Below are the nutritional supplements and over-the-counter (OTC) meds I recommend for acid reflux and GERD. Many of these are referenced inside the Stop My PPI eBook and have been very helpful in my ability to wean off (and stay off) PPI medication. Full disclosure: Along with the eBook for sale on Amazon, I also earn a small commission from qualifying purchases on the links provided.
Alginates use a unique and clever approach to controlling reflux. They contain an ingredient called alginate, which is naturally occurring in seaweed and algae. When ingested, the alginate forms a foam or gel "raft" that floats on top of the stomach contents. This raft acts as a barrier, reducing reflux severity and protecting the esophagus.
Also, alginates typically do not suppress acid as antacids do, thus avoiding rebound acid production and allowing for proper digestion.
You can use alginates at any time, but after a meal and before going to bed are most appropriate. I like to take a dose 30 minutes after a meal (give or take) or before lying down at night.
**Important - Ideally, you should take alginates after taking other supplements or medications as alginates can affect their absorption. Otherwise, wait several hours after taking alginates to take other supplements or medications.
Note: It's generally not recommended to eat or drink (other than the suggested water along with the dose) after taking the dose as it can break up the raft/barrier and reduce efficacy.
Recommended Alginate Products for Reflux:
Gaviscon Advance (Liquid)
This is different than the Gaviscon you may find in most US drug stores. This version is only available outside the US, but luckily can also be found on Amazon. There are two flavors, peppermint and anise. I prefer the peppermint, but links to both are below.
Gaviscon Advance Chewable Tablets
These are effective (perhaps less so than the liquid) but are helpul for on-the-go in case you need them. Chew lightly as they really get stuck in your teeth!
This is a relatively new one and tastes better than Gaviscon. However, I lean towards Gaviscon on efficacy. Currently available in Vanilla Caramel and Mint Chocolate (both available from the same link).
Probiotics are live bacteria which can be beneficial to your digestive system. While research is still ongoing, Probiotics have been shown to help with:
- GERD/Acid Reflux
- Proper digestion
- Irritable bowel disease and inflammatory bowel disease
- Skin conditions
- Urinary and vaginal health
- Preventing allergies and colds
- Oral health and gum disease
Probiotics can be obtained through certain foods, but most of them are acidic because they are fermented. So, pill-form supplements are the recommended source while weaning off your PPI.
Probiotics are measured in colony forming units (CFU) and by how many different strains/types are included. Most studies indicate that the more diverse the microbiome, the better.
Start with a low dose such as 5 to 10 billion CFU and gradually work up to 50 or so. Try to use a product with a variety of strains. Take as indicated on the supplement label.
There is a specific bacteria strain that has been studied and shown to help speed up digestion/motility. It's called Bifidobacterium lactis HN019. It can be found in various probiotics, including those listed below.
Recommended Probiotics for Reflux:
Note that these say 50+ formula, but I don't think that matters. The main strain I look for is the HN019.
NOW Supplements, Clinical GI Probiotic, 50+ Formula (20 Billion CFU - per two capsules)
You can start with one capsule servings of this one if you are just starting or are sensitive to probiotics.
Melatonin is a hormone found naturally in the body and in some foods. Melatonin used as medicine (or a supplement) is usually made synthetically in a laboratory. Melatonin is most commonly used for insomnia and improving sleep in different conditions.
In addition to improving sleep (a major factor in reflux management), Melatonin has been shown to help with acid reflux by:
- Increasing pressure/strength of the LES muscles to help prevent reflux
- Reducing gastric acid secretion (slightly, and perhaps by more natural means than PPIs)
- Reducing damage to and inflammation of the esophagus
What's more, Melatonin is a potent antioxidant, anti-inflammatory factor, and immune modulator. It also contributes to regulating the circadian system, possesses tumor inhibitory properties, and shows its benefits on cardiovascular functions, blood pressure, and lipid and glucose metabolism.
Most studies show supplemental melatonin to be safe in the short-term, but you should check with your doctor if you have other existing conditions or take other medications. Until the long-term safety profile of supplemental melatonin is more understood, I recommend discontinuing melatonin or taking it intermittently after weaning off and symptoms are stable.
I recommend starting with 1mg about 30-90 minutes before bedtime to test your tolerance/reaction...going up to 3mg or 5mg if needed.
Recommended Melatonin for Reflux:
I like these because Melatonin is the only main ingredient. Many products have other ingredients added for sleep/relaxation, which you may or may not want. I also prefer not to use the quick dissolve/flavored varieties as they can be acidic.
Nature's Bounty 1mg Melatonin
Alkaline water is essentially water with a higher pH level - typically 8.0 or higher. High pH is basic/alkaline, whereas low pH is acidic.
I suggest using alkaline water like a supplement and only during acute reflux episodes (when reflux has recently occurred or is currently happening). Use it as a gargle and to flush the esophagus of acid and pepsin.
Pepsin is a digestive enzyme produced in the stomach to help digest proteins...particularly animal proteins. When reflux occurs, the pepsin can find its way into the esophagus and upper digestive tract where it can cause irritation, tissue damage, and other symptoms.
I don't suggest drinking copious quantities of alkaline water, especially around mealtime where it may negatively affect digestion.
Recommended Alkaline Water for Reflux:
Any alkaline water with a pH of 8.8 or higher should suffice, and almost all grocery stores carry it now. Below are links to purchase online.
Alkaline88 Purified Ionized Water with Himalayan Minerals (4, one gallon jugs)
Calcium Carbonate (Chewable)
There are several brands of chewable calcium carbonate - read the ingredients, as some may contain other added ingredients.
Keep to a lowest effective dose and only take it when needed. Too much calcium, for too long can cause side effects.
- Important: This supplement/OTC med can be helpful and safe but be sure to monitor your total calcium intake if you use calcium carbonate consistently.
- Too much calcium can cause a condition called Milk-alkali syndrome (MAS) which consists of hypercalcemia, various degrees of renal (kidney) failure, and metabolic alkalosis due to ingestion of large amounts of calcium.
- Daily elemental calcium intake of no more than 2 grams (2,000mg) is considered safe. However, even doses lower than 2 g daily may result in MAS if additional predisposing factors are present.
- Check and calculate the amount of elemental (actual) calcium in your supplement before using. Calcium carbonate is approximately 40% elemental calcium. So 1,250mg of calcium carbonate would equate to 500mg of elemental calcium.
- There may also be a link between high-dose calcium supplements and heart disease, as well as prostate cancer. The results from studies have been mixed. Until more is understood about these possible risks it is best to avoid excessive, long-term calcium intake.
- There is some evidence that antacids can cause the stomach to produce more acid in an attempt to balance out.
Calcium carbonate is generally not recommended to take along with daily PPI use.
Recommended Calcium Carbonate for Reflux:
I like extra strength Rolaids because they also contain a small amount of magnesium hydroxide, which is another effective antacid.
Rolaids Extra Strength Antacid Chewable Tablets, 120 Tablets
Below are the rolls which are great to carry with you or keep in your vehicle.
Rolaids Extra Strength Antacid Chewable Tablets - Rolls
Deglycyrrhizinated Licorice (DGL) is a form of licorice that is processed for safer consumption.
DGL is thought to positively affect the mucosa within the upper GI, fortifying it against acid related damage
DGL can reduce indigestion and also soothe a sore throat
Take DGL as needed and per the recommended dose on the supplement label.
Before using DGL be sure to discuss potential medication interactions with your doctor. It can amplify the effects of certain potassium-lowering medications.
Though I found DGL to be helpful, I recommend only using DGL during weaning off and perhaps shortly thereafter. There are some potential side effects associated with high/long-term use.
Recommended DGL for Reflux:
I like Vitamin Shoppe's version of DGL for the dosage, mild taste, and fair price.
Vitamin Shoppe DGL 760mg
A combination of zinc and L-carnosine, Zinc Carnosine originated in Japan and has been well studied for decades for digestive health.
- Zinc Carnosine has been shown to have:
- Endoscopic healing effects
- Protective effects for the digestive tract from ulcers
- Potent antioxidant capability
- Inhibitory effect on the bacteria H. pylori
- Immune boosting ability
Take on an empty stomach - I like to take it first thing in the morning, and at least 30 min before breakfast.
Recommended Zinc Carnosine for Reflux: