Female Gastroenterology: Heartburn and Hormones

February 27, 2023

Female Gastroenterology: Heartburn and Hormones

Dr. Nicole Sundene, NMD

Holistic Gastroenterology, Nutrition and Hormones

Heartburn can impact women more often than men because of hormone imbalance. While I am not a Gastroenterologist, nor a Cardiologist this is one of the top complaints I received from women, especially after they have been to the ER thinking they are dying of a heart attack, only for the Cardiologist to tell them they just need to go to a Gastroenterologist. The GI doctor gives them an antacid and they continue to have worsening heartburn.

A serious pet peeve of mine is how we all traditionally deal with indigestion and heartburn with THE WORST DRUGS for women: Prevacic, Tums, Ranitidine, Omeprazole, etc. The use of calcium carbonate antacids, proton pump inhibitors, and H2 blockers can cause a full host of women's health diseases for me to manage when really we just need to get the patient off these horrible medications that block stomach acid.

They seem pretty benign right? You can buy them at any grocery store or pharmacy so it should be totally fine to take heartburn medications since a doctor doesn't even need to prescribe them.

But these are also my #1 LEAST FAVORITE MEDICATIONS for women to take because they actually block absorption of minerals, iron, zinc, magnesium, protein, B-12 and therefore result in anemia, hair loss, muscle spasms, and Osteoporosis.

Even more unfortunate, I find heartburn meds totally unnecessary, as a Naturopathic Doctor that has worked for fifteen years to treat the Root Cause of heartburn and reflux. I know how easy it is to fix this problem so women don't have to rely on medications that suppress their stomach acid and block mineral absorption and B-12 that are important for immune boosting, mental health, depression, anxiety, and chronic fatigue.

By neutralizing the pH in the digestive track it also makes women more susceptible to yeast overgrowth and Yeast Infections. Candida overgrowth in the digestive tract results in chronic gas and bloating.

Once half of the women's hair falls out and they have Osteoporosis it is somewhat too late for Naturopathic Medicine. Prevention is critical. Today I am writing this very important women's health PSA on heartburn. Please share this with other women so we can prevent miserable, painful Osteoporosis that can cause painful fractures during your "Golden Years."

I understand that at times we need to suppress our stomach acid just to provide some short-term relief, or to prevent it from burning our stomach lining and potentially causing ulcers and permanent scarring to our stomach and esophagus. But these medications were never designed to be taken daily as many women chronically rely on them.

Before we make any major decisions regarding inhibiting the natural processes of our digestion let’s first investigate what stomach acid was designed by nature to do for us.

Stomach acid is Hydrochloric Acid (HCL) which is produced to help break down our food for digestion and absorption. HCL is the biochemical “mother” of the digestive process triggering resultant chemical reactions and productions of enzymes as your food moves through your intestines. Certain vitamins, minerals, and macronutrients are unable to be properly metabolized without the aid of HCL. Protein, vitamin B12, iron, calcium, zinc, and most other minerals require an acidic environment for proper activation and absorption.

Now antacids are not designed for long term use, because obviously in the long term we run the risk of being deficient in protein, B12, and minerals.

Some common signs of these deficiencies can be seen as brittle hair and nails, neurological problems, anemia, osteoporosis, and fatigue to name a few. Over the counter antacids neutralize stomach acid rendering it ineffective; while most typical prescription medications for heartburn and GERD like proton pump inhibitors and histamine receptor blockers work different biochemical angles to suppress the production of stomach acid.

An alternative approach to heartburn and acid reflux is to avoid irritating substances, as well as those that cause the esophageal sphincter to relax and allow acid to creep back up such as chocolate, caffeine, mint, spicy foods, orange juice, sugar, coffee, caffeine, tomatoes and acidic foods, white refined foods, fried foods, and those foods that you may be specifically sensitive to. Herbs with volatile oils such as mint make your esophageal sphincter relax, and thus acid is able to continue to creep up from your stomach and burn your esophagus resulting in “Gastroesophageal Reflux Disorder” aka GERD. Eliminating cigarette smoking and coffee are critical to recovery for anyone with an ongoing acid reflux or active peptic or duodenal ulcer.

Aside from avoiding irritating foods, and foods that relax the esophageal sphincter, its imperative that we investigate foods you may be intolerant or allergic to further with a Food Allergy Sensitivity Test. Foods that should always be avoided in acid reflux and heartburn patients are: citrus, spicy foods, acidic foods like tomatoes, and chocolate because it relaxes the esophageal sphincter causing the esophagus to have stomach acid shooting up in to it. Women with heartburn and acid reflux should also avoid drinking a lot of water before bed since stomach acid is actually lighter than water it will cause the acid to float on top of the water and mechanically cause heartburn symptoms.

Women with heartburn are often kept up all night with insomnia from the pain. Lack of sleep can result in poor concentration, decreased memory, brain fog, and even ADHD symptoms.

Stress is an important factor to deal with because it thins the mucous that protects our stomach lining. Without a healthy protective layer of mucous covering the stomach lining, HCL becomes the enemy as it erodes the tissues and results in very painful ulcers. Stress also inhibits our stomach acid production resulting in gas and indigestion. Furthermore the suppression of stomach acid typically results in a rebound effect. Stomach acid will only be suppressed for so long before the body produces more in a natural feedback loop.

The stomach senses a high pH not conducive to digestion and overshoots by producing too much HCL to lower the pH at times when we don’t even need it… like between meals and at night time. Many people under high stress all day long will experience painful night time reflux as their body finally relaxes and has time to make some stomach acid. Unfortunately this is painful and keeps us up all night. Especially when we lack a healthy layer of mucous covering the lining of our stomach.

Eliminating aggravating foods and stressors whenever possible is a great first step towards healing from ulcers and GERD. Once irritating foods have been eliminated one can add in some soothing “demulcent” herbs such as Glycyrrhiza glabra also known as good old-fashioned licorice root. Look for the chewable “DGL” chewable licorice tablets at your health food store, Enzymatic Therapy makes a great one of you can purchase in your Fullscript account. Patients with High Blood Pressure should not take licorice in any form without checking with their Naturopathic Doctor!

Chew the tablets three times daily as directed 20 minutes prior to meals. DGL means that the component that raises blood pressure in the licorice has been removed but the demulcent properties have remained intact, however I would still use this treatment with caution and monitor your blood pressure daily if you are prone to hypertension.

You can also make teas or powder pastes with Marshmallow and Slippery Elm root. Taken between meals or twenty minutes or prior, these healing herbs will calm down the irritated lining of the stomach and allow the acid to work when it is supposed to work. Aloe vera juice is also a great therapeutic agent for those not susceptible to diarrhea. However, the “latex free” form of juice can typically be consumed without incident. Drinking fresh cabbage juice is also a highly researched remedy for healing the mucosa. The amino acid l-glutamine can also be used. None of these things will work though if we do not address Food Sensitivities and triggers that are individualized with each patient.

Many women experience chronic gas and bloating which is simply the result of lack of stomach acid from use of antacids or eating too quickly before the body has time to properly build up the digestive juices. Some will resolve with HCL supplementation (please don’t take this without advisement from your naturopathic doctor.) Eating a bitter green salad or taking Swedish Bitters before a meal can also stimulate stomach acid.

Alternatively, a shot of concentrated lemon juice, or even a teaspoon of apple cider vinegar in two ounces of water can also help with stomach acid production. If you have active acid reflux or heartburn I would advise against using foods to increase stomach acid until the reflux problem is resolved, and the stomach mucosa is healthy.

To test your stomach acid production take 1/4 teaspoon of baking soda powder in a little bit of water and wait with a timer. If you do not burp from this within 2 minutes, then there is little to no stomach acid in your stomach. If you burp between 2-5 minutes then there is low stomach acid.

Generally, I am working to first improve symptoms, and then I will work to taper medications down as they are no longer needed. Never stop taking your medications without consulting your Naturopathic Doctor.

All of these things are great quick fixes but they aren’t really addressing the root cause of most digestive upset which is that we are either eating under stress, eating the wrong foods for our specific body, or we are not slowing down and taking the time to enjoy our food properly.

Make every meal an event to give your stomach time to produce sufficient stomach acid.

Make a point with your friends and family to savor the eating ritual. An average lunch in some European countries is 1-2 hours and an average dinner is 2-4 hours. That is the spirit that we need to embrace in America in order to truly make the most out of our digestion. Not eating on the run, or at our desks while doing stressful work. Stop watching the news while you eat! Just turn it off.

If you need my help finding your Heartburn Root Cause, simply pop over to my SCHEDULE page to treat yourself to a Naturopathic visit! I would be happy to help.

Dr. Nicole Sundene

(480) 837-0900

Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause,  Thyroid,  Hashimotos,  PMS, PerimenopauseAutoimmunePostpartumChronic Fatigue, DepressionAnxiety, Food Allergies,  DigestionDermatology, AcnePsoriasis Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease. She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on InstagramTwitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!

Location: 14300 N Northsight 
Blvd Ste 124
Scottsdale, AZ 85260
Ph: 480-837-0900
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