May 24, 2018
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The connection between osteoporosis and heartburn medications

Dr. Michael Noonan
By Michael Noonan, Special to the BDN

The longer I am in practice, the more I see the fundamental wellness concepts I was taught reinforced. This happened recently, when I read that osteoporosis can be a side effect of long-term use of heartburn medications.

Why would heartburn medications cause osteoporosis? Isn’t osteoporosis caused by a calcium deficiency? That is what we have been told. To prevent it, women are recommended to get 1,000 milligrams of calcium daily, either through diet or calcium supplements. This theory is based on the idea that since bones are primarily made out of calcium, if the bones are weak it must be due to a diet with low levels of this key building block.

Unfortunately, the research does not support that theory. In fact, studies have shown exactly the opposite, that people in cultures that consume the most calcium tend to have the most osteoporosis. It is much more common in the developed world than in more primitive areas, yet the diets of people in developed countries tend to have a lot more calcium. For example, in Singapore the daily consumption of calcium is about 600 milligrams a day, compared to the U.S. at about 1,000 milligrams. Yet the U.S. has about 10 times more hip fractures.

So if osteoporosis is not caused by low dietary calcium, what does cause it?

From a wellness perspective, most “diseases of civilization” like osteoporosis are caused by our whole lifestyles, not just one single factor. Despite the fact that we ingest a lot of calcium, that alone is not enough to ensure our bones will stay strong.

Some of the key lifestyle-related factors that can lead to osteoporosis include:

Hormonal imbalances

Hormones play a part in regulating bone density; the best known is estrogen. Estrogen imbalances are very common, with symptoms like painful menstrual cycles and difficult menopause. Another very common problem is excess cortisol. Known as the stress hormone, it raises blood sugar, deposits fat around the abdomen and can contribute to osteoporosis. These imbalances are typically a direct result of our lifestyles, especially chronic stress and high blood sugar levels from refined carbohydrates.

Fatty acid imbalance

Our modern diets are high in grains, which are rich in Omega 6 fatty acids, but have little or no Omega 3s. This imbalance is worsened when we feed our animals grains; then their meat and other products are also poor sources of Omega 3s. It has been estimated that early humans consumed far more Omega 3s and far fewer Omega 6s than we do now. This imbalance is thought to contribute to inflammation, as well as osteoporosis.

Poor calcium absorption, due to an inflamed stomach producing insufficient acid

Only a healthy, acidic stomach can absorb calcium properly. Our stomachs make less acid as we age, and this process is worsened by the stress and inflammation that are hallmarks of our modern lifestyles. This makes it more difficult to absorb the calcium in our food. Of course, taking a drug that stops stomach acid production, to provide relief for heartburn, will interfere even more with the absorption and digestion of calcium.

A further irony is that heartburn is not caused by excess stomach acid, despite what the ads tell you. For most people it is caused by inflammation of the lining of the stomach, often from stress, poor diet or medications. So stopping acid production does make you feel better, but does nothing for the underlying cause. Advertising a calcium-based antacid as a great source of calcium to build bones is downright misleading, since the reduced acidity will not allow the calcium to be taken in by the body.

The conclusion? Wellness principles are proven and reinforced daily for me, both by my patients and the research. It is interesting how a side effect of a drug reinforces a basic wellness principle — that low stomach acid can lead to osteoporosis. Rather than worsening the problem with a drug, it is best to correct the underlying problem naturally.

Dr. Michael Noonan practices chiropractic, chiropractic acupuncture and other wellness therapies in Old Town. He can be reached at

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