0:04

This is Open Mind. Today's

0:21

topic is acid reflux, or heartburn as

0:23

we used to call it. It's a

0:25

common but uncomfortable condition that affects about

0:27

10-20% of people in the western

0:31

world. And that's right, in the

0:33

western world because in countries where

0:35

they don't eat crap it's not

0:37

that common. It's widespread, it doesn't

0:39

really make it normal, right? Many

0:41

people turn to lots of medications

0:43

like proton pump inhibitors like Prilosec

0:45

or Previcid or Aztefx or Nexium

0:47

to manage symptoms. But these drugs

0:49

come with significant risks, especially if you

0:51

use them long term. In fact, when I was in

0:53

medical school we were told never to use these more

0:55

than six weeks. But we're super powerful and we're harmful.

0:57

We're going to talk about why. Now, PPIs as they

1:00

are known are proton pump inhibitors. While they can be

1:02

effective at reducing the stomach acid, they lead to a

1:04

lot of side effects. Nutrient deficiencies,

1:07

infections, bacterial overgrowth in

1:09

the gut, yeast overgrowth,

1:11

osteoporosis, community acquired pneumonia, cardiovascular

1:13

issues, lots of stuff. So we're going to

1:15

talk about all that. In today's episode we're

1:17

going to dive deep into understanding the root

1:20

causes of acid reflux and why it's

1:22

really critical to go beyond just managing

1:24

your symptoms. It can be caused by

1:26

weak esophageal muscles to low stomach acid

1:28

to magnesium deficiencies to bacteria, call these

1:30

pyrilori. We're going to explore all of

1:32

that. We're going to talk about how

1:34

diet, lifestyle, even gut health all potentially

1:36

contribute to acid reflux. And

1:38

we're going to provide practical solutions that are

1:41

rooted in functional medicine so they can help

1:43

you find lasting relief without relying on medications

1:45

like these PPIs or H2

1:47

blockers like Zantac. Now whether

1:49

it's optimizing your diet or managing stress

1:52

or using natural herbs or remedies,

1:54

there's a lot of ways to tackle reflux at

1:56

its source. Also at OpenMind we

1:58

value your support. So share. thoughts on social

2:00

media, remember to rate, review, and follow HealthHacks

2:03

to help others discover the show. We really

2:05

appreciate your help in growing our show. Hi,

2:08

I'm Dr. Mark Hyman, and welcome to HealthHacks.

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Hey everyone, it's Dr. Mark. If HealthHacks has

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5:53

can't wait to see

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you there. I'm gonna give

5:57

you an overview of reflux. It's a As

6:01

I said, with about 10 to 20% of

6:03

people in the developed world having

6:05

this problem, it's common,

6:07

but it's not normal. So

6:10

what's the conventional view? What's the conventional approach

6:12

to treating reflux? Conventional docs

6:14

usually put their patients on antacid

6:17

medication like proton pump inhibitors or

6:19

histamine blockers, H2 blockers like Zantac

6:21

or Tagamet. Proton pump inhibitors or

6:23

PPIs are one of the most

6:26

commonly prescribed medications in the world.

6:29

It's I think third of all class of

6:31

medication after statins and psychiatric meds. And they're

6:33

primarily used to treat acid reflux and stomach

6:35

ulcers. In systematic reviews of trends

6:38

and practices for the global use of

6:40

these drugs, PPIs, they found

6:42

that in the research, 25% of adults use them.

6:46

That's a lot of people. Now some of the

6:48

most common are what I

6:50

mentioned like Prelosac, Prevacid, Nexium, Mass

6:52

Effects. 63% of users

6:55

of these PPIs are under 65. 7%

6:57

are over 65. Over half

6:59

are 56% of PPI users are female. And

7:04

25% of people who use these drugs are taking

7:06

them for more than a year, which is the

7:08

problem. And 28% take them for more

7:11

than three years. Now then you get in really get

7:13

into trouble. And many people are told they have to

7:15

take them for life. Now, heartburn

7:17

is not a Prelosac deficiency. I got

7:19

news for you. Now

7:22

the reason why they're overused

7:25

and overrescribed is because of our

7:27

lifestyle and diet. About

7:30

100 million prescriptions for PPIs

7:32

are dispensed every year. Up

7:35

to 70% of people who take these drugs get

7:37

no benefit from them. So that's not

7:39

so good. So how do they work?

7:41

Well, these protein pump inhibitors or PPIs

7:44

are medications designed to reduce the production

7:46

of stomach acid. Now they work by

7:48

inhibiting what we call

7:50

the hydrogen potassium ATPase

7:52

enzyme, also known as the

7:54

proton pump. Hydrogen

7:56

is a proton. Okay, so don't worry about all the

7:59

technical methods. medical jargon, but there's these cells in

8:01

your stomach called parietal cells that

8:03

produce stomach acid. And what

8:06

these drugs do is they block the production

8:08

of hydrochloric acid or stomach acid that's needed

8:11

to actually digest your food and to maintain

8:13

an acid environment in the stomach, which is

8:15

what you're supposed to have. But

8:17

if you block these pathways, this block

8:19

the proton pump, the stomach acid

8:22

secretion is reduced a lot. Now, what are

8:24

the side effects of that? Well, there's a

8:26

lot of side effects from both the short

8:28

term and the long term use of these

8:30

drugs. The short term and side effects include

8:32

things like headaches, nausea, you might get diarrhea,

8:34

constipation, irritable bowel. In fact, you get heartburn

8:36

traded for irritable bowel most of the time,

8:38

right? Abdominal pain and part of why that

8:40

happens is you block the stomach

8:42

acid and then the food you're not digesting properly,

8:44

then it can ferment in the small bowel and

8:46

then you get all these other secondary problems like

8:48

overgrowth of bacteria, overgrowth of yeast, and it's just

8:51

not good. You might get

8:53

abdominal pain, you might get increased gas,

8:55

bloating, dizziness, skin rashes, all kinds

8:57

of stuff. Now, the long term side effects

8:59

are potentially more significant

9:01

and those include serious nutritional deficiencies. One

9:03

of the biggest ones is these drugs

9:05

block the absorption of vitamin B12. Vitamin

9:08

B12 requires stomach acid to be absorbed and

9:11

if you don't have it, you're gonna get

9:13

B12 deficient over the long term and that

9:15

can create depression, neurologic problems, dementia, many, many

9:17

things. Also, it blocks

9:20

mineral absorption like magnesium. You're

9:22

gonna get low magnesium absorption and then what are the

9:24

symptoms? You can get muscle cramps, muscle

9:27

weakness, you can get irregular heartbeats,

9:29

palpitations, constipation, headaches, I mean, the

9:31

whole list of magnesium deficiency symptoms.

9:34

They also impair the absorption of calcium and what

9:36

does that do? Well, that means you get less

9:38

calcium, protect your bones, that increases the risk of

9:41

hip fractures and osteoporosis. So you take these drugs

9:43

for your heartburn but then you end up with

9:45

a hip fracture and mortality from a hip fracture

9:47

when you're older is 50%, meaning

9:49

at a year, 50% of people have

9:51

a hip fracture are gonna be dead

9:53

from that. So it's not

9:55

trivial. It also increases the risk of

9:58

infections, particularly intestinal infections like Clostridium. or

10:00

C. diff, which is terrible, I've had it, you don't

10:02

want it. That bacteria grows when there's a higher pH

10:05

or your stomach is less acidic. And that makes this

10:07

bacteria grow more and that can cause diarrhea, can cause

10:09

colitis. Also you can get

10:11

pneumonia, as I mentioned. Some studies show

10:13

that high risks of communicarid pneumonia are

10:16

prevalent in people who have regular

10:18

use of these drugs, these PPIs, because when

10:20

you have low stomach acid, maybe it allows the

10:22

bacteria to enter the respiratory tract. You can get

10:24

kidney problems, you can get severe what we call

10:26

gut dysbiosis. And this is one of the biggest

10:28

challenges. You're treating one gut problem for another gut

10:30

problem. So you've got heartburn

10:33

that might be short-term, improved by using

10:35

these drugs, but long-term, you

10:37

can imbalance in the whole microbiome. And

10:40

that causes all sorts of gastrointestinal

10:42

issues like bloating, diarrhea, small

10:45

intestinal bacterial overgrowth or SIBO, CFO

10:48

or small intestinal fungal overgrowth. And

10:51

that's not good. Additional side effects may include

10:53

the risk of dementia. Some studies

10:55

have indicated an association between long-term use

10:57

of these drugs and an increased risk

10:59

of dementia. In fact, one study that

11:01

was published in the Journal of Neurology

11:03

found that people using these drugs for

11:05

over four years were at

11:07

a high risk of dementia compared to those who

11:09

didn't use those drugs. Now, as an observational study,

11:12

it's not cause and effect, more research is needed,

11:14

but it's an interesting association. It makes sense to

11:16

think about how it works because you're blocking the

11:18

absorption of key vitamins like B12,

11:20

but you're important for cognitive function. Also

11:23

there may be cardiovascular issues, several large

11:25

observational studies, again, not proving cause and

11:27

effect, found a link with

11:30

heart disease and long-term use. A study

11:32

of 1.8 million people found

11:34

that use of these drugs elevated the risk of heart attack

11:36

by about 20%. The similar

11:38

drugs, the H2 blockers, which are like tag matters,

11:40

anti-attack didn't seem to increase the risk. Not sure

11:43

what that would be, but it's an interesting observation.

11:45

Another study, a cohort study of over 4,000 people,

11:48

found that those with greater than five years of

11:51

cumulative exposure to these drugs had

11:53

twice the risk of having heart

11:56

disease and heart failure compared

11:58

to nine users. That's... That's a significant

12:00

number. When you see an observational study with

12:03

doubling of the risk, you usually want to pay attention. If it's like

12:05

10% or 20% or 30%, but

12:09

if it's 100% increased risk, that's

12:11

concerning. Now, potential mechanisms of

12:13

how this might increase your risk of

12:15

heart attack include depleting magnesium, which can

12:17

cause arrhythmias. It can decrease the absorption

12:20

of B12 calcium and iron. It

12:22

can interact with certain drugs, like

12:24

antiplatelet drugs, clopidogrel, which potentially

12:27

reduces their effectiveness. And

12:30

some studies have shown that there may

12:32

be no increased risk for heart disease. So we need

12:34

more data, but I think if you're

12:36

at risk for heart disease, you're on medications like

12:39

blood thinners, you want to be careful. What about

12:41

other side effects? We talked about bone fractures and

12:43

osteoporosis, but long-term use of these drugs is linked

12:45

to an increased risk of all

12:47

sorts of fractures, hip fractures, spine fractures, wrist fractures,

12:50

because you're not absorbing calcium and then you get

12:52

osteoporosis. What is the trick with these drugs? When

12:54

you stop them, people go on and try to

12:56

get off it. I can't get off it because

12:58

I get heartburned. It's really bad, so I'm stuck

13:00

on it. Well, yeah, it's kind of addictive. Not

13:02

in the traditional sense of addiction, but what

13:05

happens is you get this rebound hyper secretion

13:07

of acids. In other words, the

13:09

acid's super suppressed and then you stop the

13:12

drug and then your stomach kicks in and

13:14

just oversecrete stomach acid. So you

13:16

kind of have to be careful as

13:18

you cut down on these and do it slowly. And

13:21

so you can actually get worse reflux symptoms if you try to stop

13:23

the drug. But there's a way to get off and we're gonna talk

13:25

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gift that keeps giving. Now

16:04

what is the functional medicine approach to addressing heartburn?

16:06

I, in fact, wrote a whole textbook chapter on

16:08

this. But, you know, PPIs are not the long-term

16:10

solution. In fact, I spend a lot of my

16:12

time kidding people off of these drugs. If

16:15

you understand the root causes, then

16:17

you don't really need to actually

16:19

take these drugs. Now, I know I never

16:22

get heartburn. But if I'm bad and

16:25

I'm traveling and whatever, I eat a

16:27

pizza or something once in a while,

16:29

which yes, I do, I'll

16:31

go, oh my God, I got heartburn. Now, it's

16:33

just because I ate something that's not good for me

16:35

that I get heartburn. When I eat well, I don't

16:38

get heartburn. And I think that's true for most people.

16:40

So what are the root causes? Let's go through them.

16:42

One of the causes is a weak lower

16:45

esophageal sphincter, the sphincter, which is the little

16:47

kind of tight muscle that keeps

16:49

the esophagus at

16:52

the top of the stomach tight so

16:54

you don't get pushing away up the esophagus

16:56

becomes a little bit weak. Now, there's a

16:59

lot of reasons for that. When that muscle

17:01

is weak or relaxes too much, then acid

17:03

escapes and that causes a reflex. So what

17:06

weakens this lower esophageal muscle? First of all,

17:08

obesity or having a high body mass index.

17:10

If you're overweight, it can put pressure on

17:12

the stomach. And if you're overweight,

17:14

you're more likely to get heartburn. Of course,

17:16

if you're pregnant, also because you got this

17:18

big baby pushing up, that's gonna cause heartburn.

17:20

But certain foods also cause a problem like

17:22

chocolate, alcohol, caffeine, peppermint

17:24

essential oils, carbonated drinks,

17:27

fatty foods also can

17:30

relax the lower esophageal sphincter. Also, hiatal hernia, this

17:32

is a common thing, which is when part of

17:34

the stomach kind of moves up in the chest,

17:36

that can lead to reflux. And

17:38

smoking also, that can lower the

17:41

tone of the sphincter at the top of your stomach

17:44

that's in the esophagus so you can get

17:46

reflux. Pregnancy, as I mentioned, hormonal changes occur,

17:48

but also just pressure on the stomach. Age,

17:51

as you get older, the lower esophageal sphincter

17:54

actually weakens so you can get more reflux. You

17:57

also might get slow gastric emptying. for

18:00

various reasons, like those epic, which

18:03

slows gastric emptying. You know,

18:05

that can take too long to empty the stomach and

18:07

you're more likely to have acid and stuff push back

18:09

up the esophagus. I'm

18:11

curious, I don't know if the data's out

18:13

yet, but it'd be interesting to follow and

18:16

see whether these GLP1 agonists actually cause more

18:18

reflux. Now, what causes delayed gastric emptying, right?

18:20

So we talked about what's happening at the

18:22

top of the stomach with the sphincter getting

18:25

too loose and things kind of going up. What

18:27

about when things go down, right? When you have

18:29

sort of slow movement on the way down or

18:32

delayed emptying of your stomach? Well, high fat foods,

18:34

fatty foods, fried foods, for sure if I eat

18:36

fried foods, I'm gonna get heartburned. Large meals if

18:38

you eat too much, that'll cause a problem. Certain

18:41

medications like antidepressants can cause a

18:43

problem. Opioids, also

18:46

our narcotics block stomach

18:49

function, so they basically paralyze the

18:51

bowel and you can get constipation. That's why

18:53

these drugs cause constipation. Alcohol also

18:56

will have an effect on gastric

18:58

emptying. Stress will

19:00

for sure slow your digestion because you've

19:02

got the brain, the gut, and the

19:05

gut brain, and the brain gut all

19:07

connected and the body prioritizes fight or

19:09

flight over arrest and digest. So when

19:11

you're stressed, your body's not digesting. And

19:14

when you're in a fight or flight state,

19:16

your body's producing about 80 to 90% less

19:18

stomach acid. If your thyroid's

19:20

not working, you know, it's

19:22

gonna slow many body functions including your

19:24

digestion. Certain neurologic disorders,

19:27

muscle disorders like Parkinson's or

19:29

MS can affect digestion. Diabetes,

19:31

that can cause neuropathy, which

19:34

causes damage to the vagus nerve.

19:36

That nerve is important for regulating

19:38

stomach function and intestinal function. Saliva

19:40

production might be lower. It's

19:42

important to clear acid from the esophagus, so

19:45

people with reflux often have reduced saliva. It's

19:48

hard for their body to neutralize the

19:50

acid. So what causes lower saliva? Well,

19:52

lots of things, dehydration, aging, mouth breathing,

19:54

low stomach acid. Now paradoxically, not

19:57

only high stomach acid can cause reflux.

19:59

but low stomach acid can also cause

20:02

reflux symptoms or heartburn symptoms. Why? Because

20:04

stomach acid is crucial for proper digestion.

20:06

When your levels are too low of

20:08

stomach acid, the food isn't broken down

20:12

and that can lead to digestive issues

20:14

and reflux. So the question is what

20:16

causes lower stomach acid? Well, getting older.

20:18

As you age, you have produced less

20:20

stomach acid, chronic stress, as we talked

20:22

about, poor diets if you have a

20:24

lot of processed foods, refined sugars, unhealthy

20:26

fats, all can lead to

20:28

poor stomach acid production. Nutritional deficiencies, zinc,

20:31

vitamin B12, again, lower

20:34

stomach acid because of those, and

20:36

long-term use of antacids, right? Whether

20:39

it's proton pump inhibitors like PPIs

20:41

or H2 blockers mentioned, those

20:43

cause low stomach acid and they cause nutritional

20:46

deficiencies that make the problem worse. So it's

20:48

a vicious cycle. Now, stomach

20:50

acid is really important for digestion and

20:53

the absorption of protein, of vitamin B12, of

20:55

magnesium, calcium, iron, and zinc. Now, you know,

20:57

plus other minerals. So if your stomach acid

21:00

is low, you're going to get into trouble.

21:02

You can get deficiencies of all these nutrients

21:04

if your stomach acid is too low. Calcium

21:07

magnesium deficiencies, as we mentioned, lead to

21:10

osteoporosis and that's a big concern.

21:12

Now, there's another reason sometimes that people

21:14

get reflux or heartburn, which is not

21:17

because of what they're eating. It's a

21:19

bacteria called Helicobacter pylori or H. pylori,

21:22

which is common. It interferes with the

21:24

production of stomach acid and it can cause inflammation

21:26

in the stomach lining, it can cause ulcers

21:29

and it's well known to cause ulcers. In fact, the

21:31

treatment for ulcers used to be thought

21:33

to be related to stress, but actually it's this

21:35

bacteria and taking antibiotics is

21:38

the cure. There was a scientist,

21:41

Barry Marshall from Australia, who was a gastroenterologist

21:43

who saw these bacteria

21:46

in the stomach of people with

21:48

ulcers and most GI doctors dismissed

21:50

it as sort of insignificant, but

21:52

he thought it might be the cause. So what

21:54

he did was he swallowed a beaker of this

21:56

bacteria, gave himself an ulcer and

21:58

then cured it with antibiotics. and then proved

22:00

that the bacteria were causing the

22:02

ulcers because the antibiotic secured his ulcer. And

22:05

then he won a Nobel Prize for that.

22:07

So they laughed at him first, but then

22:09

he got the Nobel Prize. There's other things

22:11

that can cause reflux, autoimmune diseases, like

22:13

hypothyroidism. And another

22:15

big category of things that cause reflux

22:18

are food sensitivities or food intolerances or

22:20

allergies. Especially dairy in

22:22

infants are gluten, in

22:24

people with celiac disease or non-celiac

22:26

gluten sensitivity can trigger a

22:29

worse than reflux. So getting off of gluten

22:31

and dairy and most common food allergens can

22:33

be really, really helpful. Other dietary factors will

22:35

cause you to have reflux. Well, it's basically

22:37

what we're eating in America, right? Processed foods

22:39

or fine carbs or fine sugars all

22:41

worsen acid reflux, they worsen inflammation,

22:44

alcohol, caffeine or coffee. Certain foods

22:46

that might be good for you,

22:48

like tomatoes can sometimes trigger for

22:50

people, chocolate, spicy foods,

22:52

fried foods, fatty foods, all may

22:54

trigger reflux. So be aware, eating

22:56

too much for sure, eating too

22:59

fast, eating too close to bedtime.

23:01

I know if I eat before bed and then

23:03

I go to sleep, I'm gonna get heartburn, not

23:05

chewing your food enough. So all these

23:07

things are easy habits to fix. Now

23:09

what else can cause reflux? Well, problems

23:12

with your gut health. Now,

23:14

if you have dysbiosis or imbalances in your gut

23:16

flora, things like small intestinal

23:18

bacterial overgrowth, that can also

23:21

cause reflux. And that

23:23

can be the result of slow gastric emptying,

23:25

low stomach acid production over use of PPI.

23:27

So it's kind of a vicious cycle. They

23:29

can both be the cause of reflux, but

23:31

also it can be the result of taking

23:34

the medications to treat reflux. So all in

23:36

all, you really wanna be careful around taking

23:39

these drugs for any long period of time.

23:41

Now, what are the functional medicine approaches to

23:44

solving the problem of acid reflux? This is not

23:46

a hard problem to solve if you know what

23:48

to do. The first step is you

23:50

need to kind of relieve the symptoms. So

23:53

you have to reduce esophageal inflammation

23:55

and you have to promote healing

23:57

of the gut. Now there's a...

24:00

bunch of things you can take that help kind

24:02

of soothe the gut lining that are anti-inflammatory

24:04

that are called demulsants which are sort of

24:06

a compound that can help soothe the lining

24:09

of the intestinal tract and they can be

24:11

pretty pretty effective and the things that I

24:13

tend to use are licorice root, marshmallow

24:16

root, slippery elm bark, all these things

24:18

can be taken as herbs and they

24:20

can be taken before meals or after

24:23

meals or before bed and

24:25

they're great as prevention. They're most effective when

24:28

taken in a powdered form or as a

24:30

tea. There are capsules for example did

24:32

glycerides licorice or DGL is a form

24:35

I use like Tums but natural Tums

24:37

and you can take two or three

24:39

tablets and chew them 10-15 minutes before

24:41

meals. You can get them online

24:44

and we offer them on the Dr.

24:46

Hyman stores you go to drhyman.com and

24:48

see the brands that I recommend. They're

24:50

effective but if

24:53

you chew them they're better. There

24:55

are other anti-inflammatory phytochemicals that you

24:57

can use aloe and one of

25:00

my favorite combos is a aloe

25:03

licorice glutamine combination and glutamine we'll talk about in

25:05

a minute but glutamine is amino acid that can

25:07

also help soothe the gut lining but

25:10

you can use aloe, ginger, artichoke leaf,

25:12

curcumin. In fact a recent trial found

25:14

that curcumin was as effective as omempersol

25:16

which is Prilosec or

25:19

a common proton pump inhibitor for

25:21

treating symptoms of what we

25:23

call functional dyspepsia which is

25:26

basically indigestion including reflux. Taking

25:28

your curcumin supplement with black pepper,

25:31

a form of black pepper called piperine

25:34

actually increases the absorption of curcumin

25:36

and that can help as well.

25:38

The limonene has shown promising results

25:40

another comment from actually lemons that's

25:42

shown benefit in early research. A

25:44

small trial 86% of subjects

25:48

experience complete relief from

25:50

reflux after 14 days using a thousand

25:54

milligrams capsule every day for five days followed

25:57

by one capsule every other day for five

25:59

days compared to just 29% of

26:02

the placebo group. So pretty big result. The mechanism

26:04

to actually, we don't really know, but it could

26:06

help coat the esophagus, it could

26:08

protect the underlying tissue from exposure to acid, it

26:10

could speed up gastric emptying. Other

26:12

things that might be helpful are melatonin, that may

26:15

be effective, it inhibits acid acid

26:17

secretion, it increases

26:19

gastrum release. Now,

26:21

gastrin is a hormone that helps prepare the digestive

26:23

system. And it also helps strengthen

26:26

the lower esophageal sphincter, which is making sure that

26:28

you don't get food coming on the way

26:30

up instead of going down. And

26:32

also melatonin seems to have an

26:34

antioxidant and anti-inflammatory property as well.

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28:15

studies have found that melatonin about three to 60

28:17

milligrams a day is as effective as 20 milligrams

28:20

of ameprazole or ParloSec, the main

28:22

PPI, in reducing reflux symptoms

28:24

like heartburn or stomach pain. So it

28:27

seems like melatonin might offer similar symptomatic

28:29

relief as the proton. Pump

28:31

inhibitors without the side effects have increased

28:33

symptoms in various diseases like we talked

28:35

about. All right, after

28:38

you use some of these things, what else can you

28:40

do? Well, you wanna address your diet and lifestyle factors,

28:42

right? Obviously I've said this over and

28:44

over, but just eliminate ultra processed foods, dramatically

28:46

reduce or cut out refined sugar and starches, get

28:49

rid of all the refined oils, fried foods,

28:51

those are bad. Get rid of the

28:53

triggers for reflux that are common that even

28:56

traditional doctors recognize like alcohol, coffee,

28:58

tomatoes, spicy foods, chocolate, fatty foods, citrus

29:00

foods, those may be a problem. Not

29:02

to say that chocolate

29:04

or coffee or tomatoes or citrus are bad, but

29:07

for some people, they may be triggers, you wanna

29:09

reduce those. I would encourage you to do an

29:11

elimination diet like the 10 day detox diet. We're

29:13

relaunching really soon. It's an

29:15

incredible approach to eating that helps

29:18

heal so many problems, including reflux. You

29:21

don't have to do it forever, but you will see very

29:23

quickly if what you're eating is causing the problem. Dairy

29:25

and gluten are the most common triggers. You

29:28

might wanna check for celiac disease or gluten

29:30

antibodies or non-celiac gluten sensitivity, that can be

29:32

a big factor. And by the way, at

29:34

Function Health, we test for all of this.

29:36

You can look at functionhealth.com/mark, jump the wait

29:38

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29:41

you can learn about all your biomarkers,

29:43

including get testing for food

29:45

sensitivities and gluten and

29:48

celiac disease. Also, you wanna incorporate whole

29:50

nutrient dense foods in your diet, as

29:52

you would always, which are high in

29:54

fiber and good fats. You wanna focus

29:57

on anti-inflammatory foods, things like dark green

29:59

leafy veggies. healthy fats like avocado, olive

30:01

oil, nuts and seeds, good

30:03

quality protein, lots of colorful

30:05

fruits and veggies. You can have

30:08

beans and grains. If you've done the tend

30:10

to detox, you wanna add stuff back, you

30:12

can add those back in, but try to

30:14

start with non-gluten grains to start. I would

30:16

also encourage you to eat a diet that

30:18

helps your gut bacteria. You've got a

30:20

tender inner garden. The best way to

30:22

do that is eating fermented foods like sauerkraut and

30:24

kimchi for gut health. Probiotics are also really important.

30:27

I recommend probiotics a lot. Eat

30:30

smaller meals, take your

30:32

time while eating, chew your

30:34

food while eating. Maybe don't drink

30:36

so much fluid while eating. See how you

30:38

would do with that. Doesn't matter for everybody. For some

30:40

people, it's a factor. And for

30:42

sure, don't eat before bed. Give yourself at least

30:44

three hours between the last meal and

30:47

bedtime. Also, certain lifestyle factors we

30:49

know for sure trigger a reflex

30:51

smoking, so don't smoke. If

30:53

you have a lot of problems at night and

30:56

you're overweight, you might

30:58

want to prop your head of your bed up. There's some beds

31:00

that actually tilt up or you can use pillows. Don't

31:03

sleep on your right side, especially after a

31:05

meal. That increases the relaxation of the lower

31:07

soft-jill sphincter, and then you get reflux. So

31:10

sleep on your left side, that might help. The next

31:12

step is healing the gut. And there's a lot of

31:14

steps to doing this, but things like digestive enzymes or

31:17

probiotics can be helpful. You want

31:19

to restore the microbiome balance with probiotics

31:21

and you also want to correct any

31:23

nutritional deficiencies like magnesium, for example. Some

31:25

of my favorite products are deglycerized licorice

31:27

or DGL, it's a chewable tablets you

31:30

can take before meals, 10,

31:32

15 minutes, take three or four, two or three, see

31:34

what you need before each meal before

31:37

bed. My combo favorite is glutagenics. It's

31:39

a product by Metagenics. It has DGL,

31:42

it has L-glutamine, it has aloe vera. Ginger

31:44

and artichoke leaf also are helpful. Sometimes

31:47

people need motility help and I recommend

31:49

something called Motility Activator. It's a supplement

31:51

by Integrative Therapeutics. It contains both of

31:54

those, ginger and artichoke leaf.

31:56

It helps support motility and transport. And

31:58

again, you can get that. that online

32:00

and find it on my

32:03

website, drhyman.com. Probiotics also

32:05

really important. They support immune function,

32:07

digestive health, they lower inflammation, which

32:10

is really important for helping reduce

32:12

reflux. And they also

32:14

compete with the other bad bugs in your

32:16

gut and reduce their overgrowth and reduce the

32:18

growth of pathogens that can make reflux worse.

32:21

And they also improve the consistency of

32:23

your stool. They reduce gas

32:25

production. They help transit time. Some

32:28

of my favorites are seed and other probiotics.

32:31

Digestive enzymes can be very helpful. Magnesium

32:34

can be very helpful. Sometimes zinc

32:36

carnosine is a form of zinc that can really help

32:38

with reflux. I use that quite a bit, about 75

32:40

milligrams twice a day. B12 also,

32:42

we're gonna link to all these in the show

32:44

notes and give you exactly a recipe for fixing

32:46

reflux. Now for low stomach acid, sometimes people might

32:48

have low stomach acid that's causing their symptoms, so

32:50

it's a little paradoxical. And

32:53

they may benefit from taking something called baiting

32:55

HCL, or even apple cider vinegar.

32:57

That can help improve stomach acid and digestion.

33:00

You can try digestive bitters. They stimulate

33:02

digestive function. They're used to address various

33:04

GI issues. They actually activate taste

33:06

receptors in the tongue. They trigger saliva

33:08

production. They speed up gastric emptying. They

33:11

protect the esophageal lining from acid damage. So

33:13

a lot of benefits. And

33:16

there's other bitters

33:18

that you can use that are out there, but

33:20

you can buy them online. They're

33:22

dandelion root, artichoke leaf. Those all are helpful.

33:25

Stress, you also wanna manage stress because things

33:27

that cause stress will make your stomach stop

33:29

working, right? You don't wanna be digesting your

33:31

food when you're running from a tiger. So

33:34

you have to learn how to reduce your stress. And

33:36

there's a lot of techniques for that, meditation, deep

33:38

breathing, yoga. Make sure you're also

33:40

getting plenty of sleep because that will make you more

33:42

stressed if you're not sleeping. A lot

33:45

of herbs can be used for reducing the stress

33:47

response. These are called the daphogenic herbs, like ginseng,

33:50

rhodiola, Siberian ginseng,

33:53

ashwagandha. Also really

33:55

can be helpful in managing stress responses in

33:57

the body. Also mindful eating.

34:00

slow down, chew thoroughly, you know,

34:02

that'll also help you digest your food. So what

34:05

I would say is that reflux is optional. For

34:08

some people they have a bacteria called H. pylori,

34:10

they might need to get treated, but

34:12

for most of us it's what we're

34:14

eating, it's having gut imbalances, it's having

34:16

food sensitivities, it's having nutritional deficiencies, all

34:19

these things are correctable. So that wraps

34:21

up today's episode on the root causes

34:23

and solutions for reflux. We've explored everything

34:25

from the risks of relying on medications

34:27

like PPI's or acid blockers to how

34:29

functional medicine can address the real underlying

34:32

causes like poor gut health,

34:34

lifestyle triggers, even low stomach acid.

34:36

Now remember, while it's easy to

34:39

reach for quick fixes like taking the pill,

34:41

getting the root cause is key to long-term

34:43

relief and your overall health. Because long term

34:45

if you're taking these drugs you're going to

34:47

get into trouble, whether it's osteoporosis or vitamin

34:49

deficiencies or pneumonia or worse

34:51

like things like C. diff, then

34:54

incorporating the right foods and focusing

34:56

on your digestion, managing stress using targeted

34:58

supplements that makes a huge difference in

35:01

not just relieving symptoms but also healing

35:03

the gut and the restoring balance overall

35:05

on your body. Now it's a process

35:07

so with the right mindset and

35:10

the tools you can actually get long-term relief

35:12

from reflux. So thanks a lot for joining

35:14

me again today and don't forget to rate

35:16

review and follow Health Hacks wherever you get

35:18

your podcasts, stay healthy, stay informed and I'll

35:21

catch you next Tuesday for another episode of

35:23

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