Short-Term Relief = Long-Term Damage

Stomach acid is required for healthy digestion and to effectively absorb vitamins and minerals, so the longterm use of acid blockers, which work by reducing acid production in the stomach, can severely decrease nutrient absorption, leading to nutrient deficiencies. Studies have found PPI users to have significantly lower levels of vitamin B12, iron, calcium, and magnesium. One study found that 75 percent of long-term PPIs users were deficient in vitamin B12, compared to only 11 percent of non-users.  And in 2011, the FDA issued a warning that long-term use (more than one year) of acid-blocking medications can result in low magnesium levels.  Likely related to the decrease in absorption of the important bone nutrients calcium and magnesium, long-term users of acid blockers also have a significantly higher risk of bone fractures, especially those of the hip and spine. Acid blockers can also lead to dangerous bacterial overgrowth in the gut, which can increase susceptibility to foodborne illnesses and infection.  Finally, evidence has emerged showing that these drugs can also increase cardiovascular risk, in part by decreasing the body’s natural production of nitric oxide, which is crucial for cardiovascular health.

Healthy Alternatives 

Heartburn hurts. When you’re suffering, you only want relief. The good news is that there are plenty of (effective!) alternatives to acid blockers—that don’t come with harmful side effects, even with long-term use.

Herbs such as slippery elm, marshmallow root, aloe vera, and deglycyrrhizinated licorice (DGL) help soothe irritation and reduce inflammation in the esophagus and stomach caused by acid reflux by coating and protecting these sensitive tissues. These herbs soothe and encourage healing without reducing stomach acid production.

While melatonin is most known for its role in supporting a normal circadian rhythm, research is finding that it also does an excellent job at relieving symptoms of acid reflux; not surprising, considering there is up to 400 times more melatonin in the gut than in the brain!  Studies have found that melatonin is as effective, or more effective, in reducing symptoms of acid reflux than omeprazole, a common PPI. Melatonin reduces stomach acid secretion while also improving lower esophageal sphincter function, helping to keep it closed, thus preventing acid reflux. Additionally, animal studies have shown that melatonin can protect the esophagus from the damage caused by stomach acid. Studies have used 3-6 mg of melatonin with efficacy.

D-limonene, extracted from the rinds of citrus fruit, has also been shown to significantly reduce heartburn symptoms. It is thought that it coats the lining of the esophagus and stomach, protecting them from stomach acid exposure, and promotes peristalsis, which helps keep the esophagus clear of stomach contents. Studies have used 1,000 mg of d-limonene daily, with signifi cant results seen in two weeks.

Often acid reflux is a result of eating too much and/or poor digestion. Taking a quality digestive enzyme such as bromelain or papaya with meals support healthy digestion and can reduce digestive discomfort after meals. And while acid reflux is thought to be caused by too much stomach acid, sometimes the problem is that there is not enough stomach acid for proper digestion, especially as the natural production of stomach acid declines as we age. A bitters supplement (usually taken in liquid form) gently stimulates digestive secretions to promote good digestion.

For general support consider a probiotic supplement and L-glutamine. While these supplements won’t help while you’re in the throes of heartburn pain, they are vital for supporting digestion and overall gut health long term. Probiotics are critical to support a healthy balance of bacteria in the gut, especially if you’ve been taking PPIs or H2 blockers since these drugs can encourage an overgrowth of unhealthy bacteria. L-glutamine is an amino acid that supports overall gastrointestinal healthy by acting as fuel for intestinal cells, maintaining a healthy mucosal lining in the gut, and reducing intestinal inflammation. And using these supplements long term only comes with healthy side effects!

So as you’re enjoying that second helping of stuffing and gravy (or that third piece of pumpkin pie), remember to keep your natural heartburn remedies close at hand! It is possible to control the painful symptoms of acid reflux without the prescription or OTC meds, and without the negative side effects.

References available upon request