Research published in the Journal of the American Medical Association (2006;296:2947–2953) reported a significant association between PPI use and hip fractures in adults over age 50. The likelihood of fracture increased with longer duration of use and higher dosage.
For decades, natural healthcare practitioners have expressed caution about long-term antacid use because stomach acid is essential for absorbing calcium and other minerals. Lowering stomach acid may:
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Reduce mineral absorption
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Alter the gut environment
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Decrease the stomach’s ability to neutralize pathogens
Bone Remodeling and Proton Pumps
Bone is constantly being remodeled.
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Osteoclasts break down bone to release minerals for reuse.
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Osteoblasts rebuild new bone tissue.
Osteoclasts rely on a type of proton pump mechanism to dissolve old bone during turnover. Some evidence suggests that PPIs may interfere with this process in addition to reducing calcium absorption, potentially influencing bone density over time. This mechanistic overlap offers one possible explanation for the association observed in the JAMA study.
