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Got GERD? Natural alternatives to PPIs for heartburn

Side effects of popular stomach acid–blocking PPI drugs like Prilosec include nutrient deficiencies, and increased risk for food-borne illnesses, infections, and hip fractures. Tierona Low Dog, MD, talks PPIs and natural alternatives.


My husband has had acid reflux since he was a baby, goes the family lore (which makes me wonder about an undiagnosed lactose intolerance), and still suffers from occasional, painful heartburn—at which point, he grabs the bottle of antacids.

He’s not alone: Increasing numbers of Americans now fill prescriptions for stomach acid–blockers proton-pump inhibitors (PPIs) such as Prilosec, Nexium, Prevacid, and Protonix, pushing sales to $13.6 million last year, according to IMS Health. Although effective and necessary for severe gastric conditions, PPIs are heavily marketed and overused by people who don’t need them.

I talked with Tierona Low Dog, MD, a well-known speaker, herbalist, and integrative physician, about potential negative side of PPIs, as well as effective natural alternatives that can help many people. Here’s what she had to say:

  1. Reducing stomach acid raises risk for both nutrient deficiencies and food-borne illness. “I think it’s no surprise that there’s been a rise in people getting sick from food at the same time there’s been an increase in the use of [PPIs],” Low Dog says. Stomach acid production already declines with age; adding in acid-blockers makes us increasingly vulnerable to both nutritional deficiencies (because the gut can’t break down food well) and food-borne illness (because the gut can’t kill pathogens), she explains. People who take PPIs or over-the-counter H2 blockers may be low in selenium, for instance.
  2.  It’s hard to get off PPIs. There was a study of people without heartburn who took PPIs, and then got heartburn after going off them, Low Dog says. When people stop taking PPIs, acid production can redouble, kind of like taking a cap off an oil gusher, she adds. You have to wean off of them slowly, she cautions.
  3. Try bitters before meals. “This is an old European tradition that we need to revive,” says Low Dog. Some people don’t digest their food well. To prime the digestive system and improve digestion, she recommends mixing one tablespoon of Angostura or Swedish bitters with a small glass of seltzer 15–20 minutes before dinner. (Taking digestive enzyme supplements before meals can have a similar effect, adding extra digestive oopmh to help break down, or predigest, foods.)

Here’s more to think about with PPIs:

PPIs can increase the risk of fractures.
Calcium, along with iron and vitamin B12, needs an acidic environment to be absorbed. This is a special concern forolder women at risk for osteoporosis.

Natural gut-health supplements can help you reduce your dose and eventually wean off PPIs.
D-limonene, an extract of orange peel, can help, Low Dog says. Other effective, traditional remedies include deglycyrrhizinated licorice (DGL), aloe vera gel, digestive enzymes, probiotics, and the amino acid glutamine.

Discuss this Blog Entry 3

Janet Lancaster (not verified)
on Aug 27, 2011

Another natural remedy for heartburn that many have had good results with is pure calcium bentonite clay. It alkalizes the body. Be sure the clay you ingest is not intended for external use only, as many on the market are just that.

on Jan 7, 2012

I like the article you wrote here; it is very informative and useful for the internet users like me. I will come back to read more blog posts on your website and I have bookmarked your website as well
Thank You

Anonymous (not verified)
on Jun 30, 2012

I tried the d-limonene and it tore up my entire digestive system. Be careful with that.

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