Answer:

Omeprazole (Prilosec), Nexium, and other proton pump inhibitor drugs can be affected by taking supplements, and can affect your ability to absorb certain vitamins and minerals. St. John's wort, for example, should not be taken with these drugs. These interactions are explained in the Proton Pump Inhibitors article, which is part of the extensive Drug Interactions section of our website (where you can look up interaction for other drugs you may be taking).

Be sure to also read about magnesium depletion which can occur with these drugs in the Magnesium Supplements Review. And, if you take a calcium supplement, read in the Calcium Supplements Review how certain forms of calcium may be preferable if you are taking these drugs.

Also see the Encyclopedia article about Gastroesophageal Reflux Disease (GERD) for other proposed treatments for this condition, including deglycyrrhizinated licorice, marshmallow, slippery elm and others, as well as our CL Answer about supplements for indigestion and heartburn.

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12 Comments

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ROY90
August 7, 2014

I was taking 40mg twice a day, then changed to protonics. My wife put me on 4 coconut
caplets a day. I no longer take any acid reflux medication, and my stomach problems have gone away.

Mary563
February 22, 2015

Why don't you take coconut oil instead of the coconut capsules?

louise8196
December 20, 2015

Be careful taking coconut oil on a daily basis. I was told that it can cause triglicerides and/or cholesterol to be high.

ConsumerLab.com
January 1, 2016

Hi Louise - A diet rich in coconut oil seems to raise good "HDL" cholesterol without raising bad "LDL" cholesterol -- although there is evidence it can raise total and LDL cholesterol in people with already elevated levels. See the CL Answer about coconut oil for more information: https://www.consumerlab.com/answers/What+are+the+benefits+of+coconut+oil/coconut_oil/

donald6933
September 9, 2015

try Apple Cider Vinegar (2 tbsp) and i tbsp of Honey

louise8197
December 20, 2015

I take one tbsp. of Bragg's apple cider vinegar in about a half of glass of tea after supper. It always helps with heartburn. If it is a bad case of heartburn, I will take 2 tbsp., but not every day.

mary ann18166
August 1, 2019

Wanted to get off prilocex, so tried all different things, nothing I tried worked, so on prilocex. Any advice.

Eva17547
February 16, 2019

I do have NERD (nonerosive acid reflux) diagnosed 3 years ago and have been on PPIs ever since. I actually don’t feel any reflux but following the gastro’s diagnosis of the symptoms that’s supposedly what it us. I’d like to get rid of the PPIs but every time I try my whole system goes haywire. Right now I’m pouring some of the content of the capsule out, little by little some more and hope that over time I’ll be able to quit it for good. Btw does anyone have any experience with NERD? I would appreciate to hear from you because even my doctor didn’t know about it. It looks as if medicine doesn’t have any conclusive info.

Alphiene19502
April 15, 2020

I was recommended Nexium or Prilosac, but decided to read further to correct my gut issues due to food indescretion. This resulted in my sole use of L- Glutamine being stirred in a glass of water before food, and a capsule of Enzymes after food.

ConsumerLab.com
April 15, 2020

Thank you for sharing this Alphiene. You can find more information about L-glutamine and stomach issues in our Muscle and Workout Supplements Review, which includes information about L-glutamine and other amino acids: https://www.consumerlab.com/reviews/review_creatine_BCAAs/creatine/#glutamine.

You may also be interested in our Review of Digestive Enzyme Supplements: https://www.consumerlab.com/reviews/digestive_enzyme_supplements/digestive-enzymes/.

Teresa17231
October 10, 2018

I'm not seeing anyone discussing the role that an ineffective esophageal sphincter (staying open too long, opening inappropriately, opening due to pressure from obesity, a too-full stomach, etc.) plays in frequent reflux. The amount of stomach acid doesn't seem to be the problem--the problem is stomach acid reaching tissues that are not meant to withstand the normal stomach pH. There are many things that can influence that, as readers have noted, but many people still have a problem despite trying ALL the things suggested here. Because you ask that commenters cite the origin of their comments (although I see a lot of people not doing that) I will say that my comments stem from my education and experience, both professional as a nurse practitioner, and personal, with acid reflux.

Stephen17230
October 10, 2018

About 8 years ago I was taking Prilosec everyday for 3 years and after reading the long term affects, I decided to research natural alternatives. In my research, I found several articles on Apple Cider Vinegar with "Mother". After taking it for 2 weeks, my heartburn went away. To this day, I still take Apple Cider Vinegar every night with dinner. Its also very good for digestion and weight loss.

ConsumerLab.com
October 24, 2018

Hi Stephen - Thank you for sharing your experience with this. You can find information about apple cider vinegar for heartburn and GERD in the "Digestion" section of our Apple Cider Vinegar Review: https://www.consumerlab.com/reviews/apple-cider-vinegars-review/apple-cider-vinegar/#digestion. The Review also discussed the clinical evidence for using apple cider vinegar for weight loss: https://www.consumerlab.com/reviews/apple-cider-vinegars-review/apple-cider-vinegar/#weight

Valarie18820
January 7, 2020

I tried ingesting organic apple cider vinegar for a few weeks. I rinsed my mouth afterward. Now, my upper teeth are breaking off. I've had one implant fail and have to be re-done, and a molar completely break off, on Christmas Day.. I'm pretty sure it was the apple cider vinegar. I was taking 2 - 3 tablespoons at night.

Jeanne17161
September 12, 2018

I have successfully gotten patients off of PPIs using chewable Diglyrhizzinated licorice (DGL). Enzymatic Therapy makes a chocolate and an unflavored one. Chewing one at the first sign of discomfort soothes the GI lining. If that isn’t enough I add in Life Extension Esophogeal Guardian, the chewable tablet prior or just after meals makes temporary little foam rafts that prevent acid from reflux if back into the esophagus.

I have no financial interests in these companies, just know they work! Of course it is better to taper off PPIs, especially after long term use, as the rebound reflux is terrible. Just my clinical experience.

ConsumerLab.com
September 12, 2018

Thank you for sharing this Jeanne. You can find more information about deglycyrrhizinated licorice in the Encyclopedia article about gastroesophageal reflux disease (GERD): https://www.consumerlab.com/tnp.asp?chunkiid=38738. You may also be interested in our CL Answer about supplements for indigestion and heartburn: https://www.consumerlab.com/answers/which-supplements-can-help-with-indigestion-and-heartburn/indigestion_heartburn/.

Anthony17163
September 12, 2018

hi Jeanne I have High blood pressure will dgl increase it

Jeanne17169
September 12, 2018

No it won’t raise BP. The "D" part of DGL removed the part of licorice responsible for sometimes raising blood pressure.

Robert15093
June 14, 2017

It is important to keep in mind that the approved use of PPIs is for a 14 day run. Aside from exceptions for unusual medical conditions, there is no good science behind long term use. In contrast, there is a growing body of evidence (some of it only tentative) showing various harms, some of them serious in relation to long term health.

As CL points out, a healthier approach involves lifestyle changes including experimenting with dietary changes and specific foods, losing weight, exercising, managing stress, and improving sleep conditions. It may even be worthwhile to examine the potential for food allergies.

Most interesting to me is the clear tipping point I am seeing in the online professional medical discussion groups to which I belong. A year ago, I recall little discussion among physicians related to the potential harms associated to the long term use of PPIs. Now, there is a great deal of discussion, usually in reaction to the release of a new research report, and 90% of the discussion is negative with respect to long term usage.

Beware: PPIs are very profitable to the pharmaceutical companies. One company created a less effective and much more expensive PPI to replace one that was going off patent protection. As usage goes down, consumers can expect to see more advertisements touting the benefits of PPIs.

If you are taking PPIs on a long term basis, and do not have a serious underlying medical condition that warrants doing so, my suggestion would be to work on gradually weaning yourself from them. To be safe, you may want to consult with your physician.

Pamela17232
October 10, 2018

Has anyone with hiatal hernia been successful weaning off PPIs (generic prilosex) and onto something else? My husband tried the D-limonene, but was not successful. Now, after a surgical complication, he is on protonics. We would love to get him off PPIs totally, but he's reluctant to experiment much.

Aaron18275
September 1, 2019

That's my issue too - hiatal hernia. I've tried switching to an H2 blocker (like Pepcid) but was unsuccessful. I had breakthrough reflux constantly. My last GI doc said the PPI studies that showed horrible statistics were flawed and that it's better to avoid Barrett's than to go off the PPI's. I did drop down to the 15mg Prevacid a decade or so ago (basically 1/2 the dose the doctor wanted me on) and I generally have no breakthrough with that, but I'd like to get off it entirely and am feeling pretty desperate. I've been on these for 20 years now and am worried about my long-term health. I have been taking calcium and magnesium supplements the whole time.

Robert14092
June 11, 2017

If you are taking proton pump inhibitors, you may develop a deficiency of magnesium.
This can lead to some constipation. Be sure you are not suffering from a depletion
of magnesium when taking those inhibitors.

ConsumerLab.com
June 12, 2017

Hi Robert - As noted in the Magnesium Review, too much magnesium may cause diarrhea ( https://www.consumerlab.com/reviews/_/magnesium/#cautions) but we are not aware of evidence of deficiency causing constipation.

susan14088
June 11, 2017

i took proton pump inhibitors for nearly 15 years... in ever increasing doses and ever increasing break through reflux. it took nearly 3 years, but i've managed to get off of them using melatonin and a b-complex. i take 3mg of melatonin most nights, but do skip on purpose as melatonin is not without side effects. i also use baking soda on an as needed basis. and i sleep on an inclined mattress support (aka box spring). in the last year i started a low carb/high fat diet and i notice when i eat bread i get more reflux. google melatonin and gerd, there are some real scienific studies that show it is as good as or better than ppis. note: there are a lot more articles on the internet about this topic then there used to be and some of them aren't very good. unfortunately, i've lost my best links when i had to replace my last laptop. good luck!

ConsumerLab.com
June 11, 2017

Thanks for sharing your experience, Susan. Details about using melatonin for gastroesophageal reflux are found in the Melatonin Supplements Review at https://www.consumerlab.com/reviews/melatonin-supplements/melatonin/#stomach.

Ellen13975
May 2, 2017

If you are experiencing regular discomfort after eating, it would be prudent to look into root cause instead of how to cover up the symptom. In addition to our guts being considered our "second brain", and providing 80% of our immune system, leaky gut (symptomized with digestive discomfort) is almost always a trigger to even bigger health problems such as autoimmunity. Try working with a nutritionist to identify the issue with your digestive system, and incorporate diet and lifestyle changes that will make you healthy long term.

Conner14085
June 11, 2017

I couldn't agree more! I am a nutritionist at an internists' practice and see *SO* many people with health problems that have resulted from taking PPIs for several years (they shouldn't be taken for more than a few weeks...).
When someone comes to me complaining of heartburn, I usually advise that they start by keeping a food journal to discover potential patterns; i.e., are there foods/types of meals/food combinations/situations (e.g., high stress) when they are more prone to heartburn?
Once we've discovered associations, I coach my clients on food alternatives, thorough chewing, mindful eating, etc. In addition, there are various natural remedies that can be very effective -- esp. for anyone needing to wean themselves off a PPI. (You shouldn;t jsut stop taking them as this usually causes rebound acidity --> heartburn).
Btw, research has found that eating lower-carb / Mediterranean diet helps with heartburn. This is borne out my my clinical -- and personal -- experience.

Mike18279
September 1, 2019

PPIs cause loss of B12 absorption and cofactor production which leads to chronic mineral deficiencies which inhibit natural cell replacement which in my case caused failure to replace nerve fibres and fibtre insulation. I now have quite severe peripheral neuropathy in my legs from my knees to my feet. This in turn causes balance problems as knowing where your feet are is a key of 3 balance systems, your eyes and inner ear being the other two. Closing my eyes could cause me to fall overt. Supllementation with fulvic acuid mineral supplemnts is slowly restoring my damaged nerves. I take ranitidine/zantac twice a day for reflux which is effective. It most important to sleep on your right side as the stomach is offset and this prevents stomach contents tipping back into your oesophagus and allows trapped gas to be burped. NOTE all acid inhibitors really slow your digestion particularly of meat like beef. When I have a routine gastroscopy they comment on residual food still in mystomach after18hrs.

mike13969
April 30, 2017

Prilosec was the worst thing i ever took for stomach acid. I stopped it and got better in a hurry. Probiotics and better nutrition was my answer to stomach acid problems. Prilosec seems to demand more and more of the drug in a vicious cycle, but doctors love to prescribe it.

Catherine14086
June 11, 2017

I agree with the comment that it is best to avoid acid inhibitors. For me, my acid reflux cleared up entirely by drinking Briggs apple cider vinegar a couple times a day. Evidently instead of having too much acid, I did not have enough. The symptoms are the same.

Catherine14087
June 11, 2017

I agree with the comment that it is best to avoid acid inhibitors. For me, my acid reflux cleared up entirely by drinking Briggs apple cider vinegar a couple times a day. Evidently instead of having too much acid, I did not have enough. The symptoms are the same.

Stanley20162
June 11, 2020

I was prescribed Prilosec to take with my heart medications. It was very disruptive to my digestive system. I also tried Zantec with the same results. I stumbled on to black ginger and have been taking it for years now with good results.

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