Prolonged Nexium Use Linked to Increased Risk of Dementia

[EZEtoGRU]

This is not just a Men's Health issue but this forum seemed to be the best place for the topic.

A recent study has identified a link between the prolonged use (more than 4.4 years) of proton pump inhibitors and increased risk (33%) of dementia.  OTC drugs like Nexium, Prilosec, and Prevacid fall into this drug class.  This concerns me greatly as I take Nexium once per day.  About 15 years ago, Tums stopped working for me and my acid reflux was becoming very problematic.  I moved over to Nexium and started taking it daily and have ever since.  I'm sure I'm not the only one here that does this.  

I obviously don't want to increase my risk of dementia in future years.  I'm wondering what I should do.  Anyone else have these concerns?

 

Popular heartburn medicine increases dementia risk by 33%. What to know to stay safe.

WWW.USATODAY.COM

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People who took acid reflux drugs for more than 4 years faced a 33% greater likelihood of developing dementia

 

Edited August 10, 2023 by EZEtoGRU

[Guest]

Long-term use of PPI's carries a multitude of serious health risks, dementia being only one of them. Yes, they're more effective than H2-blockers, but they can be addictive. Getting off them can be somewhat unpleasant, but we now know that PPI's should not be taken long-term unless one has a rare health problem such as Zollinger-Ellison Syndrome. The wisest move is to switch to an H2-blocker such as famotidine 40 mg, and then take some Maalox Plus or Mylanta EX for breakthrough symptoms. It may take a few weeks, but eventually the withdrawal gets easier. 

Cureus | Adverse Effects Associated with Proton Pump Inhibitor Use

WWW.CUREUS.COM

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Proton pump inhibitors (PPIs) marked a before and after in the management of gastric acid‐related disorders since their introduction to the market in 1989. Due to a novel...

Reducing Adverse Effects of Proton Pump Inhibitors

WWW.AAFP.ORG

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Proton pump inhibitors effectively treat gastroesophageal reflux disease, erosive esophagitis, duodenal ulcers, and pathologic hypersecretory conditions. Proton pump...

[pubic_assistance]

On 8/10/2023 at 11:08 AM, EZEtoGRU said:

About 15 years ago, Tums stopped working for me and my acid reflux was becoming very problematic. 

There are.many lifestyle issues that can sometimes be adjusted to reduce acid reflux.

Reducing coffee or liquor (or both), eating lighter meals and going for a walk after dinner and never laying down after a meal are among the various issues that can reduce the condition.

[+ Charlie]

I read about this only a few minutes before logging on here! I have had acid reflux problems since middle age, and have used over-the-counter and prescription meds (starting with Nexium) for it for many years. I usually found that each one of them became ineffective after a while, and switched to something else. I am currently taking prescription pantoprazole, one of the PPIs, and I have found better results from that than from most others, but I haven't been on it for very long.

I have never had more than one cup of coffee in the morning and a glass of wine with dinner, I eat a fairly simple healthy diet, I get a lot of exercise, and I never lie down after eating. My spouse, on the other hand, does all the things one is not supposed to do (he often goes straight from the table to the sofa to nap), and he has never had any trouble from reflux, so he has never taken any of those medications. And he has dementia. So what to do?

[+ purplekow]

First aspect, Tums is only useful, if at all,, for limited use.  Once the effect of the Tums wears off, in a relative short period of time, there may be a rebound production of acid.  Second, if you  have needed medication for that long, you should have had an upper endoscopy and should have been tested for H. pylori which is a bacteria associated with excess acid production.  If that is positive, there is a short term treatment with PPI and antibiotics which may clear the infection.  And if you have been taking Nexium for 15 years, at some point a doctor must have started it as I do not believe PPIs were over the counter 15 years ago.  Check with your doctor and see about getting off of them for a variety of reasons,   Also have your magnesium level checked as that can result from PPI use and can lead to all sorts of musculo-skeletal issues.  

[+ tassojunior]

A doc (not mine) at Kaiser mentioned to me several years ago that many people take Prilosec every day, as if it were non-harmful. I find the way to get off it is to skip a day for a week then 2 days and then just use it when severe heartburn happens, along with Tums the first day and with Tums after quitting as needed. Of course not eating much and not using Cialis or Viagra is required and I'm not giving up my Cialis, even if I have to starve. There's also the immediate-effect strong over the counter Pepcid. Glad I read this. I'll be tapering off asap and switching to Tums and Pepcid as needed with a couple days of Prilosec only when really bad. (And if I know i'll be doing a lot of Viagra I'll do Prilosec a little earlier and next day.)

Edited August 12, 2023 by tassojunior

[+ tassojunior]

and look at the paragraph a Google search gives you up top. Google is so dead now. 

 

 

Edited August 12, 2023 by tassojunior

[+ Charlie]

11 minutes ago, purplekow said:

First aspect, Tums is only useful, if at all,, for limited use.  Once the effect of the Tums wears off, in a relative short period of time, there may be a rebound production of acid.  Second, if you  have needed medication for that long, you should have had an upper endoscopy and should have been tested for H. pylori which is a bacteria associated with excess acid production.  If that is positive, there is a short term treatment with PPI and antibiotics which may clear the infection.  And if you have been taking Nexium for 15 years, at some point a doctor must have started it as I do not believe PPIs were over the counter 15 years ago.  Check with your doctor and see about getting off of them for a variety of reasons,   Also have your magnesium level checked as that can result from PPI use and can lead to all sorts of musculo-skeletal issues.  

The Nexium was prescribed by my primary care doctor when I was in my late 50s. I took it for several years, by which time it had become available over the counter. I stopped about 15 years ago, because it didn't seem effective any longer. I have had the endoscopy, and I don't have H.pylori. I used Tums when needed, until an allergy specialist put me on Omeprazole a few years ago, because he said the reflux aggravated my respiratory allergies. My current primary care doctor prescribed the pantoprazole, which seems to cause me fewer bowel problems than Omeprazole did.

[+ purplekow]

Sounds as though you are seeing a doctor rather than that quack Dr. Google

[EZEtoGRU]

2 hours ago, purplekow said:

First aspect, Tums is only useful, if at all,, for limited use.  Once the effect of the Tums wears off, in a relative short period of time, there may be a rebound production of acid.  Second, if you  have needed medication for that long, you should have had an upper endoscopy and should have been tested for H. pylori which is a bacteria associated with excess acid production.  If that is positive, there is a short term treatment with PPI and antibiotics which may clear the infection.  And if you have been taking Nexium for 15 years, at some point a doctor must have started it as I do not believe PPIs were over the counter 15 years ago.  Check with your doctor and see about getting off of them for a variety of reasons,   Also have your magnesium level checked as that can result from PPI use and can lead to all sorts of musculo-skeletal issues.  

Thanks for the input.  I do have an appointment for my annual physical in early October so I do plan to have this as a major topic of conversation with my doctor.  I started reducing my alcohol intake early this year so that's one thing.  Also, I have been working more on my weight this year so that should also help.  It seems to me I was tested for H. pylori way back when I first went on Nexium but I will ask about that again.  I was first prescribed Nexium when it was  only available by prescription but it became available OTC pretty quickly after.  It's possible it was not a full 15 years I have been on it.  Maybe it's 10-12 years.  TBH, I am reluctant to stop taking Nexium as it has served me well the whole time I have been on it.  Having said that, I don't like the thought of a 33% increased risk of dementia.  Again, thanks for your comments.

[Guest]

It has not been demonstrated that H. pylori is a cause of GERD. It's controversial at this time.

Relationship between Helicobacter pylori infection and GERD - PMC

WWW.NCBI.NLM.NIH.GOV

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Gastroesophageal reflux disease (GERD) is due to the chronic exposure of the esophageal mucosa to acid secretion from the stomach. Helicobacter pylori (H.p.)...

"...studies combining all these factors (including H.p. infection, host factors, life style habits) are needed to better define their effect on the onset of GERD."

And, a more recent study (2022):

The association between helicobacter pylori infection and erosive gastroesophageal reflux disease; a cross-sectional study | BMC Infectious Diseases | Full Text

BMCINFECTDIS.BIOMEDCENTRAL.COM

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Background The association between H. pylori (Helicobacter pylori) infection and gastroesophageal reflux disease (GERD) is a complex and confusing...

"...In their research, H. pylori infection was not associated with GERD based on both procedures [25]. Another study based on esophageal manometry, 24-h pH monitoring, and EGD showed that GERD features, such as abnormal esophageal acid, erosive esophagus, or Barrett’s esophagus, were not related to H. pylori [26], which is consistent with our results..."

Though H. pylori is extremely common, especially among gay men, and it's tempting to pin that bug on a number of problems, the association with GERD probably doesn't pan out.

[+ tassojunior]

I'm getting off Prilosec now. Last few days since I read this I've been taking it every other day with just minor heartburn and belching a Tums cured. But to taper off more I intend to rely both on Tums and Pepcid or Zantac (Famotidine) mostly in the future with Prilosec a few hours before and after I use viagra. Are H2 inhibitors like Pepcid and Zantac safer, at least from the dementia danger? Will diet shots (Wegovy etc) interact with any of these badly? 

[Guest]

I'm not sure why Tums keeps getting mentioned. Although there are different formulations, Tums in general consists of calcium carbonate. Calcium is a secondary messenger chemical to signal the parietal (acid-making) cells to produce more acid. Therefore, these tablets will neutralize the acid on contact, but signal the stomach to produce more acid afterward. As I recommended previously, most physicians would recommend Maalox Plus, Mylanta EX, Alternagel, or Gaviscon, which are usually (check the label) magnesium/aluminium based.

 

 

Edited August 13, 2023 by Unicorn

[+ GoingGood]

I was a long term nexium user and recently stopped and at the same time quit using alcohol.  The results have been great.   I don’t have the reflux and have seen other positive health benefits.   I miss the wine but I think this works best for me.  

[+ Pensant]

3 hours ago, The Big Guy said:

I was a long term nexium user and recently stopped and at the same time quit using alcohol.  The results have been great.   I don’t have the reflux and have seen other positive health benefits.   I miss the wine but I think this works best for me.  

Although I have the proverbial “iron stomach”, I’m seriously considering giving up the wine, too. The more I read, the more I find out about the downfalls of even moderate drinking.

[+ Charlie]

I hate the thought of giving up my one glass of wine with dinner every night.

[+ tassojunior]

It's only been a few days going cold turkey off Prilosec after 4 years but I'm not having any noticeable reactions. I did take a Pepcid one day after a slightly spicey meal caused a little belching. I'll still use a Prilosec with any Viagra and a half day later. Now hoping they don't find anything wrong with Pepcid. (Spoiler: They will.) I guess the certainty of daily Prilosec/Nexium was too good to last and "as needed" is always the safer route. I still like our system a lot better than EU where very few things are OTC.  

[+ GoingGood]

1 hour ago, Charlie said:

I hate the thought of giving up my one glass of wine with dinner every night.

Since I used way more than one glass I am sure my case is much different and yes I miss my many glasses of wine.  

[+ tassojunior]

Happy to report that after 4 years of daily Prilosec I've now been over 2 weeks cold turkey but on Pepcid with no effects. So now I hope I'm 30% less likely to get...........what were we talking about again? 

[Guest]

2 hours ago, tassojunior said:

Happy to report that after 4 years of daily Prilosec I've now been over 2 weeks cold turkey but on Pepcid with no effects. So now I hope I'm 30% less likely to get...........what were we talking about again? 

[harlow]

When I was in the military I took Nexium daily for over 10 years until the military got rid of it and switched me to Pantoprolezole. Still worries me about the long term effects but I have such bad acid reflux I can’t go 3 days without it. 

[+ Pensant]

New research suggests that too little stomach acid is the culprit. I’m  fortunate that I’ve never had tummy issues or reflux. I also take a daily refrigerated probiotic (Vital Flora) and try to eat a pickle or a few ounces of sauerkraut every day as well. Fermented foods are your stomach’s friends!

[+ Charlie]

2 hours ago, Pensant said:

New research suggests that too little stomach acid is the culprit. I’m  fortunate that I’ve never had tummy issues or reflux. I also take a daily refrigerated probiotic (Vital Flora) and try to eat a pickle or a few ounces of sauerkraut every day as well. Fermented foods are your stomach’s friends!

Interesting to know. I love both pickles and sauerkraut, but always ate them in moderation because I thought they were a cause of my stomach problems.

[Rod Hagen]

I can not stop taking daily PPI.  H2 antagonists, and lifestyle interventions, are unfortunately not enough.  I now have osteopaeina, that's likely due to the PPIs.  15 years ago I was hospitalized with Cdiff, and I don't rim, so that was likely due to messy fingers and decimation of protective stomach acid by the PPI. And now Dementia seems to be in my future, perhaps, due in part to PPIs.  

And yet, I live in the now and the impact of living with the persistent heart burn and unpredictable, recurrent GERD I had before PPIs, even with smart interventions and H2 Antagonists, was like living with asthma before I discovered Dupixent, it was life interrupted.  It's not an addiction, but it is a dependence.

Edited December 16, 2024 by Rod Hagen

[+ APPLE1]

On 12/15/2024 at 8:20 AM, Pensant said:

New research suggests that too little stomach acid is the culprit. I’m  fortunate that I’ve never had tummy issues or reflux. I also take a daily refrigerated probiotic (Vital Flora) and try to eat a pickle or a few ounces of sauerkraut every day as well. Fermented foods are your stomach’s friends!

After years heartburn issues, somone recommended I try Keifer as a proactive solution before eating known culprits. It has worked wonderfully for me.

As added benefits, the once or twice year, I do still get heartburn, Keifer is like an organic pepto bismal. I can keep swallowing gulps until the cool, thick texture coats my esophagus and the discomfort disappears because there is no "maximum" daily dose. It's also a great source of calcium and Vit K2.

Edited December 16, 2024 by APPLE1
Clarity