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Supplements to Avoid While Taking a Proton Pump Inhibitor (PPI)

Question:
I take omeprazole (Prilosec), a proton pump inhibitor, to reduce stomach acid. Are there supplements I should avoid, or be taking, due to this drug?

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.

Learn More About Heartburn & Acid Reflux Information:



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COMMENTS

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

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.

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.

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.

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.

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/


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This CL Answer initially posted on 11/2/2013. Last updated 8/8/2017.
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