Millions of doses of “acid blocking” proton pump inhibitor drugs are doled out every year, yet most doctors and their patients are completely oblivious to their adverse effects, like increased risk for premature death.
Proton pump inhibitors are a type of drug commonly known as acid-blockers, whose primary purpose is to reduce the amount of gastric acid secreted in the stomach wall. Available with or without a prescription, acid-blockers are used to treat common disorders such as indigestion, heartburn, acid reflux, and various ulcers. These types of digestive disturbances are so common, proton pump inhibitors, or PPIs, were prescribed at nearly 270 million hospital trips made by adults via ambulance from 2006–2010.
The standard American diet of sugar-laden, highly-acidic processed foods, and the stress-filled lifestyle that accompanies it, make it easy to swallow the fact that PPIs are among the most highly prescribed drugs on the planet.
PPIs work by raising stomach pH above normal range to inhibit secretion of pepsin, a digestive enzyme that can be irritating to the stomach lining. While this action may provide temporary relief, it also blocks secretion of normal, healthy enzymes, impairing the body’s digestive function over the long-term. Lack of adequate stomach secretions can also expose us to harmful molds, viruses, and bacteria that may be present in our food.
PPIs have developed a list of known side effects that are reported to occur within days or weeks of onset of use. The most commonly reported short-term side effects of taking PPIs are: digestive disturbances, such as nausea, vomiting, diarrhea, constipation, abdominal pain, and gas; headaches; fever or cold symptoms, such as stuffy nose, sneezing, and sore throat; skin rashes; cognitive impairment; and infection.
Safe Antacid or Smoking Gun?
Most people take acid blockers because of dietary and lifestyle choices that create an unfavorable condition in the digestive tract. Poor-quality food, consumed in a rush, is even chased down with coffee or soda. Heartburn soon follows.When pills are so readily available that help us divorce consequence from causation, these dietary indiscretions can become common and normal. “Take a pill and enjoy the foods you love,” proclaim commercials. Unfortunately, the systemic side-effects of proton pump inhibitors affect every cell in the human body.
Research conducted at Stanford University and Houston Methodist Hospital in Texas uncovered shocking findings in 2016, through research supported by the American Heart Association. What co-author Dr. John Cooke, chair of Cardiovascular Disease Research at Houston Methodist Hospital, calls “the smoking gun,” is the fact that PPIs effectively inhibit acid production throughout the body, disrupting normal, healthy metabolic processes of cells. The acid bath that PPIs disrupt in the stomach carries important digestive enzymes. When this enzymatic activity is inhibited in the rest of the body (because the effects of PPIs aren’t limited to the stomach), cells become unable to break down waste materials.
Cooke likens this process to “a garbage disposal that requires acid to work.” Cells rapidly become burdened by these waste products, and the damaging effects of aging are accelerated. This type of cellular damage leaves patients, particularly those taking PPIs for a year or more, susceptible to a host of diseases, and even premature death.
1. Increased Risk for Kidney Disease
The evidence that PPIs are damaging to the spleen and kidneys first appeared in case reports of acute interstitial nephritis, inflammation of the tissues between renal tubules that affect how our kidneys regulate and uptake water. This condition, which can lead to kidney failure, was observed to occur suddenly and in significantly higher rates among users of PPIs.Cessation of use of PPIs initiated a reversal of symptoms in many cases. Once the alarm was sounded, large observational studies were conducted that found correlations of PPI use with increased incidence of acute kidney injury, chronic kidney disease, and end-stage renal disease. These risks increase when users consume more than one dose daily of these medications.
2. Increased Risk for Heart Disease
There is now significant evidence of adverse cardiovascular effects from PPIs. A June 2016 article published in the American Journal of Cardiovascular Drugs reviewed available information on cardiovascular risks from PPIs as well as how this harm occurs.The study confirmed that proton pump inhibitor effects are not isolated to stomach cells. PPIs were observed to reduce the acidification of lysosomes, cells responsible for the breakdown of proteins, fats, carbohydrates, and nucleic acids. PPIs alter basic cellular functions, including those related to blood clotting, thereby increasing the risk of major adverse cardiac events.
A study conducted in Denmark involving more than 56,000 participants who had been hospitalized for myocardial infarction (MI), “reported a 30 percent increase in the incidence of cardiovascular death, recurrent MI, or stroke within the first month after discharge for those patients that were taking PPIs.”
3. Digestive Disorders
Most people take PPIs because of stomach upset, so it may seem oxymoronic to include this condition in the list of reasons not to take PPIs. The most common ailment cited when writing prescriptions for PPIs is gastroesophageal reflux disease, which expresses as excess acid in the stomach. But a PPI prescription is also written for 50 percent of all digestive diseases.PPI overuse has been documented in numerous studies, so whether the cause of the digestive complaint is excess acid or other, a proton pump inhibitor is often prescribed. This makes proper diagnosis of the digestive complaint impossible as a domino-effect of symptoms that may or may not be related to the original problem can cloud the picture.
4. Diminished Brain Function
Some of the most startling chronic health problems correlated with proton pump inhibitors are cognitive disorders. While it’s not such a novel idea that food affects our mood, there isn’t yet a wide consensus on food’s impact on brain health. A study released in December 2015 was prompted by research showing that PPIs increase the brain burden of amyloid-beta, an amino acid that is the main component of the amyloid plaques found in the brains of Alzheimer patients.PPIs are also known to create vitamin B12 deficiency, the second factor in Alzheimer’s disease. Researchers divided sixty volunteers into five test groups and one control group. Each of the five test groups was given a different PPI: omeprazole, lansoprazole, pantoprazole, rabeprazole, and esomeprazole. All six groups participated in computerized, neuropsychological tests at the beginning of the study, and again, seven days after taking the specific PPIs maximum daily dose. While researchers admit that a larger study is desirable, the evidence was clear:
“We found a statistically and clinically significant impairment in visual memory, attention, executive function, and working and planning function. All PPIs had a similar negative impact on cognition.”
Of the PPIs studied, omeprazole had the most significant impact (significant results on 7 of 7 cognition tests), and esomeprazole showed comparatively less (significant results on 3 of 7 tests).
5. Increased Risk of Death
It’s clear from the evidence, as well as common sense, that PPIs have a systemic effect on the entire body. PPIs launch an attack on basic cellular functioning, inhibiting healthy cell metabolism from taking place. When the body’s ability to convert the building blocks of life, namely proteins, carbohydrates, fats, and nucleic acids, into useable fuel is compromised, so is our immune system, and life begins shutting down.An older study that helped pioneer awareness of harm due to PPIs is a 2013 study called “Inhibition of lysosomal enzyme activities by proton pump inhibitors.” Researchers observed that many of the adverse effects of PPIs are caused by systemically compromised immunity, a result of PPI inhibition of lysosomal enzymes. Lysosomes are essentially tiny membranes or sacs that carry enzymes essential to cellular metabolic functions. When PPIs inhibit this function, there is an increased incidence of tumors (tumorigenesis) and infectious diseases.
While researchers admit they don’t know how each person in the study met their end, it was noted that PPI use was most prominent in older, sicker individuals. Considering that PPIs impair the body’s ability to carry out healthy cellular functions, it makes sense that people taking them would end up biologically older and sicker.
When taking or considering a proton pump inhibitor, take precautions against drug interactions or complications. Stomach acids are often instrumental to absorb swallowed medication, and for this reason, PPIs have the potential to reduce the effectiveness of any oral drug.