GERD and Protein Pump Inhibitors: Seeking Alternatives

GERD and Protein Pump Inhibitors: Seeking Alternatives
Ingrid Pincott, ND

Proton  pump inhibitors (PPIs) are one of the ten most prescribed drugs in North America. PPIs are used in the treatment of acid reflux or GERD. I see at least one patient every week who is taking PPIs and wanting to get off them.

Bob, age 45, is a typical example. He has been taking PPIs for years and his GERD symptoms were not completely under control. He also had developed a rash he could not get rid of through conventional treatment so he is ready to try and improve his health. Certainly if a person is in severe gastric pain due to hyper-secretion of stomach acid, these drugs are useful to treat the acute phase. The side effects of long term treatment include: Decreased blood flow to the stomach, bacterial overgrowth in the stomach, hyperplastic polyp formation in the stomach, increased bile reflux and increased food allergy because food is not digested properly. Hypersensitivity reactions that can occur include urticaria, contact dermatitis, and drug rashes.

One of the reasons an MD might recommend a PPI for life is due to Barrett’s esophagus which increases the risk of developing esophageal adenocarcinoma (EAC).  However, in some recent research published by F. Hvid-Jensen, 2014, the risk of developing EAC increased with PPI use due to the increased formation of polyps while taking the drug!

Other complications of long term PPI use include: gastrin secretion increases, contributing to the risk of colon cancer, and esophageal adenocarcinoma; women taking PPIs have an increased risk of hip fracture, and reduction in bone density; there is also an increased risk of developing community acquired pneumonia especially in the elderly; and, finally, there is an increased risk to developing C. difficile as well as an increased risk of having a heart attack.

I recommended to Bob to come off PPIs gradually over six months to avoid rebound excess stomach acid. Some patients I have seen come off a lot faster than that because they did many other changes at the same time. For example removing wheat from their diet, eating a low carb diet, and eating food in proper combination helps a great deal to reduce GERD symptoms quickly. I put Bob on my candida program which addressed a lot of these recommendations in one protocol. The “yeast” killers help to kill off harmful bacteria and taking a strong probiotic away from the “yeast” killers helps establish a healthy microbiome. I told Bob this treatment program has helped many with chronic GERD.

I also have great success with a digestive aid containing  licorice, marshmallow and slippery elm that is aimed to heal the  stomach and help digest starches and fats without the use of protease, which can aggravate these cases in the early phases of treatment.

I saw Bob one month later. He was using the PPIs much less and was amazed. His skin was beginning to clear and he was much less itchy. He continued on the candida program for another two months and once he was off the PPIs I recommended a slightly stronger digestive enzyme. During this time I noticed on his blood work results that his liver and gallbladder were abnormal so I added a bile thinner and detoxifier for at least three months.

At the six month mark, Bob had lost 20 pounds due to the diet changes, his liver enzymes were back to normal and the only digestive aid he needed were the probiotics and the digestive enzyme. Often the symptoms of too much stomach acid are the same as too little stomach acid. The rest of his maintenance health program included B complex, vitamin B12, omega-3 essential fatty acids, vitamin D and a calcium magnesium complex. PPIs deplete magnesium and B12 so we had some catching up to do because he had been on them for so many years.

[A version of this article originally appeared in the Campbell River Mirror, March 25, 2016.]

The Top Five Medications You Shouldn’t Take Without Trying a Natural Alternative First

The Top Five Medications You Shouldn’t Take Without Trying a Natural Alternative First

Reuben Dinsmore BScH, ND

Natural supplements, or nutraceuticals, have been given a bad rap lately—which, in some cases, has been absolutely warranted. But natural formulas that actually contain what they claim on the label, and that are formulated to have maximal efficacy, can be equal to their pharmaceutical counterparts. Better yet, they can be just as effective without the laundry list of side effects.

Statins

Statins (the class of drugs prescribed to lower cholesterol) accounted for 3.8 per cent of all money spent on prescription drugs in Canada in 2013. High cholesterol is blamed for heart attacks and strokes via formation of arterial plaques. But the real culprit is inflammation, without which the plaques wouldn’t form in the first place. Bottom line: You can lower cholesterol all you want, but as long as there is inflammation present, plaques can still form.

Some common side effects of statins include muscle pain, cognitive impairment, sexual dysfunction, and increased risk of cancer and diabetes.

Nutraceuticals are an alternative to statins. These include: Omega-3 fatty acids (best sourced from wild-caught fish oils) and curcumin (the active component in turmeric). Both are excellent supplements to lower inflammation. Garlic extracts have been proven to improve cholesterol levels as well. Another option I discuss with patients is red rice yeast extract, which is the natural compound statins were derived from in the first place, and works in a similar manner. This product may have side effects; I find that it can be beneficial for some patients, but not all, something I deal with on a patient by patient basis.

Antacids

It’s said that five million Canadians suffer from heartburn symptoms weekly. Prescriptions for the acid-blocking drugs PPIs (proton pump inhibitors) accounted for $24 million in BC alone in 2013. Risks of taking these mostly involve nutrient deficiencies from poor absorption DUE TO LOW STOMACH ACID (see the problem here?). Examples include bone fractures from poor calcium absorption or anemia from decreased levels of vitamin B12 or iron. B12 deficiency can also cause dementia and neurological damage. There has also been a correlation shown between PPI use and C. difficile infection, which causes life-threatening diarrhea.

Nutraceuticals: Long story short, most people don’t have too much stomach acid. The problem is the acid they have is getting into the wrong place (the lower esophagus) where it burns. This can be from the muscle between the esophagus and the stomach not closing properly, either from poor tone or insufficient stomach acid, which is the signal for the sphincter to close. Limonene (an extract from citrus peel) helps strengthen this muscle and promotes movement of food downward to the stomach. DGL (an extract from licorice root) stimulates mucus production in the stomach, which acts to coat and protect the sensitive lining of the esophagus.

SSRIs

SSRIs (selective serotonin reuptake inhibitors) are the most common class of anti-depressant drugs. One in twelve Canadians will experience major depression in their lifetime, but it’s still one of the most misunderstood conditions. Standard treatment protocols typically target neurotransmitter activity (most commonly serotonin). However, new research indicates the underlying cause may actually be inflammation. Either way, natural medicine has you covered.

Some nutraceuticals to consider are 5-HTP, which is used to make serotonin, with the help of vitamin B6. The herb St. John’s Wort has been studied extensively and appears to work in the same way as SSRIs. Both 5-HTP and St. John’s wort have shown similar efficacy to SSRIs when given for mild to moderate depression. And as I mentioned earlier, omega-3 fatty acids and curcumin decrease inflammation throughout the body, including the brain.

Side effects of SSRIs include sexual dysfunction, weight gain, and worsened/chronic depression. St. John’s wort also has a side effect which should be considered if taking other medications—it impacts liver function, which can result in either higher or lower blood medication levels.

Anti-hypertensives

Hypertension (i.e., high blood pressure) affects 6 million Canadians, and is responsible for approximately 13 per cent of all deaths. Various classes of anti-hypertensives include diuretics, ACE inhibitors, angiotensin II receptor blockers (ARBs). Diuretics increase urine output, which can negatively affect sodium and potassium levels, which can cause muscle cramps. ACEIs and ARBs may both cause a chronic dry cough. All anti-hypertensives can cause dizziness, headache and low blood pressure.

Again, there are many nutraceutical options for patients to consider, such as CoQ10, magnesium, garlic extracts, omega-3 fatty acids, L-arginine and vitamin C. All of these have all been shown to lower high blood pressure by various means. Dandelion leaf is an effective diuretic that doesn’t lower potassium levels.

Benzodiazepines

Benzodiazepines are a class of drugs most often prescribed for anxiety disorders and insomnia. They work by binding to receptors for GABA, a neurotransmitter in the brain that calms activity of the nervous system. Interestingly, this is the same mechanism by which alcohol acts in the brain. One obvious effect of benzodiazepines is sedation—great when the treatment target is insomnia. Not so great when you just want to decrease your anxiety but still function. Other side effects include dizziness, loss of balance, and even cognitive impairment at higher doses. They also have a significant risk of developing physical or psychological dependence and rebound anxiety when discontinued.

This is an area where you should have a thorough workup with your naturopathic doctor and consider the options that are right for you. You can take GABA as an alternative (but there’s mixed evidence on whether or not it actually gets into the brain), or herbs such as passionflower (which has the same mechanism of action as benzodiazepines). Other herbs include valerian, chamomile, kava, and many others.

So now you think you’re ready to ditch all your pharmaceuticals and go natural? Not so fast—the examples used above are by no means the only supplements that have been used effectively for these conditions. And equally as important are diet, exercise, sleep habits, relaxation techniques and other lifestyle factors. The next step is to sit down with a naturopathic doctor and work together to develop a personalized approach that takes all your health concerns into consideration.

Dr. Reuben Dinsmore practices at Yaletown Naturopathic Clinic. Call 604-235-8068 or email info@yaletownnaturopathic.com

Screen Shot 2016-05-19 at 12.17.08 PM

GERD and Protein Pump Inhibitors: Seeking Alternatives

GERD and Proton Pump Inhibitors: Seeking Alternatives

Ingrid Pincott, ND

Proton  pump inhibitors (PPIs) are one of the ten most prescribed drugs in North America. PPIs are used in the treatment of acid reflux or GERD. I see at least one patient every week who is taking PPIs and wanting to get off them.

Bob, age 45, is a typical example. He has been taking PPIs for years and his GERD symptoms were not completely under control. He also had developed a rash he could not get rid of through conventional treatment so he is ready to try and improve his health. Certainly if a person is in severe gastric pain due to hyper-secretion of stomach acid, these drugs are useful to treat the acute phase. The side effects of long term treatment include: Decreased blood flow to the stomach, bacterial overgrowth in the stomach, hyperplastic polyp formation in the stomach, increased bile reflux and increased food allergy because food is not digested properly. Hypersensitivity reactions that can occur include urticaria, contact dermatitis, and drug rashes.

One of the reasons an MD might recommend a PPI for life is due to Barrett’s esophagus which increases the risk of developing esophageal adenocarcinoma (EAC).  However, in some recent research published by F. Hvid-Jensen, 2014, the risk of developing EAC increased with PPI use due to the increased formation of polyps while taking the drug!

Other complications of long term PPI use include: gastrin secretion increases, contributing to the risk of colon cancer, and esophageal adenocarcinoma; women taking PPIs have an increased risk of hip fracture, and reduction in bone density; there is also an increased risk of developing community acquired pneumonia especially in the elderly; and, finally, there is an increased risk to developing C. difficile as well as an increased risk of having a heart attack.

I recommended to Bob to come off PPIs gradually over six months to avoid rebound excess stomach acid. Some patients I have seen come off a lot faster than that because they did many other changes at the same time. For example removing wheat from their diet, eating a low carb diet, and eating food in proper combination helps a great deal to reduce GERD symptoms quickly. I put Bob on my candida program which addressed a lot of these recommendations in one protocol. The “yeast” killers help to kill off harmful bacteria and taking a strong probiotic away from the “yeast” killers helps establish a healthy microbiome. I told Bob this treatment program has helped many with chronic GERD.

I also have great success with a digestive aid containing  licorice, marshmallow and slippery elm that is aimed to heal the  stomach and help digest starches and fats without the use of protease, which can aggravate these cases in the early phases of treatment.

I saw Bob one month later. He was using the PPIs much less and was amazed. His skin was beginning to clear and he was much less itchy. He continued on the candida program for another two months and once he was off the PPIs I recommended a slightly stronger digestive enzyme. During this time I noticed on his blood work results that his liver and gallbladder were abnormal so I added a bile thinner and detoxifier for at least three months.

At the six month mark, Bob had lost 20 pounds due to the diet changes, his liver enzymes were back to normal and the only digestive aid he needed were the probiotics and the digestive enzyme. Often the symptoms of too much stomach acid are the same as too little stomach acid. The rest of his maintenance health program included B complex, vitamin B12, omega-3 essential fatty acids, vitamin D and a calcium magnesium complex. PPIs deplete magnesium and B12 so we had some catching up to do because he had been on them for so many years.

[A version of this article originally appeared in the Campbell River Mirror, March 25, 2016.]

Naturopathic Medicine Week 2016: Another Successful Year

This year was another great year for Naturopathic Medicine Week in BC!

Events across British Columbia

We had a variety of events during Naturopathic Medicine Week 2016 – from movie nights to Intravenous Nutrient Therapy days, open houses to patient appreciation events. Many clinics ran specials on services for all or part of the week in celebration. Thanks to the naturopathic doctors and clinics who participated across BC in Vancouver, Surrey, South Surrey, Nanaimo, North Vancouver, Campbell River, Squamish, and Victoria. Several of the events that required pre-registration were booked up well in advance! So wonderful to see communities across British Columbia so engaged!

 

Daily Contests

Our Daily Contests were more popular than ever! Our daily prizes were $75 credits toward the BC Naturopathic service provider of your choice, with grand prizes of two $150 gift baskets from Finlandia Pharmacy and two gift baskets from Ferlow Botanicals, valued at over $100 each.

Congratulations to the grand prize winners: Ferlow Botanicals baskets went to Tiffany A and Marcelle M, and Leanne S and Jessica H won the gifts from Finlandia Pharmacy. Thanks to everyone who participated! If you missed out and want to watch the videos made by BC NDs for the contest, click here.

Finlandia-Logo-2015-mono-color-green+nameScreen Shot 2016-04-06 at 9.12.18 PM

We’ll see you again next year!

Sign up for BCNA’s newsletter to stay in the loop of upcoming Naturopathic events.

 

FREE B12 Shot, Living Wellness Centre, South Surrey

Put a Spring Back in Your Step!

For the month of May And June, come in for a FREE B12 shot and a FREE 15 minute consultation with a Naturopathic Doctor who specializes in root-cause personalized medicine.

Call Living Wellness Centre for more information and to reserve your spot today – spaces are
limited!

living wellness centre poster