MTHFR Mutations and Antacids are a Bad Mix

Those with MTHFR mutations tend to have elevated homocysteine levels or elevated s-adenosylhomocysteine.

Those with MTHFR mutations tend to be more toxic than those without because of an inability to detox properly.

I will discuss this in detail another time; however, I will touch on it as many antacids do affect the cytochrome P450 pathway. The cytochrome P450 pathway is critical in processing medications and toxins.

These are very serious issues and the last thing those with MTHFR mutations need is further aggravation of either one.

Well . . antacids aggravate those with MTHFR mutations.

Why do antacids make those with MTHFR mutations worse!?

  • Antacids, specifically proton pump inhibitors (PPI’s) literally inhibit absorption of vitamin B12
  • Some antacids literally shut down the body’s main detoxification pathway: cytochrome p450.

Research supports me:

B12 status declines during prolonged PPI use in older adults, but not with prolonged H2 blocker use; supplementation with RDA amounts of B12 do not prevent this decline. This report reinforces that B12 deficiency is common in the elderly and suggests that it appears prudent to monitor periodically B12 status while on prolonged PPI use, to enable correction before complications ensue.[1]

Supplementation with B12 does NOT prevent this decline. Ouch.

What happens if someone has low vitamin B12? A few examples:

  • Increased levels of homocysteine
  • Fatigue
  • Irritability
  • Depression
  • Sore tongue
  • Inability to concentrate
  • Increased risk of cancer

Don’t address the symptoms of antacids. Address the cause. Unless you want to have any of the symptoms or issues above.

Which antacids are proton pump inhibitors?[2]

  • Omeprazole (Losec, Prilosec, Zegerid, Ocid, Lomac, Omepral, Omez)
  • Lansoprazole (Prevacid, Zoton, Monolitum, Inhibitol, Levant, Lupizole)
  • Dexlansoprazole (Kapidex, Dexilant)
  • Esomeprazole (Nexium, Esotrex)
  • Pantoprazole (Protonix, Somac, Pantoloc, Zurcal, Zentro, Pan, Controloc)
  • Rabeprazole (Zehcin, Rabecid, AcipHex, Pariet, Rabeloc, Dorafem)
  • Revaprazan

 Which antacids are H2 blockers?[3]

  • Cimetidine (Tagamet)
  • Famotidine (Pepcid)
  • Nizatidine (Axid)
  • Ranitidine (Zantac)

I promised I’d talk about the other risk of antacids and their relation to increasing toxicity in the body.

If you plug the toilet and flush repeatedly, you get one heck of a mess.

If you take antacids which block the cytochrome P450 pathway, you get one heck of a mess in those with MTHFR mutations.

Cytochrome P450 processes toxins, chemicals and many many medications. If you prevent this from working, toxins, chemicals and medications do not get processed and they stick around longer in the body. As they accumulate, symptoms of pain, headaches, muscle aches, frequent fatigue, sensitivity to chemicals begins.

Which antacids reduce cytochrome P450 function?[4]

  • Proton pump inhibitors – so the same list as above
  • Lansoprazole and Pantoprazole are the most potent inhibitors of Cytochrome P450.
  • Rabeprazole has a thioester analog which is a very potent inhibitor of Cytochrome P450

Now if you have a reduced Cytochrome P450 for any reason, you want to try and remedy the situation as it is essentially one of your main detoxification pathways.

Talk with your doctor about getting off of proton pump inhibitors and switch to H2 blockers.

For a permanent solution and getting off of antacids, schedule a consult with me.

I’ve had great success repeatedly in helping people get off antacids for good.

Hello Dr. Ben,

I wanted you to know that I am off of Nexium and Prilosec!!  I have been off of Nexium for almost 2 months and stopped taking the Prilosec over 2 weeks ago.  Hooray!  Thanks so much for your support.

[1] Journal of the American Medical Directions Association, Do Acid-Lowering Agents Affect Vitamin B12 Status in Older Adults?
[2] Proton Pump Inhibitors – Wikipedia
[3] H2 Blockers – WebMD
[5] Cytochrome P450 – Wikipedia 


8 Responses to “MTHFR Mutations and Antacids are a Bad Mix”

  1. Jen March 29, 2014 at 5:43 am #

    I have one copy of each MTHFR mutation and I’m currently pregnant (following Dr Ben’s protocol). I have never had heartburn until recently. Any advice for dealing with heartburn during pregnancy?

  2. Jen August 17, 2014 at 2:58 pm #

    I’ve had severe GERD for about 30 years (I am now 36). Diet did not seem to help and I’ve had to have my esophagus widened twice due to strictures from scar tissue. I’ve been on Prevacid since 1996 and have not had any more scar tissue. I have fertility issues and have one MTHFR copy. I would love to get off prevacid. But, I don’t want to damage my esophagus any more. It is so damaged, I stopped feeling the acid reflux. So, if I continue to have it, I may not know until I am unable to swallow again. Are your suggestions regarding supplements and diet chance something that may help someone with my complications from GERD?

    I also have a form of autoimmune arthritis that started before I was on any reflux meds. So, I do have stiff/painful joints from time to time, but it is believed to be part of my arthritis and since it started prior to my PPI use, it probably isn’t related, is it?

    Thank you for any insight you can provide!!

  3. Sara February 9, 2016 at 6:33 am #

    How about tums or Gas X?

    • Toni Taylor January 8, 2018 at 8:45 pm #

      I’ve read that it’s not good to take tums with a MTHFR mutation

      • Dr Lynch January 11, 2018 at 12:57 pm #

        It’s not good in general to take antacids. It’s best to address the underlying problem.

  4. Amber Cooper February 17, 2017 at 3:56 am #

    My son is having esophagus issues with food getting stuck. We were recently in the ER because a piece of chicken was lodged. It took 12 hours and was almost in surgery with a GI doctor. Today he was prescribed Nexium for 4 weeks (and wean off by 8 weeks) to help reduce inflammation and block acid so that his doctor can send a scope down his esophagus and possibly stretch it without tearing or puncturing it. I’m at a loss as to what is the lesser of two evils. Would it be ok to do this short term to address the esophagus problem or is there a different route we could take to safely effect the desired change?


  1. MTHFR Basics – stewarding Life - February 19, 2015

    […] Avoid antacids as they block absorption of vitamin B12 and other nutrients […]

Leave a Reply

Read previous post:
MTHFR Mutations with Low Homocysteine a Problem? Yes

Most research on MTHFR mutations point to the C677T homozygous mutation and how it causes elevated levels of homocysteine. There...