Long-term use of proton pump inhibitors is associated with increased microbial product translocation, innate immune activation, and reduced immunologic recovery in patients with chronic HIV-1 infection

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ppi 2Long-term use of proton pump inhibitors is associated with increased microbial product translocation, innate immune activation, and reduced immunologic recovery in patients with chronic HIV-1 infection

Abstract

Background:

Translocation of microbial products from the damaged gut causes increased immune activation in HIV. Proton pump inhibitors (PPIs) predispose to bacterial overgrowth in the gut. We hypothesized that long-term use of PPIs is associated with greater microbial translocation and immune activation in HIV.

 

Methods:

HIV-infected persons on suppressive antiretroviral therapy (ART), including those receiving long-term PPIs (PPI+ group) or not (PPIgroup), were enrolled. We determined CD38+HLA-DR+CD8+(activated) T-cell frequency, and plasma levels of lipopolysaccharide (LPS), LPS binding protein (LBP), soluble CD14 (sCD14), and intestinal fatty acid binding protein (I-FABP).

 

Results:

We recruited 77 HIV-infected participants (37 PPI+ and 40 PPI), and 20 HIV-uninfected volunteers. PPI+ subjects were older and more likely to have hypertension and receive statins than PPI. Nadir and enrollment CD4 counts, activated T-cells, and time on ART were similar in both groups. PPI+ group had higher sCD14 (2.15 vs. 1.50 mcg/mL, P <0.01), and LBP (21.78 vs. 18.28 mcg/mL, P=0.02), but lower I-FABP levels (608.5 vs. 2281.7 pg/mL, P=0.05) than PPI. In multivariate analysis, sCD14 levels remained associated with PPIs. In the year prior to enrollment, PPI+ group lost more CD4 cells than PPI (-18 vs. 54 cells/mm3, P = 0.03). HIV-infected subjects had higher immune activation and microbial translocation biomarkers than uninfected volunteers.

 

Conclusion:

In HIV, long-term use of PPIs was associated with increased microbial translocation, innate immune activation, and reduced immune reconstitution. Further studies are needed to evaluate the clinical implications of our findings. In the meantime, cautious use of PPIs is advised.

 

https://academic.oup.com/cid/article-abstract/doi/10.1093/cid/cix609/3933542/Long-term-use-of-proton-pump-inhibitors-is?redirectedFrom=fulltext


Prevacid (lansoprazole) is a proton pump inhibitor (PPI) used to treat GERD, heartburn, gastric ulcer, and duodenal ulcer. It works by reducing acid in the stomach. … Esomeprazole is more popular than other proton pump inhibitors. It is available in brand and generic versions.


More Reasons Why Reducing Your Stomach Acid is a Risky Bet

When you take PPIs, which significantly reduce the amount of acid in your stomach, it impairs your ability to properly digest food.

Reduction of acid in your stomach also diminishes your primary defense mechanism for food-borne infections, thereby increasing your risk of food poisoning.

Additionally, if you fail to digest and absorb your food properly, you will not only increase your risk of stomach atrophy but also nearly every other chronic degenerative disease.

These drugs have also been linked to an increased risk of pneumonia, and result in an elevated risk of bone loss. The risk of a bone fracture has been estimated to be over 40 percent higher in patients who use these drugs long-term.

If You’re Already Taking These Drugs, Avoid Stopping Cold Turkey

You should NEVER stop taking proton pump inhibitors cold turkey. You have to wean yourself off them gradually or else you’ll experience a severe rebound of your symptoms, and the problem may end up being worse than before you started taking the medication.

Ideally, you’ll want to get a lower dose than you’re on now, and then gradually decrease your dose. Once you get down to the lowest dose of the proton pump inhibitor, you can start substituting with an over-the-counter H2 blocker like Tagamet, Cimetidine, Zantac, or Raniditine. Then gradually wean off the H2 blocker over the next several weeks.

Natural Treatment Options for Heartburn, GERD and Acid Reflux

As I explained in my recent Acid Reflux video,while you wean yourself off these drugs (if you’re already on one), you’ll want to start implementing a lifestyle modification program that can eliminate this condition once and for all.

These strategies include:

  • Eliminating food triggers — Food allergies can be a problem, so you’ll want to completely eliminate items such as caffeine, alcohol, and all nicotine products.
  • Increasing your body’s natural production of stomach acid — Like I said earlier, acid reflux is not caused by too much acid in your stomach — it’s usually a problem with too little acid. One of the simplest strategies to encourage your body to make sufficient amounts of hydrochloric acid (stomach acid) is to consume enough of the raw material.

One of the simplest, most basic food items that many people neglect is a high quality sea salt (unprocessed salt).

I recommend eliminating processed, regular table salt for a lot of different reasons, all of which I’ve reviewed before. But an unprocessed salt like Himalayan salt — one of the best salts on the planet – will not only provide you with the chloride your body needs to make hydrochloric acid, it also contains over 80 trace minerals your body needs to perform optimally, biochemically.

  • Taking a hydrochloric acid supplement — Another option is to take a betaine hydrochloric supplement, which is available in health food stores without prescription. You’ll want to take as many as you need to get the slightest burning sensation and then decrease by one capsule. This will help your body to better digest your food, and will also help kill the helicobacter and normalize your symptoms.
  • Modifying your diet – Eating large amounts of processed foods and sugars is a surefire way to exacerbate acid reflux as it will upset the bacterial balance in your stomach and intestine.

Instead, you’ll want to eat a lot of vegetables, and high quality, organic, biodynamic, and locally grown foods. You can also supplement with a high quality probiotic or make sure you include fermented foods in your diet. This will help balance your bowel flora, which can help eliminate helicobacter naturally.

  • Optimizing your vitamin D levels — As I’ve mentioned many times in the past, vitamin D is essential, and it’s essential for this condition as well because there’s likely an infectious component causing the problem. Once your vitamin D levels are optimized, you’re also going to optimize your production of 200 antimicrobial peptides that will help your body eradicate any infections that shouldn’t be there.

You’ll want to make sure your vitamin D level is about 60 ng/ml, and I strongly recommend you use LabCorp, which is a high quality testing facility.

As I’ve discussed in many previous articles, you can increase your vitamin D levels through appropriate amounts of sun exposure, or through the use of a safe tanning bed.

If neither of those are available, you can take an oral vitamin D3 supplement. However, whenever you use oral vitamin D, it’s imperative you get tested regularly to make sure you’re not reaching toxic levels.

  • Implementing an exercise routine — Exercise is yet another way to improve your body’s immune system, which is imperative to fight off all kinds of infections.

What is the cure for stomach acidity

  • acid.JPG

Dr Mercola wrote:

  • Acid reflux is an extremely common health problem, also called gastroesophageal reflux disease (GERD) or peptic ulcer disease
  • Acid reflux is not a disease of too much acid being produced, but rather is a condition related more commonly to hiatal hernia, a condition in which the acid is coming out of your stomach, where it’s supposed to remain
  • Heartburn is the primary symptom of acid reflux – a burning sensation that radiates up from your stomach to your chest and throat
  • Learn how to wean yourself off dangerous acid reflux drugs and implement safe and effective strategies to eliminate this problem

Strategies should include:

  • Eliminating food triggers — Food allergies can be a problem, so you’ll want to completely eliminate items such as caffeine, alcohol, and all nicotine products.
  • Increasing your body’s natural production of stomach acid — Like I said earlier, acid reflux is not caused by too much acid in your stomach — it’s usually a problem with too little acid. One of the simplest strategies to encourage your body to make sufficient amounts of hydrochloric acid (stomach acid) is to consume enough of the raw material.

    One of the simplest, most basic food items that many people neglect is a high quality sea salt (unprocessed salt).I recommend eliminating processed, regular table salt for a lot of different reasons, all of which I’ve reviewed before. But an unprocessed salt like Himalayan salt — one of the best salts on the planet – will not only provide you with the chloride your body needs to make hydrochloric acid, it also contains over 80 trace minerals your body needs to perform optimally, biochemically.

  • Taking a hydrochloric acid supplement – Another option is to take a betaine hydrochloric supplement, which is available in health food stores without prescription. You’ll want to take as many as you need to get the slightest burning sensation and then decrease by one capsule. This will help your body to better digest your food, and will also help kill the helicobacter and normalize your symptoms.
  • Modifying your diet – Eating large amounts of processed foods and sugars is a surefire way to exacerbate acid reflux as it will upset the bacterial balance in your stomach and intestine.

    Instead, you’ll want to eat a lot of vegetables, and high quality, organic, biodynamic, and locally grown foods. You can also supplement with a high quality probiotic or make sure you include fermented foods in your diet. This will help balance your bowel flora, which can help eliminate helicobacter naturally.

  • Optimizing your vitamin D levels — As I’ve mentioned many times in the past, vitamin D is essential, and it’s essential for this condition as well because there’s likely an infectious component causing the problem. Once your vitamin D levelsare optimized, you’re also going to optimize your production of 200 antimicrobial peptides that will help your body eradicate any infections that shouldn’t be there.
  • Implementing an exercise routine – Exercise is yet another way to improve your body’s immune system, which is imperative to fight off all kinds of infections.

Dr Mercola wrote:

Raw, unfiltered apple cider vinegar

Acid reflux typically results from having too little acid in your stomach. You can easily improve the acid content of your stomach by taking one tablespoon of raw unfiltered apple cider vinegar in a large glass of water.

Betaine

Another option is to take a betaine hydrochloric supplement. You’ll want to take as many as you need to get the slightest burning sensation and then decrease by one capsule. This will help your body to better digest your food, and will also help kill the H. pylori bacteria.

Baking soda

One-half to 1 full teaspoon of baking soda (sodium bicarbonate) in an 8-ounce glass of water may ease the burn of acid reflux as it helps neutralize stomach acid. I would not recommend this as a regular solution but it can sure help in an emergency when you are in excruciating pain.

Aloe juice

The juice of the aloe plant naturally helps reduce inflammation, which may ease symptoms of acid reflux. Drink about 1/2 cup of aloe vera juice before meals. If you want to avoid its laxative effect, look for a brand that has removed the laxative component.

Ginger root

Ginger has been found to have a gastroprotective effect by blocking acid and suppressing helicobacter pylori.

According to a 2007 study,

it’s also far superior to lansoprazole for preventing the formation of ulcers, exhibiting six- to eight-fold greater potency over the drug.

Add 2 or 3 slices of fresh ginger root to 2 cups of hot water. Let steep for about half an hour. Drink about 20 minutes or so before your meal.

Vitamin D

Vitamin D is important for addressing any infectious component. Once your vitamin D levels are optimized, you’re also going to optimize your production of about 200 antimicrobial peptides that will help your body eradicate any infection that shouldn’t be there.

As I’ve discussed in many previous articles, you can increase your vitamin D levels through sensible sun exposure, a tanning bed, or an oral vitamin D3 supplement.

Astaxanthin

This exceptionally potent antioxidant was found to reduce symptoms of acid reflux in patients when compared to a placebo, particularly in those with pronounced helicobacter pylori infection.

Best results were obtained at a daily dose of 4 mg.

Slippery elm

Slippery elm coats and soothes the mouth, throat, stomach, and intestines, and contains antioxidants that can help address inflammatory bowel conditions. It also stimulates nerve endings in your gastrointestinal tract. This helps increase mucus secretion, which protects your gastrointestinal tract against ulcers and excess acidity.

The University of Maryland Medical Center

makes the following adult dosing recommendations:

  • Tea: Pour 2 cups boiling water over 4 g (roughly 2 tablespoons) of powdered bark, then steep for 3 to 5 minutes. Drink 3 times per day.
  • Tincture: 5 mL, 3 times per day.
  • Capsules: 400 to 500 mg 3 to 4 times daily for 4 to 8 weeks. Take with a full glass of water.
  • Lozenges: follow dosing instructions on label.

Glutamine

Research published in 2009 found that gastrointestinal damage caused by H. pylori can be addressed with the amino acid glutamine, found in many foods, including beef, chicken, fish, eggs, dairy products and some fruits and vegetables. L-glutamine, the biologically active isomer of glutamine, is also widely available as a supplement.

Folate or folic acid (vitamin B9) and other B vitamins

Research suggests B vitamins can reduce your risk for acid reflux. Higher folic acid intake was found to reduce acid reflux by approximately 40 percent. Low vitamin B2 and B6 levels were also linked to an increased risk for acid reflux.

The best way to raise your folate levels is by eating folate-rich whole foods, such as liver, asparagus, spinach, okra, and beans.

Melatonin, l-tryptophan, vitamin B6, folic acid, vitamin B12, methionine and betaine

A dietary supplement containing melatonin, l-tryptophan, vitamin B6, folic acid, vitamin B12, methionine and betaine, was found to be superior to the drug omeprazole in the treatment of GERD.

Part of the success is thought to be due to melatonin’s inhibitory activity on nitric oxide biosynthesis, which plays an important role in transient lower esophageal sphincter (LES) relaxation, which, as I mentioned earlier, is part of the real underlying problem of GERD.

Impressively, 100 percent of patients receiving this supplement reported a complete regression of symptoms after 40 days of treatment, compared to just under 66 percent of those taking omeprazole. The authors concluded that “this formulation promotes regression of GERD symptoms with no significant side effects.”

betaine

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Cough remedies from Dr Mercola

Avoid mucus-forming foods, such as milk, flour, and eggs, as well as sugar Eat light foods such as vegetables, soups with garlic, ginger and herbal teas Homeopathic remedies for pertussis include Coccus cacti and the nosode. Pertussin. Drosera is recommended for coughing fits followed by gagging, retching, or vomiting. Cuprum may be indicated for coughing fits followed by gasping for air, difficulty breathing, or that end in exhaustion
Wild cherry bark lozenges may soothe your throat Keep well hydrated Try up to 5,000 milligrams of vitamin C daily for seven days
Keep your room and home well-ventilated and free of smoke Use a warm air humidifier with essential oils (try basil, cyprus, marjoram, thyme, wintergreen, tea tree, camphor, lavender, chamomile, peppermint, or eucalyptus) Massage essential oils with a carrier oil (like coconut oil) into the patient’s chest or back
Acupuncture may be beneficial (and its effects for whooping cough are recognized by the World Health Organization) Rest and avoid exertion Arrange pillows so the patient can be more upright while sleeping
Boil fresh ginger root in water for 20 minutes, then add the water to a foot bath to soak feet for up to 20 minutes Heat a pan of water to just boiling, then add a few drops of oil of thyme. Have the patient breathe in the steam from the pan (cover his or her head with a towel, being careful to avoid getting burned) Keep skin hydrated by massaging in coconut oil daily
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