Each month, more than 40% of Americans experience heartburn, a burning sensation in the chest, throat, neck, or back. It is the hallmark symptom of gastroesophageal reflux disease (GERD), and it can cause serious damage to the esophagus leading to cancer and other respiratory conditions. In order to reduce the risks associated with this disease, physicians often recommend that a patient reduce their stomach acid production with the use of proton pump inhibitors (PPIs). Unfortunately, PPIs also have many negative side effects, including dementia, kidney disease, heart attacks, osteopenia/osteoporosis, and dysbiosis in the gastrointestinal tract.
Heartburn is commonly associated with overeating, the consumption of certain foods, especially those that are spicy or fatty, pregnancy, and obesity. Despite these frequently-associated causes, many of our new patients who present with this symptom as a daily concern do not fit into one of these categories. Here at AIM, we also take into consideration other factors before we treat:
Your overall stress levels and sleep hygiene:
Cortisol is a hormone released by your adrenal glands to help you wake up each morning and deal with stress. It does this by breaking down glycogen, a complex starch primarily stored in your liver and muscles, which is used by the body to increase the glucose (sugar) levels in your blood stream. In the morning, this increase in sugar stimulates your metabolism and wakes you up. When under stress, the extra sugar available to your brain and muscles helps you to think more clearly and aid in your fight or flight response.
Melatonin is a hormone produced by your pineal gland that is released in the evening to help you fall and stay asleep. It has an inverse relationship with your cortisol, i.e. when your cortisol is high, your melatonin production is low. Melatonin also helps strengthen your lower esophageal sphincter (LES), a muscle between your esophagus and stomach that inhibits stomach acid moving up into your throat. This is incredibly helpful at night when you’re lying horizontally and don’t want your stomach acid moving upwards and burning your esophagus, mouth and lungs!
- Stress: When you have high amounts of stress in your life, this leads to high cortisol and low melatonin output.
- Poor sleep hygiene: When you go to bed too late, you stress out your body. In turn, it dumps more cortisol to deal with the stress, you get “a second wind,” and end up with low melatonin output.
Both of these scenarios lead to a weakening of the LES and an increase in heartburn symptoms.
How can I start fixing this today?
- Talk with your AIM physician about checking your cortisol levels. If your cortisol levels are too high, especially at night, they can use nutrients and herbs to support proper production of this hormone.
- Reduce your stress with meditation by listening to the Change Your Life Series.
- Create a healthy bedtime routine, including a reduction of your blue-light exposure from electronic devices. In a recent study, participants who wore blue-light blockers after sunset had a 58% increase in melatonin production after just two weeks!
- Improve your LES strength with melatonin and B vitamin supplementation. Talk with you AIM physician about how to dose these nutrients to reduce your risk of a “melatonin-hangover” and interactions with other medications.
Next month, in part 2 of Why do I have Heartburn?, we will discuss how weak concentrations of stomach acid along with environmental and food allergies or sensitivities can cause this aggravating symptom.