Heartburn and Statins – Do Statins Cause Acid Reflux?

There has been a lot of talk suggesting that statins (the popular class of cholesterol-lowering drugs) can be a cause of heartburn. It is listed on numerous websites as having the side effect of heartburn and this connection is also mentioned in several popular books on acid reflux. However, is there any evidence of this? Let’s find out!

Statins – What Are They?

The term statins simply refers to the class of medications that have become very popular around the world for their ability to reduce LDL cholesterol and inflammation in the body. The most popular statins include the brands Lipitor, Zycor, and Crestor (among others). Given the ubiquity of obesity, statins are among the most prescribed medications in the United States.

Statins and Heartburn – The Research

Despite the fact that statins are linked with heartburn anecdotally as well as listed on multiple third-party websites, the official NIH (National Institute of Health) page as well as the official site for Lipitor make no mention of acid reflux being a recognized side effect of statins. Now, this does not mean they aren’t recognized – it just is not documented.

I will say that of the listed side effects, other digestive issues such as upset stomach, constipation, or diarrhea are recognized as side effects of most statins (note that there are slight differences among each type of statin – but this is beyond the scope of this article). Additionally, unusual muscle function (cramping, involuntary contractions, fatigue) are also reported.

With that in mind, given that heartburn can be caused by irregular motility of the digestive tract, and that the usage of statins seems to cause irregular muscle activity, it would stand to reason that stains may indeed have acid reflux as a side effect.

Statins and Acid Reflux – What to Do

However, just because statins may have lead to heartburn does not mean that you should disregard your doctor’s advice if he (or she) prescribes them. Now, understand that I have very negative feelings about the chronic usage of prescription medication, but the facts are the facts: statins save lives.

Statins do not just make you more comfortable; there are dozens of very large studies which have reported that statins reduce not only cholesterol but also all-cause mortality (1, 2). There are many other studies that report the same thing: people who take statins just live longer.

The results surrounding statins are so good that some doctors have been even issuing them to those with low-risk for developing cardiac disease to help prevent cardiac disease from developing. It has become so wide spread that a recent Cochrane Review stated that while statins were beneficial, they did not recommend issuing them for low-risk patients (2).

The point is this – yes, statins may have side effects, but if you are a moderate or high-risk individual, they can save your life and help you live a lot longer. In regards to the development of acid reflux – you can talk to your doctor if you develop side effects, but personally I’d rather be alive with acid reflux than die prematurely without it. Interestingly though, a recent study reported that the use of statins was actually reported to reduce the risk of developing esophageal adenocarinoma (esophageal cancer) in those with Barrett’s Esophagus (a condition present in some with esophageal damage, particularly due to GERD) (3). Perhaps due to the anti-inflammatory properties of statins they can even reduce the damage done by acid reflux and be protective rather than destructive.

There are two important takeaways that you should get from this article. The first is that although statins may or may not cause heartburn, they do save lives and have been repeatedly shown to reduce all-cause mortality. The other thing to remember is that those who need cholesterol-lowering drugs and those who have acid reflux have a few common factors: obesity, smoking, and a poor diet.

Perhaps if you are on statin medications and are developing acid reflux, this may serve as a bit of a wake-up call. If you need to lose weight, quit smoking, or start following a smart acid reflux diet, those are things should be at the top of your priority list so that you can live a healthier and more satisfying life.

As always, everyone responds to medication differently. The decision to start or stop a medication should always be done under a doctor’s supervision. Statins do have some dangerous side effects, particularly related to liver and kidney dysfunction. Talk to your doctor about your medication if you have any concerns or side effects.

References

1. Baigent C., et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010 Nov 13;376(9753):1670-81.

2. Taylor F., et al. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2011 Jan 19;(1):CD004816.

3. Nguyen DM, Richardson P, El-Serag HB. Medications (NSAIDs, statins, proton pump inhibitors) and the risk of esophageal adenocarcinoma in patients with Barrett’s esophagus. Gastroenterology. 2010 Jun;138(7):2260-6.

A Simple Fix for Heartburn Every Morning

One of the more rare ways acid reflux can manifest itself is via heartburn in the morning. While most people suffer from heartburn in the evening or at night, some people get heartburn every morning. This could be the cause of nighttime heartburn that does not wake the afflicted individual up, but also some people just have an upset stomach in the morning.

For those people who tend to have an upset stomach and heartburn upon waking and for the early morning hours, I have a simple fix for you: have a protein shake for breakfast.

Having a protein shake in the morning (with nothing else) first thing after waking is a great way to help reduce acid reflux. In particular, protein actually helps increase the Lower Esophageal Sphincter (the thing that seals off the stomach from the esophagus). Note: no reference to support this, but there is evidence out there – I had read through the entire study which had demonstrated that LES pressure increased on average by 8 mm Hg after eating protein in the test subjects, but it seems I deleted the .pdf file and cannot find it!

The routine is simple: take 20-50g of protein in a shake, right after waking. The amount used depends on body weight; if you weigh 100 pounds (45 kg), use 20 grams; if you weigh 200 pounds or more (90 kg or more), use 50 grams; everyone else can be somewhere in the middle.

Give yourself 20 minutes or so to let your stomach settle down before drinking any coffee or any more water. Do not drink any extra water with your morning protein until your acid reflux has calmed down. The reason for this is that extra water dilutes stomach acid and enzymes and makes it much harder to digest the protein. Use as little as water as necessary, and only drink water or coffee in the morning after your reflux has subsided.

Protein’s effect on the digestive system can be very positive, but you want to be sure to choose the right type. A lot of people think that protein powders can lead to an upset stomach, but that is simply because they chose the wrong powder type.

The best powder you can get is pure whey protein, filtered or processed as finely as possible. At a bare minimum, you will want a protein which has “whey isolate” written on the ingredients label. When you look at the nutrition facts, you want to find one that has no carbs, and if possible no fat as well. I prefer VPX’s Zero Carb SRO brand for this purpose (I have no affiliation with this company – it is just a great product for morning use if you wake up with reflux).

The reason you want this type of protein is because it is very easily tolerated and it mixes extremely well with even small amounts of water. You can easily mix 20g of this high-quality protein with just 4-5 ounces of water. Cheap protein might require 2-3x as much water to mix, and as such will not be nearly as beneficial as water.

Cheaper milk proteins (whey is a component of milk protein) will also contain lactose, dairy fat, and casein, all of which are things you want to completely avoid if you have acid reflux. You have to order higher quality proteins like this online unless you want to pay an arm and a leg, because they tend to be very expensive in supplement stores and are simply not available at big retailers.

As far as soy proteins go, most soy proteins are extremely cheap and I do not recommend them for anyone. If you are a vegan, be sure to avoid “soy protein concentrate” like the plague. Soy protein concentrate is extremely cheap, but is laden in chemicals that you do not want, particularly plant isoflavones (an estrogen-mimicking plant chemical) and even hexane (a neurotoxin used in processing of soy). Soy isolate tends to have most of these byproducts removed. Ideally if you insist on using soy, you want to only use organic soy isolate; anything else has too many impurities and potentially toxic chemical byproducts.

Having a protein shake for breakfast is a great way to eliminate heartburn in the morning. Just remember that the best quality proteins make the best heartburn home remedies; stick to whey isolate (or better) or organic soy isolate for best results. A a general rule of thumb, the lower the carbohydrate and fat totals a protein has, the higher quality it is.

My Top 4 Heartburn Remedies

In this article below, I will be revealing my top 4 heartburn remedies. These are things I have used time and time again and I have found that they really work!

A little backstory: I recently came down with a really bad case of the flu, complete with vomiting and just about every digestive problem you can imagine. Ever since then, I have had to deal with heartburn all the time. I have become a bit of a guru on heartburn remedies since then as otherwise I would be in pain all the time!

Top Heartburn Remedy: Gum

I would say out of all the heartburn remedies I have tried, my favorite is chewing gum. It is just so easy to do and you can do it anywhere, which is great for me as I am always on the go. After all, some of the other remedies can require a time commitment, or just aren’t easy for travel. Popping a stick of gum in after a meal is so easy and so effective. Nowadays every time I eat I make sure chew on some gum, and since doing this I have virtually no heartburn. I do have to be careful though as I do not want to injure my jaw from all the chewing!

#2: Walking

Whenever I have the chance (usually after dinner or lunch) I try to take a walk. This combats heartburn on multiple levels. First off, walking helps increase digestive motility, which is just a fancy way of saying it increases the rate at which the stomach and intestines move food along. This is great because food hanging out for too long in the stomach is one of the main reasons people get heartburn.

It also is a great way to lose some extra weight, and being overweight is a strong risk factor for getting heartburn.

#3 – New Toothpaste

Without fail, I had the uncanny ability to get heartburn right before going to bed. I knew laying down made heartburn often get worse, but this often started while I was still sitting up for no apparent reason. I finally figured it out: I was getting heartburn within 5-10 minutes of brushing my teeth!

It turns out that certain ingredients in toothpaste can act as a trigger for heartburn. I switched to one of those granola “natural” toothpastes, and while they feel a little gritty when you are brushing with them, it has certainly reduced my heartburn.

#4 – Mustard

I found out that mustard contains vinegar, and that vinegar is a great home heartburn remedy. Apparently vinegar stimulates the production of saliva, and saliva is great for combating heartburn. What I like to do is cook with mustard; I use it in many meat sauces and marinades and it works great. When I combine this with chewing gum and going for a walk, I can have a really tasty dinner without reeling in pain all night.

Try some of these heartburn remedies out, you won’t be disappointed!

 

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