Modern medicine has reformed not only the quality, but the longevity of our lives. With that said, while the medical field strives to provide the best in healthcare, they have many hurdles and challenges to face in the process. For instance, obtaining the necessary funding for research and programs, yet balancing the influence that goes hand in hand with financial support.
Enter the world of heartburn relief.
The Statistics Say it All
One of the most common over-the-counter medicated ailments is heartburn, also referred to as Acid Reflux for Gastroesophageal Reflux Disease (GERD) in it’s more exacerbated forms. With “60 million Americans” experiencing symptoms once a month and a suggested “15 million Americans” experiencing symptoms daily, heartburn has quickly progressed to epidemic proportions. Yet, heartburn medication is relatively new. In the 1960s, as this common health issue grew, pharmaceutical companies stepped in to create an easy access medication to relieve sufferers.
Hello to the invent of Tagamet and over-the-counter antacids!
While the initial heartburn statistics seem staggering, the true surprise is that “one-half of American adults” — more than those actually diagnosed or experiencing heartburn — have taken antacids. On top of that, “twenty-seven percent of adults take 2 or more doses per month,” and “seventy-five percent of total antacid consumption is by heavy users,” meaning those taking more than “six doses per week.”
The human component is compelling, yet financial statistics are even more daunting.
Proton pump inhibitors (PPIs) — a popular treatment for exacerbated forms of heartburn — are “one of the best-selling classes of drugs int he U.S., with sales of nine and a half billion dollars in 2012,” alone. Furthermore, Americans have spent “over two billion dollars annually on liquid and tablet antacids,” while “in 2016, private-label sales of antacids reached almost eight hundred and sixty million dollars.” This includes two of the most popular labels, Nexium 24HR and Zantac, which “totaled over half a billion dollars more.”
This means, if you’re reading this article, it’s very possible that you’ve consumed antacids at one point in your life or are currently using them. Yet, how much do you know about this medication, about the ingredients used to create them, and the potential health risks of long-term use?
If you’re curious, stick around and I’ll dive into all the details about antacids!
A Theory to Consider: The Allopathic Treatment Cascade
Before we launch into specifics, let’s take a look at how these medications have a way of intervening in negative ways. While antacids and acid blockers have provided a wealth of relief for sufferers, studies into long-term use of these medications have revealed growing health concerns specifically in relation to the “potential consequences of prolonged acid suppression.”
In an extensive article from Dr. Christopher Amuroso published by the Weston A. Price Foundation, a theory called the allopathic treatment cascade is argued. The allopathic treatment cascade refers to two avenues of heartburn treatment that coincide in more serious health issues: firstly, a series of medications that bandage instead of treat the condition, and, secondly, an avoidance of treating the root cause of the condition.
Per Dr. Amuroso, the cascade begins with self-medication using OTC antacids (think Tums and Rolaids) and, when symptoms persist, is followed with OTC or prescription medication for hyperacidity — referring to a “set of symptoms caused by an imbalance between the acid-secreting mechanism” and those mechanisms meant to protect your digestive system from acid. These next step medications include “HS (histamine 2) antagonists” such as “Axid, Pepcid, Tagamet, and Zantac,” which block acid secreting H2 receptors and prevent “the production of hydrochloric acid.”
When you get to this point, for those regularly consuming these medications, one of the major problems is digestion. Unfortunately, per the National Institutes of Health, “HS receptor blockers decrease stomach acid secretions over a twenty-four-hour period by 70 percent,” which means your body is unable to properly digest the food you eat during this time period. If you’re taking an antacid daily, this means your digestive system isn’t able to appropriately digest food on a regular basis.
If HS antagonists fail, the last medication step of the cascade, before other interventions such as surgery, is typically a prescribed or OTC gastric proton pump inhibitor referred to as a PPI. The most common is Prilosec or the prescribed version called Omeprazole. Gastric proton pumps “essentially shut down the pumps that make hydrochloric acid for the stomach.”
While you may have relief from symptoms, antacids, HS antagonists, and PPIs may have long-term risks and side-effects such as bacterial overgrowth, “kidney disease, decreased calcium, iron and vitamin B12 absorption, magnesium deficiency,” as well as “pneumonia, dementia,” life-threatening infections, and even cardiovascular disease.
With that said, it’s very important to note that for some these medications boost the quality of life and are necessary due to other health conditions. Yet, it’s important to understand that these medications should not be consumed lightly.
Getting to Know Your Antacids
Where does the cascade start? With over-the-counter antacids.
While it’s always a good idea to speak with your doctor about HS antagonists and PPIs, antacids are generally freely consumed without consultation. Most of us have a bottle of Tums or Rolaids in our medicine cabinet. I used to have a bottle of antacids in the house, in the car, and in my backpack. Whenever I felt a twinge of stomach upset, I’d pop three of these chalky treats. That was until I learned what’s in these colorful, tasty tablets.
What are Antacids
You’ll most likely recognize antacids by their branding names such as Tums, Rolaids, Maalox, and Gaviscon. So, how do they work? Antacids reduce “excess stomach acid to relieve heartburn, sour stomach, acid indigestion, and stomach upset,” and are also used to “relieve the pain of stomach and duodenal ulcers,” as well as reduce gas.
While antacids all work in relatively the same way, most brands use different active agents. If you take a look at the ingredients list for these medications, you’ll see a host of terms that need deciphering. For instance, Alka-Seltzer uses sodium bicarbonate (also called baking soda), Phillips’ Milk of Magnesia uses magnesium compounds, Tums uses calcium carbonate, and Amphojel uses aluminum.
So, what’s safe? Which of these active agents have negative side-effects? How do you decide which one to choose, if any at all?
In order to determine whether to consume antacids or not, it’s beneficial to take a closer look at their inactive ingredients along with the active ones. These are the little extras generally added for visual appeasement, coloring, and taste. Here are a few of the most common and oftentimes dangerous inactive ingredients in antacids.
This ingredient is found in both Tums and Rolaids, as well as many popularly purchased, highly-processed foods. If you’re a bit of a health nut, the word “processed” already raises a red alert.
Dextrose is a “simple sugar that is made from corn and is chemically identical to glucose, or blood sugar.” Simple sugars are carbohydrates which can be found naturally — such as in fruit and milk — but are also created artificially, such as dextrose. Generally, simple sugars are incredibly low in nutritional content and they can spike blood sugar levels. This is why one of the most popular uses for dextrose is in the medical field as a way to “increase a person’s blood sugar.” Yet, you’ll also see dextrose on the label of processed foods as it’s an integral component of corn syrup and sweeteners, including “white bread, pasta, and in refined sugars.” Overconsumption of dextrose in its raw form can lead to negative side effects including dehydration, dry skin, nausea, shortness of breath, fatigue, shortness of breath, and even cognitive issue such as confusion.
This is one of the more benign ingredients, yet, when combined with the list of other ingredients, can complicate the heartburn healing process.
Magnesium stearate is a white powder that is widely used to coat vitamins and medications. What’s in it? In short, it’s a “simple salt made up of two substances, a saturated fat called stearic acid and the mineral magnesium.” While mineral magnesium is a little more obscure, stearic acid is very common and is found in popular plant-based foods including coconut, cotton, palm oils, walnuts, chocolate, as well as animal products such as salmon, cheese, and chicken.
When it comes to medications, such as antacids, magnesium stearate prevents individual ingredients from sticking to each other, improves quality of medication capsules, and delays the “breakdown and absorption of medications” which means the medication makes it to the right place in the body.
All seems good, right? The other side of magnesium stearate is not so sunny.
For those that are regularly consuming magnesium stearate, such as people who take chalky antacids every day, it can begin to “irritate the mucosal lining of your bowels” which “causes your bowels to spasm, triggering a bowel movement.” In short, overconsumption can have a laxative effect. Those suffering from heartburn most likely already deal with related digestive issues, whether it’s constipation or the alternative, and ingesting continuous amounts of magnesium stearate can cause even more digestive issues.
While magnesium stearate may be one of the more benign ingredients, polyethylene glycol is definitely one you want to avoid.
To start off with, it’s one of the main components in antifreeze. Yep, you heard me right. To get more scientific polyethylene glycol (PEG) “is a petroleum-derivative compound that is made from ethylene glycol (ethane-1, 2-diol),” which also happens to be the “main ingredient in antifreeze.”
Yet, PEG is also found in “skin creams and personal lubricants, and as a food additive for anti-foaming purposes,” as well as in constipation medications and, you guessed it, in an antacid called Tums. The form of this substance used in antacids is called polyethylene glycol 3350, which is also used “to clean the bowel before colonoscopy, a barium x-ray, or other intestinal procedures.”
The question you have to ask yourself is, do you really want to consume an antifreeze-ingredient, bowel-cleanser on a daily basis or pretty much any day at all?
Pre-Gelatinized Starch, Sucralose, and Sucrose
I’ve put the three of these in the same category because they are all forms of sugar. Many antacids use one or all three of these ingredients plus dextrose. That’s a lot of processed sugar!
Pre-gelatinized starches are basically dried and cooked starches that are usually made from corn. When it comes to food, pre-gelatinized starches are found in processed foods such as “puddings, pie fillings, soup mixes, salad dressings, [and] candy.” In the pharmaceutical industry, starches are used broadly as a disintegrant which “enables tablets and capsules to break down into smaller fragments (dissolve) so that the drug can be released for absorption.” While there aren’t current studies making pre-gelatinized starch a hazard, overconsumption of “excessive quantities of raw starch has resulted in obesity and iron-deficiency anemia in humans.”
Sucralose and sucrose are both artificial sweeteners. As with dextrose, those that are familiar with ingredients labels know that added or artificial sweeteners should be contemplated before consuming. Sucralose is made from real sugar, yet has been chemically altered so that it passes through the body almost completely undigested. It’s also found in lots of processed foods including “diet drinks, chewing gum, gelatin and frozen desserts.” Sucrose, on the other hand, is simply the technical term for table sugar, which is a “disaccharide consisting of one molecule of glucose linked with one molecule of fructose.”
While both sucralose and sucrose have been FDA approved, that doesn’t mean there are no consequences. Studies have linked these artificial sweeteners to negative effects on the “gut microbiota, insulin levels, and weight,” as well as a study published in the Canadian Medical Association Journal finding that “regularly eating these sweeteners is associated with an increased risk of high blood pressure, metabolic syndrome, type 2 diabetes and heart problems.”
This one I saved for the last, due to the fact that it may be one of the most damaging and least well-known ingredients in antacids.
When you’re reading the ingredients label of your antacid, you’ll most likely see something along the lines of FD&C #6 Aluminum Lake Dye. In short, this is a color additive, yet the term “lake” means that the straight dye has been “mixed with precipitants and salts.” It’s what makes those tropical flavored Tums match in both color and taste. Yet, aluminum food dyes are also found in cosmetic and food products. So, you may want to take a minute and review the ingredients labels on any processed foods in your kitchen pantry to look for any FD&C dyes.
While research is underway in regards to the effect of aluminum on health, preliminary findings are somewhat alarming.
In 2011, the FDA reviewed studies and literature regarding aluminum consumption in children and uncovered “personal stories that artificial dye consumption [resulted] in behavioral issues including hyperactivity, attention deficit, irritability, and lack of attention.” Specifically, FD&C Yellow #6 was reported to have negative side effects such as “gastric upset, hives, runny nose, allergies, hyperactivity, tumors in animals, mood swings, and headaches.” In fact, these findings were so alarming that Norway and Finland have officially banned this additive. Beyond this, there are studies showing a link between the food-derived aluminum dye and “Alzheimer’s, as well as some forms of cancer.”
Natural Heartburn Remedies
At this point, you may be thinking twice about those antacids in your medicine cabinet. Yet, what about those days where you’re experiencing discomfort, nausea, or even vomiting due to your heartburn? Believe, me I understand the moral dilemma! Luckily, there are some wonderful plant-based, natural remedies that you can try out!
With that said, if you’ve been regularly taking antacids for heartburn, you may want to ease into plant-based remedies by reducing your antacids while upticking your intake of these new foods. On top of that, it’s always a good idea to speak with your doctor before changing medication or diet!
Peach and Lemongrass Shrub/One Green Planet
Every plant-based kitchen should always have a bottle of apple cider vinegar. Not only can this miraculous ingredient be used in natural cleaning products, green beauty products, and as an agent to combat the common cold and flu, but it’s a great way to fight heartburn. Apple cider vinegar works to reduce heartburn symptoms, not by blocking the natural process of digestion, but by helping to balance stomach acid. Mix one tablespoon of apple cider vinegar with one cup of water before meals. It’s also a wonderful ingredient to incorporate into recipes such as this Peach and Lemongrass Shrub beverage, in this Sesame Citrus Dressing, or in this tasty Fire Cider Vinegar.
Homemade Kimchi/One Green Planet
It’s absolutely impossible to steer clear of this powerful and incredibly healthy remedy. Not only do fermented veggies boost the health of your gut microbiome, but lactobacillus, “a naturally occurring bacteria” within fermented veggies, has been shown to “relieve inflammation in the stomach, healing the lining of the stomach and effectively alleviating heartburn.” Plus, it’s easy to find simple recipes such as these Simple Fermented Vegetables, this Homemade Raw Sauerkraut, or even this flavorful Homemade Kimchi recipe.
Raspberry Almond Coconut Bar/One Green Planet
This one may be counterintuitive — plus, it may not be for everyone — but it’s definitely a natural step to try out!
Healthy fats have been shown to help reduce heartburn symptoms due to anti-inflammatory properties, slowing digestion, reducing over-eating, and aiding in the reduction of “aggravators such as sugars and refined grains.” Some of the best healthy fats include coconut and extra virgin olive oil, avocados, and nuts and seeds. Plus, healthy fats are incredibly tasty and versatile. Coconut and olive oils can be used for baking, cooking, frying, broiling, or simply consumed raw. Avocados can be consumed raw or are great for vegan desserts such as these Avo Paletas or this Chocolate Avocado Mousse. Nuts and seeds are great to snack on, but can also be used to create snack recipes such as these Raspberry Almond Coconut Bars or this Brazil Nut Fudge.
In order to reduce your antacid consumption and up your natural heartburn fighters, we highly recommend downloading our Food Monster App, which is available for both Android and iPhone, and can also be found on Instagram and Facebook. The app has more than 15,000 plant-based, allergy-friendly recipes, and subscribers gain access to new recipes every day. Check it out!
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