The heartburn drugs known as proton pump inhibitors or PPIs have already been proven to increase the risk of osteoporosis, vitamin B12 deficiencies, and pneumonia. Some of the best-known PPIs include Nexium, Prilosec and Prevacid. Vitamin B12 deficiencies, especially in the elderly, can cause anemia, fatigue, depression dementia and irreversible nerve damage.
Now an FDA advisory warns that long-term use of PPIs can also cause hypomagnesemia, or low magnesium levels, which in turn can cause severe muscle spasms, arrhythmias (irregular heartbeat), tremors, and seizures. Many blood pressure drugs can also cause low magnesium, so the combination of the two types of drugs creates an even higher risk. The combination of the heart drug digoxin and a PPI can also cause low magnesium.
According to the FDA, the risk of magnesium deficiency is greatest after one year of use, but it can occur in as few as three months. Furthermore, in 25% of PPI users, magnesium supplementation did not change the risk. The FDA report also warns that PPI users with low magnesium levels may not show any obvious symptoms.
Heartburn Drugs that Can Cause Low Magnesium Levels
esomeprazole magnesium (Nexium)
esomeprazole magnesium/naproxen (Vimovo)
omeprazole/sodium bicarbonate (Zergerid)
pantoprazole sodium (Protonix)
rabeprazole sodium (AcipHex)
Disease or a Drug Side Effect?
This is yet another example of drugs that can cause side effects that masquerade as other diseases, especially in the elderly. (See Parkinson’s Disease or Prescription Drug Side Effects?) The symptoms caused by PPI-induced seizures, tremors and abnormal heart rhythms could be mistaken for epilepsy, Parkinson’s disease, and heart disease, for example, leading to unnecessary treatments and even admission to a nursing home.
Magnesium Deficiency Symptoms
Magnesium is undoubtedly the most important mineral in the prevention and treatment of heart disease. It has been shown to help with angina and to improve the symptoms of congestive heart failure. Low magnesium levels are also associated with mitral valve prolapse, high blood pressure, kidney disease, muscle weakness, osteoporosis, fatigue, and headaches. For details on magnesium and heart disease, read Prescription Alternatives.
Other Drug Options
Although the H2 blocker heartburn drugs such as Tagamet and Zantac can have their own significant side effects, they’re less potent and have fewer side effects than the proton pump inhibitors.
What Your Doctor May Not Tell You about Heartburn
For more information about prevention and treatment of heartburn, read the article, What Your Doctor May Not Tell You about Heartburn, by John R. Lee, MD and Virginia Hopkins.