We tend to think of melatonin, often called the "sleep hormone," in terms of-you guessed it-sleep. So what does melatonin have to do with your digestion? The answer is a lot, according to new research. It turns out that this hormone, in addition to regulating our sleep/wake cycle, also can help gastroesophageal reflux disease GERD). This is very good news!

Known for its symptoms of acid reflux or heartburn, GERD is a very common condition that occurs when the lower esophageal sphincter-the valve between the esophagus and the stomach-relaxes at the wrong time, allowing gastric acid to escape from the stomach into the esophagus. The result is pain and a burning sensation in the chest and throat. Over time, the acid exposure from GERD can damage the esophagus, even causing cancer and other serious conditions.

Melatonin as an effective treatment is exciting news because there are many possible dangerous side effects (such as bone fractures and stomach disorders) that can occur with popular medications for GERD-namely, proton-pump inhibitors (PPI) and H2 receptor antagonists, which work by suppressing stomach acid production. One study even suggests that their long-term use may increase risk for cognitive decline.

The Melatonin Breakthrough

Melatonin is a naturally occurring hormone that is made in various parts of the body. When produced by the brain's pineal gland (which happens whenever you're exposed to darkness), melatonin has a strong influence on circadian rhythms and encourages sleep. It also has many other beneficial effects. Preliminary studies show that it is an effective treatment for migraine, obesity and seasonal affective disorder.

What many people don't know: The gastrointestinal (GD tract secretes up to 500 times as much melatonin as the pineal gland. Researchers have determined that the hormone plays an important role in the GI system by preventing oxidative stress on GI cells...regulating cholesterol uptake by the intestinal wall...helping to heal damage to the lining of the GI tract...and promoting the secretion of other hormones that aid digestion and elimination. Studies have shown that supplementing with melatonin can help to treat esophageal ulcers, dyspepsia (upset stomach) and irritable bowel syndrome.

Now there is evidence that melatonin supplements also alleviate GERD symptoms.

One possible reason: Melatonin has been found to reduce gastric acid secretion (although not to the degree of PPIs) and to normalize pressure of the lower esophageal sphincter, allowing it to close more effectively.

In one study, published in Journal of Pineal Research, GERD patients received a daily supplement of 6 milligrams (mg) of melatonin, along with L-tryptophan, vitamin B-6, folic acid, vitamin B-12, methionine and betaine (the additional nutrients were administered for their anti-inflammatory and analgesic effects). An equal number of subjects were treated with daily 20-mg doses of the PPI omeprazole. Remarkably, after 40 days, 100% of the melatonin group reported no noticeable GERD symptoms, compared with just 65% of the omeprazole group.

My advice: I recommend that patients with GERD take 3 mg to 6 mg daily of melatonin 30 minutes before bedtime. I recommend the sublingual form for those who have trouble falling asleep or the time-release form if they tend to wake up during the night. If you have no obvious sleep problems, take a close look at your sleep pattern and determine if you have a tendency to either struggle when falling asleep or wake at night and take the form accordingly. Melatonin is not recommended for children or for women who are pregnant.

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