With Thanksgiving, Christmas, and a host of other holidays right around the corner, heartburn medication use is expected to shoot up again as it does every holiday season. But if you’ve turned on your TV even once in 2020 you know that this holiday season won’t be like the previous ones.
Covid-19 is still very much raging across the country and the world and researchers across the globe continue looking for new insight on how exactly the disease works and what we can do to prevent or treat it.
One such significant study from earlier in the year showed a particular connection between Covid-19 and Proton pump inhibitors (PPIs), which is medication typically used for heartburn.
The way PPIs work is by blocking stomach acid production and thus reducing heartburn. They are undoubtedly effective and are one of the most popular over-the-counter drugs for heartburn in the U.S.
At the same time, however, long-term use of PPIs has been linked with multiple different health issues:
- Chronic kidney disease
- Gut infections
- Type 2 diabetes
- Bone fractures and other disorders
The reason why PPIs are still used is that they’re not meant to be taken daily and for prolonged periods of time.
What’s the connection between Proton pump inhibitors and Covid-19?
The Covid-19 study about PPIs from earlier this year was conducted online and included 53,130 U.S. patients that used PPIs at least once or twice a day, every day. Of them, 3,386 patients (or 6.4%) reported positive Covid-19 tests. This was during May and June, during the first wave of Covid-19 which has already been surpassed in scale by this winter’s third wave.
This alone doesn’t prove a connection between Covid-19 and PPIs, of course – correlation does not equal causation. It may very well be that people who take heartburn medications get sick with Covid-19 because they lead more social lives.
Except, the researchers also tested PPI use against the use of other heartburn medications.
The survey also looked at patients taking histamine-2 receptor antagonists (H2RAs) – another type of heartburn medication that is generally less potent. According to the study, taking H2RAs leads to no increased risk of Covid-19.
“We found a strong, independent effect of using PPIs on the risk of COVID-19, including a dose-response relationship with nearly a fourfold increased risk for twice-daily dosing,” said one of the study’s authors, Dr. Brennan M. R. Spiegel of Los Angeles-based Cedars-Sinai. “But we found no relationship with the less powerful H2RAs, such as famotidine or cimetidine.”
Stomach Acid Protects Your Body
Covid-19 is a respiratory virus so what does our gastrointestinal health have to do with it? Isn’t it the case that you either inhale Covid-19 and get sick or you don’t?
Not really, no.
While SARS-CoV-2, the virus causing Covid-19, is most likely to enter our bodies through the respiratory system, it can also easily infect us through our GI system. The receptors used by the virus to latch onto our respiratory tract is also very suitable for attaching to our intestinal tract and replicating there.
Additionally, the fact that you’ve inhaled or ingested a bit of the virus doesn’t necessarily mean you’ll get sick – small doses of the virus are often manageable by a healthy organism and its immune system – that’s why the point of social distancing and mask usage is not only to reduce the risk of contracting the virus but also to reduce the viral load when exposed.
But here’s the kicker – our body’s ability to deal with even just a minor viral load depends on how healthy we are. Having unhealthy or weakened respiratory or gastrointestinal tracts means that even a small viral load is very likely to lead to a full-blown Covid-19 infection. That’s exactly why the elderly and people with pre-existing conditions are at risk.
And this leads us back to PPIs – while H2RAs heartburn medications don’t seem to increase the risk of Covid-19, the high potency of PPIs drastically increases the risk of getting infected with the virus and with the spread of the disease.
What can we do about it?
The first and obvious point is to avoid or at least limit the use of PPIs during the holidays. If you’ve been using them every day, try to space them out. If you’ve been using them twice a day, try to limit yourself to just one. If H2RAs are effective for you, you can switch to them too.
Additionally, you can consider various nutritional supplements such as betaine hydrochloride (HCl) which have been shown to effectively normalize our gastric acidity levels and promote healthy gut functions.
There’s also the amino acid L-glutamate (glutamic acid) which activates pepsin, a digestive enzyme that helps our bodies absorb protein. Also, consider herbs like peppermint and Gentian root that are also very effective for our GI health.
And last but not least – definitely try to limit social interactions during the holiday season. Experts are sounding the alarm for the need for social distancing and mask use during the 2020-21 winter season as hundreds of thousands of lives are on the line in the U.S. alone.
One interesting point that hasn’t been mentioned earlier is that heartburn and reflux isn’t always caused by acid overproduction. In some instances, it can actually be a sign of incomplete digestion. Overeating processed foods, not chewing food long enough can all lead to heartburn. That’s definitely something to keep in mind!