I’m done with Omeprazole, why you should be, too.

I’m sitting here writing this post with generic Target-branded antacids at the ready, chomping them regularly. But the truth is that, after ten years of swallowing a prescription Omeprazole every day, I’ve finally decided that the health benefits are outweighed by it’s many deficits. And I thought I’d share with you the concerns I have, so you can arrive at your own decisions.

Of course, the first and most important caveat is that I am not, in fact, a doctor. I don’t play one on TV either, though I’ve been known to play one extracurricularly from time to time. What I can do for you is link to all the relevant information, like a good blogger, and let you explore for yourself.

Proton-Pump Inhibitors

Omeprazole is one of a handful of drugs called proton-pump inhibitors, and their job is essentially to turn down the enzyme in your stomach that produces acid. This enzyme allows the build-up of protons – therefore positively charged ions, therefore acids – on one side of a biological membrane. In the stomach, the result is a build-up of stomach acid. That build-up is not only ok but necessary, when there is food to digest. However when the stomach is empty, that acid has nothing to break down but the walls of the stomach.

For most people – but not all – acid reflux is caused by the over-production of these acids. PPIs like Omeprazole have provided relief for people suffering from the awful burning and burping associated with acid reflux. There are signs that perhaps these drugs are being over-prescribed. As many as 110 million prescriptions for PPIs have been issued, resulting in a $13bn cash cow for the pharmaceutical industry.

Undoubtedly, there are those for whom the pain and suffering from acid reflux requires strong measures. For these people, Omeprazole might be a godsend. I certainly thought it was when I started taking it. But slowly, over the last decade, I have learned about the downsides.

Leach your bones, starve your blood cells

It has actually been known for some time that PPIs have a bad habit of preventing bones from absorbing essential minerals like iron, calcium, B12 and magnesium. The reason is that the acids produced in the stomach facilitate the digestion of these minerals and vitamins. B12 will be digested by pancreatic digestive fluids later on, but only if the proteins to which they are bound are doused with stomach acid. Calcium is separated from otherwise-insoluble salts.

The long-term effects of this slow leaching of minerals is that older adults who use PPIs like Omeprazole show a significant increase in the number of bone and hip fractures over those who do not use them. But beyond this, new research suggests that in many people, the result can be a type of suppression of the production of blood cells, called bone marrow depression.

Bone marrow depression means that the bone marrow, starved for nutrients, slows the production of new blood cells. The short-term effects of this condition would be decreased energy. The long-term effects of this condition include renal (liver) failure and rheumatoid arthritis.

Heart Burn or Heart Attack?

The most recent revelation – and the one that ultimately convinced me to quit taking Omeprazole – was the correlation between Omeprazole use and heart attack. A 20% increase in heart attacks, actually.

Details on this particular threat are sketchy, at best. As I pointed out when I initially linked to this new study, correlation does not prove causation. Just because a lot of people seem to have had heart attacks that used Omeprazole, that doesn’t definitively prove that the Omeprazole caused the heart attacks. But considering that the same report found no such correlation between other acid-fighting medications, the case is considerably stronger.

All things being equal, I’m willing to risk short term digestive problems if it means eliminating what seem like very serious downstream health concerns. But of course, that meant I would have to quit. And quitting, son, is a bitch.

The Big Quit: not as easy as it sounds.

Here’s the thing: when your body expects certain levels of chemicals to maintain homeostasis, your body adjusts to compensate. When the level of this or that enzyme goes down, the body’s natural response is to speed up that enzyme’s production. In the case of PPIs, this condition is called “acid rebound.”

In short, even after just a few days of being on Omeprazole, your stomach starts producing more of the enzyme that allows for the production of stomach acid. Now when the user stops using Omeprazole, the result is way more acid, way more burning and way more pain.

I’ve experienced this first hand a number of times: every once in a while, your prescription runs out and you don’t get to the store right away. Then your stomach reminds you. A time was that I could let me Omeprazole prescription run out for a week or more without symptoms. Now, I am a slave to it.

Ten years ago, when I initially went on Omeprazole, my doctor had assumed that if I lost some weight, I would no longer need the drug. I had, after all, gained almost 100lbs in five years. But nothing could have been further from the truth: I’ve lost almost as much as I’ve gained and never stopped using Omeprazole. Now, I know why.

So, the only remedy for me in the last month has been my antacid tabs and a goodly dose of willpower. I have sat and burned for fifteen minutes or more, just waiting to ride it out. No, it makes no difference what I eat and in fact, often happens when I’m hungry instead of full.

Things have gotten better, albeit slowly. I don’t have any idea whether, at the end of this trial, I’ll have to take something like Tagamet or some other non-PPI medication. Time will tell.