as it were?
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I'm no stomach specialist, but to my knowledge GERD is caused by mechanical malfunction of the LES. This sphincter is not designed to close for 100%. Some reflux is physiologic. Some patients are extremely sensitive for this reflux and develop symptoms.
So maybe it is more the local reaction to the small amount of acid than the volume of acid content.
Much debate concerning the pathophysiology to my knowledge.
Also the enormous difference worldwide in the incidence. Most likely caused by diet and posture. It
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Not a doctor but have suffered from GERD for decades. And I agree. Reducing stomach acid is treating the symptom, not the problem. The same way cold "medicines" don't actually treat the cold, they simply try to minimize the symptoms. Which is exactly why they have the two week treatment period.
In my case adding some fresh, raw fruit and veggies clears it up. The old saying "An apple a day keeps the doctor away" actually works in my case. An apple will clear up my GERD in about 45 minutes.
Who knew that
Not new knowledge (Score:2)
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Which is worse? (Score:2)
The sleazy money game that is the drug corporations and their focus on lucrative, often dangerous drugs for aging boomers in denial over aging, and the endless studies that reek of ambiguity and questionable data capture? Everybody has something to gain here (market share and more research grants).
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Does weird stuff to me ... (Score:1)
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Raw Apple Cider Vinegar (Score:1)
Before you take these... (Score:2)
First off. I am not a doctor but I'd like to relate my personal anecdotal experience.
I was told to go on nexum for life, but was uncomfortable with long term use of a product that didn't seem to be well tested long term.
SOO.... i looked into it. Something that , according to my doctor, and several other sources has been used in the past to help fix acid reflux
is the stimulate acid production so you food digest more quickly. One way to do this is to drink 2 tablesppons of apple cider with a cup of water be
change your diet (Score:1)
Stop making the problem (Score:2)
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You have no idea what you're talking about. It has nothing to do with anything you just said. I can eat my food fast, slow, it makes no difference, I still get attacked. And here's the best part: in my case, the healthier the food, the worse it is for me. Carrots, apples, cabbage, white meat are all guaranteed acid attacks. Chicken wings, fries, shit food, no problem.
And so you understand, I am the most anti-drug person you know. I take nothing. NOTHING. I resisted taking proton pump inhibitors for
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Some people's bodies work right, some people's don't. For the latter category, no amount of diet modification is going to solve everything 100%.
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