PPI and irregular heart beat and chest pains

Hi Everyone,

I'm obviously new here, but have been looking around before posting, and wanted to get some people's take on a situation I've recently found myself in. Apologies in advance for the long post, but I feel it's important to give the full history.

To give you some background, I'm 44 now and have been on PPI's (Omeprazole or Lanzoprazole) since I was 18. so that's 26 pears in total. Over the last 7 or 8 years I've had a number of weird problems, none of which I'd connected to PPI's, stupidly perhaps, I'd just never really thought of it, or perhaps expected medical professionals to point these things out. For instance things started, roughly 8 years ago, with high levels of anxiety, for no apparent reason. I'd wake in the mornings with these huge feelings of anxiety, and had no idea why. This got worse and worse over the course of a couple of years, until I then started getting chest pains. Obviously at that point I did start to get genuinely worried and went to my GP for help. I was then sent for an ECG and a treadmill test, both of which showed up as normal, other than a slightly higher resting heart rate than normal. I was then effectively dismissed, however the problem was getting worse. I was subsequently referred to a cardiologist, who did further ECG tests, another treadmill test, and even an echocardiogram and a 24 hour ECG. Again, all of which came out as normal, other than the higher than average resting heart rate.

Anyway, about 3 years ago I starting getting palpitations as well, which on top of the chest pain is obviously quite scary. This time, as I'd been down the heart route a number of times, I was referred to an endocrinologist. I therefore had multiple blood and urine tests, which ended up showing increased adrenaline levels and a slightly raised white blood cell count, which apparently can mean you're carrying an infection of some kind. I was then sent back for the same tests to double check, however this time the adrenaline tests came back as normal, so again I was dismissed.

2 years ago I relocated from London to the north of England, which obviously meant a change of GP etc. This GP decided he'd refer me to an Endocrinologist again, as he thought it was odd that the 2 tests I'd had done were different. Anyway, I had further blood and urine tests done, and even an MRI, as they were looking for a suspected adrenaline producing tumor. Again, everything came back as normal, apart from the slightly high white blood cell count.

The GP then referred me back to a cardiologist, which was a few months ago now. The cardiologist decided this time to do, the usual blood tests, a stress and rest Myoview scan, which is where they track the movement of blood around your heart under stressed and rested conditions. He also had me do a 7 day ECG.

This brings me up to date, where this week I went to see the cardiologist for the results. Basically, he explained to me that the Myoview scan all showed up as completely normal, and the blood tests again were normal, apart from a slightly increased white blood cell count. However, the 7 day ECG showed that my heart was frequently speeding up and occasionally slowing down, to the point of sometimes stopping for as much as 3 seconds. His response to this was that I needed drugs to slow the heart rate, but also a pace maker to stop the heart from slowing down completely. Needless to say I was a little freaked out, and said I needed time to think, despite the cardiologist strongly recommending I need the pace maker fitting. I was obviously VERY worried about the prospect of having a pace maker fitted at age 44, and needed to gather my thoughts before moving forward.

So that's where I am, and as a result, and from a little pushing from my mother who'd read various things, I decided to look into the long term effects of PPI use, which is where I suddenly discovered mention of side effects such as anxiety, chest pains and irregular heart rate. So I'm now in a position where I have a cardiologist who is strongly recommending I get a pace maker fittied but I'm now beginning to strongly believe my problem is actually related to decades of taking PPI medication.

So I'd love to hear people's thoughts as to whether I'm right in believing PPI's may be my real problem. And if so, after 26 years how do I come off of them?

Thanks to anybody that's gotten this far through my first post, and I'd REALLY appreciate it if anybody gives some feedback.

Thanks for the reply librooks, and apologies, I should have mentioned that I'm a man.

My main reason for suspecting the PPI's is because of the amount of factual and anecdotal evidence I've found on the internet just from a few hours of looking. For instance, the FDA have warned against long term PPI use, specifying they can cause the body to stop absorbing magnesium, and hence create symptoms such as irregular heartbeat. The Notice is here...

www.fda.gov/drugs/drugsafety/ucm245011.htm

Also see WebMD for their listing of known side effects for Omeprazole...

www.webmd.com/drugs/drug-3766-omeprazole.aspx?drugid=3766&drugname=omeprazole&source=1&pagenumber=6

On top of that there are many, many posts from people, including on this very forum, of people experiencing the same problems from having been on PPI's for extended periods of time, anxiety being another common symptom.

Hi Andy1986. As mentioned, I have tried both Omeprazole and Lanzoprazole, both with the same effect. Reducing the dose has lessened the problem, but it is still prevalent. Also, fundamentally, all PPI's are the same in that they do the same job i.e. suppress the production of acid in the stomach. That then leads to the body being unable to absorb nutrients as the body needs acid to break down the food properly. Hence the risk of low serum magesium levels and the fact that PPI users can't absorb calcium, for instance, leading also to reduced bone density in later life.

Also, if the problem is GERD itself, it seems strange that the FDA would specifically point at PPI drugs as a cause of this problem. To quote directly from the FDA...

"The U.S. Food and Drug Administration (FDA) is informing the public that prescription proton pump inhibitor (PPI) drugs may cause low serum magnesium levels (hypomagnesemia) if taken for prolonged periods of time (in most cases, longer than one year)......

.....Low serum magnesium levels can result in serious adverse events including muscle spasm (tetany), irregular heartbeat (arrhythmias), and convulsions (seizures)"

That seems pretty clear cut to me, and the FDA is not the only official channel reporting this.

Maybe I'm clutching at straws, but it is certainly true that irregular heartbeat is a published and known side effect of long term PPI use, hence that's what makes me think that is the problem.

Looks like you have anxiety symptoms just like I had a year ago. I had 2 major brain surgeries in 2012. After the first surgery I ended up using hydrocortisone which messes with stomach. My symptoms got worse everyday; chest pain, palpitations, irregular beats etc. I started using Lansoprazole then Nexium. At one point, I started to freak out about these symptoms. I went to ER several times. I had pointless appointments with various doctors including my Endocrinologist. All said that everything is normal. Then I decided to pay a visit to a psychiatrist. He diagnosed my with Anxiety Disorder and put me on 5 mg Lexapro which is the minimal dose. After 6 months, I started feeling much better, no panics anymore. I still get palpitations, chest pain, irregular beats time to time but I just don't care :)