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Medicine Biotech

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."
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Studies Link Some Stomach Drugs To Alzheimer's Disease and Kidney Problems

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  • by Anonymous Coward on Sunday February 05, 2017 @11:15PM (#53809805)

    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.

    • Re: (Score:3, Informative)

      by slashrio ( 2584709 )
      So what's wrong with supplementing vit B12 methylcobalamin? Problem 1 solved. Cheaply.
      • So what's wrong with supplementing vit B12 methylcobalamin? Problem 1 solved. Cheaply.

        Nothing. But most people don't know to do this.

      • by omnichad ( 1198475 ) on Monday February 06, 2017 @11:46AM (#53811979) Homepage

        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.

        • ...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

      • Most people take the cyanide version of B12 (cyanocobalamin) and not the methyl version (methylcobalamin) - and most of the B12 supplements out there contain the cyanide version. I only found out I need the methylcobalamin version because of a blood test (5 MTHFR genetic abnormality, I think it's called).
        • Yes, cyanocobalamin is much cheaper than methylcobalamin.
          So apparently it goes like this:
          "Let's use the useless stuff, because the real deal is more expensive." Sigh..
  • by msauve ( 701917 ) on Monday February 06, 2017 @12:30AM (#53809999)
    "While the recommended dosage for Nexium, Prevacid and Prilose is just two weeks"

    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)?
    • Always check your units! Your units are wrong! cried the teacher. Your church weighs six joules — what a feature! And the people inside Are four hours wide, And eight gauss away from the preacher! -David Morin
    • Re: (Score:3, Interesting)

      by Anonymous Coward

      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)

    by manu0601 ( 2221348 ) on Monday February 06, 2017 @12:45AM (#53810063)

    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.

    • by amiga3D ( 567632 )

      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.

  • 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).

    • Did you read the article? They performed tests directly on cells in a lab, rather than on patients.

  • 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.

    • by Anonymous Coward

      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

      • by ami.one ( 897193 )

        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.

    • I might trigger a rant or two here, but someone told me that after eating 3 - 5 leaves of the neem tree every morning before breakfast, after 4 months he got rid of his stomach problems.
  • by symes ( 835608 ) on Monday February 06, 2017 @04:12AM (#53810507) Journal

    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.

  • From the summary :

    The papers did not prove that PPIs cause the problems.

    So, click-bait, then ?

  • Complex issue (Score:4, Informative)

    by dr.Flake ( 601029 ) on Monday February 06, 2017 @07:22AM (#53810819)

    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

    • 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?

      • 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

      • by Anonymous Coward

        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

  • It has been know for ages Omeprazol fucks up your brain. Now that could explain one thing or two about my ex. I already warned my parents to not abuse it...
  • 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).

  • I have tried these drugs twice, and each time never made it through the two weeks. They triggered severe, daily migraines, with extreme halo effects. It literally felt like they messed with my brain. I will never take them again.
    • I feel the same way about antihistamines - well , they don't give me migraine, but I do feel like they mess with my brain. I'd rather a) avoid the foods I cannot eat due to allergy and b) during the time of year I have allergic reactions, live with it.
  • I previously would occasionally take a Tums here or there, but my wife mentioned I should try drinking a small amount of Raw Apple Cider Vinegar. It tastes horrible, and you have to rinse your teeth, but shockingly it works better than anything I've ever tried.
  • 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

  • Low carb and moderation will end acid reflux.
  • Most drugs, just treat the SYMPTOMS, not the cause. If you constantly have headaches, "aspirin" might get rid of the headache, but the headache comes back. You need to treat WHY you are getting the headache. Same with some of these stomach drugs. Yeah, they might get rid of your ache, but it keeps coming back. Is it masking an underlying problem?

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