Heartburn Drugs Drain You of Magnesium

Published: October 1, 2012

A lot of people take the acid-blocking proton-pump inhibitors (PPIs), such as Nexium, Prevacid and Prilosec — they're the third bestselling class of drugs in the U.S., with nearly $14 billion in yearly sales. They're so popular because 50% of Americans have heartburn — sour stomach acid splashing into your throat, and painful post-meal burning and belching. Fifteen million Americans experience those symptoms every day.

But while the FDA-approved labeling for PPIs says the drugs are meant to be taken for no longer than 2 months, many people take them for years. And studies link that type of chronic use to a lot of health problems:

  • Doubled risk of hip fracture (because the drug blocks the absorption of bone-strengthening calcium).
  • Doubled risk of colds and flu (because normal levels of stomach acid kills bacteria and viruses).
  • Higher risk of other infections, such as pneumonia and hospital-acquired infection with clostridium difficile (C. diff).
  • Doubled risk of B12 deficiency (the body needs stomach acid to digest B12).
  • Increased risk of re-hospitalization or death after severe angina or a heart attack (nobody knows why, but study results are clear).

Now, the FDA has added a new warning to long-term use of PPIs — magnesium deficiency.

FDA Warning

In March of this year, the FDA issued a warning about PPIs, saying regular use for a year or longer may lead to low levels of magnesium — increasing the risk of leg spasms, arrhythmias (irregular heart beats that can cause heart attack or stroke), and seizures.

Their warning said the problem could be reversed with magnesium supplements. But in 25% of cases it couldn’t reverse the deficiency, and PPIs had to be discontinued.

Additionally, they warned that the problem could be particularly bad among patients taking other magnesium-depleting drugs, such as diuretics for high blood pressure and digoxin for heart disease.

All PPIs were implicated: Nexium, Prilosec, Prevacid, Dexilant, Zegerid, AcipHex, Vimovo, and the OTC versions of Prilosec, Prevacid and Zegerid.

Physicians "should consider obtaining serum magnesium levels prior to initiation of prescription PPI therapy in patients expected to be on these drugs for long periods of time," said the FDA.

That would be good advice if the standard blood test for magnesium levels was reliable. But it’s not. It measures blood levels of magnesium, when the important measurement is the amount of magnesium in your cells. By the time blood levels of magnesium drop low enough to indicate a deficiency, the body has already lost 30% of its total magnesium — a severe, and possibly even life-threatening form of the deficiency. (Imagine losing 30% of your weight before your scale could detect it. You definitely wouldn’t trust your scale!). This means that many people taking PPIs who have "normal" blood levels of magnesium already have a health-hurting deficiency.

Bottom Line

PPIs can sabotage the body's natural demand for magnesium, for a healthy heart, healthy bones, healthy nerves, healthy muscles — healthy everything! The good news is you don't need PPIs to correct heartburn, which is usually caused not by too much stomach acid, but by too little.

To learn more about the real cause of heartburn — and simple, natural ways to solve the problem — see "Eliminating Chronic Acid Reflux & Indigestion." You can also check out the chapter "Heartburn and Indigestion" in my new book, Real Cause, Real Cure: The 9 root causes of the most common health problems and how to solve them (Rodale, July 2011).


"Proton Pump Inhibitor drugs (PPIs): Drug Safety Communication - Low Magnesium Levels Can Be Associated With Long-Term Use." U.S. Food and Drug Administration

Jacob Teitelbaum, MD

is one of the world's leading integrative medical authorities on fibromyalgia and chronic fatigue. He is the lead author of eight research studies on their effective treatments, and has published numerous health & wellness books, including the bestseller on fibromyalgia From Fatigued to Fantastic! and The Fatigue and Fibromyalgia Solution. Dr. Teitelbaum is one of the most frequently quoted fibromyalgia experts in the world and appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health.

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