Are you on bone builders? Plus acid blockers (PPIs – proton pump inhibitors)? There is evidence for an association between PPI use along with acid blockers, that this combo can be especially bone damaging and significantly increase your risk of fractures.

This means if your bones are thin, so you are on meds for that, AND if you are ALSO on acid blocker meds, you are at increased RISK of breaking the very bones you are trying to protect. This is the exact opposite of what you are trying to do by taking, supposedly, bone building medications. (Welcome to my world)

What’s going on?

Recent studies suggested an increased risk of breaking bones when you are on a risky med combo:
1. Bisphosphonates meds for bone density protection and,
2. Proton pump inhibitors for GERD or heartburn.

Four unique studies including 57259 patients were analyzed with a recent meta-analysis (looking at similar studies and seeing if we can see a “trend” of what they are saying to scientists and thus the public)

When the scientists looked at a clump of studies, their analysis showed that taking these two meds at the same time (acid blockers and bone builders) caused a significant increase in fractures. Especially in the spine. Your back. This review included 12 studies covering 1,521,062 patients.


This meta-analysis suggests links with increased fracture risk (particularly for spine and those of the Asian race) between bisphosphonates and acid blockers.

What to do

Even if your docs don’t know this, and don’t pick up that you are on both meds, you should pick up on it and figure out other ways to get rid of your heart burn and build stronger bones. (PS Many cases of severe heartburn are due to too little acid, though some have too much, and/or food allergies, and other factors. One third of cases of heartburn are proven to be linked to other issues even in younger people.)

FACT: There is EVIDENCE for a modest association between PPI use and increased risk of fractures. The association is especially most consistent for spine fractures. (neck, mid, lower and hip areas)

FACT: PPIs rinse magnesium out of your bones, which you need to make calcium work. Magnesium protects your heart. Heart issues are linked to chronic PPI use (over one month). FDA has placed black box warnings on these meds for this issue but most docs do not pay attention. PPIs also rinse out B12. So PPIs are proven to be linked to anemia and fatigue. But they are handed out like M & Ms. If you have a patient load of 25 up to 50 patients this is much easier to do than figure out what is really going on.


 Don’t take acid blockers without figuring out if there are better, which there usually are, answers. And especially do NOT take them with bone building meds at the same time. They not only cancel each other out, they put you at more risk of bone problems.
And… work with a medical nutritionist in the know. Like me. Berkson 512 507 3279, I work in Austin, Tulsa and remotely internationally.
And there you have it.

Bone. 2011 Apr 1;48(4):768-76. doi: 10.1016/j.bone.2010.12.015. Epub 2010 Dec 23. Meta-analysis: risk of fractures with acid-suppressing medication. Kwok CS1, Yeong JK, Loke YK