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ACID REFLUX AND COUGH MEDICATIONS


Prescription acid reflux and cough medication can cause osteoporosis if used for long periods. Inexpensive vitamins and minerals can help to protect your bones.

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Acid reflux and cough medications called proton pump inhibitors (PPIs) are extraordinarily effective at reducing gastric acid production- which is essential for calcium absorption and bone health. They are among the most widely-selling drugs in the world and are used in the treatment of the following conditions:

  • Dyspepsia
  • Peptic ulcers (PUD)
  • Gastroesophageal reflux disease (GORD/GERD)
  • Laryngopharyngeal Reflux Disease
  • Barrett’s esophagus
  • Prevention of stress gastritis
  • Gastinomas and other conditions that cause hypersecretion of acid
  • Zollinger-Ellison syndrome

Clinically used acid reflux and cough medication include:

  • Omeprazole (brand names: Losec, Prilosec, Zegerid, ocid, Lomac, Omepral, Omez)
  • Lansoprazole (brand names: Prevacid, Zoton, Inhibitol, Levant, Lupizole)
  • Dexlansoprazole (brand name: Kapidex)
  • Esomeprazole (brand names: Nexium, Esotrex)
  • Pantoprazole (brand names: Protonix, Somac, Pantoloc, Pantozol, Zurcal, Pan)
  • Rabeprazole (brand names: Rabecid, Aciphex, Pariet, Rabeloc. Dorafem

Over the years, there has been increased concern over the impact of the above drugs on calcium absorption and bone health. One study of 135,000 people (50 or older) found that those taking high doses of PPIs for longer than one year were 2.6 times more likely to break a hip. Those taking smaller doses for 1 to 4 years were 1.2 to 1.6 times more likely to break a hip. The risk of a fracture increased with the length of time taking acid reflux and cough medication.

Yang, YX; Lewis JD, Epstein S, Metz DC (Dec 27 2006). "Long-term proton pump inhibitor therapy and risk of hip fracture". Journal of the American Medical Association 296 (24): 2947–53. doi:10.1001/jama.296.24.2947. PMID 17190895.

These results were confirmed in a 2008 study which found the following:

“Use of proton pump inhibitors for 7 or more years is associated with a significantly increased risk of an osteoporosis-related fracture. There is an increased risk of hip fracture after 5 or more years exposure.”

“Use of proton pump inhibitors and risk of osteoporosis-related fractures”, Laura E. Targownik, MD MSHS, Lisa M. Lix, PhD, Colleen J. Metge, PhD, Heather J. Prior, MSc, Stella Leung, MSc and William D. Leslie, MD CMAJ • August 12, 2008; 179 (4). doi:10.1503/cmaj.071330.

One theory suggests that lower stomach acid reduces the amount of calcium that is dissolved in the stomach. A second theory suggests that PPIs may interfere with the breakdown and rebuilding of bone by interfering with the acid production of osteoclasts.

Seppa, Nathan (January 7 2007). "Bad to the Bone: Acid stoppers appear to have a downside". Science News 171 (1): 3.

A final theory suggests that the reduction of vitamin B12 (by raising homocysteine) may increase bone fragility.

These studies are sufficiently alarming for people taking PPIs to be concerned about their bone health. At a minimum, it is recommended that they consult with their doctors and monitor their bone mineral density every couple of years to ensure that a problem is not developing. Updates on this issue may be found on the Men's Osteoporosis Support Group website.

Interestingly, acid reflux is often caused by poor eating habits including excessive consumption of meat and soda at the expense of fruit and vegetables. Most nutritionists agree that an alkaline diet that emphasizes fruit and vegetables (rather than animal protein) will facilitate a better acid balance in the digestive process.

While it is not necessary to become a vegetarian to control acid reflux, readers may be interested on one person's transition to a vegan diet to balance his stomach acid without the use of acid reflux and cough medication and to treat his osteoporosis.


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For information on supplements that help protect bone loss due to acid reflux and cough medication...visit Osteoporosis Treatment Guidelines.


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