More warnings about PPI's

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marg
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Post by marg »

Thanks for your replies Tex,
I have decided to half the dose of Omerprazole and see what reaction I get, I see GI 18th July and will ask about taking H2 instead, its no use asking my GP to perscribe H2 now as he will just tell me to ask GI when I see him on the 18th.
they don,t like stepping on each others toes do they :roll:
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PPI's

Post by Jeanie »

Tex,
I feel like I'm between a rock and a hard place. I have read much recently about PPIs and how bad they are for us. I have been taking Omeprazole since August 2007 and I took Prilosec (same thing) for several years before that. Prior to the meds, I bought the drug stores out of Tums because I've had heartburn since I was a teenager. Long ago my Dad and I took baking soda. In September 2008 I took Ranitidine for a short time but the heartburn got so bad, I had to find a store selling Tums (I was out of town at the time). Then I went right back on the Omeprazole. I am still very concerned about the PPI and so this past week I did not take it one day and I was okay but I took the Omeprazole the following day as I didn't want to be sick on New Year's. So I tried again on Thursday and Friday and left them off. By Friday afternoon I was getting very miserable. Food coming up into my throat and a burning feeling. I took 6 tums that evening and then broke down and took an Omeprazole pill. Of course it didn't help right away and I had a miserable night. Finally at 3 AM I got out of bed and took some baking soda in water (like in the old days.) So now I'm back on the pills again. I'm wondering if Pepcid or Axid might work better, but the Zantac (ranitidine) didn't help so I'm quite skeptical. I know that I don't want to take the PPI pills but perhaps it is the lesser of two evils. I did talk to my holistic GP doctor a while back and she said I should keep taking the pills, however I'm not sure how much she understands about the MC. Especially after she tried to get me to take Psyllium! I certainly don't want any problems with my esophagus.

I have quit taking the Statin drug (horrible muscle cramps) and also the baby aspirin. Not sure if that's a good idea or not. But I have always hated the Statins and I have read even more recently about the cholesterol isn't as serious a problem when we get older. I also took Niaspan for many years but quit taking that when I had a five hour reaction one night! (20 minutes I could handle, but not five hours!)

Thanks again for your much appreciated advice.

Jean
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Post by Gabes-Apg »

Jean
I would migrate slowly.

Do you take Vit D3? I would look to balance some of the common deficiencies linked to upper digestion issues, like Vit D3, Magnesium, Potassium, etc. , then with inflammation reduced in your gut, etc, then taper off the PPI's

3 years ago I had to take alot of magnesium powder/baking soda as I had near constant GERD (also lived on Rantitidine)
Couldnt tie my shoe laces without almost vomitting.
once i fixed the deficiencies and balanced histamine inflammation, i no longer have any issues.
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problems with PPIs

Post by Jeanie »

Thank you Gabes,

I do take Vit D3 along with a ton of other supplements. The Ranitidine did nothing for me. On Thursday and Friday I also had liquid D which seems much better today. I would surely like to get off of the PPIs but I just can't take the burning and all the rest of the misery. I just wish I had never started taking them. Who knew? I do feel that my abdomen is bloated most of the time. I have tried to eliminate dairy and a lot of other things and I scarcely know what to eat anymore. Today I went to a funeral and had some raw veggies as there was nothing else I could eat but that wasn't so great either. I just feel like I'm losing ground with this whole thing.

Jean
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Post by Gabes-Apg »

Jeanie,
It is tough at first....

Get your eating plan sorted, and reduce inflammation levels.
Get the D3 levels up, and use magnesium spray
How much Vit D3 are you taking?? When the gerd was at its worst, I was taking 8,000 iu per day.... I was taking this lingually which optimises absorption...

It can take at least 8 weeks to fix deficiencies/heal in normal circumstances...
It might take longer ie 12-16 weeks if you are still sorting out the eating plan.

After a few months, then try and taper off the PPI's.
One step at a time. I know it is frustrating and overwhelming how complicated these things can be, and that there is no quick fix, easy solution.

Keep in mind, Success will be limited until your eating plan is sorted and inflammation levels are reduced...
Hope this helps.
Gabes Ryan

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Post by JFR »

I used to have terrible gerd and couldn't live without Prilosec. When I switched to a low carb diet, eliminating grains, sugar and all fruits except a few berries, the gerd disappeared and I was able to stop the Prilosec. I still eat a low carb paleo diet and the gerd stays away.

Jean
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Post by UkuleleLady »

Getting off PPIs after 10+ years of constant debilitating heartburn was one of the scariest things I've ever done.

My GI told me it was safe to take double doses of both lansoprazole and Zantac daily...really? Not to mention both drugs have been linked to MC. It's not just a coincidence. Before this, I'd been on every PPI known to man., over the years. None of them ever really worked that well.

absolutely gluten dairy free are the way to go.

There is a rebound effect when you get off these meds. It wasn't easy. But I knew for me it was the right thing. I chewed a lot of those DGL tablets and took tums, and slept with the wedge pillow for a while.
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tex
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Post by tex »

Hi Jean,

You've received some excellent responses, and those responses are valid because they're based on actual personal experiences. The sad truth is that virtually all physicians have (without thinking about future consequences) nudged many of their patients into very undesirable situations by prescribing a PPI rather than actually testing their patient's gastric acid level, and/or giving them practical advice on how to control their reflux/heartburn issues by innovative lifestyle changes. Unless I am overlooking possible exceptions, every PPI product contains the caveat:

do not take for more than 14 days or more often than every 4 months unless directed by a doctor.

But despite the ominous tone of that warning, it seems that most doctors continue to prescribe the drugs for continued use on virtually a perpetual schedule, in total disregard of the risks. This is (IMO) blatant iatrogenesis at it's worst.

At this point you have been using the products for so long that you almost surely have permanent damage to the parietal cells of your stomach, and that will make weaning off PPIs even more difficult. It can be done, but as you are well aware, it will be tough for probably at least several months.

Gabes' suggestion to take a significant amount of vitamin D daily is not only valid, but supported by actual medical research data. Reflux problems are often due to a vitamin D deficiency. But instead of testing a patient's vitamin D level and/or recommending an adequate vitamin D supplemental treatment, doctors typically prescribe a PPI, and within a couple of weeks or so, the patient is hooked on PPIs (and still has a vitamin D deficiency). And once we become dependent upon a PPI, resolving a vitamin D deficiency will not resolve the PPI dependency, because PPIs promote the very symptoms that they are prescribed to treat, which typically makes discontinuing them very difficult to do (because the rebound symptoms are very real, and very potent). The quote copied below is taken from one of my previous posts, made (a couple of months ago) in response to another member who was dealing with a similar situation with PPI dependency, from the thread at the link below:
Have you checked your vitamin D level lately? Not only GERD, but MC and all other AI issues (yes the evidence suggests that GERD is an AI issue, according to recent medical research) are associated with a vitamin D deficiency. But more than that, research also shows that vitamin D is also very effective at treating GERD and associated reflux problems (even when a vitamin D deficiency is not present). Several members here have found that the treatment does indeed work, and it works very well. Note that this requires a serious amount of vitamin D, not the anemic RDA recommended by "health experts". Most members find that using 8,000–10,000 IU per day for a couple of weeks or so will provide relief much faster than using 5,000 IU or less.

But weaning off a PPI is not easy, because PPIs actually cause the very problem that they are prescribed to prevent. They actually weaken the lower esophageal sphincter (LES), which makes it more likely that acid contents of the stomach will backflow into the esophagus. But the patient doesn't feel any acid burn, because the PPI neutralizes stomach acid by preventing the stomach from producing it. And it takes time for the LES to regain it's strength, after weaning off a PPI, which means that many unfortunate patients find themselves stuck in a vicious cycle, having to use PPIs because they are unable to wean off them without a strong rebound effect that can be worse than the original symptoms.

As we get older, we tend to lose the ability to produce adequate amounts of stomach acid, and this can cause poor digestion, resulting in indigestion, heartburn, nausea, and acid reflux. The reason why it causes acid reflux is because the clenching strength of the LES is determined by the pH of the stomach contents on the back side of the LES. The lower the pH (IOW, the greater the acidity), the tighter the LES clinches. If the acidity is weak, the LES doesn't have much incentive to remain tightly clenched. That's why PPIs weaken the LES, because like any muscle, if we don't use it, it becomes weaker over time.

When a patient complains of reflux or stomach pain, doctors virtually never bother to test stomach acidity — instead they prescribe a PPI or an antacid, which may be just the opposite of what the patient actually needs. The truth is, very, very few patients actually have too much stomach acid, but that doesn't keep doctors from prescribing acid reducers right and left, because drug reps promote PPIs and H2 antihistamines — they never promote stomach acid enhancers (such as Betaine HCL), because they're cheap.

As far as treating/controlling GERD is concerned, that question comes up very often here, and there are many discussions about it in the archives. To save time and effort, I'll just point to another thread that you may find to be helpful, especially my first post on the second page of that thread, where I list ways to prevent GERD. Here's a quote of the part of that post that addresses GERD, but you may find that reading the rest of the thread is also helpful, because as you will see there, vitamin D level is extremely important for preventing/treating GERD, and antihistamines can help.
Tex wrote:You're probably aware that avoiding eating for several hours before bedtime is very helpful, especially for retraining our lower esophageal sphinctor. And avoiding foods known to cause reflux problems at all times is usually necessary for treating a GERD problem. Examples of such foods include chocolate, alcohol, coffee, tomatoes, peppermint, etc. Definitely avoid them for several hours before bedtime, because they can almost guarantee reflux problems.

One very important trick to help prevent GERD/reflux issues is to never lie on your right side, because that position places much of the stomach higher than the lower esophageal sphinctor (LES), which will allow acidic stomach contents to backflow into the esophagus if the LES fails to clench tightly enough at all times. This is very important, because taking any antacid or H2 blocker (or PPI) will lower your stomach acidity, and research shows that the weaker the stomach acidity on the backside of the LES, the less tightly it will clench. IOW, the stronger the stomach acid, the more tightly the LES will clench to hold back the acid. The reason why I advise against PPIs, is because they are known to weaken the clenching strength of the LES, and it can take months to rebuild the strength of the LES after a PPI is discontinued. That makes it very difficult to wean off a PPI, because weaning off them will actually cause the very problem that they are prescribed to treat.

The only time that I ever had a serious reflux problem in my life is when I was recovering from surgery, and the doctor in charge insisted that I take a PPI each day, while in the hospital. As best I can recall, I only took a PPI for 3 days, but it took me many months to get rid of the reflux problem after that. That's when I learned to never sleep on my right side.

Some people find that elevating the head of their bed a few inches by placing those legs on blocks, can help to prevent GERD/reflux problems, also.


http://www.perskyfarms.com/phpBB2/viewtopic.php?t=621

If you have serious problems trying to wean off the PPI, you should be able to bridge the gap by using an H2 blocker for a while, but please be aware that it takes months to overcome the damage caused by PPIs. IMO, PPIs should be illegal, except in very exceptional situations.

And yes, if you are only avoiding gluten in your diet, it is very possible that you may have other food sensitivities that have developed over the past year. You may have been sensitive to other foods initially, but your immune system wasn't producing enough antibodies to them to cause any problems. Over time, antibody levels are cumulative, and so they can eventually reach a point at which they surpass the threshold at which a reaction is triggered.

I hope that this is helpful.

Tex
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=20650

If/when you decide to try to wean off PPIs again, at some point in the future, you might find it beneficial to take Betaine HCL before each meal, in order to boost your gastric acid level. Long-term (some of which is likely to be permanent) damage to the parietal cells will result in a lowered response capability, and therefore less reliable gastric acid production. A gastric acid deficiency (too little stomach acid) results in incomplete/poor digestion, resulting in gas, bloating, heartburn, reflux, etc. Betaine HCL promotes the production of gastric acid, and allows improved digestion for anyone who has a reduced ability to produce gastric acid (which is very common as we get older).

When you get to this point, please ask about how to use the Betaine HCL, because there are some guidelines to using it that should be followed, in order to determine the correct dose. It involves a somewhat long, detailed discussion, so I won't include it here, since this post is already fairly long.

At any rate, you've been taking a PPI for so long that getting away from them is going to be a major project that should be considered only when you are in the proper frame of mind, and when you have the time (and the willpower) to devote to it, so that you can persevere until you have successfully kicked the PPIs to the curb. They will fight tooth and nail, to try to prevent you from ditching them. That's only 1 of the many reasons why I believe it should be illegal for doctors to prescribe them except under very exceptional circumstances.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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PPIs

Post by Jeanie »

I have been bothered by heartburn since I was a kid. In the old days we used to take soda in water. And after that I took many bottles of Tums. Now I have been on a PPI for many years. A few years back I tried to go off of it and I switched to Ranitidine but on the third day I was miserable and unfortunately I was out of town so I had to go somewhere to find some Tums. It simply did not work for me so I went back on the PPI.

Recently I was determined to get off of them so I quit but on the third day I was in such agony I had to go back to them. I have just recently figured out that I had mast cell issues. I have also had nasal allergies most of my life. Also I had a coronary stent put in two years ago and I was on Plavix for the first year. I have been concerned that the Plavix might not have been as effective as it should have been. I just saw my heart doctor today and he didn't seem to be too concerned. He wants me to take Isosorbide Mononitrate and I have been reluctant to do that as I don't see where it is necessary and I am already on a lot of other medications. Also, I had quit taking my cholesterol medicine a few weeks ago because of way too much muscle cramps. Even though I'm not concerned about the fact that my cholesterol count is high, he wants me to take 40 mg of pravastatin. I have been reading recently that the cholesterol count isn't is serious when you get older and also that the cholesterol situation has been overblown. Some days I feel that I am between a rock and a hard place. Guess I just have too many issues.

Jean
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Post by Gabes-Apg »

Jeanie
it has been a tough process for many...

if you are deficient in key elements such as Vit D3, magnesium, etc it will be quite difficult to transition off the meds.
have you had your Vit D3 levels checked recently?

the combo of meds would have depleted magnesium levels. If you have histamine inflammation good doses of Magnesium, Vit C and Zinc will help. Also if you were taking a statin, you would be deficient in CoQ10.

If it was me I would spend a couple of months fixing highly probable deficiencies, balance the histamine inflammation and then maybe try again.
good doses of Vit D3 - upwards of 7000iu (more if your blood test level is low)
magnesium, Vit C, Zinc, CoQ10.

the magnesium spray/lotion is a really safe way to get good doses of Magnesium without risking D issues.
the aim would be to get at least 800mg of 'Elemental' magnesium per day to start to correct deficiencies.

if you want any further info let me know,
take care
Gabes Ryan

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PPIs

Post by Jeanie »

I apologize. I had written my last message before I read the responses on this page. I had read them previously but I am still struggling with this and after my doctor visit today I wanted to figure out what I should do. Mostly about the heartburn issue and then with the cholesterol problem. I'm sorry if I repeated myself but as you can see the issues seem to keep going on. When I read that it could take months to resolve the heartburn issue I don't think I'd live through it!

Jean
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Post by Gabes-Apg »

jean
no apologies needed, dealing with this stuff is full on and overwhelming....
the reality that there is no easy fix and it takes a sh*te load of time and energy for very small moments of progress is hard to swollen.

looking at Paula (humingbird) post today, it took her years to resolve her MC issues...
it took me 2 years to resolve my GERD/Mast cell issues.

all i can say is, the hard work is worth it.
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Post by tex »

Hi Jean,

There's no question, it's extremely tough to wean off a PPI after taking them for years, because they cause a dependency due to the rebound effect whenever they are discontinued.

Do you know your vitamin D blood level? You might still be deficient, even if you are taking a vitamin D supplement, because you may not be absorbing it very well. Are you aware that vitamin D deficiency is associated with heartburn and reflux problems? If a vitamin D deficiency is the problem, then correcting the deficiency may resolve the heartburn and reflux issues.

And you are correct. Once we pass a certain age, the higher our cholesterol level, the longer we are likely to live. I no longer worry about my cholesterol level being too high — instead, I'm concerned about it being too low, despite what my doctor thinks.

I have a theory that if we take enough prescription medications, none of them help, because so many of them interact with the others, that they cancel out the benefits of each other. :lol:

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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