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Stomach acid effects on oral Bisphosphonates

Nanaedake profile image
10 Replies

Has anyone got experience of how Bisphosphonates are affected by stomach acid? Could reduced stomach acid cause unresponsive esophageal valves that then leak stomach contents after taking Bisphosphonates?

Presumably, Bisphosphonates are tested on healthy volunteers, not those people with coexisting conditions. This could mean that no matter how 'correctly' people take their medicine they may experience adverse effects due to another condition affecting the way their stomach works. Is there any research into this?

According to some information a thyroid condition, for example, may cause low stomach acid.

Also, why does the NHS prescribe calcium carbonate for osteoporosis? I've read it neutralises stomach acid and is often included in antacid medicines.

I thought good stomach acid is needed to extract nutrients efficiently from food?

Why can't the NHS prescribe calcium citrate and a separate vitamin D3? Vit D3 should be taken with the fattest meal of the day but calcium citrate can be taken any time and doesn't neutralise stomach acid.

None of it makes any good sense to me.

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Nanaedake profile image
Nanaedake
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10 Replies
pigeonCl-HU profile image
pigeonCl-HU

Hi Nanaedake, totally agree with you regarding stomach acid, necessary for the efficient extraction of nutrients from the food we eat.

Yet everywhere you look, stomach acid seems to be the bad guy.

I never thought much of the fashionable "alkaline" diet.

What you say about calcium, carbonate vs. citrate, makes sense to me.

I can only assume that carbonate is prescribes as it contains higher percentage of elemental calcium then citrate, and is the cheaper of the two....

pigeon

Markarska profile image
Markarska

I agree with you. I have used acid suppressant tablets for years but now my gp and rheumatologist both agree that these can reduce the absorption of calcium etc and I am weaning myself off them. I think calcium carbonate is just the cheapest option but I hope to get adequate calcium from my diet. I take vit D3 separately, and K2. I have no idea if anything I am doing will work but so far have resisted bisphosphonates due to side effects for acid reflux and don’t want injections incase of bad reactions. It’s all a shot in the dark really!

Nanaedake profile image
Nanaedake in reply to Markarska

I read that adequate magnesium helps absorb calcium so am using a magnesium spray. Unless you have kidney disease your body excretes any excess. My fingernails are growing really well so it could be good for bones too. I'm also supplementing folate which is always a bit low despite eating greens every day. I take methylfolate which is most absorbable.

I don't want an infusion or injections either. I feel much better not taking Bisphosphonates. They made me feel ill.

Markarska profile image
Markarska in reply to Nanaedake

I use a magnesium spray too and take folic acid which I have to use as on methotrexate for inflammatory arthritis. My gp wants me to have an annual injection but I am resisting.

Nanaedake profile image
Nanaedake in reply to Markarska

Have you ever tried going gluten free? I've been doing it for about 18 months because apparently if sensitive to gluten it can prevent you absorbing calcium properly. I don't know if it helps or not.

Markarska profile image
Markarska in reply to Nanaedake

Not something I have tried.

Titian8 profile image
Titian8 in reply to Markarska

I love to take Epsom Salt (magnesium sulphate) baths as prefer taking the least amount of pills/supplements possible. I buy it in bulk 10kg tubs and works out quite cheap.

Good advice re stopping PPI's. They are prescribed too often, too quickly with serious side effects when gentler more natural alternatives can work just as effectively. Wish I had done my research on these 'prazoles ' years ago. I successfully stopped them also after too many years of use.

One-Blue-Lady profile image
One-Blue-Lady in reply to Titian8

How did you wean yourself off from? I’m getting swallowing problems if I leave them off for a couple of days.

Titian8 profile image
Titian8 in reply to One-Blue-Lady

I had swallowing problems too, it felt like a pea was stuck constantly in my throat. Had the feeling of this lump in my throat for ages but it eventually disappeared.

I swapped PPI for natural supplements, namely Slippery Elm and also Marshmallow supplement. I order them from British Supplements, based in Ireland as they have no artificial ingredients such as anti caking, colours, preservatives, and all the other unnecessary additions - its one of the few companies who offer 'clean' supplements. More expensive but worth it. Maybe read the reviews before considering if you wish to try them.

Slippery Elm also comes in powder form but it doesn't look good and tastes awful but definitely acts faster than the capsules. Have a look online at the general benefits of S.E. and its uses.

It takes time and I had to persevere. I started off doubling the recommended dose {I don't suggest others do this, just my own judgement} then when things felt better reverted to standard dose (it can take a few weeks to kick in). I still can get heartburn when I do the gardening, bending down to weed etc but I haven't taken a PPI in years.

Also helps if sleep on left hand side. Hope this helps and you get some relief soon.

One-Blue-Lady profile image
One-Blue-Lady in reply to Titian8

Thank you Titian8 I have recently discovered British Supplements but haven’t discovered what others are using for my problem. Your advice makes sense to me. I went through endoscopy and should have gone back to get further treatment but have been putting it off, no reflux now just the blockage problem I haven’t been able to go more than a couple of days without resorting to Loosec which is another omprazol brand that is easy to swallow. I broke a tooth and thought that was what had caused a blockage, A&E kept me in two days on NBM, sent me home with more tablets!

I was shocked to be told I had osteoporosis and that side effects from the treatment. So will try your suggestions and persevere. Thank you.

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