Fast Facts
- A new study found an association between acid reflux medications and an increased risk of migraines and severe headaches.
- People who took proton pump inhibitors, the most commonly used acid reflux medications, had the highest odds of developing migraine.
- The study adds to growing research showing a connection between antacids and migraines.
About 20% of Americans contend with acid reflux, a condition that causes burning and irritation in the chest due to stomach acid moving into the esophagus.1 Now, a new study suggests that taking medications to ease symptoms may increase the risk of another painful condition: migraines.
The study, published in late April in the journal Neurology Clinical Practice, found the strongest association between higher migraine risk and the use of proton pump inhibitors (PPIs), the most common and effective acid reflux medication.2
The research adds to growing evidence suggesting that acid-suppressing medications have a connection to migraines and severe headaches. A study from 2022, for example, found that PPI use was potentially associated with migraines “irrespective of the elapsed time since use and the duration of use.”3
Praveen Guntipalli, MD, who is board-certified in internal medicine and obesity medicine and wasn’t involved with the study, told Health that the new study highlights “the need for careful evaluation of these medications in patients prone to migraines.”
Finding a Link Between Antacids and Migraine Risk
Researchers pulled data from 1,818 adults who participated between 1999 and 2004 in the National Health and Nutrition Examination Survey, an ongoing study run by the Centers for Disease Control and Prevention and other agencies to assess the health and nutritional status of the nation’s residents.
Participants reported whether they took PPIs, H2 receptor antagonists (H2RAs), and generic antacids. (The study focused on prescription medications, but PPIs such as esomeprazole and omeprazole are also available over the counter, though at lower dosages.)
The surveys also asked participants whether they had developed a migraine or severe headache within three months of taking the drug.
Researchers discovered that, compared to people who didn’t take acid reflux medications, those taking H2RAs and generic antacids had a respective 40% and 30% higher chance of developing a migraine or severe headache within three months. Participants who used PPIs had an increased migraine risk of 70%.
Guntipalli noted that one of the study’s limitations is that it relies on self-reported information. Furthermore, it only shows an association between the medications and increased migraine risk and does not establish causation.
What’s Behind the Migraine and Acid Reflux Connection?
Researchers are still learning about the connection between acid reflux and migraines.
Medhat Mikhael, MD, a pain management specialist at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, suggested that PPIs might cause migraine because their acid-suppressing effect interferes with the absorption of nutrients such as magnesium—low levels of which have been linked to headaches.
It’s also possible that people who need acid reflux medication are simply more prone to migraines, whether or not they take antacids, experts said.
According to Mikhael, acid reflux may spur a migraine through an “inflammatory cascade reaction that starts at the GI level” and triggers the central nervous system to “facilitate the release of the calcitonin gene-related peptides.”
Stress may also account for a potential link between the conditions, Clifford Segil, DO, a neurologist at Providence Saint John’s Health Center in Santa Monica, CA, told Health.
“Patients with increased life stress would be expected to produce more acid as a stress response, which is what I see in clinical practice,” he explained. “Patients with increased life stress would also be expected to have more frequent headaches.”
Therefore, he continued, “I am not surprised to see the treatment group requiring the strongest acid-decreasing family of medications, PPIs, to have the most frequent headaches as a comorbidity.”
What's apparent, Guntipalli said, is that the connection between acid reflux medications and migraines “clearly warrants further investigation."
Sources:
- Shaqran TM, Ismaeel MM, Alnuaman AA, et al. Epidemiology, causes, and management of gastro-esophageal reflux disease: a systematic review. Cureus. 2023;15(10):e47420. doi:10.7759/cureus.47420
- Slavin M, Frankenfeld CL, Guirguis AB, Seng EK. Use of acid-suppression therapy and odds of migraine and severe headache in the National Health and Nutrition Examination Survey. Neurol Clin Pract. 2024;14(3):e200302. doi:10.1212/CPJ.0000000000200302
- Kang HS, Kim SY, Kim JH, et al. Association between migraines and prior proton pump inhibitor use: a nested case-control study using a national health screening cohort. Pharmaceuticals (Basel). 2022;15(11):1385. doi:10.3390/ph15111385
Important Notice: This article was originally published at www.health.com by Kaitlin Vogel where all credits are due. Fact checked by Nick Blackmer.
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