For over 30 years, Zantac was assumed to be a safe tool for managing heartburn. How did things go wrong? 

With over 15 million prescriptions every year, no one suspected that the popular heartburn drug Zantac could cause serious harm. It has been used for years to reduce the production of stomach acid in cases of ulcers and heartburn.

However, testing revealed in September that Zantac and its generic, ranitidine, contained a “probable” carcinogen (cancer-causing substance). Half a dozen generic manufacturers pulled ranitidine off the market, and Sanofi recalled brand-name Zantac from pharmacies and retailers. What happened? 

Nitrites May Be The Key To Possible Carcinogens In Zantac

Zantac and its generic versions have been found to contain dangerous levels of nitrosodimethylamine, or NDMA, which is a probable carcinogen. The substance is formed by the drug’s instability. What this means is ranitidine products have been harming users since the 1980s, when Zantac was first approved. 

The Food and Drug Administration (FDA) did not find evidence that ranitidine forms carcinogens in the stomach, but their methods did not involve combining it with nitrates. When the Connecticut-based pharmacy and laboratory Valisure tested the drug in the presence of nitrites, they found that just one tablet of Zantac produced over 3,100 times the acceptable limit of NDMA.

Nitrites are found in the body and are produced from the nitrates in cured meat, such as bacon, salami, ham, and hot dogs. Many fruits and vegetables contain some nitrates, too. This means that Valisure’s methods are more applicable to people because the consumption of these foods is common. High nitrate intake may, in fact, contribute to heartburn, so it could be a counterproductive combination in that way, too. 

While the FDA is currently suggesting voluntary recalls until they gather more evidence, other countries are taking no chances. Health Canada, along with European nations including Germany, Switzerland, France, and Italy have stopped distributing the drugs. Pakistan banned all manufacture and sale, while Taiwan will fine pharmacies that continue to sell ranitidine. 

More Recalls Shake America’s Confidence In Pharma

Ranitidine products are not the only drugs affected by recalls in recent times. NDMA is the same carcinogen that led to a recall of losartan, irbesartan, and valsartan, three drugs used to lower blood pressure, in July 2018. Their recall was due to a new manufacturing process in Chinese factories that led to the formation of NDMA. 

Adding to the pharmaceutical industry’s questionable track record, a batch of Xanax distributed between July and August 2019 was recalled in November due to contamination. Bottles of 500 pills with the lot number 8082708 and an expiry date of September 2020 may contain a foreign substance.

Even if you don’t have Xanax from this batch, this and other benzodiazepines are known to cause cognitive and motor disturbances and raise the risk of cancer, dementia, hip fracture, and death from any cause. These side effects are some of the reasons why many people have kicked Xanax with CBD oil

Most recently, the FDA has begun to investigate metformin for NDMA contamination. Metformin is used to control blood sugar and increase insulin sensitivity. It is the fourth most commonly prescribed drug in the United States. Over 30 million Americans have diabetes and 90-95 percent of cases are the type II form. We are watching this developing story for updates. 

What Really Causes Heartburn?

Recent research suggests that, apart from the cancer scare, treating heartburn and other digestive distress with anti-acid medications is exactly the wrong way to go. 

Heartburn does not come from a deficiency of ranitidine or even too much stomach acid, as is commonly assumed. Poor digestion is behind many cases of heartburn. Many healthcare practitioners argue that heartburn is better treated, and ultimately prevented, by healing the digestive system. And that many sufferers actually suffer from low acid, not too much acid. Despite the pharmaceutical treatment being aimed at reducing stomach acid, not enough acid is linked with more severe heartburn.

Poor digestion causes heartburn by leading to food staying in the stomach for longer periods. Low stomach acid is also linked to increased risk of infection and bone loss. With the associated risks of low stomach acid, why reduce it further? 

Countless patients have found relief with betaine HCl and/or digestive enzymes. Hydrochloric acid (HCl) is the type of acid that the stomach produces. Supplementation with this acid and enzymes helps to fill in the gaps if you cannot produce enough by yourself. It’s also best to avoid drinking too close to meals. This dilutes the stomach acid and digestive enzymes you already have.

Easy Heartburn Solutions

One simple way to improve digestion and prevent heartburn is to chew gum. But avoid those filled with sugar and artificial ingredients. Chewing stimulates saliva production, which helps to neutralize stomach acid in the esophagus and maintain appropriate muscle contraction through the digestive tract. When researchers combined this benefit with added ingredients of licorice, papain, and apple cider vinegar, heartburn and acid reflux scores were half that of the group chewing on regular gum. 

How do they work?

Licorice is a soothing herb that can protect tissue such as the esophageal lining, while papain contains protein-digesting enzymes. As for apple cider vinegar, research shows that this and other bitter foods work by acting on the vagus nerve. This is a cranial nerve that serves as an information highway between the brain and the digestive system. Stimulation with bitters increases the release of stomach acid, enzymes and bile, which aids digestion. 

Another way to relieve heartburn is to address any underlying food allergy or intolerance. Cow’s milk allergy is a common cause of heartburn in children. As for adults, studies have found that participants with celiac disease were less likely to suffer a recurrence of heartburn if they stuck to a gluten-free diet.

Going on a ketogenic diet with less than 20 grams of carbohydrates per day can be another effective way to relieve heartburn. After only six days, obese volunteers had significantly lower symptom scores and their time with an acidic esophageal pH dropped by half. These benefits were the same as what you get from pharmaceutical drugs. 

What’s Your Alternate Approach?

Given the risks involved with seemingly innocuous drugs, it’s worth trying some of these alternative approaches to relieving and preventing heartburn. Whether the best solution for your heartburn is as simple as chewing a digestion-stimulating gum, adopting a ketogenic diet, or one of the other diet and lifestyle changes associated with reducing heartburn, these may prove to be the best remedies for your long-term health.

Alexandra Preston is an Australian naturopath, passionate about empowering others to take charge of their health and healing the planet. Her special area of interest in natural health is antiaging; she also loves the beach and is a semi-professional dancer.

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