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10 Best Supplements for Heartburn & Acid Reflux

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If you have heartburn or acid reflux, either occasional or chronic, here are 10 supplements you should know about that can help you find relief without taking the standard antacids or proton pump inhibitors.

What to Know about Antacids and Proton Pump Inhibitors

               To treat heartburn and acid reflux, you may turn towards different types of medications.  Some of the most common types of medications for heartburn symptoms are antacids (like Mylanta, Rolaids, and Tums) which neutralize the acid that has traveled back up the esophagus and causes the uncomfortable burning sensation.  These antacids work quickly but do not last very long, and they do not help address the underlying causes of heartburn or acid reflux.

               The other common medications used for heartburn and acid reflux include Pepcid (famotidine) and Tagamet (cimetidine).  The are considered antacids but belong to a particular group of medications called histamine blockers (sometimes abbreviated as H2 blockers).  These medications work by blocking the signal which causes cells in the digestive tract to secrete stomach acid.  Generally, these histamine blockers provide 12 hours of relief from symptoms.

               If you aren’t getting any relief from antacids, you may be prescribed medications like Prilosec, Nexium, Dexilant, or Prevacid.  These medications are called Proton Pump Inhibitors (abbreviated PPIs) and are popular because they provide relief for up to 72 hours.  This class of medications treats heartburn and acid reflux symptoms by shutting down the pumps which regulates the secretion of acid altogether.  PPIs are so effective at shutting down the acid production in the stomach that they also shut down acid production in other parts of the body.  The cells rely on acid to remove waste, so the systemic effects of taking PPIs should also be taken into consideration (1).

Nutrient Deficiencies Caused by Histamine Blockers and PPIs

               One of the problems with chronic use of PPIs and Histamine Blockers is nutrient depletion.  H2 blockers inhibit the absorption of zinc, and PPIs inhibit the absorption of calcium, magnesium, and zinc. 

  • Zinc is necessary for stomach and intestinal health: zinc heals the layers of mucous membranes in the stomach and protects the mucosal layers from the caustic effects of stomach acid, while also regulating and keeping just the right amount of acid secretion (2, 3, 4).
  • Magnesium is so affected by the use of long-term PPIs that the FDA issued a warning in 2011 recommending that serum magnesium levels should be checked before starting long-term administration of PPIs.  PPIs deplete magnesium on their own, and the FDA is particularly concerned with patients who are also taking other medications known to deplete magnesium and recommends close monitoring in those cases.  Common mag-depleting medications include the heart medication digoxin, and it even extends to people who have had stents placed in their hearts or experienced any percutaneous cardiovascular events.  A quarter of the people who experience extreme magnesium deficiency while taking PPIs could not resolve the deficiency with just taking supplemental magnesium—they had to stop the PPI altogether in order to correct the deficiency (3).
  • Calcium can be depleted by PPIs because they block the production of stomach acid.  This means that less calcium is available in the intestinal tract for absorption.  PPIs have also been implicated in atrophying parathyroid glands which means that calcium begins to be leached from the bones instead.  The FDA recommended in 2011 that PPIs should be used for 2-week time periods only and just 3 intervals per year after bone loss was implicated in connection with more fractures in patients on PPIs (4, 5).

Risk of Dementia & PPIs

A study found that people who regularly took PPIs had a 44% increase in their risk of developing dementia (6).

10 Alternative Remedies and Supplements for Heartburn & Acid Reflux

1)  D-Limonene neutralizes gastric acid and forms a barrier on the top of the stomach acid because it floats, preventing the acid from causing discomfort in the esophagus.  D-limonene neutralizes acids the same way it’s been used to dissolve the cholesterol contained in gallstones (7, 8).

D-Limonene can be found with #2 on this list, seabuckthorn seed oil, in this product.

2) Seabuckthorn Seed Oil heals stomach ulcers better than H2 blockers or PPIs in preliminary animal studies (12).   This product combines D-limonene and Seabuckthorn Seed Oil.

3) Melatonin is secreted by the gastrointestinal tract and is produced 400 times more there than in the pituitary gland. People with GERD and acid reflux often have lower levels of melatonin. Melatonin inhibits the synthesis of nitric oxide which is tied to lower esophageal sphincter tone. A common PPI, omeprazole, is almost structurally identical to melatonin (10).

4) Zinc Carnosine supplementation resulted in a 61% improvement in heartburn and acid reflux symptoms after 4 weeks of use and a 75% improvement by week 8 (9).

5) Marshmallow Root is a demulcent herb, meaning it coats and forms a physical protective barrier in the esophagus and stomach which guards against damage from acid. Other demulcent herbs like slippery elm also have this effect (13, 14). This product contains the demulcents marshmallow root, slippery elm, aloe vera, and DGL.

6) Deglycyrrhizinated licorice (DGL) worked better in a clinical study than conventional antacids (11). This product combines DGL with the herbs marshmallow root, slippery elm, and aloe vera.

7)  Bromelain is an enzyme found in pineapple which has been included in digestive enzymes which may provide relief for heartburn sufferers.

8) Ginger is an age-old remedy for stomach complaints and nausea and may provide relief against nausea and pressure from symptoms of heartburn or acid reflux.

9)  Apple Cider Vinegar is anecdotally used to treat acid reflux.  Though many people swear by it, the scientific evidence is scarce; but it may work for you.

10) Fennel is an herb that has been used in traditional folk medicines to relieve stomach discomfort and heartburn.

               With so many alternatives to try, you may be able to find something which provides relief without the undesired side effects that antacids, histamine blockers, and PPIs can cause.  Remember to address the lifestyle issues that can contribute to heartburn for a comprehensive approach.  For a deeper read about heartburn and acid reflux, how these supplements work, and the risk factors that contribute to heartburn and acid reflux, visit here.

References

Yepuri, Gautham, et al. “Proton Pump Inhibitors Accelerate Endothelial Senescence.” Circulation Research, vol. 118, no. 12, 2016, doi:10.1161/circresaha.116.308807.

2. Shafaghi, Afshin et al. “The Effect of Zinc Supplementationon the Symptoms of Gastroesophageal Reflux Disease; a Randomized Clinical Trial.” Middle East journal of digestive diseases vol. 8,4 (2016): 289-296. doi:10.15171/mejdd.2016.38

3. Peck, Peggy. “FDA Warns GERD Drugs May Deplete Magnesium.” Medical News and Free CME Online, MedpageToday, 10 June 2020, www.medpagetoday.com/gastroenterology/gerd/25147.

4. Yang, Yu-Xiao. “Chronic proton pump inihibitor therapy and calcium metabolism.” Current gastroenterology reports vol. 14,6 (2012): 473-9. doi:10.1007/s11894-012-0290-4

5. FDA Drug Safety Communication: Possible Increased Risk of … www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fda-drug-safety-communication-possible-increased-risk-fractures-hip-wrist-and-spine-use-proton-pump.

6. Lehault, William B, and David M Hughes. “Review of the Long-Term Effects of Proton Pump Inhibitors.” Federal practitioner : for the health care professionals of the VA, DoD, and PHS vol. 34,2 (2017): 19-23.

7. Sun J. D-Limonene: safety and clinical applications. Altern Med Rev. 2007;12(3):259‐264.

8. Martin, Russel. “Natural Relief from Heartburn.” LE Magazine, www.luckyvitamin.com/images/brochures/LE_Esophaguard.pdf.

9. Hudson, Tori, and AuthorTori Hudson. “Nutrient Profile: Zinc-Carnosine.” Natural Medicine Journal, www.naturalmedicinejournal.com/journal/2013-11/nutrient-profile-zinc-carnosine.

10. Joanna Dulce Favacho de Oliveira Torres, and Ricardo de Souza Pereira. “Which Is the Best Choice for Gastroesophageal Disorders: Melatonin or Proton Pump Inhibitors?” World Journal of Gastrointestinal Pharmacology and Therapeutics, Baishideng Publishing Group Inc., 6 Oct. 2010, www.wjgnet.com/2150-5349/full/v1/i5/102.htm.

11. RMIT Training PTY LTD. “#{Title}.” Journal of the Australian Traditional-Medicine Society, Australian Traditional-Medicine Society, search.informit.com.au/documentSummary;dn=950298610899394;res=IELHEA.

12. Dogra, Richa, et al. “Efficacy of Seabuckthorn (Hippophae Rhamnoides) Oil Vis-a-Vis Other Standard Drugs for Management of Gastric Ulceration and Erosions in Dogs.” Veterinary Medicine International, Hindawi Publishing Corporation, 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3703904/.

13. “Demulcent.” The Naturopathic Herbalist, 14 May 2014, thenaturopathicherbalist.com/herbal-actions/b-d/demulcent-2/.

14. Marshmallow – Kaiser Permanente. wa.kaiserpermanente.org/kbase/topic.jhtml?docId=hn-2128005.

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