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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 5

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.

on Jul 2, 2015

After a chronic throat pain, and some acid reflux symptoms, my doctor put me into a therapy with PPIs. At that moment, I had no inkling of what PPIs are. The therapy lasted for more than a month. The chronic throat pain got over when it had to (but much later) but then I started to become more vulnerable to acid reflux symptoms and stomach pain, now and then.

At that moment, I did not realize what was going on. In between, I went to the doctor again, and the doctor would recommend me the PPIs again for a week or two. And, after some time, I realized that when I took the PPIs, things got better, and it worsened again after stopping the medicine. Then I started looking up the internet for PPIs, and found this whole lot of things about the Acid Rebound Effect. PPIs suppress the acid release, thereby reducing acid reflux, but when you stop the medicine, the acid rebound increases the ph level in the stomach to new levels, which you have not experienced before. The suggested advice in the internet forums was to reduced the dosage gradually, rather than abruptly stopping the medicine.

So, I took it into my own, and reduced the dosage from 20 to 10 to 5 msg (using alternate days) over 3-4 weeks period. In the meantime, I also controlled my diet, avoiding spicy foods and alcohol, also taking whole grain foods, rice and all those stuffs as a gastric diet. The best thing I did was, I got myself into a 3 months training during that time to participate in a long distance run. Seems like mind and gut are strongly linked, do not know if the gut controls the mind or the mind controls the gut. The regular stomach pain was getting on my nerves. But, training for the run, and trying a gastric diet led me to better balance between the mind and gut.

After that, there used to be mild pain here and there, but no where near like the acid rebound pain before. I also finished the run:) in a good time, thought I could never run long distance before.

Now, I atleast feel that I got over with the PPIs. It was something I did not ask for her, it came as a simple generic medication with prescription from the doctor and I took it without checking for its side effects. That was mistake on my part.

So, watch out guys, PPIs may provide some relief but you need to know how to get off this medicine, or if you can do without it. Later is the better choice. Take care

on Jan 5, 2016

Hey Susan,
Thanks for sharing such informative post on heartburn. I agree with your one statement that is "Some people don’t digest their food well" as with changing life style peoples are eating fast foods and don't chewing well. That makes a big reason for damaging the good healths. So we should careful about our health. Apart from that if we facing health problems then we should try home natural remedies or natural medicines like "Acidgone®" instead go for chemical treatments.

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