Recently the Food and Drug Administration (FDA) announced that ranitidine, an ingredient found in certain over the counter (OTC) and prescription medications commonly used to relieve and prevent heartburn, contained unacceptable levels of NDMA, a probable human carcinogen. While the FDA has not called for individuals to cease using these medications while they continue their investigation, this announcement led to a manufacturers voluntary recall, as well as corporate decisions to voluntarily remove the brand name Zantac and other generic versions from store shelves. Neither the FDA nor product manufacturers have received reports of adverse events and the products may not pose any immediate health risks. However, as current evidence suggests that NDMA may be present in ranitidine, Canada and France have taken the precautionary step of recalling all ranitidine products.
Ranitidine belongs to a class of prescription and OTC drugs known as H2, or histamine 2 blockers, which reduce the amount of acid the stomach produces. While it is strictly recommended for short-term use, many consumers regularly use these products as a long-term solution for heartburn and gastroesophageal reflux disease (GERD), as well as to treat or prevent stomach and intestinal ulcers. Although classified as a probable carcinogen, NDMA may only cause cancer after exposure to high doses over a long period of time. NDMA is one of the same impurities that was found to be present in certain heart medications that resulted in the recall of many products last year.
Fortunately, there are other healthier solutions for impaired digestive function, a common age-related condition. Although the requirement for vitamins, minerals and nutrients remains constant though all stages of life, our ability to digest food and absorb vital nutrients declines with advancing age. Surprisingly, one of the most common age-related causes of inadequate digestion is a reduction of the amount of hydrochloric acid (HCI) the stomach produces. Secretion of hydrochloric acid and pepsin is a prerequisite for healthy digestion. HCI enables the body to digest and absorb proteins, carbohydrates and fats; activates enzyme and hormone production; and aids in the absorption of vitamins and minerals, increasing their bioavailability by positively affecting their release from food. Pepsin is one the main digestive enzymes produced by the body.
Additionally, HCI helps to maintain a sterile stomach environment, protecting against orally ingested pathogens and acting as a barrier to prevent harmful bacterial overgrowth in the gastrointestinal tract. Normally, the stomach contains enough free HCI to maintain constant balanced stomach acidity. Low stomach acid or the absence of stomach acid are common conditions that can result in symptoms of heartburn, indigestion, bloating, stomach upset, burning and excessive amounts of gas. Impaired acid secretion is also associated with certain chronic health conditions, including allergies, asthma and gallstones, as well as diabetes, lupus and chronic autoimmune disorders.
Heartburn is caused by regurgitation of bile into the lower esophagus, resulting in a burning sensation. Surprisingly, this is often a symptom of low gastric acid. The traditional approach to treating heartburn is to suppress gastric acid, in many cases worsening the problem where more acid is actually needed. Symptoms of heartburn and indigestion can often be relieved by taking supplemental hydrochloric acid and pepsin. In fact, for over a century, hydrochloric acid was the prescribed treatment for an absence of or low stomach acid. Supplemental HCI is viewed as a safe and effective way to restore normal gastric levels, especially when normal aging or chronic conditions indicate that nutrients are not being properly utilized.
- Betaine hydrochloride has been used for over a century to safely restore normal gastric acidity and support healthy gut function. In the stomach, betaine hydrochloride separates into betaine and hydrochloric acid, where it increases stomach acid. Betaine is a molecule that regulates water balance in cells. It is seen as cardioprotective, due to its ability to methylate homocysteine.
- Pepsin has a long history of use and can be safely administered to assist digestion, typically in conjunction with HCI.
- Gentian, a bitter herb, has been utilized as a traditional digestive aid for centuries. It is currently used in the treatment of digestive symptoms, such as loss of appetite, bloating and gas.
- Digestive enzyme supplements support the optimal digestion of proteins, carbohydrates and fats, as well the efficient absorption of energy creating nutrients. Enzyme deficiencies resulting from aging, diet or lifestyle can lead to a variety of digestive discomforts, including occasional gas, bloating, indigestion and irregularity.
Professional Supplement Center offers high quality formulations for digestive support:
Betaine HCL with Pepsin by Pure Encapsulations®: This hypoallergenic formulation offers 520 mg of pure, potent betaine HCI and 21 mg of pure pepsin in support a healthy digestive tract and optimal gastric lumen acidity for a healthy microbial balance. Gluten and soy free, Non-GMO formulation.
Betaine HCI with Pepsin and Gentian Root Extract by Vital Nutrients®: This beneficial nutrient combination helps maintain a healthy stomach pH balance and supports proper digestion and nutrient absorption. The formula includes 1040 mg of betaine, 42 mg of pure, lactose free pepsin and 100 mg of gentian root powder. Free of wheat, rye and barley gluten, dairy, soy, eggs, sugar, coatings and bindings.
Betaine Hydrochloride with Pepsin by Metabolic Maintenance®: Taken with meals, this formula increases stomach acidity to aid nutrient digestion and may also reduce food sensitivities. Ingredients include 648 mg of betaine hydrochloride and 200 mg of pepsin. Gluten and excipient free formulation.
Digestive Enzymes & Herbs by Pioneer®: This herbal and enzyme formula aids and supports normal digestion of proteins, carbohydrates and fats. Contains digestive enzymes and organic ginger, fennel, peppermint, gentian, artichoke and cayenne. Gluten free, vegetarian formulation.
Popular heartburn drug ranitidine recalled: What you need to know and do. https://www.health.harvard.edu/blog/popular-heartburn-drug-ranitidine-recalled-what-you-need-to-know-and-do-2019092817911
Gastric Balance: Heartburn Not Always Caused by Excess Acid. https://nutritionreview.org/2018/11/gastric-balance-heartburn-caused-excess-acid/
The Health Benefits of Gentian. https://www.verywellhealth.com/gentian-benefits-4588623
Questions and Answers: NDMA impurities in ranitidine (commonly known as Zantac). https://www.fda.gov/drugs/drug-safety-and-availability/questions-and-answers-ndma-impurities-ranitidine-commonly-known-zantac