In last week’s blog, we whisked you, Dear Reader, into a deep discussion about the dark side of antacids (PPIs). You know, those medications touted for suppressing symptoms of heartburn and acid reflux, returning calm to your dinner experience? Yeah, those. We wrote all about it here and want to continue the conversation in the space below.

Long-term dependence on PPI¹ antacids, as you know, often triggers a host of dysfunctions in the body. This isn’t revelatory; PPIs work temporarily by suppressing the stomach’s healthy and necessary acid production to control the symptoms of heartburn. They are patchwork over a deeper issue, and unless we address the root cause of heartburn, we cannot expect to restore harmony to the body’s inner ecology. More problems will prop onto your diagnostics chart as the root problem is left untreated.

So what can you do? Should you quit taking PPIs cold turkey?

As with many things in life, quitting PPIs cold turkey isn’t recommended. The withdrawal agonies from quitting antacids are somewhat comparable to those of caffeine and sugar withdrawal (the former, or course, being many degrees worse). While quitting caffeine makes you irritable and lethargic and prone to a bad case of madness—snapping at your succulents from your bed at 1:35 p.m., wondering if you will ever have the energy to adult again—quitting antacids actually worsens your reflux problem. Having suppressed your stomach acid for so long, quitting PPIs cold turkey causes your body to produce high levels of gastrin, the hormone that stimulates the secretion of gastric acid by the parietal cells of the stomach. Your body overcompensates by producing larger-than-normal amounts of stomach acid which then translates into a worse case of acid reflux. It’s common that people who take PPIs for long periods of time grow addicted to them; when they decide to quit, their reflux is worse and more unbearable than it was when it started.

How to get off these medications?

It goes without saying: consult your healthcare provider! This is especially crucial if you are taking PPIs for conditions other than acid reflux and heartburn. Some patients take antacids for more serious conditions and need thorough consultation and evaluation of their condition before they can safely terminate their prescription. Most functional medicine doctors, pharmacists, and naturopaths might be able to wean you off safely and effectively. In any case, below are general pro-tips for weaning off of antacid pills:

FIRST, employ the principles of gradualism: decrease your dosage slowly and gauge your body’s response. If you are taking Omeprazole 40 mg, for example, reduce the dose to 20 mg. If you are taking a double dose daily, slash it to once-a-day. Keep at this for at least two weeks, and if you find that you’re managing, reduce the dose to every other day… and then to every third day… and if you are experiencing side effects (i.e. acid reflux, heartburn) on the medication-free days, try H2 blockers² to relieve those symptoms. Switch over to a daily dose of H2 blocker if needed and then gradually decrease that in a similar style until you have no symptoms.

SECOND, with Jedi-like intentions, uncover the culprits undermining your gut health and develop drug-free strategies for restoring balance to the force. Or, more accurately, restoring health to your gut. Begin by eliminating processed foods, bad oils (vegetable, soy, corn, canola), processed sugars, and refined carbohydrates from your diet. Stomp them out like you would an infiltrating army of Stormtroopers: immediately and without question. In their place, load up on fresh and organic produce and their nutritious sidekicks. But avoid anything that may irritate your recovering stomach, such as citrus foods (tomatoes, oranges, lemons, etc.), deep fried foods, coffee, alcohol, cigarettes, chocolates, and soda pops. Keep in mind, too, that our generation of Americans is becoming increasingly sensitive to gluten and dairy products. So maybe pass on that latte and scone during your lunch break?

THIRD, begin a food diary documenting the foods you eat alongside any symptoms you experience—both their frequency and severity. You can even undergo a food sensitivity lab test for good measure. During this time, follow these basic food rules for preventing acid reflux:

• Do not lie down right after you eat.
• Always eat an early dinner, approximately four hours before you go to bed. Eating or snacking too close to bedtime is detrimental, not only to your stomach health, but to your overall health and wellbeing.
• Eat smaller meals and chew your food thoroughly.
• Find innovative ways to elevate your head above your chest while you sleep. Larger, fluffier pillows? An adjustable mattress?

FOURTH, sprinkle fermented food onto your meals like you would confetti at your friend’s wedding party! These healthy-gut-bacteria-restoring foods include sauerkraut, kimchi, miso, apple cider vinegar, kombucha, organic raw honey, among many others. Also, don’t succumb to commercially-sold yogurts; not only are they bereft of healthy probiotics, but they are also loaded with sugar—sometimes even more than your favorite tub of ice cream. While these yogurts masquerade as “healthy,” they often go through a pasteurization process which inevitably strips them of their good bacteria. Probiotic supplements and digestive enzymes can help improve your gut health too.

Another friend to your healthy-gut-bacteria-restoring ventures is Aloe Vera juice, which eases acid reflux symptoms by reducing inflammation in your gut. Drinking about one-half cup before meals helps prevent unwanted symptoms.

Ginger root is also extremely beneficial and far superior to lansoprazole, according to a 2007 study. It works amazingly well in blocking acid and suppressing bad stomach bacteria, including H Pylori. Drinking ginger tea, or just plain ginger water, half an hour before meals helps prevent symptoms.

Here’s one that will take you by surprise: melatonin. A humble supplement³ of this sleep hormone (3-5 mg) is enough to help you wean off your PPI medication, as it restores gut health and curbs gastrointestinal symptoms. Believe it or not, our stomachs produce 400 times as much melatonin as the pineal gland, making this hormone a key player in this discussion.

And that, Dear Reader, is your ultimate list of go-to strategies for tackling heartburn and acid reflux, medication-free. The time of chest-wrenching meal experiences is over. The era of smooth food indulgences (nutritious, of course) is about to begin. And in your pursuit of healthy gut bacteria and stomach acid balance, remember that PPI medications can have a role in your health narrative, but they shouldn’t budge as an all-star cast.

Foot Notes

¹ Common Proton Pump Inhibitors (PPIs) include: Omeprazole (Prilosec), Esomeprazole (Nexium), Lansoprazole (Prevacid), Pantoprozole (Protonix), Rabeprozole (Aciphex), Omeprazole/Sodium Bicarbonate (Zegerid).

² H2 blockers include: nizatidine (Axid), famotidine (Pepcid), cimetidine (Tagamet), or ranitidine (Zantac)

³ Other effective supplements for GERD are L-Tryptophan, Vitamin B6, Folate, Vitamin B12, Methionine, Betaine HCL Pepsin, Vitamin D, Glutamine, Slippary elm, and Astaxanthin.

Between splitting headaches, periods, and muscle soreness, millions of Americans turn to a trusted companion for momentary relief: pain killers. These seemingly harmless pills are everywhere, and their existence is as plentiful as the number of symptoms they promise to treat. They populate the purses of women, the desk drawers of office workers, and they can be exchanged between strangers with a passing question: “Hey, got any pain killers on you?”

…and pop! goes the bottle.

Among the top selling painkillers is a particular category called “NSAIDs,” which stands for “non-steroidal anti-inflammatories.” NSAIDs are readily available and can be purchased as casually as you would a box of bandaids: over the counter, with or without prescription. Most people don’t even think twice before reaching out for these pills. When battling sniffles or body aches, they quickly summon the magical powers of an Ibuprofen (Advil) or Naproxen (Aleve) pill for quick relief. But what eludes us in the fine print is the side effects brought upon us by these pills. They can trigger serious health problems, including health complications that lead to death. In fact, NSAIDs cause over 16,000 deaths each year in the United States alone.

Let’s Dissect the Issue

The ease at which we purchase these pills, their accessibility, their discounted prices—all of these convince us of their safety. We can pick them up with drive-thru-like convenience. But here’s the catch: everyone who takes NSAID painkillers is left with some degree of health damage. And the longer you take them, the worse it gets. Studies show that people who take NSAIDs for arthritis pain over the period of a year suffer more joint damage than those who take nothing at all. NSAIDs, ironically, inhibit your body’s ability to build cartilage (a necessary function for joint health). On the contrary, they promote cartilage destruction.

NSAIDs are also notorious for eating up healthy gut lining, thereby causing ulcers, internal bleeding, and gastrointestinal perforation. These gut complications, as common as they can be, are like silent saboteurs; they crawl up on painkiller-dependants with no warning, especially when their victims have no prior history of stomach issues. The outcome is even worse when NSAIDs are taken with alcohol. In fact, an Ibuprofen accompanied by your evening glass of wine can increase your risk of gastrointestinal bleeding by fourfold.

So it is no secret that NSAIDs damage the tissues in our digestive system. And since an unhealthy gut is the gateway to most human diseases, these pills often trigger several diseases and health conditions that are far worse than the mild symptoms NSAIDs attempt to treat.

Wait, There’s More…

Another less recognized adverse effect of NSAIDs is increased intestinal permeability, also known as “leaky gut.” Imagine this: for every pain, for every rash, for every soreness, you reach for a painkiller, and with time, these pills begin to thin your intestinal lining, thereby widening the spaces between cells, allowing larger, undigested food particles and toxins to leak from the gut and into the bloodstream, triggering inflammation, which ultimately leads to allergies, autoimmune diseases, depression, obesity, type 2 diabetes, heart disease, and in some cases, cancer.

Still not convinced? Here’s another list of health risks from prolonged NSAID use:

• Heart attack
• Stroke
• Kidney/liver failure
• Hearing loss
• Headaches
• Ringing in the ears
• Skin rashes
• Increased sun sensitivity
• Anemia
• Vision problems
• Pancreatic problems

Aspirin is also classified as an NSAID. In our medical database is a collection of studies linking regular use of Aspirin to an increased risk of  macular degeneration, an eye condition where eye vessels leak blood into the retina causing damage, distorted vision, and even blindness. So if you take aspirin regularly for its cardiovascular health benefits, be sure to have your vision checked regularly.

Sleepless in the PM

Remember the last time you tossed and turned in bed, worried that insomnia was upon you? In those moments, most Americans fumble for an Advil PM or an Aleve PM to get their much needed z’s. But did you know that these pills actually play with your sleep hormone, Melatonin, which alone causes insomnia? They are a major culprit, studies show, in reducing Melatonin production and causing sleep disturbance. It is as though these pills are counteragents to the very problems they are supposed to solve.

For Your Information…

They say ignorance is bliss, but undue ignorance about the chemicals and pills you consume is a danger to your wellbeing. So do yourself a favor and be aware of these common over-the-counter NSAIDs; also keep in mind the damage they bring from long-term use.

• Ibuprofen (Advil®)
• Naproxen (Aleve®)
• Aspirin (Bayer®)

Prescription brands of these painkiller medications include:

• Celecoxib (Celebrex®)
• Diclofenac (Voltaren®)
• Etodolac (Lodine®)
• Fenoprefen (Nalfon®)
• Indomethacin (Indocin®)
• Ketoprofen (Orudis®, Oruvail®)
• Ketoralac (Toradol®)
• Oxaprozin (Daypro®)
• Nabumetone (Relafen®)
• Sulindac (Clinoril®)
• Tolmetin (Tolectin®)