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What do you think of when you hear the mention of melatonin? Most people think insomnia. That’s because this hormone is perceived as a natural sleep aid. Melatonin is made by the brain’s pineal gland and helps regulate the sleep-wake cycle. But this hormone is also made in the digestive tract. In fact, it is 400 times more abundant in the Gi tract than the pineal gland (Antioxidants, Nov. 2022). What is it doing there? Could melatonin be helpful in easing the symptoms of heartburn or gastroesophageal reflux disease (GERD)?
Millions of Americans experience heartburn, either occasionally or on a regular basis. Most people are aware of OTC medicines to treat this uncomfortable condition. Such drugs work either to neutralize acid or suppress acid production. What if the problem has more to do the esophagus (food tube) than the stomach?
Could Melatonin Really Help Control Reflux?
Q. Twice you have said that melatonin can help control acid reflux or GERD, but you haven’t mentioned an actual dose (either with or without omeprazole). I take a Pepcid AC once a day but not omeprazole. Could you please suggest a possible dosage of melatonin?
A. In a small controlled clinical trial, researchers found that 3 mg/day of melatonin under the tongue together with a 20 mg/day dose of omeprazole seemed more effective than omeprazole alone (Turkish Journal of Gastroenterology, Dec. 2023). This dose is available without a prescription.
If you decide to try this, you may want to take the melatonin in the evening. Some people find that 3 mg of melatonin taken an hour or two before bedtime helps them sleep. You wouldn’t want that effect in the middle of the day.
Does Hormone Work Against Heartburn?
Q. Did a guest on your radio show talk about using melatonin for heartburn? I think I heard that melatonin was equally effective as a PPI for reducing acid reflux. I seem to recall that this supplement acts by tightening the sphincter between the stomach and the esophagus. Is it worth trying?
A. You recall correctly. Dr. Tieraona Low Dog mentioned that melatonin improves the mucosal barrier of the stomach and esophagus. More importantly, it also increases the muscle tone of the lower esophageal sphincter (LES) that separates the stomach from the esophagus.
This is particularly important because the LES keeps stomach acid and other irritating substances from harming the esophagus. This may in part explain how this natural compound protects the esophagus.
Another reader wonders whether melatonin plus Prilosec (omeprazole) might be better than either treatment alone:
Q. I read that melatonin might relieve acid reflux. I have been taking Prilosec for several years for GERD. Would melatonin improve the effectiveness of a drug like Prilosec?
A. A randomized controlled trial compared omeprazole plus melatonin to omeprazole plus placebo (Turkish Journal of Gastroenterology, Dec. 2023). Heartburn pain and frequency were lower among those taking melatonin with omeprazole. There were no serious adverse effects.
Additional evidence suggests that melatonin might help protect the tissues of the esophagus (International Journal of Molecular Sciences, July, 2018). Since the development of esophageal cancer is the most serious potential consequence of long-lasting GERD, such protection might be valuable.
You can learn more about GERD along with the pros and cons of Prilosec and nondrug approaches to treating heartburn using melatonin in our eGuide to Overcoming Digestive Disorders. This online resource may be found under the Health eGuides tab.
Melatonin Successful for Nighttime Reflux:
Q. You have written about a study comparing PPIs with melatonin. Apparently, melatonin was as effective as acid-suppressing drugs, with one difference: Melatonin tightens the sphincter between the stomach and the esophagus, thus reducing reflux.
I started using melatonin for my occasional reflux at night and have had excellent results. In addition, a couple of my adult children also had severe problems with reflux. They too started taking melatonin, happily seeing a great benefit.
A. A review article in the journal Nutrients (Feb. 5, 2022) concluded that melatonin looks promising in the treatment of gastroesophageal reflex disease (GERD). It appears to work just as you describe, by keeping acid in the stomach where it belongs.
If you wish, you can learn more about a variety of strategies to reduce heartburn, gas, constipation and diarrhea in our eGuide to Overcoming Digestive Disorders.
Alternatives to Treat Acid Reflux:
Q. You’ve written about melatonin maybe helping to restrict gastric juices from splashing back up into the esophagus. Can you give me a link to that article? I have an appointment with my gastroenterologist soon and I would like to discuss the information with him.
A. A recent review article characterizes the evidence on melatonin to ease GERD (gastroesophageal reflux disease) as of moderate quality (Nutrients, Feb. 5, 2022). The full text is available without a payment, so both you and your doctor can read it. Beyond melatonin, the authors cite the herbs ginger, peppermint and caraway as supported by good evidence.
There are some individual studies, including one that concluded melatonin plus certain vitamins and phytonutrients was better than omeprazole against heartburn symptoms (Journal of Pineal Research, Oct. 2006).
Pros & Cons of PPIs:
Doctors recommend proton pump inhibitors (PPIs) such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec) and pantoprazole (Protonix) for acid reflux. Although such drugs usually ease heartburn and other symptoms quite well, they can have downsides, particularly over the long term. PPIs increase the risk of pneumonia, diarrhea due to Clostridium difficile (Expert Review of Clinical Pharmacology, July, 2013), bone fractures (Annals of Epidemiology, April, 2014) and nutritional deficiencies. Kidney damage (JAMA Internal Medicine, Feb., 2016) and dementia (JAMA Neurology, April, 2016) are frightening long-term consequences that have come to light more recently. If interested, you could read more about these problems here.
Given such problems, it is little wonder that people are looking for alternatives to calm their symptoms. Could they use melatonin?
Might You Use Melatonin for Barrett’s Esophagus?
Q. As I understand it, Prilosec is useful for Barrett’s (and GERD). It helps heal irritation in the esophagus that could lead to cancer. But it seems there is no conclusive evidence that using Prilosec prevents cancer.
Today I read that melatonin does just as good a job at healing the body. Apparently, it takes about 30 days.
You can even take it with Prilosec, and that will make it easier to get off the acid suppressor. I plan to gradually reduce my dose of Prilosec by taking melatonin. I’ll use an H2 blocker or an antacid like Tums instead if I have symptoms. This seems to be working for me.
The Research Findings on Melatonin for Digestive Problems:
A. We usually think of melatonin in connection with the brain, especially for sleep. However, that is not its only function in the body.
A pilot study found that melatonin, alone or in combination with omeprazole
“is a promising therapeutic agent for the treatment of GERD. It is an effective line of treatment in relieving epigastric pain and heartburn” (BMC Gastroenterology, online Jan. 18, 2010).
For this study, patients took as little as 3 mg or as much as 6 mg of melatonin before bedtime. The results showed that combining it with omeprazole was most effective at healing esophageal injury.
In addition, a review of other studies concludes that melatonin supplements can speed ulcer healing (Current Pharmaceutical Design, vol. 20 #30, 2014). Moreover, melatonin may ease stress-induced symptoms of irritable bowel syndrome (Journal of Physiology and Pharmacology, Dec. 2011).
Learn More:
There are a number of other natural approaches to easing heartburn symptoms that may be useful for people who would like to discontinue taking a PPI or would prefer not to start taking such a drug. You can learn more about ginger, persimmon tea and deglycyrrhizinated licorice (DGL) and melatonin in our eGuide to Digestive Disorders.
Kay
Thank you for the suggestion of Melatonin in addition to an antacid. I take famotidine, and it was working well until quite recently. I added 10mg Melatonin this week, and it has made a very big difference!!
Florida K
I am one of the people who gets a melatonin “hangover” no matter how small the amount I take (I split a 5mg tablet into quarters and still get the hangover effect when taking one quarter at night). I suffer the whole next day and then have trouble sleeping the next night, so I don’t even try it anymore for occasional insomnia, mush less acid reflux.
Chuck
Musings of a NON-indoctrinated Pharmacist:
The GREATEST DIS-SERVICE a healthcare provider can do to a patient is to go straight to a PPI for GERD, without trying other alternatives first. Try simple things first: Peppermint, Melatonin and/or Pepcid. Once patients are on a PPI it is nearly impossible to get off of it. In my many years as a Pharmacist I have know only 1 patient to get off PPI’s. They said that they did not enjoy the nearly 1 year trip to get off.
Margaret
I read the original research and took melatonin for 3 months straight. I don’t remember what the recommended dose was. There was no improvement in my nighttime acid reflux. I wish it had worked, but it didn’t.
Linda
I found out by accident that melatonin works for nighttime reflux. I tried it for sleep and found no benefit. However, when I stopped taking it, my nighttime reflux returned. I experimented taking it and skipping it to see if the effect was real. It is. I use .5 milligrams at bedtime.
Kathy
I started taking melatonin a year ago when I first read about it here. Just went to my name-brand drug store & bought a bottle of 10 mg pills & take every night. I was also taking omeprazole at bedtime and famitodine (Pepcid) during the day. You would think the combo of all 3 would knock out the acid reflux. I’m trying to get off of the omeprazole for a second time & keep the famitodine & melatonin. Usually the combination of using all 3 works. However, I’ve had a few instances when I was awakened with minor reflux. I will keep trying to give up omeprazole & hope the melatonin also keeps working!!
Sharon
I took Melatonin for years because, after reading Dr Russel Reiter’s research on it, seemed like a healthy supplement. During that time I had become carnivore, and so I was blaming my diet for the uncontrollable diarrhea I experienced. Finally, after so long and having to be house bound due to the diarrhea I realized the melatonin was the culprit. A blog I found with people having the exact same issues made the light bulb come on. It is really bad for some people, and I don’t know why.
I always comment about it in case someone is suffering horribly like I was.
Terry
I see peppermint mentioned. I had found that sleeping with a Halls Menthol Cough Drop (sugar free) tucked between my cheek and gum (I am an incurable teeth grinder, so I felt all that clenching precluded any risk of choking–esp since the cough drop sort of stuck there, fused to my cheek in such a way as I had to pry the remnants out in the morning) completely alleviated/prevented any reflux. Unfortunately, it turns out that even sugar free cough drops can create an acidity problem in the mouth and my teeth started breaking, forcing me to quit…just taking a cough drop at bedtime is not enough, I needed the constant, though obviously extremely minimal, drip of menthol.
Arlene
Do you take the melatonin at bedtime?
Arie
I forgot to mention that I called a Speech therapist.
They do treat throat Gerd. I am looking forward to going there for help.
and yes, I too wish the amount of melatonin would have been suggested.
Arie
This could not come at a better time. Newley diagnosed and Dr. says I have Acid reflux. However, over the counter and I researched PPI’s lower my blood sugar. I have had many insulin reactions, day and night. I am desperate to find something safe. Oh, I read ginger, and green tea can lower blood sugar too. I need help.
I will research melatonin to see if will work for me.
thanks again!
Nancy
I want to thank you for publishing the information about how melatonin may help soothe the gut so that people can stop taking PPIs such as omeprazole. I have suffered with GERD for years and kept trying to wean myself off of omeprazole, but then would feel the familiar burn return. I tried to stay off omeprazole and manage my symptoms using licorice and antacids, which helped a little. But then I read your column about melatonin, so decided to try the lowest dose I could find, 1mg at night. The next day I noticed no difference, but the day after that and ever since, for the last 5 months, my symptoms have not returned! I take one every night, and feel great. Thank you!
MKRay
One reader commented last year that melatonin helped her migraines but caused GERD. I have found that melatonin gives me migraines, so I can’t try it for GERD. So just a heads up, especially for migraine sufferers: If you try melatonin for GERD, watch for headaches. I got migraines within a couple of days on melatonin, with no other headache triggers present (hormones, weather, allergies).
Jack
I got off of Omeprazole (thanks to the People’s Pharmacy) and started taking Melatonin. I discovered one big side effect, for me, was nighttime incontinence. I no longer need any medication, as changing my diet helped with the Barrett’s Esophagus. Still, the side effects can be a problem.
Daniel
Hi Jack.
What kind of diet did help with Barrett´s?
Thank you
Meredith
Do you know what “pill” the people took in the study that had melatonin, amino acids and vitamins? Is it available to buy? Thank you for your help!
Meg
None of us are deficient in PPIs. It’s unfortunate that our Drs don’t seem to know (or share) that reflux is usually caused by NOT ENOUGH stomach acid. Reflux is NOT a problem of having too much acid. And there are things one can do to increase stomach acid. Sufficient stomach acid is what triggers the lower esophogeal sphincter to close so that acid/food contents do not wash back up. It also helps break our food down so that we can absorb nutrients, and if that’s not happening on a regular basis, we can become deficient in the very nutrients needed to keep processes working right. And taking PPIs and other acid- suppressing drugs also change the gut biome, and not in a good way. Bacterial imbalances can occur as a result causing further gut dysfunction. I’ve used HCL to increase my acid levels, and my reflux is better! I don’t tolerate melatonin well, or I would have tried that.
Charlotte
Prilosec, Pepsid, Nexium, etc. all can cause and worsen tinnitus. I would rather deal with anything rather than have my ears screaming with noise 24/7.
Sam
Look at the data with concomitant therapy with both melatonin and a PPI for GERD. It maybe more effective than single therapy as it affects both the LES and stomach PH.
CW
(I’d like to add this to the comment I submitted earlier today): I know not to experiment with a valid prescription, but my gastroenterologist believes totally in the safety and efficacy of my PPI, and it would be advantageous for me to make informed points in discussing alternatives.
CW
I was disappointed to discover that the article lacks the following details promised in the “How To” title: I found no details on “HOW to use melatonin,” no recommendations as to dosage, timing, or procedure for reducing or gradually stopping PPIs. I’m currently taking 20 mg of omeprazole daily for Barrett’s esophagus.
Peggy
I was on PPIs years ago and tried going off but had rebound effect. Someone told me to try Pepcid, as you don’t have any bad symptoms with it, just good results for no more GERD, heartburn. I have been taking one 20mg Pepcid daily for years now and no worry of dementia or other health issues caused from PPIs.
Sharon
Find any and all of Russel J Reiter PH.D MD videos. He’s been studying Melatonin longer than most people have been alive.
John
Be aware that licorice can raise blood pressure, so if one is subject to elevated levels of blood pressure, be sure to monitor it closely if using licorice. Licorice has a long and excellent track record in conjunction with gastrointestinal issues.
Ann
Interesting. I took melatonin for migraines at the urging of my neurologist. It did decrease the frequency of migraines and, as a bonus, helped me get to sleep. However, I found that melatonin caused horrible acid reflux. After stopping the melatonin, my acid reflux symptoms have disappeared.
Brenda
I am taking omeprazole daily but want to gradually decrease the amount. I have been taking 3 mg or 1 1/2 mg at night of melatonin. I will increase that to 6 mg. Do you know what “pill” the people took in the study that had melatonin and herbs? Is it available to buy? Thank you for your help!
Carmen S.
QLD
I have GERD so severe that I experience a burning in the back of my mouth and chronic breathlessness. I am so depressed, as I can’t breathe or even talk at times, and my throat feels like it’s on fire. I am on Omeprozole, and I must have taken 3, 10 mg gelatin tablets. I hope it will work. I am at my wits’ end.
Harmlessoldlady
Georgia
I have been taking PPIs for decades, and I have tried to get off them, but the rebound reflux was so horrible, I quit. Also, I started taking prescription Nexium before it it was OTC, because I have GERD! I mean I had severe recurrent heartburn, so I needed to take something. And the PPI have worked for that for all these years. sorta. My journey follows:
I switched from prescription Nexium which my insurance company made difficult to obtain, to ordering a kind of generic aciphex online (rabeprazole). When the supplier turned out to be in China, I didn’t think I could trust it. So then I went to the drug store and bought OTC generic lansoprazole. I take 40 mgs lansoprazole daily. And sometimes that’s not enough, and I supplement with Gaviscon tabs.
A year or so ago, however, I finally began to have the vitamin B shortage and developed sores in the corners of my mouth. So I started taking vitamin B, and that fixed it. Yet, I read People’s Pharmacy and what you say makes sense, so I think I would like to get off this PPI.
I have bought the guide to digestive health, and read this thread, and I have just bought a ton of the recommended helps including generic famotidine, culturelle, ginger root caps, turmeric caps, and my old friend acidophilus. I had to go online to order the melatonin, DGL (deglycerized licorice tabs), aloe vera gel and apple cider vinegar caps. What I am having trouble understanding is whether to take all this stuff every day? or to choose just one or two of them? as I try to reduce the 40 mgs of lansoprazole I have been taking daily.
I think the ginger, turmeric, culturelle, acidophilus, licorice, aloe and vinegar are probably harmless. I won’t take the generic pepcid (famotidine) unless I have heartburn. But I must say I am worried about all this, and not looking forward to that rebound reflux.
Assunta
Riverside, CA
I tried to get info from the NIH on this, and sadly there is nothing I could find. I sure wish the authorities would comment. There are some great articles, well referenced in the latest (February Issue) of LIFE EXTENSION MAGAZINE, the theme of which is GERD this month – Check it out. I am particularly interested in their mention of raft alginates, which are basically herbs in a chewable form that expand and float on the top of the gastric contents, effectively forming a barrier which prevents the gastric acidic contents from splashing up into the esophagus. This works WITHOUT decreasing the stomach acid at all, which BELONGS in the STOMACH where it is intended to do a very important job in proper digestion so nutrients can be absorbed!
Debra
North Carolina
In reply to dosages. References were provided so that you could read scientific studies regarding them. Here is a quote: “patients suffering from GERD; receiving melatonin alone for treatment of GERD in a dose of 3 mg once daily at the bedtime [10]. Group III included nine patients suffering from GERD, receiving omeprazole alone for treatment of GERD in a dose of 20 mg twice daily [11]. Group IV included nine patients suffering from GERD receiving omeprazole and melatonin for treatment of GERD in the same dose of each of them.”
It is from an interesting article.
Fran
This entry has an aspirational title. What you’ll find out if you follow the research listed – and further googling – is that you might take up to 6 mg of melatonin before bedtime or split the dose and take half with a meal earlier in the day.
My husband has taken 3 mg of melatonin at bedtime for about four years now for its anti-cancer benefits and unless he sticks to a very low-carb diet still has reflux. He’ll now try 6 mg for several months to see if it makes a difference. I’m upping my dose as well because melatonin seems to have a beneficial effect on the gut lining – I have atrophic gastritis and none of the doctors I’ve seen has suggested any help for that.
Connie
Fayetteville,NC
Will taking Melatonin work for getting off Dexilant also? I am taking a 60 MG daily. Thank you.
Terry Graedon
We don’t know for sure, but it is worth trying along with a gradual reduction in dose.
Nancy
Flat rock,nc
Since it is widly known as a sleep aid, how much and when should it be taken with an antacid?
Gale
Beaufort, SC
As you reviewed the recent literature, any evidence melatonin can ease silent reflux (a trigger of nighttime wheezing)?
Jochan
Battling breast cancer, I found a naturopath who specializes in cancer treatment & he has, among a few other immune boosters. Recommended high dose Melatonin. The Naturopathic college here agreed with that as I checked. Interesting??
HelenM
Modesto
I am going to send this to a friend who has expressed concern about the nexium she is taking and its ability to block absorption of certain nutrients she takes for her hypoparathyroidism.
Thank you. Again. The work you do is very valuable; I am glad you keep archives which can be rerun and pick up new, helpful, comments and suggestions.
Debbie
Henderson, NV
I’m just assuming that the melatonin needs to be taken at night before bed ? Is there a recommendation on the dosage needed ? I’d love to be able to discontinue my heartburn medication. Thanks.
Terry Graedon
I hunted for a study that specified the dose and finally found it: BMC Gastroenterology, online Jan. 18, 2010. Here’s the quote:
“We used an oral fast release melatonin at a dose of 3 mg/day for 4 and 8 weeks. Werbach [24] found that melatonin up to 6 mg at bedtime may be an effective treatment for GERD with fewer and less serious adverse effects.” In the context, that is less serious adverse effects than PPIs.
Dorothy
Georgia
On a major TV station in the Atlanta area on May 2, 2016, there was a segment about PPI’s. The same information that has been stated on People’s Pharmacy for a while now, was repeated, and later followed by one of those lawyers’ commercials looking for consumers to join a class-action suit concerning PPI users. Looks like this is more serious that first suggested. I am trying to withdraw from my Zantac generic, even though it is not one of the worst ones.
Gates
TX
Could we have more specific information on the amount of melatonin to take for gerd? It is assumed the dosage would be taken before retiring for the evening.
JE
NC
If one decides to use melatonin for acid reflux, what would be the suggested dosage and frequency? When is the best time to take it? What about papaya / papain? My doctor wanted to prescribe PPIs for me a few years ago. Instead I decided to chew 2 or 3 papaya tablets. This always brings relief whenever I have occasional indigestion or upset stomach. The papaya also alleviated the burning sensation in my esophagus & stomach following a week of antibiotics.
Jo
North Carolina
Recommended melatonin dosage, please.
Lynn
Illinois
What dosage of Melatonin would you use and when would you take it?
MJ
US
More information about the amount of melatonin, dosing time – bedtime I’d imagine given its sleep-inducing properties – would be helpful.
Also, do tart cherries – which have some relationship to melatonin – and products made from them work too? Such products are gaining popularity with athletes for anti-inflammatory and muscle recovery properties.
Larry
IN
What dose of Melatonin to take to get off ppi’s ?
Melanie
FL
Please note the FDA website has a 5 page paper warning about Magnesium loss, which will lead to Potassium loss. I only learned of these life-threatening side effects when I got out of the hospital, where I had been on Iv minerals for 3 weeks, because of my occasional use of proton – pump inhibitors! I now have to take prescription Potassium along with 3 tablets of sustained-release Magnesium for 5 years, & get my levels checked quarterly. Beware of Proton Pump Inhibitors! They almost killed me!
annie
NZ
I have been taking Solux (Lansoprazole) for 4-5yrs for at times severe GERD. For many months at various times I was taking it twice a day to control symptoms. Other times I could cut down to 1 a day. I had tried several times over the years to come off it but the reflux was so bad I had to restart the Solux.
I have been reading your posts about PPI’s for a few months now and was concerned at the mounting number of side effects I was becoming aware of. I was determined to have another go at coming off Solux. I am pleased to say I have been Solux free for 3 weeks now. It has been difficult and painful and I am still struggling at times but am succeeding.
I have taken quite a lot of Gaviscon both liquid and chewable tablets and I have increased my water intake which seems to be working. Thanks for the continuing information.