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Doctors Grow More Cautious
It doesn't matter whether you're talking about aspirin or a powerful, prescription-only medication, there's one consistent rule. Unless you have your doctor's approval, it's unwise, and sometimes dangerous, to take the drug for too long. The main reason is the effect called tolerance. When you first start taking a "foreign" substance, it comes as a shock to your body. All the automatic systems for deciding whether this is a dangerous invading substance come into play. Because of all the work done in the clinical trials, most people find their body accepts the drug and it then works its magic with few side effects. Slowly, the body adapts to this new substance. As it grows used to having it floating around in the bloodstream, the effect of the drug gently reduces. This gives you a choice. You can either stop taking the drug before it loses it effect altogether, or you can increase the dosage. This increase works for a while but, as tolerance builds up, you are on a slippery slope. The more you increase the dosage, the greater the risk you will become dependent on it. This involves complications should you wish to stop. There ...
... will be unpleasant withdrawal symptoms unless you taper the dosage and wean yourself off.
The proton pump inhibitors (PPIs) are not addictive in this sense. Indeed, for many years, these drugs were considered completely safe, but there's increasing evidence of a long-term problem. To extract energy from the food you eat, there must be a good balance between the gastric acid, which is actually quite a strong hydrochloric acid, and the enzymes to process the dissolved food. If the body consistently produces too little acid, this can change the range of nutrients, vitamins and essential chemicals extracted. If the body does not receive the expected nutrients, the body can be damaged.
The new evidence is emerging among older women who have been taking PPIs for more than one year. Menopausal women over 50 are at risk of osteoporosis as the level of calcium falls in the bone structure. It's now becoming clear this fact has hidden the effect of PPIs. It seems long-term use slows down the rate at which the body absorbs calcium. This results in sometimes quite serious fracture as women slip and fall. The most obvious areas at risk are the wrist, elbow, and hip. Depending on the direction of the fall, any other fragile bones may be damaged. As a result, doctors are now reviewing whether PPIs should be prescribed over longer periods of time for older women.
If this applies to you, make an appointment to discuss alternative approaches to managing the problem of acid reflux. There are reasonably straightforward options in changing diet and making lifestyle changes. These may now be considered the better way of avoiding further problems of heartburn. For men, it seems Nexium may still be considered reasonably safe over long-term use although, for the sake of safety, it may be worth considering whether to take a calcium supplement as you age. All this should highlight an important truth about drugs. Nexium was licensed for short-term use. The FDA suggested a limit of three months. If you are taking it for longer, this may not be risk free.
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