Introduction
One simple rule that would save a lot of suffering in the world is to “never take a drug that has more severe side effects than your symptoms.” A new study highlights this adage as it shows an extremely popular group of stomach acid-blocking drugs, the proton-pump inhibitors (PPIs), are now linked strongly to another serious side effect – this time dementia.
This risk is added to the other conditions these drugs produce including osteoporosis, heart attacks, strokes, intestinal infections, bacterial pneumonia, and multiple nutrient deficiencies. Here is the blaring fact that not enough doctors and patients know. It is conservatively estimated by noted experts in conventional medicine that up to 70% of all PPI prescriptions are likely inappropriate. In alternative medical circles that number is 100%.
Popular examples of PPIs include Nexium, Prilosec, Protonix, Prevacid, and Aciphex.
These drugs are dominant medical treatment of peptic ulcers, gastroesophageal reflux disease (GERD), and indigestion.
Background Data:
PPIs will typically raise the gastric pH above the normal range of 3.5, effectively inhibiting the action of pepsin – an enzyme involved in protein digestion that can be irritating to the stomach. Although raising the pH can reduce symptoms, it also substantially blocks a normal body process – digestion! The manufacture and secretion of stomach acid is very important not only to the digestive process, but also because it is an important protective mechanism against infection. Stomach secretions can neutralize bacteria, viruses and molds before they can cause gastrointestinal infection.
As far as the digestive process, stomach acid is not only important in the initiation of protein digestion, it ionizes minerals and other nutrients for enhanced absorption; and without sufficient secretion of HCl in the stomach the pancreas does not get the signal to secrete its digestive enzymes.
PPIs drugs are associated with numerous side effects and here are just a small number of examples:
- Pneumonia – People using acid blockers were 4.5 times as likely to develop pneumonia as were people who never used the drugs. Apparently, without acid in the stomach, bacteria from the intestine can migrate upstream to reach the throat and then lungs to cause infection.
- Increased fractures – people taking high doses of acid-blocking drugs for longer than a year had a 260 percent increase in hip fracture rates compared to people not taking an acid blocker. Evidence suggests that these drugs may disrupt bone remodeling making bones weaker and more prone to fracture.
- Heart attacks – Stanford researchers found regular use of PPIs to have a two-fold increase in dying from heart disease compared to those not taking PPIs.
- Vitamin B12 insufficiency – acid blocking drugs not only reduce the secretion of stomach acid, but also intrinsic factor (a compound that binds to and assists the absorption of vitamin B12). Vitamin B12 deficiency is among the most common nutritional inadequacy in older people. Studies indicate that 10 to 43 percent of the elderly are deficient in vitamin B12 making them at risk for a number of health conditions including dementia. Many elderly put away in nursing homes for Alzheimer’s disease, may simply be suffering from vitamin B12
New Data:
A new study from the German Center for Neurodegenerative Diseases published online February 15, 2016 in JAMA Neurology, has confirmed the suspected link between PPIs and dementia. The study used the largest mandatory public health insurer in Germany, which includes one third of the overall population and as much as 50% of the elderly population. Its database includes information on diagnoses and drug prescriptions.
The analysis included 73,679 subjects aged 75 years or older who initially did not have dementia at baseline. The results showed that the patients who were regularly using a PPI had a 44% greater risk for dementia compared with those not taking PPIs. It did not seem to matter what brand/form of PPI was used. The results were similar for all of them.
In addition to the link between PPIs and vitamin B12 deficiency, there is evidence that PPIs may get into the brain and cause an increase in the beta-amyloid deposits characteristic of Alzheimer’s disease.
Having diabetes and being prescribed five or more drugs other than the PPI (defined as polypharmacy) were also associated with significantly elevated dementia risk, but the risk was about a 16% increase. That was much lower than the 44% increased risk due to regular PPI use.
These results of the study highlight the need for first eliminating inappropriate PPI prescribing and then looking to natural alternatives for peptic ulcers, GERD, and other conditions currently being treated with PPIs.
Commentary:
The significance of this German study for the aging population in the United States is enormous. With the widespread use of PPIs among our elderly population, it is likely that PPI use is a major contributor to new cases of dementia in the US every year.
I have written about the illogical approach to indigestion, GERD, and peptic ulcers by using PPIs as well as older acid-blocking drugs like Tagamet and Pepcid. My focus instead is to focus on dealing the underlying issues and aiding digestion through natural measures. Please check my Health Conditions section for recommendations to address specific gastrointestinal issues, such as my recommendations with GERD.
Reference:
Gomm W, von Holt K, Thomé F, et al. Association of Proton Pump Inhibitors With Risk of Dementia: A Pharmacoepidemiological Claims Data Analysis. JAMA Neurol. 2016 Feb 15. doi: 10.1001/jamaneurol.2015.4791. [Epub ahead of print]
Dr. Michael Murray
2/23/16
