Melatonin: natural heartburn relief

May 24, 2017 (Updated: July 31, 2017)
Leigh Erin Connealy, M.D.

Today, let’s give melatonin an extra dose of respect.  This body-clock-regulating hormone calms us for sleep as darkness falls, and rouses us to greet the day.  It also plays a role when heartburn and acid reflux strike. So, if you’re a sufferer, read on for natural heartburn relief.

The burning question—what is (and isn’t) acid reflux?

Acid reflux and heartburn are different beasts. Heartburn produces a painful sensation in the gut, around the bottom of your ribcage. Acid reflux is caused by partially digested food sneaking up from your stomach into your throat.

They have stomach acid in common as a partial cause, so I’m focusing on acid reflux—but will cite heartburn research when it’s relevant.

Be sure what you’re dealing with isn’t food allergies, by the way.  The symptoms can be similar. That’s why the first thing I make sure of is that my patients with symptoms are allergy free.

It takes muscle to guard this border

The lower esophageal sphincter (LES) is a small muscle between the bottom of your throat, or esophagus, and the top of your stomach.

Normally tightly sealed, its job is:

  • To relax when you eat, to let your food travel down into your stomach
  • To tighten selectively when you eat, to keep your food from rising back up out of your stomach—as acid reflux

Note the word acid. We’re talking about stomach acid, mainly hydrochloric—the kind your chemistry teacher warned you not to touch without protection. It’s just what we need to fully digest our food and get all the nutrients into our bloodstream.

But it’s really strong acid—that belongs nowhere near the tender tissues of our esophagus. Which is what happens when your LES muscle relaxes and lets spurts of that nasty acid, and partially digested food, roil up from your stomach to your throat.

A lazy, incompetent LES?

Not at all. Once upon an ancient time, everything we ate was natural. Our LES was happy.

Then came processed foods, environmental toxins, and bad habits.

Today? Your poor LES has to battle:

  • Too much food in the stomach (overeating)
  • Too much pressure on the stomach (frequently caused by gas, obesity, pregnancy, or constipation)
  • Diets high in unhealthy fats and oils
  • Unnatural un-foods
  • Stress and lack of sleep
  • Smoking

Nor is it your LES’s fault that certain foods, even healthy foods, prompt it to relax, including:

  • Tomatoes
  • Citrus fruits
  • Garlic
  • Onions
  • Chocolate
  • Caffeine
  • Alcohol
  • Peppermint

And piling on, some medications also increase your acid reflux risk, including aspirin, ibuprofen, other pain relievers, and others:

  • Antibiotics
  • Sedatives, anti-depressants
  • Iron supplements
  • Blood pressure drugs
  • Osteoporosis drugs
  • Potassium supplements

But please don’t do what most folks do when acid reflux hits—don’t grab the Tums, the Rolaids or some other acid blocker. These may temporarily relieve the burning, but at a high price: they suppress the acids you need for proper, full digestion of essential nutrients. They’re stealing your meal.

Natural relief is far better.

Melatonin—working the night shift

Melatonin has sailed through boatloads of the most rigorous and conclusive studies researchers could throw at it.

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Results? A mountain of research tells us that melatonin:

  • Helps to significantly relieve heartburn and acid indigestion
  • Helps seal off your LES, preventing that “slosh-back” of acid
  • Helps promote long-term LES health
  • Helps keep your LES from opening after eating
  • Helps protect the mucus membranes of the esophagus

In fact, 100% of patients reported no more symptoms after less than six weeks of using melatonin. 100%!

It’s almost a case of simple exercise mechanics—only without the exercise. When muscle (the LES) meets hormone (melatonin), the muscle becomes stronger and more effective in doing its job. But unlike other muscles, your LES doesn’t need resistance training or aerobics stay tip-top-toned. Just melatonin.

That’s one smart hormone.  How does it work?

A major cause of acid reflux is damage to the esophageal wall. Over time, acid exposure, even a little at a time, can reduce the production of protective esophageal mucosa. This says “Hi, c’mon in” to inflammation, the origin point of nearly every disease in the book.

It’s thought that melatonin acts as an antioxidant, protecting the mucosal layer from damage, as well as stimulating additional production of protective mucosa.

Melatonin also reduces the inflammation, making it an important anti-inflammatory, as well as an antioxidant, that can work both down in the gut and up in the esophagus.

Give your LES a break

Your LES is a brilliant, hardworking muscle, but it can always use some help. In addition to a healthy diet, and a melatonin supplement (dosage to follow), I recommend:

  • For safe, temporary relief, drink half water, half aloe vera
  • Chew gum. It increases saliva production and reduces the amount of acid in the esophagus (but avoid spearmint or peppermint, which can relax the LES)
  • Sit up straight while eating. It gives gravity a chance to help food travel downward
  • Don’t lie down for at least two hours after eating—same reason
  • Don’t eat and run—to bed. I recommend no sleep for at least 2 hours after dinner, but four or even six hours would be better.

And you should build every meal around:

  • Fresh, organic, local fruits and vegetables, except citrus
  • Lean protein, like eggs, lean meat that you grill, poach, broil, or bake—never fry
  • Complex carbohydrates—steel-cut or rolled oats, 100% whole grain bread, brown rice, and couscous
  • Potatoes and other root vegetables for their good carbs and digestible fiber (but never prepared with onion or garlic)
  • Good monounsaturated fats, from fish and plants, from olive, sesame, and sunflower oils, and from avocados, peanuts, and peanut butter, and many nuts and seeds
  • Good polyunsaturated fats—oils such as safflower, soybean, corn, flaxseed, and walnut; and fatty fish such as salmon, mackerel, and trout

Oh, right, there’s one more little bit of advice that your LES will be grateful for ….

De-stress(!!!)

I don’t have to tell you again, but I will—stress sickens, and sickness kills. Even moments a day of more exercise, meditation, yoga, tai chi, a pleasurable bath, counseling…there’s a world of choices within our reach.  Make some of them part of your routine and add healthy years to your life.

Sleep tight—literally

Remember that melatonin regulates our body clocks, promoting restful sleep—but only when we produce it in sufficient amounts.  Indeed, research shows that melatonin deficiency comes at a price.

Just for example, people with heartburn tend to produce 24 percent less melatonin, and overweight people who wake up at night to eat tend also to produce less.

It stands to reason that more melatonin would mean less heartburn and less midnight snacking—which, by the way, is a habit that surely messes with your body clock.

I recommend my reflux patients take 6 mg of melatonin about 30-60 minutes before bedtime. This is a much larger dose than I would recommend to help you just get to sleep, but it’s the amount shown most effective for heartburn/acid reflux, in human clinical studies. So make sure that you’re ready to lie down and drift into dreamland before when you take it—never during the day or before working or driving.

That’s a big part of taking good care.

References

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  • jolynn

    is there a particular brand of melatonin that is more pure and has less fillers?

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