Antacids, Proton pump inhibitors, and Bone! Oh My!

January 19, 2012 3 min read

Antacids, Proton pump inhibitors, and Bone! Oh My!

Are Antacids the Answer?

Tums, Tum, Tum Tums Tuuuuuuummmmms! Those of you who remember the words from this advertisement know that Tums is advertised as an antacid, but is it a good source of calcium? NO! Could chronic antacid use result in poor uptake of calcium and other digestive problems?

While studies are scant in this area let’s review the importance of the stomach acid that Tums and other antacids neutralize. We need stomach acid (HCL) to break down protein as well as aid in the absorption of calcium. It does not make sense to take antacids on a regular basis.

Many people do suffer from burning sensations (heart burn) and some have gastric reflux (GERD), which is a regurgitation of stomach acid up into the esophagus. GERD is all to common, but the answer is not taking antacids, the answer is deeper than that and usually involves dietary changes.

Proton pump inhibitors (PPIs) are a group of drugs (Nexium, Prilosec) whose main action is a pronounced and long-lasting reduction of gastric acid production. Studies have shown that over time bone loss can occur.

I have patients who have been on these medications for years. If someone has been on these meds for years can they get off these drugs successfully? Yes, but with great care.

The diet needs to be cleaned up first and then the weaning process can begin, slowly. Most people will experience a rebound effect of excessive stomach acid production for a period of time.

I, like many other alternative doctors see the importance of a healthy digestive system. Hydrochloric acid is critical for digesting food and aiding in the absorption of nutrients.

Don’t just pop these pills and treat the symptoms, find a doctor who works with nutrition to resolve the condition permanently. 

Patients With Normal Bone Density Can Delay Retests, Study Suggests

This is the leading headline of an article posted in today’s New York Times.

"The study followed nearly 5,000 women ages 67 and older for more than a decade. The women had a bone density test when they entered the study and did not have osteoporosis. (In a separate national study by the Centers for Disease Control and Prevention, about 70 percent of women over age 65 did not have osteoporosis.)

The researchers report that fewer than 1 percent of women with normal bone density when they entered the study, and fewer than 5 percent with mildly low bone density, developed osteoporosis in the ensuing 15 years. But of those with substantially low bone density at the study’s start, close to the cutoff point for osteoporosis of fewer than 2.5 standard deviations from the reference level, 10 percent progressed to osteoporosis in about a year."

Dr. Lani’s comments:

I agree that those who have a normal bone density test who are over the age of 65 do not need another test for many years, unless there is reason to assume bone loss may have occurred due to medications or some other potential cause of active bone loss. What I am concerned about is people misreading this study. I find that people with known risk factors are not being tested for bone density. Those who have the biggest risk of bone loss are women who are approaching menopause. Some women can lose 20% bone mass in the 10 years just before and following menopause. Estrogen, takes a dive after menopause. Estrogen keeps the bone cells (osteoclasts) that get rid of old bone cells in check. So when estrogen levels decrease, bone loss can be excessive in some people. More often than not, women who suffer from osteoporosis have similar body types. Women who are small-boned with low body fat run the greatest risk of bone loss during this time. This is because extra weight protects bones and fat cells produce some estrogen.

If a woman is nearing menopause and she has any of the following risk factors I recommend a baseline bone density exam for women. Women who have a history of; an eating disorder, smoking, drug or alcohol abuse, fractures, digestive disorders resulting in malabsorption of nutrients, lack of weight-bearing exercise or excessive exercise, vitamin D deficiency and many other nutrient deficiencies including vitamins K, magnesium, calcium. Many medications can also result in bone loss including, proton pump inhibitors, corticosteroids (use ever over a three month period) and other medications. If you are taking medications, check to see if bone loss is a side effect.

Men too can suffer bone loss for the same risk factors above and also should be considered for bone density testing if warranted.

Bone is very complex and those at risk should be evaluated for bone density. Nutritional and digestive health is a must for healthy bone. Healthy bone means good quality bone and quality bone requires a healthy digestive system and a bone healthy eating plan.