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 


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

  1. Cassie Brown October 4, 2011 at 12:18 pm # Reply

    From personal experience, I have to agree with this totally. I have had GERD for years and have a slight hiatal hernia as well. I started out on Zantac. Over the years, I have tried Protonix, Nexium, and Lansoprazole. I end up going back to Zantac or generic ranitidine. Even though the others help with the heartburn, they cause other side effects that I don’t get with the Zantac.

    • Dr Ben October 4, 2011 at 6:15 pm # Reply

      Cassie –

      There are ways to get off heartburn medications.

      It makes it more difficult to do so with a hiatal hernia but it is worth a shot.

      While research shows H2 blockers to be less severe than proton pump inhibitors, I do recommend trying to get off of both.

      I do read case reports of H2 blockers causing B12 deficiency

      Consider trying ZCG 500 by Seeking Health – 1 capsule in the morning and as needed. Combining Manuka Honey and L-Glutamine Powder is also indicated as they both are very healing for the stomach lining. All these may be found in the Chronic Gastritis section at HealthE Goods.

      Avoiding wheat, spicy foods, caffeine and making sure you chew your foods very well before swallowing are also effective at reducing GERD.

      • Cassie Brown October 6, 2011 at 2:22 pm # Reply

        Thank you for the reply. I had read about the Manuka honey. Would regular honey be effective at all? Actually, spicy food does not bother me at all. My triggers are greasy, sweets, and acidic, and especially if it is both sweet and acidic like fruit. I tried Atkins diet several years ago and my GERD completely went away. It was awesome. Unfortunatley, I didn’t lose any weight with it so I stopped the diet.

        • Dr Ben October 6, 2011 at 9:59 pm # Reply

          Cassie –

          Standard honey does not cut it. Has to be Manuka as Manuka contains a special bactericidal component.

          Atkins can lead to high weight gain as can any diet.

          I prefer lifestyle changes.

          Read The Paleo Solution by Robb Wolf.

          He has some great tips on how to proceed with the paleolithic lifestyle.

          • Terri June 18, 2014 at 4:21 am #

            None of your suggestions have worked for me and I’ve been doing alkaline water as well…enzymes aren’t preventing bloating or gas and don’t work on the reflux either. Almost a year of this and gasping for air at night.

  2. Anna Morris November 14, 2011 at 6:19 pm # Reply

    Dear Dr. Ben,

    First of all, thank you for this website and your dedication to improving the lives of those of us afflicted with MTHFR. I have just been diagnosed with homozygous C677T and plan to schedule a phone consult with you as soon as all of my lab work is complete. I am post Lymes disease and also have sick building syndrome(I lived in a water damaged house for three years at the same time that I was fighting the Lyme’s). My TGF-beta 1 is 15320(ref range 344-2382). The high level can indicate some cancers but is also seen in people who have sick building syndrome. My Lyme doctor is trying to find the cause of this and she is the one who ordered the genetic testing for MTHFR.

    I want to comment on H2 antacids that you recommend. Cimetidine is a potent cytochrome P450 inhibitor; Ranitidine has 10% the affinity that Cimetidine has on P450. Pepcid and Axid have no effect on cytochrome P450 so these would be the safest for us to use. I was a pharmaceutical rep in the mid 1980’s and we were required to learn these effects of these drugs. The early H2 inhibitors had the P450 problem which lead to the developement of Pepcid and others that had no effect on P450.

    I am looking forward to talking with you. My lab tests and cancer screenings should be complete by the end of December.

    Again, Thank you for this website and your help,


    • Dr Ben November 14, 2011 at 7:43 pm # Reply

      Anna –

      Thank you for your comment. Very helpful to have an ‘insider’ post this critical information.

      I look forward to working with you.

      Dr Ben

  3. Tamer December 8, 2011 at 2:28 pm # Reply

    Dear Dr.

    I have been diagnosed for GERD and minor inflamtion in stomach and the doctor gave me Controloc 40g and Antodine and i take one pil of each every day but latley i am experiencing joint and back pain and fatigue. Was it right to combinethese two medciation as antiacid drugs?

    • Dr Ben December 9, 2011 at 12:24 am # Reply

      Tamer –

      You have a MTHFR mutation? If so – and you are taking these antacids, you are increasing your toxicity which can cause pain and fatigue.

      Even if you don’t have a MTHFR mutation and taking antacids, it is possible to get pain and fatigue due to:
      – low B12 absorption – or none at all
      – low iron absorption – or none at all
      – decreased ability to detoxify due to shutting down of your body’s main detoxification pathway via the cytochrome P450 enzyme

      GERD and stomach inflammation are common and I highly recommend you watch this video that I did some time ago on Gastritis:

      Talk with your doctor about getting off of these antacids.

      It is possible to heal GERD and stomach inflammation naturally. Antacids only worsen the problem – not fix it.

      These chronic gastritis supplements may help you significantly:
      – D-Limonene
      – Manuka Honey
      – L-Gltuamine
      – ZCG 500
      – ProBiota 12 Probiotic Powder
      – Saccharomyces Boulardii

      These along with lifestyle and dietary changes help people significantly with GERD and stomach pain.

      If you’d like to schedule a consult to go into this in detail, I am available next week.

      It typically takes about 3 to 4 months to naturally get nearly complete resolution of GERD and stomach inflammation down.

    • Tamer December 9, 2011 at 7:36 am # Reply

      Dear Dr ben:

      I also had a blood test and it should the platelet count about 168,000 and and the normal percentage bgins from 150,000. The report came saying (normal blodd picture and low normal platelet and some aggregative are seen) can controloc and antodine cause this?

      • Dr Ben December 10, 2011 at 1:34 am # Reply

        Tamer –

        I am not sure. You may type in the names of your medication into Google and write:
        Controloc Package Insert
        Antodine Package Insert
        [Drug name] Package Insert

        This way you’ll get lots of information about the medication.

        To see interactions of drug-to-drug, use

  4. Allie June 3, 2012 at 12:49 am # Reply

    Couple of days ago, at a consult with my gastroenterologist:

    Me: “I haven’t taken any of the Somac you prescribed, I have this genetic issue that means it’s not a good idea, causes problems with B12.”

    At this point I present some basic info about MTHFR (homo C677T) that I’ve prepared, with screenshot copies of a couple of slides from Dr Ben’s presentation – including list of medications that should not be taken – to back up my assertions.

    Doc (smiling reassuringly): “Sounds like you’ve been seeing a Naturopath! You don’t need to worry about that, there’s plenty of studies to say it’s all good, and we can give you 3 monthly shots of B12 so it’s really not an issue at all.”

    Me: “I know it’s not as simple as that and I’m following up other options, thanks….”

    I would have had so much more faith if he had shown an interest, admitted he’d never heard of it, offered to find out more and get back to me, whatever…. I left the notes with him, I expect they have been ‘filed’ by now.

    Yes I did check it all out again on here when I got back, next time I’ll tell him there’s no point giving me B12 shots as my body won’t be able to use them, and no I still don’t want his Somac. I think there’s little point trying to find another GI doctor, and at least he respects my decision and didn’t give me too much of a hard time over it.

    He couldn’t get his head around the fact that I have been diagnosed with LOW stomach acid and am supplementing it, or that my latest discovery (with the help of my an integrative doctor who is both a medical doctor and a naturopath) is mercury toxicity, with symptoms going back 40 years, thanks to a dozen amalgams.

    I am finally learning to educate myself and stand up to doctors. It’s worth it!
    Thanks again for all the wonderful information available to me here!

    • Dr Ben June 3, 2012 at 9:30 pm # Reply

      Good for you, Allie. You are right – if your doctor showed an interest instead of brushing you off, things could have been different.

      Keep it up ;)

  5. Adrianne August 26, 2012 at 9:08 pm # Reply

    What about Tums? My husband has CFS and has a lot of stomach issues. Are tums in moderation a problem as well? They weren’t on the list. Thanks for this site!

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

    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?

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

    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!!


  1. MTHFR C677T Mutation: Basic Protocol | | MTHFR.NetMTHFR.Net - February 24, 2012

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

  2. MTHFR Mutation- C677T | Lyme Disease Mommy - May 20, 2012

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

  3. How to Manage MTFHR Mutations for Optimum Fertility and a Healthy Pregnancy | Natural Fertility Breakthrough - November 28, 2012

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

  4. 30 Ways To Improve Digestion and Gut Health (Part Two) • MTHFR Living - September 29, 2013

    […] absorption of nutrients and medications, weaken your digestive system and contain harmful fillers. People with MTHFR should especially not consume antacids because they interfere with your detoxification […]

  5. Important News For You III • MTHFR Living - December 22, 2013

    […] from interfering with the body’s main detoxification pathway, antacids have also been found to cause vitamin B12 deficiency, which was further explored in a […]

  6. 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...