More on dangers of Prilosec and other PPIs

February 22, 2016

Prilosec (omeprazole), Nexium, Prevacid, and other similar drugs in the family of proton pump inhibitors (PPIs) can cause headaches directly, but more often by reducing the absorption of vitamins such as B12 and D, and minerals such as magnesium, over a longer period of time. My previous post described a 26,000 patient study that convincingly showed that PPIs cause vitamin B12 deficiency. We also know that older women on PPIs have a higher risk of bone fractures.

A report just published in JAMA Neurology adds another dangerous association. This was also a very large study that involved over 73,000 older people, of whom almost 3,000 were taking PPIs. Those on PPIs had a significantly higher risk of developing dementia. This is possibly due to a direct toxic effect of these drugs, but more likely it is because these drugs cause vitamin and mineral deficiencies.

Three month earlier, the same journal published a study that showed that low vitamin D levels are associated with a significantly higher risk of developing dementia. A very important finding of this study was that even those who had what is considered a normal vitamin D level of between 30 and 50 had an increased risk of dementia, compared with those whose level was above 50. This is not surprising because a study of multiple sclerosis (MS) showed that those with low normal levels had many more attacks of MS than those who had high normal levels. Vitamin D seems to protect from many other diseases and to prolong life.

Many doctors will often tell you that your vitamin D level is normal if it is above 30, but you should ask what your actual level is and try to get it up to at least into 40s or 50s. The upper limit of normal is 100 (level higher than 125 can be harmful). This may require you taking 5,000 or more a day. Our government’s recommended daily requirement of 600 units is insufficient for most people. The same applies to vitamin B12 – many labs will consider a level between 200 to 1,100 to be normal, but in fact it should be at least 400.

If you take PPIs, try to get off them, which is not an easy task. Stopping such drug causes “rebound” increase in acid secretion, which makes symptoms worse than they were before PPI was started. The way to do it is to switch ot Zantac or Pepcid with antacids taken as needed. Then, you try to stop Zantac and keep taking antacids. After a while, with proper diet, you may be able to stop antacids as well.

Written by
Alexander Mauskop, MD
Continue reading
September 17, 2026
Music and Pain
Music can relieve pain, but what kind of music?
Read article
September 10, 2026
Brain disorders
Genetic connection of fibromyalgia with low back pain, PTSD, IBS, and other disorders.
A genome-wide study published in Nature Medicine found that fibromyalgia shares genetic risk factors with chronic pain conditions, IBS, PTSD, and sleep disturbances. This supports treating these overlapping conditions as one problem of a hyperexcitable nervous system rather than as separate diseases, using a multidisciplinary approach that combines psychological therapies with medications, injections, and neurostimulation.
Read article
August 23, 2026
Alternative Therapies
The Butterfly Effect in Migraine: When Tiny Doses Bring Big Relief
Sometimes a small dose of a drug or a natural substance can produce an outsized positive effect
Read article
Insights from Dr. Alexander Mauskop on headaches and migraines
Subscribe to the Blog.
Subscribe
Subscribe