PPIs & Dementia: What's UP?

From the American Academy of Neurology

People who take acid reflux medications called proton pump inhibitors or PPIs for 4 1/2 years or more have a higher risk of dementia, compared to people who do not take these medications.

This study does not prove that acid reflux drugs cause dementia; it only shows an association. Personally, that’s enough for me to take note.

Acid reflux is when stomach acid or the the contents of the stomach with insufficient stomach acid, flows into the esophagus, usually after a meal or when lying down. People with frequent acid reflux may develop gastroesophageal reflux disease, or GERD, which can lead to cancer of the esophagus. BUT RARELY!

People with acid reflux may experience heartburn and ulcers. Or coughing in the middle of the night. Or waking up with a hoarse voice. Or ear, lung, and throat issues, and that, as odd as it seems, may be linked to reflux.

In functional medicine, often IDENTIFYING AND FIXING food sensitivities, digestive player issues (such as NOT ADEQUATE stomach acid as you can get heart burn from too little stomach acid, too), and transit time issues (time for food to go through your body and slow transit or fast transit times can be problematic), rids reflux. Rather quickly. Often without meds. Or just using acid blockers for 6 weeks, but not longer. As the insert reads!

But these types of digestive issues are often NOT addressed by gastroenterologists. They mostly don’t regard food as having a lot to do with the gut, other than fiber or probiotics. That’s what my kind and really good guy gut doc told me when he “allowed” me to do a presentation at Austin Regional Gastroenterology.

Proton pump inhibitors reduce stomach acid by targeting the enzymes in the stomach lining that produce that acid.

"Proton pump inhibitors are a useful tool to help control acid reflux.

“However long-term use has been linked in previous studies to a higher risk of stroke, bone fractures and chronic kidney disease," said study author Kamakshi Lakshminarayan, MBBS, PhD, of the University of Minnesota School of Public Health in Minneapolis, and a member of the American Academy of Neurology.

I told my gastroenterologist about the link between PPIs and kidney disease and he knew nothing about it. This was when he recommended it to me when I had just been diagnosed with reflux for the first time. I mentioned this possible worsening of my kidney and he shrugged his shoulders and still recommended it. As PPI’s are one of gut doc’s major tools.

BTW, I used oxytocin and mucolox, plus avoidance of food sensitivities, and got rid of my reflux that he wanted me, with one kidney, to take PPIs for. I no longer have reflux!

But I do get regular endoscopic exams. I have had several friends, very savvy nutritional docs, die from esophageal cancer. They had no idea they had it. They had not had esophageal imaging till it was too late. Esophageal cancer, sadly, is often “silent”I digress.

The PPI/Brain Study

Researchers from the University of Minnesota, Optum, University of California, Davis, the NINDS, the University of Mississippi Medical Center, and UNC collaboratively looked at 5,712 people, age 45 and older, who did not have dementia at the start of their study. They had an average age of 75.

Researchers determined if participants took acid reflux drugs (they did not specifiy if this means other acid blockers besides PPIS) by reviewing their medications during study visits and yearly phone calls.

Of the participants, 1,490 people, or 26%, had taken the drugs.

Participants were then followed for a median duration of 5.5 years.

During this time, 585 people, or 10%, developed dementia.

After adjusting for factors (such as age, sex, and race, as well as health-related factors such as high blood pressure and diabetes), researchers found:

• People who had been taking acid reflux drugs for “more” than 4.4 years had a 33% “higher” risk of developing dementia compared to people who never took the drugs.

• Researchers did “not” find a higher risk of dementia for people who took the drugs for “fewer” than 4.4 years.

The authors concluded:

Classification of Evidence. This study provides Class III evidence that the use of prescribed PPIs for > 4.4 years by individuals ages 45 years and older is associated with a higher incidence of newly diagnosed dementia.

KEEP THIS IN MIND. TO KEEP YOUR MIND.

I had this one veteran who got all his health needs addressed at the VA come in to see me. He had been on PPIs for 40 years. They started his script for reflux (not Barrett’s) and never stopped. This guy was very tired and getting some bone fractures as he could not absorb his minerals.

Remember, you need stomach acid (betaine hydrochloride) to digest many food items, such as minerals. Minerals support bone matrix.

Surprisingly, he did not have SIBO. Why do I say this? Stomach acid is one of Nature’s ways to prevent SIBO. Acid “kills” bacteria that may come in with various foods we eat.

By strategically going off PPIs, and avoiding food sensitivities, etc., he got his energy back within two to three months and started to feel younger again. Like his old self again. He even mentioned how much better he was thinking!

KNOWLEDGE IS POWER.

Dr. B.

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Reference:

Cumulative Use of Proton Pump Inhibitors and Risk of Dementia: The Atherosclerosis Risk in Communities Study. Neurology, 2023; 10.1212/WNL.0000000000207747 DOI: 10.1212/WNL.0000000000207747