Julie Rehmeyer's 'Through the Shadowlands'
Writer Never Give Up talks about Julie Rehmeyer's new book "Through the Shadowlands: A Science Writer's Odyssey into an Illness Science Doesn't Understand" and shares an interview with Julie ...
Discuss the article on the Forums.

heartburn

Discussion in 'General Treatment' started by Rrrr, Apr 30, 2012.

  1. Rrrr

    Rrrr Senior Member

    Messages:
    1,552
    Likes:
    693
    I wrote Rich Van K an email about heartburn and decided to continue the discussion online so everyone can benefit. Here was my initial email to him and his reply.

    rich,

    may i ask for your help? my heartburn has been fierce lately. it may be due to eating too much sugar. so i'll stop. meanwhile, i'm looking over yr post of May 26, 2010, where you talk about:

    1. doing the burp test to assess stomach acid levels (so i will do it tomorrow morning)

    2. how "zinc deficiency could be a possible reason for low stomach acid production" (so i'll re-bump up my zinc intake to 50 mg per day)

    3. that "If taking zinc and glutathione do not restore stomach acid levels, one can still use the approach of taking a hydrochloric acid solution orally (properly diluted so as not to damage the mouth, throat and esophagus, but to still be strong enough to help in the stomach) such as the product sold by Allergy Research Group. (Using a drinking straw and rinsing the mouth with water afterward will protect the enamel on the teeth.) Taking betaine-HCl is another possibility, but I have not been able to resolve the question as to whether the betaine in this supplement would speed up the BHMT alternative pathway in the liver and kidneys too much, at the expense of the methionine synthase pathway, which is partially blocked, and which the methylation cycle treatment seeks to speed up."

    i'm just wondering two things:

    a. do you still subscribe to this thinking (your above quotes)?

    b. how would digestive enzymes help or hurt the goal of restoring stomach acid levels? would taking digestive enzymes be the same approach as trying a "hydrochloric acid solution/betaine HCI" approach?

    thank you in advance for your thoughts. and for your original very detailed post from May 2010 (which i had saved on my computer).

    best,
    xxxxxxxx
    ______

    On Apr 30, 2012, at 12:40 AM, rich wrote:
    Hi, xxxxxxxx.

    Sorry, heartburn is no fun.

    Yes, it's important to find out whether it is due to insufficient stomach acid, which seems paradoxical, but turns out to be true in a lot of cases, and maybe most cases. So the baking soda burp test is what I suggest doing first.

    Yes, low zinc is a possible cause, but in ME/CFS, I think that low glutathione is more probable as the cause, and it's necessary to lift the methylation cycle block to get glutathione to come up on a permanent basis. Liposomal glutathione may help temporarily.

    The Allergy Research Group dilute hydrochloric acid, taken with each meal, would be my first choice for augmenting the stomach acid, until the normal secretion of it can be restored by bringing up glutathione with a methylation protocol.

    Betaine-HCl is probably O.K., too, though it may boost the BHMT alternative methylation pathway too much. I'm still not sure about that.

    Lemon juice would probably work, too, and some people have reported that apple cider vinegar works for them. I do recommend using a straw and flushing the teeth with water afterward.

    Digestive enzymes might help by speeding up the digestion in the gut, so that the food mixture can move from the stomach to the gut faster. I think this motility can be slowed either by low stomach acid or by low digestive enzymes. I think that the way that low acid will slow motility is that normally the acid in the food mixture signals cells in the wall of the duodenum when it arrives there. These cells put secretin and cholecystokinin into the blood, and they signal the pancreas and the gall bladder to send in digestive enzymes and bile. If this message does not get sent well because the acid is low, then the digestion will be slowed down. So I think that's how these are related.
    If you do both an acid booster and digestive enzymes, you will have a "belt and suspenders" approach, and hopefully that will help with the heartburn.

    Best regards,

    Rich
    _________

    hi rich,

    thank you so much! a belt and suspenders sounds great.

    BURP TEST: No burp came until 3 minutes after i took the baking soda and water. so i am low on stomach acid, clearly. (Here's a simple home do-it-yourself test: On an empty stomach, such as first thing in the morning, drink an 8-ounce glass of water, into which you have mixed one-quarter teaspoon of baking soda (sodium bicarbonate). Time how long it takes you to burp. If you have not burped in 2 minutes, you have low stomach acid.)

    GLUTATHIONE: i am hesitant. i have always reacted very badly to it (IM, IV, oral). each time i got very sick for days or wks from a small amount. i last tried it before gcmaf tho, so maybe i should try again. ugh.

    METHYLATION PROTOCOL: sushi told me that you said the gcmaf protocol (gcmaf + nexavir + b12 shots; i've been on this 1 yr) helps lift the methylation cycle block and that while on it one (me!) does not need to be on the methylation protocol. is this true? (i am sure i asked you this just a few months ago, and you said i should still be on one of the 5 supps, the Solgar Folate/Metafolin, right?)

    RE-SEND: can you please direct me to the most update methylation protocol? i have a version from March 2011 and i want to be sure i have the most updated version.

    ACV or LEMON: you mention these below. do you mean i could take this with meals (instead of hydrochloric acid) or between meals? if you are suggesting them with meals, i'm confused, as both ACV and lemon are alkalizing, not acidic.

    thank you again!
    xxxxxx
    ________
     
  2. Rrrr

    Rrrr Senior Member

    Messages:
    1,552
    Likes:
    693
    i will note that rich also posted some of his thoughts on this thread
    http://forums.phoenixrising.me/showthread.php?17085-Alternative-to-Proton-Pump-Inhibitors

    this is the post rich posted that i found helpful

    Hi, Googsta.

    Many cases of reflux are (somewhat paradoxically) caused by having not enough stomach acid, rather than too much. The reason is that the acid level needs to be high enough in order to signal the opening of the pyloric sphincter (the one at the bottom of the stomach that leads to the duodenum). If this sphincter doesn't open when it should, the food and acid mixture tends to come back up through the gastroesophageal sphincter, producing reflux and heartburn. This is not true in all cases, since some people do have serious hiatal hernias or poorly functioning upper sphincters, but it is true in many cases.

    Before resorting to efforts to decrease stomach acid, which causes a lot of problems for the digestive system and the nutritional status in the long run, it is best to first run a test to see if the stomach acid is actually low instead of high. Here's a simple home do-it-yourself test: On an empty stomach, such as first thing in the morning, drink an 8-ounce glass of water, into which you have mixed one-quarter teaspoon of baking soda (sodium bicarbonate). Time how long it takes you to burp. If you have not burped in 2 minutes, you have low stomach acid. Note: If you have been taking a proton pump inhibitor, you would need to stop taking it, and wait a couple of days for your parietal cells to recover before running this test. Otherwise, there can be a "rebound" effect when you stop the drug, and that can cause excess acid production, giving misleading results.

    If it turns out that you have low stomach acid instead of high, you can augment it by taking betaine-HCl tablets or capsules, or the Allergy Research Group dilute hydrochloric acid, or lemon juice, with each meal. If you use lemon juice, be sure to use a drinking straw and to flush the teeth with water afterward to avoid damaging the enamel by chelation of calcium by citric acid. To determine the appropriate dosage of betaine-HCl, start with one pill for a meal, and then raise the dosage by one more for the next meal, and so on, until you experience a warm feeling in your stomach. Then drop the dosage by one pill, and use that dosage for each meal.

    Best regards,

    Rich
     
  3. nanonug

    nanonug Senior Member

    Messages:
    1,250
    Likes:
    422
    Virginia, USA
    Here's how I would go about it:

    1. Upper endoscopy to assess condition of esophagus, stomach and duodene
    2. If, after above test, Helicobacter pylori is present, treat it
    3. Else, if no signs of gastritis, take d-limonene
     
  4. Rrrr

    Rrrr Senior Member

    Messages:
    1,552
    Likes:
    693
    Rrrr's heartburn research results

    == Rrrr's heartburn research results ==

    First, see if my stomach has enough stomach acid present:
    Here's a simple home do-it-yourself test: On an empty stomach, such as first thing in the morning, drink an 8-ounce glass of water, into which you have mixed one-quarter teaspoon of baking soda (sodium bicarbonate). Time how long it takes you to burp. If you have not burped in 2 minutes, you have low stomach acid. If so, see "If you want to add acid" list below.

    IF YOU WANT TO ADD ACID
    If stomach acid is low, try any of these suggestions by Rich Van K:
    1. "The Allergy Research Group dilute hydrochloric acid, taken with each meal, would be my first choice for augmenting the stomach acid, until the normal secretion of it can be restored by bringing up glutathione with a methylation protocol."
    2. "Betaine-HCl is probably O.K., too, though it may boost the BHMT alternative methylation pathway too much. I'm still not sure about that. To determine the appropriate dosage of betaine-HCl, start with one pill for a meal, and then raise the dosage by one more for the next meal, and so on, until you experience a warm feeling in your stomach. Then drop the dosage by one pill, and use that dosage for each meal"
    3. "Lemon juice would probably work, too, and some people have reported that apple cider vinegar works for them. I do recommend using a straw and flushing the teeth with water afterward."

    IF YOU WANT TO ALKALIZE
    If I want to make my stomach less acidic (more alkaline) between meals, do these things, (but do not alkalize your stomach during meals. With meals, you want an acidic stomach):
    - Add baking soda to my water when you guzzle it (too much water causes an acidic stomach) add 1/4 teaspoon for 12 ounces of fluid. By doing this all the time, you'll always be alkalizing your stomach and body.
    - Put a mix of baking soda & Bragg's apple cider vinegar into 4-6 oz. of water & consume after every meal and snack. This will alkalize the contents of your stomach and act as a preventative. http://bewell-naturally.blogspot.com/2006/07/acidic-foods-can-stop-acid-reflux-and.html
    - Not consuming liquid 30 minutes before and 45 minutes after food consumption. Water (liquids) often times slow digestion and digestive fluids, thus contributing to acid reflux and slow digestion.

    FOR IMMEDIATE RELIEF OF HEARTBURN
    - Acid reflux is reduced if you sleep on your left side.
    - Eat an apple or pear
    - Apple cider vinegar with baking soda (see earthclinic.com) -- "Put a mix of baking soda & Bragg's apple cider vinegar into 4-6 oz. of water & consume after every meal and snack. This will alkalize the contents of your stomach and act as a preventative."
    - Baking soda alone -- "1/4 tsp of bicarb in 1/4 glass of water at least 1 hour after food is another way to lower stomach acid."
    - Mustard -- "1/2 tsp with heartburn, and again in the a.m. and heartburn may go away for life"
    - Celery -- 1/2 to 1 stalk
    - Coconut water
    - Soy, almond, rice, and even coconut milk to soothe heartburn. "I find that when I drink the non-dairy milks it will take a lot more to soothe the burning than dairy milk. However, my favorite remedy is chocolate milk and dark chocolate almond milk (better than water!) Try silk almond chocolate milk, tastes great and more effective than tums or other methods. it works in minutes"

    LONG TERM SOLUTIONS TO HEARTBURN
    (Some of these may be the acid approach and others may be the alkaline approach. I have not yet figured out which is which. And some may not have anything to do with acid/alkaline)
    - Eliminate sugar (recommended on earthclinic.com) because candida can cause heartburn
    - Low carb diet (recommended on earthclinic.com: "By low carb I mean 30-40g of carbs per day. If you feel you have tried everything to cure heartburn, this may be just what you needed.")
    - Gluten-free diet
    - Digestive enzymes
    - Probiotics
    - Magnesium chloride (http://www.earthclinic.com) "take in liquid form: 2 teaspoons 3 times a day completely gets rid of all my acid reflux symptoms." -- "The dose I have found to be about 250-500 mg taken three times a day in one warm cup of water. The magnesium was designed to protect against the toxicity of the excitotoxins, which occur from monosodium glutamate, aspartame, aspartic acid, for example. It's effect in relieving the acid reflux is almost instant upon taking the first dose, but almost a complete stoppage of acid reflux may occur after three days to seven days."
    - Aloe vera gel
    - Orange peel extract (d-limonene). See http://www.drweil.com/drw/u/QAA400477/What-Quenches-Heartburn.html
    "d-limonene stimulates esophageal peristalsis, helping move acid and liquids back into the stomach. She recommends buying it as orange peel extract in 1,000 mg doses (standardized to d-limonene 97-99%) and taking it once a day every other day for a total of 10 doses over 20 days. After that, take it as needed. Note that some orange peel extracts are standardized to synephrine, a stimulant drug that is generally taken for weight loss. Synephrine-containing products can cause unwanted side effects and are not what you want for heartburn treatment."
    - DGL (deglycyrrhizinated licorice). "How does DGL work [for heartburn]? It doesn't reduce stomach acid itself or decrease acid reflux. DGL may soothe the tissues of the stomach and esophagus that have been irritated by refluxed stomach acid. It may also act as an anti-inflammatory." -- "The natural remedy I usually recommend for heartburn is deglycyrrhizinated licorice (DGL). Whole licorice can increase blood pressure; no such effect occurs with DGL. You can buy DGL in powder or tablet form. The easiest way to take it is to chew two tablets slowly 15 minutes before every meal and at bedtime, or take one-half teaspoon of the powder before meals. Allow either form to dissolve in the mouth and slowly trickle down the throat. You can continue to take DGL as long as you have symptoms." -- "It will repair the esophagus and correct the GERD in a few days." -- "1 in the morning and one in the evening. Take the whole bottle. After that I take one pill about 4 or 5 times a wk. End of problem." -- "Research and you will find several articles saying DGL cures ulcers! Take it 20 minutes prior to eating each meal (up to 3 times/day). I went from having acid reflux every day-all day to seldom if ever. I no longer vomit stomach acid in the morning and I am able to eat spicy foods again. I also don't have to take it before every meal anymore. I only take it before I eat spicy foods. Two last things, if you don't like licorice, they do have German Chocolate flavored DGL which helps to disguise the flavor. Secondly, if you have high blood pressure, make sure you buy the kind that has the glycyrrhizin compound (associated with high blood pressure) removed."
    - idea: take my normal dose of licorice root extract at night instead of morning?
    - Turmeric, coconut oil, black pepper combo
    - Slippery Elm Bark
    - Zinc ("Zinc deficiency could be a possible reason for low stomach acid production")
    - Create a permanent alkaline environment in your stomach with an Alkaline diet (search for ph Diets online)
    - Mint tea (idea: maybe after dinner, before bed?): earthclinic.com "One cup a day for a week. By the second day I hadn't had an attack. By the end of the week I threw away my Zantac. The tea was only used for a week as it was. After about 1 month the erosion was healed and it would be 4 years before I would have heartburn again." -- "I just did my science fair project on this subject and got a 1st, and Best of Show. I found that peppermint will actually lower the acidity in your stomach. Like a mint (like peppermint candy) or peppermint tea will help lower the acid in your stomach that produces the acid that gives you heartburn."
    - Papaya enzyme
    - Pinch of sea salt on the tongue
    - Miso soup (it is alkaline)
    - L-Glutamine (???) to heal stomach (?????????)
     
  5. richvank

    richvank Senior Member

    Messages:
    2,716
    Likes:
    876
    Hi, Rrrr.

    Yes, it does sound as though you have low stomach acid. That seems to be true in most cases of ME/CFS.

    If glutathione has caused problems for you in the past, I think you should avoid it.

    I suspect that Nexavir has some folate in it, because it is supposedly a low-molecular-weight extract from liver. Since the treatment you mentioned also includes high-dose hydroxoB12, that's the basis on which I suspect that this treatment does support the methylation cycle. Since I'm not sure about the folate content, it would probably be a good idea to continue with Metafolin or its equivalent as well, though (FolaPro, MethylMate B, Quatrefolic, or a little bit of Deplin).

    The March 2011 version is still the most current, though some people prefer a tablet for the folinic acid, instead of a capsule. They prefer to split a tablet rather than to deal with powder. If you feel that way, too, you might try the Source Naturals Megafolinic.

    Yes, I mean to take lemon juice or apple cider vinegar with meals. The alkalizing/acidizing situation with these is a little paradoxical. When you swallow them, they contain acid (citric or acetic, respectively) and that does acidify the stomach, which helps you to digest your food. However, after you absorb them, your cells metabolize the citrate or acetate, and what is left over are ions that form strong bases (which are alkaline). These include sodium, potassium, calcium and magnesium. When the excess of these goes into the urine, because they are base-formers, they alkalinize the urine, and that helps you to excrete toxins that are in the chemical form of weak acids. So you win both ways! Flush your teeth, though, especially with lemon juice, because citrate is a chelator for calcium and will do a number on your enamel!

    Best regards,

    Rich
     
  6. Rrrr

    Rrrr Senior Member

    Messages:
    1,552
    Likes:
    693
    thanks, nanonug. i guess i should schedule at upper endoscopy. ugh.

    i did the h. pylori tests (blood and breath) and both were negative.

    i did research the d-limonene you mention and it looks promising.

    but for now, i'm starting these things right away, since i have them on hand:
    - DGL licorice tablets 20 min before meals
    - probiotics (re-starting these) before meals
    - digestive enzymes with meals
    - Apple cider vinegar with meals
     
  7. Rrrr

    Rrrr Senior Member

    Messages:
    1,552
    Likes:
    693
    thanks, rich! now i understand the ACV and lemon thing.
     
  8. Rrrr

    Rrrr Senior Member

    Messages:
    1,552
    Likes:
    693
    nanonug, how much and how often and how long do you do the d-limonene?
     
  9. Rrrr

    Rrrr Senior Member

    Messages:
    1,552
    Likes:
    693
    rich, as you may recall, after doing your methylation protocol for 1 year (and having no relapses in that one year!!! amazing), i suddenly had a life crisis and became hypersensitive to all supplements. i had to stop the methylation protocol. the high dose b-12 injections, also, were just too much. now i can only seem to tolerate 1/10th of a cc of the 10,000 mcg per day (so 1 cc of 1000 mcg per day).

    is that still enough in your mind?
     
  10. nanonug

    nanonug Senior Member

    Messages:
    1,250
    Likes:
    422
    Virginia, USA
    Depends. I have read about people needing to take it everyday. Others just a few times a week. However, if you have ulcers or duodenitis, it will burn like crazy.
     
  11. Rrrr

    Rrrr Senior Member

    Messages:
    1,552
    Likes:
    693
    rich, could 1 gram of Vit C take the place of apple cider vinegar or lemon (taken with meals)?
     
  12. Googsta

    Googsta Doing Well

    Messages:
    390
    Likes:
    158
    Australia
    Awesome thread Rrrr, thankyou so much for compiling all the information :thumbsup:
     
  13. richvank

    richvank Senior Member

    Messages:
    2,716
    Likes:
    876
    Hi, Rrrr.

    I can't say for sure. It may be that the reason a higher dose is not tolerable is that it is lifting the methylation cycle partial block.

    Best regards,

    Rich
     
  14. richvank

    richvank Senior Member

    Messages:
    2,716
    Likes:
    876
    Yes, I think that would work. Ascorbic acid (vitamin C) is a pretty strong acid, stronger than acetic acid, for example. The strength of an acid is evaluated by what is called the pKa value. The lower this value, the stronger the acid. For ascorbic acid, it's 4.1, and for acetic acid, it's 4.8.

    Best regards,

    Rich
     
  15. nanonug

    nanonug Senior Member

    Messages:
    1,250
    Likes:
    422
    Virginia, USA
    Thing is, isn't HCl pKa -3 or even less? Anyone looking for an alternative runs the risk of being disappointed really fast!
     
  16. richvank

    richvank Senior Member

    Messages:
    2,716
    Likes:
    876
    Hi, nano.

    It's true that HCl is a strong acid and ionizes completely, even in pretty high concentration.

    However, the concentration of HCl in the food mixture in the stomach is normally such that the pH is around pH3. Even though weak acids have a higher pKa value, it is still possible to use them to get the pH low enough so that pepsinogen will convert to pepsin and begin the digestion of protein.

    Best regards,

    Rich
     
  17. nanonug

    nanonug Senior Member

    Messages:
    1,250
    Likes:
    422
    Virginia, USA
    Given my very meager understanding of chemistry, I was under the impression that it takes a strong acid such as hydrochloric acid to fully denature proteins. Wouldn't incomplete denaturing (quaternary through primary structures) affect hydrolysis of the protein regardless of pepsin availability? In any case, this is an interesting subject and I need to do a little bit of reading on this...
     

See more popular forum discussions.

Share This Page