GERD, Acid Reflux Stop The Heartburn

GERD, Acid Reflux: Stop the Heartburn https://constantinek.substack.com/p/gerd-acid-reflux-stop-the-heartbur...
PREMIUM ARTICLES
GERD, Acid Reflux: Stop the Heartburn

With an Argument Against the Use of PPIs.
CONSTANTINE KANARGELIDIS
NOV 18, 2023
3 Share
The full post is free until MONDAY - NOVEMBER 20, and then it will only be
available to paid subscribers. Free subscribers will still be able to see part of the post.
One way to obtain paid subscriber status for a period of time is to participate in the
referrals program:
*N
None of this is medical advice. I am not a medical professional, always talk to your
d oc t o r *
GERD, Bruxisim & Somnambulism

Gastroesophageal re�ux disease “GERD” is also known as “acid re�ux” or more
colloquially “heartburn”. Why the addition of Bruxism (teeth clenching) which is related
to teeth grinding, and Somnambulism (sleepwalking)? There is some evidence that acid
re�ux can be a major contributor to both of these nighttime issues, and I will go into
more detail on this connection later on in the article.
• Associations among Bruxism, Gastroesophageal Re�ux Disease, and Tooth Wear
• Gastroesophageal Re�ux Disease and Sleep Disorders: Evidence for a Causal Link
and Therapeutic Implications
I think
� a good
Our use place
of cookies to start in this article on GERD is to make an argument for what not
We use necessary© 2023 Constantine
cookies Kanargelidis
to make our site ∙ Privacy
work. We also ∙ Terms ∙ Collection
set performance notice cookies that help us
and functionality
to do. Most notably, I will argue why it is a terrible idea to go on any medication that is
Substack
make improvements by measuring traffic onisour
thesite.
home Forfor great
more writing
detailed information about the cookies we use,
classed
pleaseas
seea our
Proton
privacyPump
policy. Inhibitor, or “PPI”. For one, it seems like a major contributor
1 of 12 11/18/2023, 6:44 PM
to acid re�ux is inadequate production of stomach acid. The reason being that if there is
not enough stomach acid production then the esophageal sphincter preventing stomach
acid from �owing up into the esophagus does not stay �rmly closed. As a result,
stomach acid can get into the esophagus causing the uncomfortable feeling of
heartburn. This can sound counterintuitive, especially because lowering the stomach
acid temporarily can cause immediate relief from the acid re�ux symptoms, but it does
nothing to �x the actual problem, which for people with chronic acid re�ux is likely, at
least partly, caused by low stomach acid.
I personally know someone that occasionally cant sleep because of heartburn. When
this happens they take a couple of capsules of Beatine HCL (which increases stomach
acid) and this takes away their heartburn and allows them to sleep soundly.
For this reason, chronically lowering stomach acid with PPIs will worsen the problem
over time. The way PPIs work is by directly limiting the amount of acid that is produced
for the stomach. This alone makes PPIs a poor choice for treating chronic GERD.
Furthermore, the downstream e�ects of lower-than-optimal stomach acid levels are
quite undesirable. For instance, stomach acid is one line of defence against bacterial
overgrowth and infection. When we consume anything that goes through the stomach
we want there to be adequate acid (at an adequate PH level) to kill o� any pathogens,
such as bacteria, parasites and other harmful things that can be present in the things we
consume. Furthermore, we need enough acid in the stomach in order to break down the
protein we eat, and it is important for the absorption of many of the minerals we get
from food. Inadequate acid will cause the protein we consume to cause problems further
down in the digestive tract, potentially leading to putrefying proteins in the intestines.
“It is common to confuse re�ux symptoms for hyperchlorhydria (high stomach acid),
when the symptom may actually be associated with hypochlorhydria (low stomach
acid)”
“Hypochlorhydria has detrimental health e�ects with long-term use, including

autoimmune disorders.7 HCL plays a key role in many physiological processes; it
triggers
� Our use ofintestinal
cookies hormones; prepares folate and B12 for absorption; and is essential
We use necessary cookies to make our site work. We also set performance and functionality cookies that help us
for the absorption of minerals, including calcium, magnesium, potassium, zinc, and
make improvements by measuring traffic on our site. For more detailed information about the cookies we use,
iron. Lack
please see ouror suppression
privacy policy. of HCL has been associated with increase in osteoporosis;
2 of 12 11/18/2023, 6:44 PM
bone fractures; and impaired absorption of B12, iron and magnesium.8 HCL also
prevents the overgrowth of pathogens in the upper GI tract, so hypochlorhydria can
be a risk factor for SIBO.9 HCL is also responsible for breaking down dietary
proteins aiding in the prevention of food allergies associated with incomplete
digestion of protein. Acid-blocking medications are widely available and, despite
the fact that they were initially approved for short-term use, they are o�en taken
for extended periods, even years.”
• Nutritional Interventions for Gastroesophageal Re�ux, Irritable Bowel

Syndrome, and Hypochlorhydria: A Case Report
However, the main reasons why people should avoid PPIs goes way further than this
point. PPIs themselves lead to a variety of issues.
These PPIs may possibly lead to:

1. Esophageal cancer
a. Maintenance proton pump inhibition therapy and risk of oesophageal cancer
i. “...Long-term maintenance therapy with proton-pump inhibitors (PPIs)

was shown to be associated with an increased risk for esophageal cancer,
even in patients taking PPIs for indications not previously associated
with this cancer risk, according to results from a new study from Sweden.
The authors call for "a more restrictive attitude towards maintenance use
of PPIs.”
2. Gastric (stomach) cancer
a. Long-term proton pump inhibitors and risk of gastric cancer development

a�er treatment for Helicobacter pylori: a population-based study C. Di�cile
infection
i. “There was also a clear dose–response and time–response trend of PPIs

uses and gastric cancer risk. Physicians should therefore exercise caution
when prescribing long-term PPIs to these patients even a�er successful
� Our use of cookies
eradication of H. pylori.”
3.make
C. Di�cile Infection
improvements by measuring traffic on our site. For more detailed information about the cookies we use,
please see our privacy policy.
3 of 12 11/18/2023, 6:44 PM
a. Intestinal calcium and bile salts facilitate germination of Clostridium di�cile

spores
i. “For example, patients taking proton pump inhibitors (PPIs) have an

elevated risk of contracting CDI (C. Di�cile”
4. IBD
5. Bacterial overgrowth
6. Magnesium De�ciency
a. Nutritional Interventions for Gastroesophageal Re�ux, Irritable Bowel

7. Osteopenia, Osteoporosis
a. Nutritional Interventions for Gastroesophageal Re�ux, Irritable Bowel

8. Depression
a. Use of proton-pump inhibitors is associated with depression: a population-

based study
9. Early death (potential increase in all-cause mortality)
a. Risk of death among users of Proton Pump Inhibitors: a longitudinal

observational cohort study of United States veterans
i. “We employed a new user (incident user) approach and evaluated the
association between PPI use and risk of death using a number of analytical
approaches where we consistently found a signi�cant association between
PPI use and increased risk of death.”
10. Heart failure & Heart Attacks
a. Proton Pump Inhibitors Linked to Risk for Heart Failure, Death in CAD
i. “PPI use increased the risk for all-cause heart failure or death (HR, 5.713; P
=.007), but not for acute ischemic events.”
� Ourb.
useHeartburn
of cookies Drugs Linked to Heart Attacks
11. Kidney failure
please
a. see our privacy policy.
Commonly used re�ux and ulcer medication may cause serious kidney damage
4 of 12 11/18/2023, 6:44 PM
i. “Patients who took proton pump inhibitors for heartburn, acid re�ux, or
ulcers had an increased risk of kidney function decline, chronic kidney
disease, and kidney failure.”
b. Heartburn Drugs Tied to Kidney Problems
i. “Proton pump inhibitors, or P.P.I.s, the commonly used heartburn

medicines, may increase the risk for kidney disease.”
12. Inhibition of Steroidogenesis (ddecreased product ion of steroid hormones such as

Testosterone and Progesterone…)
a. In vivo and in vitro studies of the site of inhibitory action of omeprazole on

adrenocortical steroidogenesis
13. Dementia
a. Association of Proton Pump Inhibitors With Risk of Dementia
i. “The patients receiving regular PPI medication (n = 2950; mean [SD] age,
83.8 [5.4] years; 77.9% female) had a signi�cantly increased risk of incident
dementia compared with the patients not receiving PPI medication”
*Special thanks to Georgi Dinkov (Haidut) who has written an abundance of posts about the
harms of PPIs. His research was an immense help.*
A�er knowing all this, I’d expect most people would want to do everything they can to
avoid the dreaded PPI. Even if you are not convinced that GERD is potentially caused by
low stomach acid you should still avoid PPIs because of all the risks mentioned above
(kidney failure, osteoporosis, cancers, dementia etc). An alternative to PPIs that is much
safer (and can be purchased OTC) is the H2 antagonist famotidine, which is “Pepcid”.
Famotidine is a pretty safe medication and it can be useful for someone with GERD if
they need relief from bad acid re�ux. Furthermore, there is a lot of evidence that
famotidine can be a useful tool in the eradication of H. Pylori, which is thought to be a
major contributor to GERD.
TheWefollowing
use necessary cookies was
excerpt to make our site work.
graciously We alsoand
written set performance
sent to me and
byfunctionality
my very goodcookiesfriend
that help us
Catalina “Kitty” Martone, “Healthy Gut Girl”, the host of the podcast “Stu� Your
5 of 12 11/18/2023, 6:44 PM
Doctor Should Know”.
If you were to ask 10 experts about the root cause of acid re�ux, you'd likely receive 10
di�erent answers, each with its own valuable insight. These explanations range from
dietary factors like indulging in fried, spicy, or processed foods, to the impacts of stress,
alcohol consumption, and the presence of H. pylori bacteria. While all of these factors
can certainly exacerbate acid re�ux or trigger a �are-up, the core issue lies in poor
digestion.
In essence, our digestive system is designed to thoroughly break down our food,
disinfect it with stomach acids, initiate the digestion process, absorb nutrients in the
small intestine, and handle the absorption of �uids and waste elimination in the large
intestine. If any part of this intricate process, or worse, all of them, begins to operate
sluggishly or ine�ciently, it sets the stage for a gradual decline in digestion. This initial
domino represents the start of a long list of health issues and imbalances. In fact, almost
any imbalance can ultimately be traced back to the root of poor digestion.
But what hinders healthy digestion?
If we look at acid re�ux from a pro-metabolic lens, we can see how hormones can play a
major role.
Cortisol has a cycle that begins in the adrenals and ends in the gut. We even have a
speci�c strain of bacteria that live in the gut called Bi�dobacterium Longum 1714, and
when this bacteria’s population is diminished by ongoing stressors, the e�ects of
cortisol on the integrity of the intestines are detrimental.
Constantine will provide a multitude of solutions to aid in healing and preventing acid
re�ux, which can be seamlessly integrated with my emphasis on fostering a diverse and
healthy microbiome.
Here is what I recommend;
Sporebased
� 1.Our probiotics
use of cookies
2.make
B vitamins andbyBi�dobacterium
improvements measuring traffic on Longum
our site. For1714
more (combined in theabout
detailed information product Zenbiome
the cookies we use,
Cope
please seeby
ourmicrobiome
privacy policy. labs)
6 of 12 11/18/2023, 6:44 PM
3. Supplementing with HCL and digestive enzymes; Contrary to the common internet
advice of taking HCL until you experience a burning sensation and then decreasing
the dosage, this approach risks the development of an ulcer. Under no
circumstances should Betaine HCL cause burning, pressure, or stomach nausea. A
reasonable starting point is 1000mg of betaine HCL per meal. If undesirable side
e�ects manifest, discontinue the supplement. It's plausible that persistent acid
re�ux may have caused damage to the stomach lining, necessitating healing.
Recommended supplements or herbs include:
• Mastic Gum
• Aloe Vera
• Digestive herbal teas
• Pyloguard from Microbiome Labs
Also contrary to misguided internet advice, it's important to note that Hydrochloric
acid (HCL) is not solely required for protein digestion. This misconception is inaccurate.
HCL serves the purpose of activating pepsin, a gastric enzyme responsible for protein
digestion in the stomach, yes. However, it also plays a crucial role in the absorption of
vitamin B12.
Vitamin B12 is indispensable for the proper functioning and maintenance of red blood
cells and the health of nervous tissues in the brain, spine, and nerves. Beyond this, HCL
has additional functions, including disinfecting anything passing through the stomach.
Some experts even consider it one of our initial lines of defence against parasites,
certain viral infections such as the potentially deadly Norovirus, and other pathogens.
While it is strongly advised to consult a healthcare professional when experiencing

persistent acid re�ux, it's worth noting that conventional medicine o�en resorts to the
frequent use of proton pump inhibitors (PPIs) and acid reducers as a common
treatment. While these can provide relief for short-term discomfort, prolonged use of
PPIs has been linked to heightened risks of bone fractures, acute and chronic kidney
disease, gastrointestinal infections, and magnesium de�ciency.
-- make improvements by measuring traffic on our site. For more detailed information about the cookies we use,
Catalina (Kitty) Martone,
7 of 12 11/18/2023, 6:44 PM
CEO, Ona’s Natural

Health Educator &
Host of the podcast
'Stu� Your Doctor Should Know'
www.healthygutgirl.com
IG: healthygutgirl_
FB: healthy gut girl
A concern people have when they have chronic GERD is developing a peptic ulcer. One
supplement that can really help with the prevention of these ulcers is vitamin B6. This is
especially true when it comes to stress-induced ulcers. Another major contributor to
ulcers is an H. Pylori infection.
“Antiserotonin drugs are used for controlling diarrhea and vomit ing, and some of them are
protective against ulcers” - Ray Peat
Helicobacter pylori “hereina�er referred to as H. Pylori” is a type of bacteria that can

multiply in the stomach leading to to GERD symptoms. You can con�rm if you have
high levels of H. Pylori via a breath test. If you do have this infection then this is likely
the cause of your GERD symptoms. H. Pylori does not appear to be necessary for GERD
to be present, but it does seem to be su�cient.
If it’s con�rmed you have H. pylori then it would be a good idea to eradicate it. There
are some things that people can take to help reduce the amount of this bacteria. Mastic
gum from the island of Chios is o�en touted to be a useful tool for the eradication of H.
pylori. Famotadine (Pepcid), bismuth (pepto bismol) and even melatonin all seem to be
useful in killing o� H. pylori. Green tea, oregano, licorice, honey, propolis (manuka
honey
� Our seems best) and
use of cookies garlic may also be useful for this issue. People with a vitamin D
de�ciency seem to be more susceptible to H. Pylori infection.
8 of 12 11/18/2023, 6:44 PM
• Successful Eradication of Helicobacter pylori With Over-the-counter Products
◦ “Natural agents such as bismuth, mastic gum, and oil of oregano may achieve
the therapeutic goal of eradication without undue risks.”
• Famotidine, an Antiulcer Agent, Strongly Inhibits Helicobacter pylori and Human

Carbonic Anhydrases
• The Association between Serum Vitamin D Levels and Helicobacter pylori Presence
and Eradication
• In Vitro and In Vivo Activities of Chios Mastic Gum Extracts and Constituents
against Helicobacter pylori
• Melatonin Treats H Pylori and Gastric Ulcers
• How to E�ectively Use Bismuth Quadruple Therapy: The Good, the Bad, and the
Ugly
• Exploring alternative treatments for Helicobacter pylori infection
There are also speci�c antibiotics that can be prescribed for the eradication of H.
Pylori, but these usually come with a PPI. It may be possible to ask the doctor to use
famotidine instead of a PPI. Someone once told me that black seed oil and distilled water
are useful for eradicating H. Pylori.
Melatonin seems to be useful when it comes to GERD via multiple mechanisms.
• Melatonin for the treatment of gastroesophageal re�ux disease; protocol for a

systematic review and meta-analysis
• The potential therapeutic e�ect of melatonin in gastro-esophageal re�ux

disease
There is some evidence that GERD can also be exacerbated by excessive in�ammation
and estrogen (and cortisol) levels. This makes me think progesterone and vitamin E
(anti-estrogen and anti-in�ammatory) would be useful for GERD.

• From Haidut, Estrogen may cause/exacerbate re�ux disease (GERD)
Oneplease
reason people are convinced to take PPIs is to prevent esophageal damage from
see our privacy policy.
9 of 12 11/18/2023, 6:44 PM
acid re�ux. Well, it just so happens that the very bene�cial amino acid glycine can help
to prevent this damage from happening. The dosage of glycine that seems to help with
this issue is likely around 5-15g a day for most people. This can easily be obtained
through the diet via consuming collagen, gelatin and di�erent high glycine cuts of meat
like ox tail, ribs, lamb shank or even �ank steak. However, you can also supplement with
glycine itself. Glycine easily dissolves in water, and it is sweet tasting, hence the name
“glycine” which has its etymology in the Greek word for sweet. Lactoferrin is also
helpful for this issue and is found in high amounts in colostrum.
• Protective e�ect of lactoferrin on acute acid re�ux-induced esophageal mucosal

damage
Turning back to the issue of producing adequate stomach acid, there are many reasons
that this can happen. Hypothyroidism is a major cause of low stomach acid production.
Not eating adequate protein and salt (sodium chloride) could also a�ect this. Zinc
carnosine, thiamine, choline and creatine monohydrate can be useful supplements, as
can betaine HCL.
“Thyroid hormone increases digestive activity, including stomach acid and peristalsis”
-Ray Peat, Ph.D.
If someone needs immediate relief from heartburn I think it’s useful to drink a glass of
water with baking soda (sodium bicarbonate) dissolved in it. You can also consume some
milk as the calcium content should give you relief, or take some calcium carbonate. You
can also take some Pepto bismol or Pepcid if you have an acute case of bad heartburn.
Other useful supplements for GERD are aloe vera and marshmallow root extract.
Lastly, there is a correlation with sleepwalking, teeth clenching and teeth grinding with
� Our use
GERD. of cookies
I think there is also reason to believe that these conditions are also worsened by
intestinal in�ammation. A classic cause of intestinal in�ammation would be some type
of “infection”.
please see our This
privacycould
policy. be bacterial, parasitic or fungal. For example, if someone has
10 of 12 11/18/2023, 6:44 PM
bad teeth clenching at night then they may very well have some type of overgrowth and
it would be useful to try and �x this issue. One basic thing to try would be Ray Peat’s
daily raw carrot salad, which is grated raw carrots, olive oil (or coconut oil), salt and
vinegar, eaten daily. One could also add in other things such as monolaurin, oregano oil,
and even activated charcoal to help reduce excessive bacteria in the intestines. This
should help, in addition to addressing the GERD which is probably underlying these
issues. Also, clonidine (a medication that lowers certain stress hormones) is used successfully
for teeth clenching and grinding, which indicates that high-stress hormones are
involved in these conditions.
Some useful tools for GERD:
1. Zinc carnosine
2. Creatine Monohydrate
3. Melatonin
4. Glycine
5. Lactoferrin
6. Mastic Gum
7. Vitamin D
8. Choline
9. Famotidine (Pepcid)
10. Bismuth (Pepto Bismol is one option)
11. Vitamin B6 (for ulcer protection)
12. Oregano oil, garlic, green tea, honey and propolis
13. Marshmallow root extract, licorice, aloe vera
14. Betaine HCL
15. Thiamine
�16.Our
Vitamin E
use of cookies
17.make
Progesterone
improvements by measuring traffic on our site. For more detailed information about the cookies we use,
11 of 12 11/18/2023, 6:44 PM
*N
None of this is medical advice. I am not a medical professional, always talk to your
d oc t o r *
If you enjoyed this article, please consider checking out the other articles I’ve written. Also,
please feel free to subscribe (it is free to do so) and share the articles with others. Thank you!
BTW: I am a frequent guest on the podcast “Stu� Your Doctor Should Know”.
Discount code DEAN works at:
1. Ona’s Naturals (pprogesterone oil, topical progesterone and pregnenolone creams)
2. LifeBlud (M
Magnesium products, Taurine, Theanine, B vitamins, Methylene Blue)
3 Likes
3. Health Natura (ooral pregnenolone, Methylene Blue)
Comments
Write a comment...

12 of 12 11/18/2023, 6:44 PM

GERD, Acid Reflux Stop The Heartburn

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

GERD, Acid Reflux Stop The Heartburn

Uploaded by

Copyright:

Available Formats

GERD, Acid Reflux: Stop the Heartburn https://constantinek.substack.com/p/gerd-acid-reflux-stop-the-heartbur...

GERD, Acid Reflux: Stop the Heartburn

GERD, Bruxisim & Somnambulism

• Associations among Bruxism, Gastroesophageal Re�ux Disease, and Tooth Wear

“Hypochlorhydria has detrimental health e�ects with long-term use, including

• Nutritional Interventions for Gastroesophageal Re�ux, Irritable Bowel

These PPIs may possibly lead to:

a. Maintenance proton pump inhibition therapy and risk of oesophageal cancer

i. “...Long-term maintenance therapy with proton-pump inhibitors (PPIs)

2. Gastric (stomach) cancer

a. Long-term proton pump inhibitors and risk of gastric cancer development

i. “There was also a clear dose–response and time–response trend of PPIs

a. Intestinal calcium and bile salts facilitate germination of Clostridium di�cile

i. “For example, patients taking proton pump inhibitors (PPIs) have an

a. Nutritional Interventions for Gastroesophageal Re�ux, Irritable Bowel

a. Nutritional Interventions for Gastroesophageal Re�ux, Irritable Bowel

a. Use of proton-pump inhibitors is associated with depression: a population-

9. Early death (potential increase in all-cause mortality)

a. Risk of death among users of Proton Pump Inhibitors: a longitudinal

10. Heart failure & Heart Attacks

b. Heartburn Drugs Tied to Kidney Problems

i. “Proton pump inhibitors, or P.P.I.s, the commonly used heartburn

12. Inhibition of Steroidogenesis (ddecreased product ion of steroid hormones such as

a. In vivo and in vitro studies of the site of inhibitory action of omeprazole on

a. Association of Proton Pump Inhibitors With Risk of Dementia

� Our use of cookies

Doctor Should Know”.

But what hinders healthy digestion?

Here is what I recommend;

• Digestive herbal teas

• Pyloguard from Microbiome Labs

While it is strongly advised to consult a healthcare professional when experiencing

CEO, Ona’s Natural

Helicobacter pylori “hereina�er referred to as H. Pylori” is a type of bacteria that can

• Successful Eradication of Helicobacter pylori With Over-the-counter Products

• Famotidine, an Antiulcer Agent, Strongly Inhibits Helicobacter pylori and Human

• Melatonin Treats H Pylori and Gastric Ulcers

• Exploring alternative treatments for Helicobacter pylori infection

Melatonin seems to be useful when it comes to GERD via multiple mechanisms.

• Melatonin for the treatment of gastroesophageal re�ux disease; protocol for a

• The potential therapeutic e�ect of melatonin in gastro-esophageal re�ux

� Our use of cookies

• Protective e�ect of lactoferrin on acute acid re�ux-induced esophageal mucosal

-Ray Peat, Ph.D.

Some useful tools for GERD:

10. Bismuth (Pepto Bismol is one option)

11. Vitamin B6 (for ulcer protection)

12. Oregano oil, garlic, green tea, honey and propolis

13. Marshmallow root extract, licorice, aloe vera

14. Betaine HCL

Discount code DEAN works at:

1. Ona’s Naturals (pprogesterone oil, topical progesterone and pregnenolone creams)

3. Health Natura (ooral pregnenolone, Methylene Blue)

� Our use of cookies

You might also like