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Gastrointestinal Health – Reflux Support -- Valeria Mallett Nutrition

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Evidence: Melatonin 3 mg before sleep for 40 days to allow for optimal regression of symptoms ( Kandil 2010 ; Pereira 2006 ) 3 mg of melatonin before sleep was found to be associated with a significant reduction in signs and symptoms of GERD, such as increased lower esophageal sphincter tone, and reduced epigastric pain, both without and with omeprazole (the latter being an additive effect), noting a greater effect of omeprazole versus melatonin when given individually. ( Kandil 2010 ) After dinner supplementation of 6 mg of melatonin, along with vitamins B6, B12, folic acid, methionine, tryptophan, and betaine, was associated with complete regression of symptoms in 100% of 176 individuals, versus 66% of the omeprazole group, after 40 days. ( Pereira 2006 ) Melatonin has been found to be secreted by GI mucosal cells, at concentrations 100-400x blood plasma levels, where it may strengthen the esophageal and gastric mucosal barriers to irritants from endogenous or exogenous production ( Majka 2018 ); additionally, melatonin has been found to be associated with quicker healing of stomach ulcers. ( Celinski 2011 ) Licorice Dose variable based on each form; duration 8 weeks ( Young 1986 ) Deglycyrrhizinated licorice (DGL), a formulation without the blood pressure raising effects of licorice, ( Ahuja 2019 ) was examined along with slippery elm and peppermint and was found to significantly improve symptoms of gastric and intestinal irritation, with higher effects than is commonly reported with antacids. Unfortunately, they did not explicitly distinguish between GERD, dyspepsia, and other ailments such as IBS & Crohn’s disease. ( Setright 2017 ) B complex Variable based on each B vitamin and form In a sample of 960 participants, intakes of vitamin B2, B6, and folate were inversely proportionally to risk of reflux esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma ( Sharp 2013 ) A combination supplement containing vitamin B6, folic acid, B12, methionine, betaine, l-tryptophan, and melatonin was associated with complete regression of symptoms in 100% of 176 individuals, versus 66% of the omeprazole group, after 40 days. ( Pereira 2006 ) Long-term proton pump inhibitor (PPIs) usage was significantly associated with lower levels of serum vitamin B12, and was proposed as a mechanism for the presence of increased fracture risk in those taking PPIs long-term. ( Lewis 2014 ) With lower B12, homocysteine levels may also rise, possibly elevating cardiovascular disease risk. ( Arturo J Martí-Carvajal 2017 ) A 2017 Cochrane review found that supplementation of vitamins B6, B9, and/or B12 (to reduce homocysteine levels) was associated with a 10% reduced risk of stroke, with low dose and high dose likely having similar benefits. ( Arturo J Martí-Carvajal 2017 ) Probiotics 4 billion CFU of Bifidobacterium bifidum ( B. bifidum ) strain daily for approximately 4 weeks ( Cheng 2020 ) A 2020 systematic review found 13 prospective studies on GERD and probiotics, with five rated as high quality RCTs, showing significant reductions in symptoms of regurgitation and heartburn, ( Cheng 2020 ) with doses ranging from 1-46 billion CFU of various strains for 1-12 weeks. Over three billion CFU of B. bifidum was given to 39 participants (40 were given placebo) in an RCT for four weeks, where B. bifidum supplementation was associated with a significantly higher relief rate for postprandial discomfort and epigastric pain scores. ( Gomi 2018 ) B. lactis , when supplemented for 2 weeks at a dose of 17 billion CFU, was found to be associated with reduced regurgitation and improved whole gut transit time in 54 participants versus placebo. ( Waller 2011 )

TOP Micronutrients for Blood Sugar Regulation

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