Your acid reflux was never from too much acid

Part 2: Medicine got stomach acid completely backwards

May 06, 2025

Proton Pump Inhibitors (PPIs)

Proton pump inhibitors are drugs that significantly reduce stomach acid production by blocking proton pumps in parietal cells that make hydrochloric acid (HCl)—sometimes leading to complete loss of function.

Examples: Omeprazole (Prilosec, Zegerid), Esomeprazole (Nexium), Pantoprazole (Protonix), Lansoprazole (Prevacid), Dexlansoprazole (Dexilant)

This little purple pill could be the reason you’re always exhausted, foggy, and bloated and why your heartburn/reflux isn’t getting any better.

This may be one of the most important and influential pieces of information you read for your health. No. I’m certain it will be.

And before we get too deep into it, can I ask you a favor? Please share this article with as many people as you can. You could save someone’s life—and I don’t take that statement lightly.

With love,

Alex

Does this sound like you?

You feel full hours after eating. You’re bloated constantly. You burp or get heartburn even when you haven’t eaten much. You avoid acidic foods. Your hair’s thinning, your nails break, your digestion is sluggish af but your bloodwork looks "fine."

Maybe you’ve been diagnosed with reflux, heartburn or GERD and have been told you need proton pump inhibitors (PPIs).

But what if the real problem isn’t too much acid…
What if it’s not enough?

“Stomach acid has little or no value to our health…”

That’s how the opening paragraph begins in Why Stomach Acid Is Good for You by Jonathan V. Wright, MD, and Lane Lenard, PhD.

Obviously, they’re mocking the modern medical model—and it’s so absurd, you have to laugh. But it’s exactly how reflux has been treated for the last 40 years.

This book completely changed my health and my life. And I can guarentee it will change yours too. You can find it here.

Because if doctors truly understood the purpose of stomach acid, they wouldn’t be handing out PPIs like candy or putting them next to the vitamin shelf at your corner drugstore.

What does stomach acid actually do again?

When your stomach acid is low, you stop absorbing key nutrients. That’s why so many people on PPIs end up with fatigue from low iron, nerve pain from low B12, insomnia from magnesium deficiency, and even osteoporosis from impaired calcium absorption.

Proteins aren’t fully broken down and purify in the small intestine causing bloating, gas, and yes—reflux. Because stomach acid is an indirect chemical signal to keep the lower esophageal sphincter closed. Let that one sink in.

Without stomach acid, our bodies start to fall apart.

Micronutrients your body can’t absorb without sufficient levels of stomach acid:

Iron → Chronic fatigue, hair loss, cold hands and feet
B12 → Brain fog, mood swings, memory issues, neuropathy
Magnesium → Muscle cramps, arrhythmias, constipation, insomnia
Zinc → Impaired immune function, loss of taste/smell, poor skin healing
Calcium → Bone loss, brittle nails, tooth decay
Folate → Neural repair, detox pathways, methylation—all sluggish

Health problems linked to low stomach acid:

Gut & Digestion

Bloating, reflux, constipation
SIBO (bacterial overgrowth)
Gastritis & achlorhydria

Nutrient Deficiency

Low B12 → fatigue, brain fog, nerve pain
Low iron → anemia, hair loss
Low calcium/magnesium → cramps, osteoporosis

Immunity & Autoimmunity

Frequent infections
Food sensitivities
Autoimmune flares (Hashimoto’s, lupus)

Brain & Mood

Anxiety, depression
Cognitive decline
Tingling or numbness (neuropathy)

Skin, Hair & Hormones

Acne, eczema, rosacea
Thinning hair, brittle nails
Thyroid dysfunction, blood sugar crashes

But isn’t the problem too much acid?

Most people assume so. But I might just change your mind.

We’re told that proton pump inhibitors (PPIs) solve acid reflux by reducing acid production.

And they do—very effectively I might add.

So now that you have “too much acid” from NSAIDs, you can magically erase your reflux or heartburn with PPIs right?

Except… what if “too much stomach acid” was never the problem?

This might explain all your symptoms

Alexandra Kassis

May 2

Read full story

If you missed our last article on how NSAIDs lead to low stomach acid I highly suggest you check that out first. I also started a conversation over on the Untreated podcast and would love to know how often you guys take NSAIDs. So make sure to head over there and comment which NSAIDs you take and how often! No judge zone! 🙅

The PPI traps

Loop 1: PPI → Low Acid → Fermentation → Reflux → More PPIs

PPIs shut down your acid pumps. So food doesn’t break down properly.
Proteins rot. Carbs ferment. Fats just kind of sit there.
Stagnant food becomes fuel for bacterial overgrowth (SIBO).
Bacteria make gas → gas creates pressure → pressure pushes acid (even if there’s barely any) upward into your esophagus.
So the reflux comes back—usually worse.
You assume you didn’t take enough PPI.
Back on the pill.

And so the loop begins.

The problem was never “too much acid.”
It was poor motility, slow digestion, and fermentation from not enough acid to start with.

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Loop 2: PPI → Nutrient Deficiency → Symptoms → Misdiagnosis → More Meds

No stomach acid = no absorption of B12, iron, calcium, magnesium, or zinc.
You get chronically ill but not bad enough to be taken seriously.
You feel chronically fatigued. Your hair falls out. You get mood swings.
You’re diagnosed with anemia, IBS, depression, anxiety, osteopenia.
So what do you get?
→ SSRIs, laxatives, iron supplements, more antacids.

None of which fix the root cause.
And many of these actually worsen acid suppression even further.

Loop 3: PPI → Microbiome Shift → Leaky Gut → Autoimmunity

With little to no acid, pathogens walk right in (I’ll do a piece on H. pylori later because that deserves its own dedicated article).
You lose microbial diversity. Opportunistic bugs take over.
Their byproducts irritate your gut lining.
→ Zonulin goes up. Tight junctions loosen.
→ Welcome to leaky gut (or for some of us—hello again!)
Your immune system starts attacking food particles or even you.
Autoimmunity gets triggered.
Inflammation worsens.
Your motility slows even more. You absorb nutrients even less.
Symptoms return… and guess what you do?

Back on the PPIs.

At this point, I’m nearly laughing out loud writing this. Because this is the definition of insanity.

Loop 4: PPI → Rebound → Lifelong Dependency

You try to stop the drug.
Your reflux returns with a vengeance.
So you assume your “condition” is just permanent.
But what you’re actually experiencing is rebound acid hypersecretion.
Your body is trying to correct years of suppressed acid by overcompensating.
You panic. You go back on the PPI.

Eventually, long-term PPI use can lead to parietal cell failure—where your stomach loses the ability to make acid at all.

Let that sink in. You might lose your stomach’s ability to function… permanently.

But aren’t PPIs protecting us from cancer?

That’s what your doctor’s worried about—especially Barrett’s esophagus, a pre-cancerous condition caused by chronic reflux.

Of course they care about you (well hopefully most do).
But it’s hard to see the full picture when Pharma has them scared out of their minds.

“You wouldn’t want your patients to get esophageal cancer, would you?”
So they prescribe Prilosec, Nexium, Protonix—and move on to the next 5-minute visit.

“The #1 doctor-recommended heartburn medicine for 8 straight years!”

Yes. That was an actual commercial. And there’s many more like it unfortunately still running today.

And yes—it’s still legal in the United States to advertise a drug linked to:

And we still let this stuff sit on the shelves at Walgreens like it’s Pez. lol.

So what’s the answer?

Well, it sure doesn’t seem to be too much acid, that’s for sure.

Low acid → poor digestion → food that rots instead of digests → can’t absorb nutrients → bacteria overgrow → mucosal barrier gets damaged → gas builds from microbes (SIBO) → pressure pushes up on the lower esophageal sphincter (LES) to relax inappropriately, allowing stomach acid to flow back into the esophagus, causing or exacerbating reflux symptoms.

And if you’re still thinking to yourself, “Well, I’m a different case because I only get it once in a while, I don’t have SIBO… it probably is from too much acid,” let me stop you right there.

Even occasional reflux is a sign your digestive system is off. Your body doesn’t randomly squirt acid where it doesn’t belong. It only happens when digestion is sluggish, pressured, or dysfunctional. All classic signs of too little stomach acid.

Let me say it plainly:
You don’t need to suppress acid. You need to restore function.

You don’t need a bandaid.
You need your stomach to work again.

Because every time you suppress the acid—even "just once in a while"—you’re fueling the very cycle that’s keeping you stuck.

Stomach acid is one of our most important protective mechanisms and absolutely essential to our health. So when your body loses one of its most important tools, it tries to adapt and survive without it. You need to restore function. And you definitely can’t do that while continuing to suppress stomach acid.

References

B12 Deficiency:

Lam, J. R., et al. (2013). Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA, 310(22), 2435-2442.
Found a significant association between long-term PPI use and vitamin B12 deficiency. https://jamanetwork.com/journals/jama/fullarticle/1788456

Magnesium Deficiency:

U.S. Food and Drug Administration (FDA). (2011). Low magnesium levels can be associated with long-term use of proton pump inhibitors (PPIs).
Describes cases of severe hypomagnesemia linked to long-term PPI use. Patients often required magnesium supplementation or PPI discontinuation to restore magnesium levels.

https://www.fda.gov/

Calcium Deficiency and Fracture Risk:

Poly, T. N., et al. (2019). Proton pump inhibitors and risk of hip fracture: A Meta-Analysis of observational studies. Osteoporosis International, 30(1), 103-114.
Analyzed 24 studies with over 2 million participants, finding a 20-30% increased risk of hip fractures in PPI users, with higher doses and longer duration linked to greater fracture risk. https://pubmed.ncbi.nlm.nih.gov/30539272/
Yu, E. W., et al. (2011). Proton pump inhibitors and risk of fractures: A Meta-Analysis of 11 international studies. The American Journal of Medicine, 124(6), 519–526.
Analyzed 11 observational studies and found that PPI use was associated with a 30% increased risk of hip fractures, and a 56% increased risk of spine fractures, and a 16% increased risk of any-site fractures. https://pmc.ncbi.nlm.nih.gov/articles/PMC3101476/

C. difficile Risk:

Janarthanan, S., et al. (2012). Proton pump inhibitor use and the risk of Clostridium difficile infection: A Meta-Analysis. American Journal of Gastroenterology, 107(7), 1001-1010.
Found a 65% increased risk of C. difficile infection in PPI users. https://pubmed.ncbi.nlm.nih.gov/22710578/
U.S. Food and Drug Administration (FDA). (2012). FDA Drug Safety Communication: Clostridium difficile associated diarrhea can be associated with stomach acid drugs known as proton pump inhibitors (PPIs).
FDA reviewed 28 observational studies and found that PPI use may be associated with a 1.4 to 2.75 times higher risk of Clostridium difficile–associated diarrhea compared to non-users.

https://www.fda.gov/

SIBO Risk:

Su, T., et al. (2018). Meta-Analysis: Proton pump inhibitors moderately increase the risk of small intestinal bacterial overgrowth. Journal of Gastroenterology, 53(1), 27-36.
Pooled data from 19 studies with over 7,000 subjects, finding a 71% increased risk of SIBO in PPI users. https://pubmed.ncbi.nlm.nih.gov/28770351/

Gastric Atrophy Risk/H. pylori Risk:

Li, Z., et al. (2017). Effect of long-term proton pump inhibitor administration on gastric mucosal atrophy: A Meta-Analysis. Saudi Journal of Gastroenterology, 23(4), 222-228.
Found a nearly 9-fold higher risk of gastric atrophy in H. pylori-positive patients compared to H. pylori-negative patients, and a 72% increased risk in H. pylori-positive patients using PPIs long-term. https://pubmed.ncbi.nlm.nih.gov/28721975/

Heart Attack Risk:

Shah, N. H., et al. (2015). Proton pump inhibitor usage and the risk of myocardial infarction in the general population. PLOS ONE, 10(6), e0124653.
Analyzed millions of clinical records and found that people who use PPIs have 16-21% higher risk of heart attack, even if they have no prior history of heart disease. https://pubmed.ncbi.nlm.nih.gov/26061035/

Kidney Disease Risk

Wijarnpreecha, K., et al. (2017). Associations of Proton-Pump Inhibitors and H2 Receptor Antagonists with Chronic Kidney Disease: A Meta-Analysis. Digestive Diseases and Sciences, 62(10), 2821-2827.
This meta-analysis of 536,902 patients found that PPI users had a 33% higher risk of developing chronic kidney disease (CKD) and an 88% higher risk of end-stage renal disease (ESRD) compared to non-users. https://pubmed.ncbi.nlm.nih.gov/28836158/

Dementia Risk:

Pourhadi, N., et al. (2024). Proton pump inhibitors and dementia: A nationwide population-based study. Alzheimer's & Dementia, 20(2), 837–845.
This large Danish cohort study followed nearly 2 million individuals aged 60 to 75 over a median of 10 years. It found that PPI use was associated with an increased risk of dementia before age 90, with the strongest associations in those diagnosed at younger ages. Longer durations of PPI use further elevated the risk.

https://alz-journals.onlinelibrary.wiley.com

Gomm, W., et al. (2016). Association of proton pump inhibitors with risk of dementia. JAMA Neurology, 73(4), 410-416. Reported a 44% higher risk of dementia in PPI users. https://jamanetwork.com/journals/jamaneurology/fullarticle/2487379

Gut Microbiome Changes:

Zhang, J., et al. (2024). Meta-analysis of the effects of proton pump inhibitors on the human gut microbiota. Frontiers in Microbiology, 15, Article 10278323.
This meta-analysis found that PPI use is associated with a decrease in gut microbial diversity and depletion of beneficial bacteria from the Ruminococcaceae and Lachnospiraceae families, which produce short-chain fatty acids (SCFAs). The study identified specific microbial and gene biomarkers related to PPI use, highlighting metabolic shifts towards carbohydrate and energy metabolism. 10.3389/fmicb.2024.10278323

All Cause Mortality:

Xie, Y., et al. (2017). Proton pump inhibitors and risk of all-cause mortality: A longitudinal observational cohort study of United States veterans. BMJ Open, 7(6), e015735. https://doi.org/10.1136/bmjopen-2016-015735

Proton Pump Inhibitor Market

Market Size Projection: DataHorizzon Research. (2025). Proton Pump Inhibitors Market Size, Share, Trends, Growth Analysis Report, 2023-2033. DataHorizzon Research. Projects the global PPI market will reach $36 billion by 2033. Link