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Long Term Effects of Proton Pump Inhibitors

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Chronic Fatigue Syndrome
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Posted 5/13/2007 5:18 PM (GMT -5)
Hi Everyone,

I used this forum for info while I was sick so I feel obligated to come back now that I know what made me sick.

I now have positive confirmation that the thing that made me very sick for 9 months (and much longer in a more functional capacity) was the PPIs (prevacid, aciphex, Nexium, et al) that I took for almost a decade. I got worse and worse over a 9 month period, starting last July, and then, after I stopped taking them, I got better and better until now. I'm almost back to normal (and no longer ready to jump off a bridge). I met the clinical criteria for Chronic Fatigue Syndrome and had horrible anxiety and panic attacks (even before I finally got "sick"). In late January, after reading up on digestion and particularly the problems that can be caused by having too little stomach acid, I decided to discontinue taking Prevacid. That's a decision I wish I would have made a lot earlier.

Basically, the lack of stomach acid caused me to stop assimilating protein properly and stopped me from absorbing many vitamins and minerals properly. This caused me to get very sick, both physically and mentally.

If you are sick and you are taking this stuff, I highly recommend that you quit. I wish I had known years ago what I know now. I had a bunch of seemingly unrelated symptoms (like problems sleeping, fatigue, anxiety, further stomach or digestive problems, psoriasis, carpal tunnel syndrome)and now I know it was the PPIs all along. It's simple: stomach acid is required for proper digestion for many reasons and your digestion will not work right without it. You will suffer, it's just a matter of how long it takes and how badly. For me, it took a couple of years of daily use before any symptoms started and then I flew under the radar for another 6 or 7 years before I totally hit the wall.

Some people have to be on this medication and it is valuable in a short term capacity (as it was originally designed to be used) but I am now convinced that very few people should be taking this medicine long term.

Let me know if you have any questions.

Post Edited (Lenny66) : 5/13/2007 4:39:17 PM (GMT-6)

Posted 8/28/2008 12:06 AM (GMT -5)
It matches some research papers: http://www.fasebj.org/cgi/content/full/19/6/656
Isn't it crazy that doctors prescribe this stuff and create a lot of pain for people? It is almost common sense if you know anything about enzymes and digestion that this would be a problem. How does this kind of blatant misuse of a drug happen? Oh wait, I forgot. There's money to be made in inflicting suffering.
Posted 8/28/2008 10:31 AM (GMT -5)
I need to ask my doctor about this because I keep hearing that being on these meds long term is not good for a lot of reasons. I'm kind of stuck though because the prednisone I take for my lupus eats my stomach alive and I'd be in a lot of pain without my prilosec, but I don't like all of the long term risks that go along with it. I see my doctor next month, so I need to ask him about it.
Posted 9/2/2008 11:47 PM (GMT -5)
There may be hope for lupus yet. Probably a few years off yet, but even so. See: http://www.sciencedaily.com/releases/2008/08/080825175001.htm
It cites a successful reversal of diabetes and unspecified other auto-immune diseases in mice. It involves using TNF to eliminate CD8 type T cells which are responsible for the auto-immunity. Fingers crossed!
Posted 9/3/2008 11:05 AM (GMT -5)
This subject is very upsetting to me as well. I am so glad to hear you were able to control whatever condition you were taking the PPI for, without having to take it any longer. I am also amazed you did not suffer a severe acid rebound when stopping it, as most people do.

I must take a PPI because most of my pancreas was destroyed by gallstones, and the strong prescription digestive enzymes I take don't work well enough to digest fats without the PPI to give them a boost. I dont' know why that works, but it does, and is standard procedure in severe pancreatic insufficiency.

Pancreatic insufficiency lowers life span by 1/5 even when treated, otherwise, I would just suffer the undigested fats, even though it dries out my skin to the point of pain. Not digesting fats caused some badly needed weight loss and helped my lipids, but most of our brain is made up of fats, so we must digest them to live.

My osteopenia has already doubled in only one year on Prilosec. Taking a PPI for just one year increases bone fracture risk by 44%.

I read somewhere that Prilosec works just as well if taken every other day, instead of daily, and so far, so good.

I also increased the amount of my vitamin D supp., and calcium, magnesium, manganese and boron supps., as well as taking Strontium on an empty stomach every other day.

I have big bones and have exercised all my life. Dairy is my favorite source of protein and always has been. I eat dark green salad twice daily. I've always done everything right and figured osteoporosis was the one thing I would never have to worry about. Wrong. This illness attacks every system in the body.

klutzo
Posted 9/4/2008 1:28 AM (GMT -5)
Hi Klutzo - I did have acid rebound when I quit. I had been on the PPI (ranitidine) for almost a year then. I managed to control the acid by diet and homeopathics, but it sounds more complicated for you. I eventually discovered that I have Crohn's and that was causing inflammation in the stomach as well. The problem appears to be one of impaired digestion (PPI's possibly being one cause) which passes undigested food to the gut bacteria and this results in slowed peristalsis and thus a slower clearing of the stomach.

Did they call your problem pancreatitis? I ask because that is a common problem for Crohn's patients. I have not actually seen the mechanism spelled out anywhere, but some papers I have read suggest the following: Gut permeability is increased due one of several environmental factors (gut infection, stress, NSAIDS, alcohol and other causes of gut inflammation). The increase in permeability allows gut bacteria to encounter the tissue underlying the mucous membrane and trigger an immune response. The immune response causes more inflammation (and more gut permeability) and kills off some of the gut bacteria. The killed bacteria release endotoxins which then can migrate through the gut wall (due to permeability). The liver is taxed with the job of removing the endotoxins and if the gut reaction is strong, the liver will not successfully remove all of them. So far, I have seen papers describing this scenario. Next is supposition. My guess is that the production of bile is impacted and gall stones are produced, or maybe the endotoxins are passed to the gall bladder if the liver is overloaded. Your mention of the pancreas being destroyed by gall stones is the first that I have heard of that connection, but it completes the circle. I had previously thought that the inflamed gall bladder was responsible for some of the reflux symptoms.

I don't know if it is possible to repair damage to the pancreas, but it should be possible to prevent further damage by controlling gut permeability. How? First, avoid the triggers mentioned above. Second, there will be some food allergies triggered by gut permeability and incomplete digestion of food. You would have to avoid the trigger foods since the allergic response will maintain inflammation in the gut and thus maintain gut permeability. A naturopath is probably the best resource to help with that. Third, support the mucosa by taking a glutamine supplement. Glutamine is depleted in inflammation and the mucosa use it to regenerate.
Posted 9/4/2008 12:40 PM (GMT -5)
More on the pancreas - it is not only involved in supplying of digestive enzymes, it also is involved in the neutralizing of the acidic stomach contents when they are passed into the small intestine. The pH control is essential to the proper function of enzymes in the ileum, and I wonder if it is working well enough to allow the enzymes there to function (they only work in a small range of pH). The pH of the stomach is probably about 4.0 or so due to the PPI, so a number of stomach enzymes will not work properly. If the pancreas is not neutralizing the stomach contents properly, that might account for the acid reflux - the stomach contents would be held back rather that passed into a small intestine that is not properly neutralized. I don't know if there are any options to help control the pH in the small intestine, but I would guess that it would help to do that, if possible.
Posted 9/4/2008 12:55 PM (GMT -5)
Link confirming the diminished capacity of the pancreas to neutralize acidity in Pancreatic Insufficiency: http://www.springerlink.com/content/v28214665j347w22/

A quick look for means of neutralizing the stomach contents when passed to the small intestine basically implied that the PPI's were used to do that. It seems like a poor method to me. It causes poor digestion in the stomach and does not guarantee that the contents are neutralized in the SI. Talk to your doctor?
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