Do PPIs Directly Damage Bone Collagen?
Do PPIs Directly Affect Bone Collagen Beyond Calcium Absorption?
Yes, emerging research suggests that proton pump inhibitors may have direct effects on bone collagen synthesis and structure beyond their well-known impairment of calcium absorption. These direct effects on collagen formation and bone matrix quality could contribute to PPI-associated osteoporosis and fracture risk through mechanisms independent of calcium and vitamin D deficiency.
Dr. Kumar’s Take
This research opens up a new understanding of how PPIs might affect bone health. We’ve long known that PPIs impair calcium absorption, but this suggests they might also directly interfere with the protein scaffolding that makes bones strong - the collagen matrix. If PPIs are affecting both the mineral content (through calcium) and the protein structure (through collagen), that would explain why the bone effects seem more severe than we’d expect from calcium deficiency alone. This could change how we think about preventing PPI-related bone problems.