Getting off Proton Pump Inhibitor GERD Meds Cold Turkey

Back when I was just transitioning into Paleoish eating, one goal was to get off my prescription medications I'd been on for a long time. One of those was for seasonal allergies that I had come to have to take year round for the previous decade. The other was various Proton Pump Inhibitors prescribed for what I called "nuclear heartburn," officially knows as Gastroesophageal Reflux Disease (GERD).

What I found in the end is that I just began forgetting to take both, eventually realizing I didn't need them.

That was a few years ago, and after some experience with family members and anecdotes I'd heard over the years, I had a pretty good idea how one might successfully go cold turkey when I got an email from a reader a couple of weeks ago.

I have a question or 2 for you. I remember reading that you used to take anti-gerd medicine (prilosec?). My question is, do you wean yourself off it (going from every other day to every 3 days, to once/week) or did you quit cold turkey? ...

For what it's worth, the Paleo-ish is going well. I've lost a couple of inches around the waist and feel great. I say paleo-ish, because I'm doing the 80-20 thing. I allow myself one pasta meal/week, although I make sure to do it the Italian way and not have pasta be the dominant item on the plate. And as a nod to my Bavarian heritage (born and raised), I drink one wheat beer a day with dinner. I can claim that the beer is medicinal, when I was in the hospital in Munich recovering from kidney stones, my doctor told me that if I drank a wheat beer a day that I'd never get another one. 23 years of following his advice and I haven't had one since.

Basically, I just asked myself what I'd do if I were back at the start to go cold turkey, knowing what I know now. My 1-2-3 reply.

Best to go cold turkey on the GERD meds in my view. Here's a couple of tips to help you if you have problems:

  1. Go pure paleo for a few days to a week, no added fat, i.e., lean meats & veggies with at most a drizzle of olive oil.
  2. No alcohol, coffee, tea, or tobacco during that pure paleo week. Water only.
  3. Supplement with sodium bicarbonate (baking soda), about a level tsp mixed in water after each meal if you get heartburn.

Most people seem to get back to normal within about a week. But you'll definitely want to forego the pasta and the beer for that week.

Congrats on the success.

How could it be any simpler? And for this reader, apparently it was pretty simple, for I received this email just a few days ago.

Worked like a charm. Now working on getting rid of the lipitor. And after I've lost 20 lbs, I'll be able to convince my doctor to drop the blood pressure meds. (as I did doing Ornish/Pritikin).

Glad he could follow the simple advice, advice he'd likely never get from a drug pusher in a white coat.

Any other tips from self-experimentation experience? I know some recommend betaine HCL, probiotics, digestive enzymes and such, but personally I have never noticed any benefit with any of those for myself.

In terms of learning everything you always wanted to know about GERD, what it really is (too little, not too much stomach acid), how devastating PPI GERD meds can be long term and why you want to get off them, Chis Kresser is the go-to guy on this. See his multi-part series at The Healthy Skeptic.

For the newbies just leaning about how to go Paleoish, here's a primer with links to follow.

Know anyone with nuclear heartburn? Then forward this along, share it with Facebook Friends, and Tweet it using the buttons at the top of the post.

Comments

  1. I keep forgetting to write my post on this, but my advice is always
    1. Very low carb paleo for at least a week
    2. The same as yours
    3. Supplement with a tablespoon ACV in a cup of water after meals, and with a probiotic once you start having some carbs. Don’t mix carbs with added fat until things are normal (can slow down upper GI and feed misplaced bacteria there).

  2. Why do so many people say things like “convince my doctor…” to do anything? You don’t need to convince your doctor of a damned thing. He’s an advisor. Like a mechanic is an advisor for the health of your car.

    If my mechanic told me the turbocharger on my truck needed to be replaced, I wouldn’t convince him of anything. I’d say “You’re an idiot. My truck doesn’t HAVE a turbocharger!!!”

    If you’re knowledgeable enough to make decisions about your car, house, whatever, then be the same with your body. Take your doctor’s advice, consider it, make your choices. YOU determine what goes in your mouth, be it food or medicine, not him!

    People acting like the doctor’s get to tell them what to do, and we wonder why they have god complexes? Stop giving them that power, problem solved. And if he gets nasty, remind him he works for you and is your advisor, nothing more.

  3. @Bill: Agreed. FWIW, I’m the reader Richard wrote about.

    • Awesome!

      Seriously, many would have taken offense at my response. Glad to see you agree, and hope you experience phenomenal health as you proceed! I know I have. I peaked at 239 years ago. Right now I’m just barely over 190, but deadlifting 425, squatting 335, etc. Ran a mile for the first time in my life at 40, in just over 10 minutes. Now that’s under 6:30.

      The changes you can make are nothing short of miraculous if you persevere, and there’s not a drug any doctor can presribe that would have done anything close to what I’ve done with food.

      How can we take 150mg of some weird man-made substance and think we couldn’t achieve more with the several pounds of food we eat each day?

      • How can we take 150mg of some weird man-made substance and think we couldn’t achieve more with the several pounds of food we eat each day?
        Like you, I tried the Haas (remember Eat to Win?)/Pritiken/Ornish. And for awhile, it worked. I brought my blood pressure down and had ‘nearly normal’ cholesterol readings, except for low HDL’s. The problem was (in addition to the low HDL) was that I was always hungry and so the diet was not sustainable. On this diet, I am never hungry and never feel deprived.

      • Hah! Bingo!

        Yep, I was a serious low-fat advocate. Preaching to the family, and anyone else unfortunate enough to pay attention for a while.

        What B.S. All of that was one of the reasons when I went to Paleo my family waited and watched. And I didn’t bother trying to convert any of them. Eventually my father-in-law was sick and needed to get better. We hired a nutritionist who understand paleo to create his meal plans and counsel him. Sometimes you hear it better from someone else. From 230 to 190, and no longer at risk of losing his feet (he’s type I diabetic).

        Then my parents called and asked how to get started. 8 months later, they’re down a total of 100 pounds between the two of them.

        I have friends who ask, and then when they hear what’s involved say they could never do without ________. Fill in the blank with whatever you want.

        My favorite was the guy who came to me and said “My doctor has me on this cholesterol and blood pressure medication and now I’m impotent. I can’t get it up at all! Do you think I could get off the medication with changes to my diet?”

        After a 10 minutes discussion, explaining how it would help him, and in fact would make his little problem with staying little better than before the medication, he said…drumroll…”I just coulnd’t give up bread.”

        What!?!??!?!

        I told him he didn’t have to. He could give up sex, and I’d give up bread because my dick still gets hard.

        Last I heard he had made no change. I no longer beat my head against the wall with this stuff though, and that’s one of the reasons your response was so refreshing. Juts embrace change and figure out what makes a change for the better! Again, awesome.

  4. Brian Scott says:

    Hi, I’ve been following your blog for a while and it’s my first time commenting. I’ve been implementing bit by bit pieces of paleo/primal (slowed mainly because I don’t cook for myself, trying to fix that. Eggs are wonderfully easy, though). Started at a far too high 320 lbs, got down to 290ish, stalled at Christmas. Started again last week and down to 283~285. So I’m convinced that it does work even with a very minimal implementation (I think the first step in a beginner’s guide to paleo would be “stop drinking sodas and juices” :P)

    I found a small editorial in my local newspaper about primal lifestyle: http://compasscayman.com/caycompass/2011/01/27/Get-a-fresh-start—go-primal/

    Thought you’d find it interesting who far word can travel.

  5. My wife has asthma, and was also taking Prilosec for heartburn every day for several years. She still refuses to go full paleo, but she had had an allergy test a while ago showing some sensitivity to wheat. As a result, I was able to convince her to go gluten-free. Within a month, I also had her off of the Prilosec (cold turkey, no looking back).

    (I should add that she is now effectively 80% paleo, since she has also given up most sugar and I’m the one who cooks dinner).

  6. I just started this week to try and get off the PPIs that I have been on for 7+ years. It’s a little more serious for me because I have a pre-cancerous condition called Barrett’s Esophagus that was caused by both heredity (thanks, Dad) and YEARS of volcanic heartburn; and even the pros like Chris Kresser say that I may have to stay on the drugs because of that.
    But I have been paleo (w/dairy) for almost a year now and the GERD has NOT resolved like it did for a lot of folks when they started eating this way. (I know – next step is to try dropping the dairy.) And I am also pretty convinced after reading Chris’s series that not only is my problem caused by too little stomach acid, but that most of my health issues stem from poor digestion because of that also.
    So, since I am seeing a new gastro-doc Friday to set up my next monitoring endoscopy, I figured it wouldn’t be too bad to give it a go for a few days. I am using the Betaine HCL w/pepsin at each meal and I THINK that it is slowly beginning to work. In any case, I will have an evidence base to begin discussions about how to move forward with this new guy. (Got rid of my old doc when he basically called me an idiot for even QUESTIONING his non-tested diagnosis of too much stomach acid.)
    My goal in life right now is to be one of these GERD success stories like Richard and Melissa McEwen. (grin)

  7. Lute Nikoley says:

    I used to take Tums and Rolaids like candy for about 35-40 years because of constant nuclear heartburn no matter what I ate. Then the PPI’s, I considered a “miracle drug” because as long as I took it daily, I had no heartburn whatsoever. After I was on those for about 10 more years, went Paleo, dropped taking the PPI’s and never looked back. I’ve had to take a Rolaids a half dozen times in the last 2 years.

    I also went off of Statins, which I had been on for about 10 years, and Hypertension Medication I had been on since I was 38, I am now 73. The meds I haven’t been able to drop are the ones I take for enlarged prostate and also one for RLS (restless leg syndrome).

  8. Great story. Love how he got off the heartburn meds eating meats! I know several people who have gone off GERD meds after going paleo. My dad never took the meds, but had heartburn his whole life (he loved carbs). Now that he is almost fully paleo, his digestive troubles and heartburn are totally gone. A lot of people I’ve worked with see heartburn symptoms go away after just removing gluten and almost all of them see it disappear after going paleo.

  9. I took Protonix for years, but once I had been vlc Paleo for about a month, I dropped it and supplemented with Pepcid as needed for a couple months. That gradually grew less and less frequent until now I only need one once in awhile- coffee and margaritas are usually the culprit ;)
    -Kari

  10. Yeah, I agree with Bill about the “Now working on getting rid of the lipitor. And after I’ve lost 20 lbs, I’ll be able to convince my doctor to drop the blood pressure meds. (as I did doing Ornish/Pritikin).” statement. Lipitor? I would not take that if you offered me a million bucks. I don’t feel any need to wait for my doctor to tell me I can do something! I used to suffer from serious GERD too. After every test the doctors could think of back then – GI series, abdominal CAT scan, endoscopy – they could find nothing wrong and just told me I’d have to be on Zantac the rest of my life. I had to discover on my own that eliminating wheat from my diet cleared up the symptoms (which I had had for years) in less that one single week. I stopped Zantac on my own, never told the doctor, and the symptoms have never come back again.

  11. gallier2 says:

    Did he stop his Weizenbier? Because that is exactly the worse offender imaginable for me. I can drink beer without getting acid reflux, but Hefe-Weizen is guaranteed bad night. I suppose it’s the combination of yeast and wheat because Kristallweizen hasn’t that effect.
    http://en.wikipedia.org/wiki/Wheat_beer

    • Gallier – Hard to say if it was the coffee or the hefeweizen. I gave up coffee in favor of tea and limit myself to one hefeweizen/week and haven’t had reflux since. Of course, I’ve also been losing weight and I think that also might have something to do with it, along with fixing the blood pressure issue.

  12. Sidney Cammeresi says:

    “I allow myself one pasta meal/week, although I make sure to do it the Italian way and not have pasta be the dominant item on the plate.”

    LOL, I am living in Italy right now, and if pasta isn’t supposed to be dominant in an Italian pasta dish, somebody should tell the Italians that they aren’t doing it the Italian way.

    • Dove in Italia?
      What I meant to say, and wasn’t very clear about it, is that in my experience in Italy, pasta usually was not the only thing served at a meal – that it’s just a part of the overall meal. In other words, I make sure that pasta is not the only thing served at the meal; I usually include some meat and f-bombed veggies.

  13. Phocion Timon says:

    Cold turkey, baby. I didn’t have GERD, et. al., but in early 2009 I did have very high blood pressure, I’d suffered for twenty years from gout, and I had just been diagnosed as “pre-diabetic.” Oh shit, oh dear.

    I literally stumbled into Mark Sisson’s blog and bought his book. BANG! Epiphany. I called in sick so I could read the book and do more research and I stopped taking the blood pressure meds and the gout meds that day and went 99.99% paleo. Within two weeks — TWO EFFING WEEKS!! — my blood pressure dropped to low normal (the Witch Doctor was literally speachless when I told him what I had done) and I haven’t had a gout attack in almost two years. As for my pre-diabetic condition, my blood glucose now ranges from 75 to 90, down from an average of 160 mg/dL. Cool, man, very cool.

    As a side note, my medical bills were running about $2000/yr. In 2010 I didn’t spend a single penny on anything relating to the medical industry, not even aspirin.

    Fuck the Witch Doctors.

  14. Great article, Richard. I agree that most people don’t need to bother with HCL, enzymes, etc. Switching to low-ish carb Paleo is usually enough. But for those who’ve been on PPIs for several years or longer, HCL may be necessary to kick start the stomach acid production again. I just heard from an elderly fellow who’d been on PPIs for 20 years. Horrible heartburn every night between 2-4am – so bad it kept him awake. Within two days of switching to LC/Paleo and taking HCL, his heartburn was completely gone. He called my office just to tell me about it – he was that excited.

    Here’s the real kicker, though. When he told his doc he’d been reading up on GERD and saw some articles suggesting it was caused by too little – and not too much – stomach acid, the doc basically laughed in his face and mentioned something about “pseudo science”. This guy said “Wait a minute. I’ve had heartburn for 20 years and I’ve done everything you’ve told me to do, taken every drug you’ve prescribed. Now I found a way to completely eliminate my symptoms in 2 days, and it cost me $10 to do it (for the HCL). And you’re telling me it’s pseudo-science?”

    The arrogance of the medical profession never ceases to amaze me.

    • What if the maximum amount of HCl over many months doesn’t actually kick start stomach acid production, in spite of eating Primal/Paleo for almost 2 years? (Would like to mention that I’m truly happy for your patient’s success and not meaning to steal his thunder, but would be grateful for suggestions).

      • You know, in my case with rebouts of heartburn, HCI did nothing, but baking soda did, for me. That’s my go-to cure, simple alka seltzer, especially if you mix it in club soda (add lemon or lime if you like).

        But if I don’t drink, no HB (and not always, when I drink). Baking soda has been so effective for me on those times that it’s just something I have to put out there for people to try. I find its effects to be lasting.

  15. Once again a home run Richard. I went very LC a little over a year ago and started weaning myself off PPI’s. After less than 2 weeks I realized I didn’t need them anymore period. Haven’t looked back since. For me the main culprit was sugar and GRAINS. As long as I stay away from too much of those I’m fine. Any indulgence is vanished with alka-selzer heartburn. Btw, when I excitedly told my doc that I had cured my GERD with LC diet, he just waived it off.

  16. Although this may seem counter-intuitive, I’ve taken (though not since eating healthy) and many of my relatives, to whom I’ve recommended it, have taken 1 table spoon of Apple Cider Vinegar immediately when feeling Heartburn. This worked every time for me and has worked for every person I’ve recommended it to (and within minutes). I don’t remember from who I heard this but it was quite a while ago. As much as I can recall, the explanation went something like this – In most cases Heartburn is initially due to not enough acid being produced; this leads to an over-production of acid to compensate for the lack thereof (and an inability to recognize when no more is needed), thus causing Heartburn. When the person takes a spoonful of Apple Cider Vinegar this ‘tricks’ the stomach into thinking that enough acid has been released and so it stops releasing acid, and no more Heartburn. You might ask the question of why ACV and not any other acid. I have no Idea, but that’s what has worked in my experience and I haven’t tried anything else. When I did this I would take a spoonful then wait a minute or so, and in 8 or 9 out of 10 cases it would immediately stop the Heartburn. In the other cases I would take another spoonful and wait again. I don’t think it ever took more than 3 tries to get rid of the heartburn completely.

  17. There’s very little I can add. My getting off Prilosec was a struggle. But then, I never gave up the coffee and tea. Moreover, my transitioning to a primal/paleo diet happened easiest by adding gobs of animal and coconut fat to my food. But looking back, I probably could have done it cold turkey if I had embraced the idea of using Tums as a transitioning agent–which I eventually did anyway. I haven’t taken a Tums for nearly a month now. But it’s been replaced with a new transitioning agent–Halls Menthol cough and sore throat candies. So when I feel a belch thrash at my throat I reach for a sugar free Halls instead of a Tums. And thankfully those needful moments have decreased significantly.

    All I can say is I’m glad you quit using soap and shampoo. Otherwise I may have never heard about the primal/paleo diet. I also want to thank Melissa McEwen for her posting about how much of a struggle it was for her to get off the PPI med. Otherwise, I probably would’ve given up. My thanks also goes to Chris Kresser for his excellent series. My one year anniversary for getting off Prilosec comes up in April. Then, only one more year before the effect of that evil drug will be completely gone.

  18. Nah, the applause goes to you for showing how easy it is to eat this way. I’m not even on a “diet”. I love this way of eating.

  19. trying the baksing soda thing… especially after i eat my usual massive amount of cheese :)

    will definitely report back… in the mean time, what is a good wine to get>? any brands in particular? i went to buy a bottle and theres a gazillion types… preferably a paleo one!

    • Mallory, since none of the Scottish or Irish distilleries make wine, I don’t have a clue. I usually get French wines, red, when I buy, or I taste first and buy. If you’re spending more than $8 per bottle, taste first, be discriminating, and when you find it, get a case or two. You’ll save money, long run.

  20. I had serious heartburn/reflux problems for years. I threw away my Prilosec a few weeks after going paleo. Haven’t looked back. If I slip and eat a bunch of chips or something, I have symptoms. If I don’t, I don’t. Pretty simple, really.

  21. I have a few different stories of self experimentation.

    3 years ago, I was downing one or more Pepcids a day for daily heartburn, which was especially bad during running and at night. My tendency to avoid doctors was the only thing that kept me from being on a prescription at this point. Pepcid isn’t cheap — this was a $1 to $2 a day habit.

    Experiment 1: Gluten free.
    I went gluten free (100%) for about 2 months as part of trying to rid myself of worsening GI problem. This was not primal or paleo, in fact I knew nothing about that at the time, just gluten free. An unexpected side-effect was immediate and total relief from the heartburn. I stopped gluten free because it was too much work trying to make pretend foods out of different flours, for instance pizza crust out of rice or potato flour. Blech. When I stopped being gluten free, the heartburn returned. The non-paleo gluten free world has a lot of bad recipes.

    Experiment 2: Paleo with dairy, 100% grain free.
    Again, complete relief within 24 hours. This wasn’t a “maybe something has changed” sort of thing. This was “aaaahhhhg it feels like it’s burning a hole through my throat” to not even a hint of heartburn.

    Clearly for me, grains were the issue since that is the only thing I cut out in experiment 1.

  22. Josh Spradley says:

    I used to have HORRIBLE acid reflux, I took Nexium for years and ate Tums like they were candy. Then I went primal/paleo and as soon as I stopped drinking sodas and eating grains, no more GERD.

    I have had ONE instance of GERD in the 5 months I’ve been eating primal and I attribute that to a 3 day spicy food marathon coupled with a 7 mile hike and drinking water purified with iodine (could be wrong there though) but since then not a single instance.

    Everyone I work with has horrible GERD, several of them have had surgery to fix it, and they all still pop back Mountain Dew, Budweiser, and eat “healthy” grains like there’s no tomorrow and then wonder why their GERD is so bad…

  23. Hey all, I’m 28 now and have been taking Prilosec for 14 years. I think I was eating way too much carbs and sugary candy as a kid and those (insert expletive here) doctors told me Prilosec was the only solution. I began to have IBS-type symptoms about a year ago and had to completely stop eating onions. I love onions. I began to search for solutions and found the Paleo diet from reading a lot of barefoot running blogs. I’ve been Paleo for about 6 weeks now with fairly low carbs and been loving the results.

    I came across this post last week and checked out Chris Kresser’s excellent info…it was like an epiphany. Everything Chris was saying I had experienced. On the one hand I was pissed off at those (insert expletive here) doctors but also hopeful I could get rid of my heartburn and poor digestion. I stopped taking Prilosec three days ago, started the betaine and probiotics, and have been having mild success. I slept fairly well the first two nights, about 6 hours, but last night I maybe got 4 hours. I’m feeling horrible today and would love to be able to get some better sleep.

    Did anyone else have similar sleep problems while quitting PPIs? What did you do to help? I’m already sleeping at about a 30-degree incline and drinking anti-heartburn tea before going to bed. Should I try to cut out all carbs for a few days? What about fasting for a day? Any advice will be appreciated!

    • Dan, you might try leanish meat and fish for a few days, like 3-5 and see how you feel. You might also incorporate an eating window of say 8 hours so your system gets 16 hours per day of rest. No alcohol, coffee, or tea. Water only.

      See how that works.

      • Thanks for the tips Richard! I’ll try the 8 hour eating window and stay away from alcohol (damn), coffee, tea, and non-lean meat (damn again). Whatever it takes to kick this will be totally worth it.

        Just curious, how come non-lean meats are bad in relation to heartburn?

      • Dan, it may make no difference, simply a precaution because it’s better to overshoot the problem than undershoot it. Being a heartburn sufferer myself (now only on occasion), I have found that the absolutely gentlest thing is lean meat and water.

        So, I’d just do that for a 3-5 days and if good to go, add fatty meat and if good to go, veggies and fruits.

      • Sounds like a plan then, thanks again!

Trackbacks

  1. [...] Getting off Gerd Meds Cold Turkey – Free The Animal Matt "Size" Mercurio Dottie busting out legit hand stand push ups! Definitely one of the first ladies at the 908 to do this. [...]

  2. [...] I’ve discussed the paleo diet in previous posts, and linked to a number of clinical trials that show eating a grain-free diet supports excellent health, strong immunity, fat loss, muscle gain, and has other numerous benefits (including cessation of allergy and asthma symptoms in my own case).  In addition to the clinical research, there are thousands of anecdotes that hint at the possibility that a paleo diet (with various degrees of strictness) can reverse autism, lead to massive fat loss, and reverse chronic heartburn/GERD. [...]