Reflux Treatment Trap: Is Your Cure Making You Sicker?

Diagnosed with Reflux? Imagine following your doctor’s orders to the letter, taking your prescribed medications religiously, and adhering to a strict diet—only to find yourself feeling worse than when you started. For many reflux sufferers, this isn’t just a hypothetical scenario; it’s a frustrating reality. The very treatments meant to provide relief can cause many new problems, from nutritional deficiencies to anxiety and beyond.

In this deep dive into the world of one chronic reflux suffer (me), we’ll explore the hidden dangers behind common treatments and the potential long-term consequences that your doctor almost definitely never mentioned. Through my personal journey—a three-year rollercoaster filled with triumphs, setbacks, and unexpected twists—I try to share:

• Why standard reflux treatments can be a double-edged sword
• The surprising connections between reflux, nutrition, and overall health
• How well-intentioned medical advice could be hindering your recovery
• Strategies for potentially breaking free from the reflux treatment trap, especially for those early in your reflux treatment (it gets harder the longer you stay on a limited diet + any of the medications, but I still say never give up).

Whether you’re newly diagnosed or a long-time reflux sufferer, my goal is to arm you with the knowledge to take control of your health and ask the right questions. Because when it comes to reflux, what you don’t know really can hurt you.

So get ready—it’s time to challenge everything you thought you knew about reflux treatment.

My Reflux Backstory

I developed mild reflux after a totally random infection busted my eardrum, eventually requiring ear surgery in 2019. My post-surgical reflux was so mild that I barely mentioned it to my doctor (and I had no idea that I was experiencing reflux).

The next year, immediately after both (1) covid (I think), and (2) hitting my head & neck on a run in December of 2021, my reflux rapidly became far worse.

I had zero symptoms of reflux (or anxiety, as would later become relevant) before those three events occurred.

I had an extremely active & healthy lifestyle before this all happened, and still do. All docs agree that nerve damage caused my reflux. “Regular” reflux (not caused by nerve damage) should heal within 3 weeks to 3 months of following the generally recommended MD plan, according to the two expert reflux MDs I consulted.

Nerve damage related reflux can take longer, or even last forever. But the MD consensus was that my nerve damage would, most likely & eventually “shake itself out.”

As far as their nerve damage diagnosis, as I continued not healing one year after I started the MD reflux protocols (although I did not comply perfectly, I was pretty good), I started to wonder whether I had a B12 deficiency that was causing the nerve damage, rather than the surgery + covid as they had both assumed.  I developed this suspicion after reading an article about a woman who’s long covid was healed after she treated her iron and B12 deficiencies.

Then I read a few books and many studies about B12 and iron deficiencies.  I had been struggling with low ferritin for a few years before this all started, I knew.  And I was mostly a plant-based eater and distance runner.  Those are generally risk factors for developing these deficiencies. (And there were other reasons I had an iron deficiency, including that running in the heat in Florida reduces your iron stores, plus I had been having very heavy periods.)

If I was correct about the B12 deficiency, the surgery could still have indirectly caused the nerve damage (and therefore the timing would still make sense), because surgery deactivates low B12 stores. This is a known phenomenon. I learned from the B12 books that those who have low B12 in their diets should have their B12 levels checked before and after surgery. And B12 deficiencies can cause reflux.

(When you think about it, WHY else would ear surgery cause vagal nerve damage??  I guess from the intubation. But the B12, in my view, makes a lot more sense, because a B12 deficiency is known to cause nerve damage, and surgery on someone with low B12 (which I had) would have made the deficiency much worse, and low B12 can cause reflux.)

Since I had been about a 95% plant-based eater for many years, I would have been at high risk for having a B12 deficiency, even before the surgery. Unfortunately, I didn’t have my B12 levels checked before I started supplementing, pretty much the minute after I suspected I might have a deficiency and learned how bad that could become. However, because I didn’t test myself before I started supplementing, the only way to know whether B12 was the culprit was “treating to test,” then gauging before & after symptoms.

(In my view, my B12 theory was confirmed a couple of months ago, when I decided to stop my injections.  Within a couple of weeks, all my B12 deficiency symptoms returned, including much worse reflux. So, I had to start back the injections, which caused all my symptoms to quickly improve again, just not as much as I need to fully heal my reflux.)

That’s all a very long story, but hopefully gives you a beginning glimpse of what caused my reflux.

Here’s the other complicated thing about reflux caused by nerve damage. Those of us with nerve damage induced reflux still must follow ALL the correct reflux protocols for “normal” reflux, in addition to treating whatever caused the nerve damage. The reason is that, once reflux develops, the valve is damaged, and that lets reflux keep coming up the esophagus, regardless of whether the nerves are healed, or not.  And a damaged valve causes reflux, regardless of whether the nerve is healed. So, you must address both issues on an ongoing basis – the nerve damage, plus the regular ‘ole reflux symptoms.

My Current Reflux Status

My current predicament is a lot more difficult than I faced at the beginning.  (Hopefully you are at the beginning of your reflux challenges, so that you can avoid the progression of the illness & its whole-body effects.)

The reason the beginning is ideal, for getting better, is because, as my time on this horrible diet + medication marched forward, despite my extremely healthy diet and lifestyle, I developed a series of more serious medical issues: (1) significant immunity problems; (2) something that seemed to resemble chronic fatigue last year (thankfully those extremely concerning symptoms stopped, but they always followed viral illnesses, which I have avoided this year by living in isolation, plus I have tried adding a little more iron to my diet, and cut back on Pepcid for most of the year); and (3) severe anxiety.  I believe those were all the inevitable long-term consequences of an extremely restrictive diet + further impairing nutrient absorption via long-term antacid use.

Can Anxiety Cause Reflux?

Here’s the fun part.  Anxiety can cause reflux.  So, what caused the anxiety?  I never had anxiety before my medical issues developed.

My current belief is that either Pepcid or the nutritional deficiencies, particularly low iron (caused by Pepcid + the diet) are causing my now severe anxiety symptoms.  And those symptoms are preventing me from healing quickly, as I had done much more easily in the beginning (before all my setbacks).

This has become extremely serious for me because now, when I take Pepcid, it usually works during the day, but causes literal sweating, shaking, and then gasping, as I fall asleep at night. That gasping causes reflux to come up my throat, which offsets whatever progress I made that same day following the normal MD reflux protocol like a champ.  However, at least reflux doesn’t continue coming up all night.

However, if I don’t take the Pepcid, then I have a milder (i.e., non-gasping) but more persistent reflux coming up, throughout the night, which gets worse night after night (and the pain becomes unbearable).

In other words, I need the Pepcid, but the Pepcid side effects are making complete healing impossible. The second scenario (non-gasping but persistent overnight reflux) is more painful than the first, which is why I continue taking Pepcid. But both predicaments make complete healing impossible.

Can Long-Term Pepcid Use Cause Anxiety, Which Then Causes Severe Reflux?

I noticed that Pepcid affected my mood probably a year after I started taking it. But this “gasping” effect only started a couple of months ago – as my anxiety has worsened. I know that Pepcid is causing some degree of anxiety because:

1. As soon as I take Pepcid now, these severe anxiety symptoms start within minutes.
2. Whenever I’ve stopped Pepcid in the past (through successful tapering), what in the early days of my Pepcid-induced anxiety used to be mild tremors in my legs, and a general uneasy feeling, would stop very quickly the few times I was able to taper & stop Pepcid.
3. Also, after I stopped Pepcid, I would go back to normal as far as my moods. There was a night and day effect on my mental state. I told my husband that it was like the clouds parted, and I could see the sun again, every time I stopped Pepcid.

So, I am very confident that Pepcid has caused anxiety and some level of depression in me.

Can Reflux Cause Anxiety?

The other complicated factor is that reflux can cause anxiety, because of the pain. And Pepcid can lose its effectiveness over time. So, the other possibility is that Pepcid isn’t working as well, and the untreated, significant and chronic pain is worsening my pre-existing Pepcid-induced anxiety. I still know that Pepcid is causing anxiety (because I have milder anxiety even if when I have less frequent pain & gasping) – but maybe the severity of the anxiety has worsened because Pepcid has lost some of its effectiveness, and the frequency & duration of my pain has increased?  Who knows.

Can A B12 Deficiency Cause Either Anxiety or Reflux?

Yet another possibility is I have nerve damage from the B12 deficiency.  Nerve damage caused by B12 deficiencies normally improves with supplementation, but only about 50% of people fully recover from B12 induced nerve damage.  (However, since my reflux has healed since I started B12 supplementation, only to be followed by setbacks, I continue to hope and believe that I’m in the lucky 50% group.) But B12 deficiencies are known causes for both anxiety and reflux.

Can Low Ferritin Cause Anxiety or Reflux?

And yet another possibility is my chronic low ferritin is causing anxiety, and reflux.  Low ferritin can cause reflux, constipation, IBS, tissue failure to heal, and anxiety. The hematologist I visited a couple of years ago said that low ferritin could be causing my symptoms and recommended an iron infusion.

I’m just praying that I can maximize healing in all other ways, and somehow overcome whatever the low ferritin is causing.  My attitude that I must rely on “hopes and prayers,” regarding my low iron status, developed after many months of trying iron supplements (last year), which only caused more and more reflux setbacks (because the iron supplements, in the going down process, ALL make reflux much worse).

To explain further, my ferritin levels are very low, which could potentially be causing or worsening my reflux (not to mention other health issues). But when I try to take iron supplements, they make my reflux much worse – not because of the iron itself, but because the supplements physically irritate my esophagus as they go down. It’s like being stuck between a rock and a hard place. I need the iron, but I can’t handle the most common ways of getting it into my body.

Iron infusions are an option, but I’m hesitant because iron infusions can cause oxidative stress and, in some cases, reflux related to that oxidative stress (again, not because of the iron value, but because essentially artificial iron can damage the body, short and long-term). So here I am, knowing that low iron could be part of the problem, but unable to safely supplement it. It’s just one more piece of this frustrating reflux puzzle that I’m trying to solve. And believe me, I’ve explored every option out there with my doctors and top-notch nutritionists. Sometimes, it feels like my body is playing a cruel joke on me – “Oh, you need iron? Here’s some extra reflux to go with that!”

My solution, beyond hopes and prayers, has been to add one tablespoon of pea protein powder (link goes to Amazon) to my morning smoothie. This has a little iron and is well tolerated as far as reflux (nutritionist recommended this type & brand, but one reflux doc said that all protein powders are acidic – the mix that I take is not, I’ve tested it), and I’ve added sprouted quinoa (link to Amazon) + sprouted black beans (link to Amazon) or sprouted lentils (link to Amazon) to my few bites of dinner.  The sprouted versions help with my digestion, which has been chronically hampered by these meds (lentils are easier than black beans if that’s a real issue but combining both works well and adds more plant variety, which helps your microbiome). All these foods were recommended by my nutritionist to add a tiny bit more iron than I was getting before, all in tolerable forms.

Unfortunately, my diet still has way too little iron for a distance runner, especially when you consider that I’m still taking Pepcid, which interferes especially with iron & B12 absorption. But it’s more than I was getting before.  And I think it’s the best that I can safely do right now.

Are There Any Other Concerns?

Don’t even get me started on my serious concerns about my teeth (where major damage has already occurred and is continuing), my bones due to very little calcium intake + my age + Pepcid (this is a long-term but real concern), and my gut microbiome, from all of these medications.  I cannot tolerate any form of calcium supplementation because, together with the meds, I get totally constipated. I do add this delicious and raw / pure almond butter (link to Amazon) to my breakfast and lunch, and that’s the best I can do, for now, regarding calcium.

Is My Case Unique or Could This Happen to You?

Now, I know all of this sounds like a complicated mess, and trust me, living it feels even worse. But I strongly believe that my case is not unique, especially for those of us stuck in the long-term Pepcid-plus-restrictive-diet loop. Sure, my most plant-based diet and running might have sped things up. But the truth is that anyone on this regimen long enough is playing nutritional Russian roulette. Think about it: you’re popping pills that mess with your nutrient absorption, while simultaneously cutting almost all nutrient-rich foods. It’s like trying to fill a bucket with a hole in the bottom – you’re always going to be running a deficit. And that’s where the real fun begins. These nutritional shortfalls can make your reflux worse, or spark a whole new health issue, which – you guessed it – might require even more dietary restrictions or medications. It’s a downward spiral that’s hard to escape. The frustrating part? Traditional treatments often don’t address this potential root cause. Surgery is an option. But the outcomes aren’t guaranteed, and those all come with serious risks. Iron infusions could help, but they’re not without potential serious side effects. So here I am, taking every missing supplement (besides iron), watching my formerly exceptional health very slowly spiral downward – one step forward, two steps back. It’s enough to make you want to scream into your low-acid, lukewarm, caffeine-free beverage of choice.

Reflux Expert MDs Are Missing an Important Piece Of The Reflux Puzzle

One of my MAJOR annoyances throughout this ordeal is that Pepcid + an extremely restrictive diet absolutely can cause or worsen B12, iron and other deficiencies. Many of those can either cause reflux, cause anxiety, cause constipation (which causes reflux), cause IBS (which causes reflux), prevent tissue healing, or all the above. So, the fact that the leading MD reflux experts do not recommend IMMEDIATE testing for these deficiencies (or at least inquire about lifestyle and diet, to learn whether those might be worth exploring), and rely instead on rushed and/or scripted office visits, followed by standard recommended medications and diets that can only make any potential deficiency induced conditions worse, is a major source of ongoing mental irritation for me.

Incidentally, the expert reflux MDs both say that constipation does not cause reflux. Dr. Bulsiewicz, a leading board-certified gastroenterologist, NY Times best selling author, and the instructor of the 6 week gut health course, which I took a couple of years ago, says that treating constipation will often resolve reflux. He told me that he has seen people heal from reflux “many times” after treating their constipation. There are also several studies linking the two conditions (and one showing that treating constipation in children resolved reflux).  I’m not sure why the reflux docs were adamant that the two conditions are not connected. But in my personal experience, whenever I’ve been constipated from these meds or diet or both, my reflux is worse.

Also, as far as constipation, Dr. B also said that many people have constipation without knowing it.  If you have bloating, then there is a good chance that you also have constipation (according to him). (And I went through a whole lot of research down the “do I have SIBO?” road – which I didn’t believe for a few reasons: (1) many good doctors say this isn’t something to be treated with antibiotics; (2) this is a cash cow for alternative med practitioners and you will likely never escape from their grasp – just treat any constipation and reflux).

Now there can be other causes of bloating, reflux, and / or constipation. So you absolutely must check with your doctor. Do not rely on someone who is not a doctor on the Internet to tell you what condition you have. But Dr. B also said that most people who are bloated are actually constipated, many people do not know they are constipated, and, to learn whether you are constipated, you need imaging, plus instructions to the radiologist to “rule out constipation.”  I had two MRIs with those instructions about a year apart – both showed moderate constipation, even though I have regular bowel movements every day.  And only slight bloating at this point (the bloating was severe when I first started all of these protocols – I’ve learned to not take more than I can handle without causing worse bloating).

Bottom line, it is very important that you make sure your food is moving through your body.

Also, which theory as to what is causing my reflux doesn’t matter, in my view.  Either way, I have reflux, and I must try treating everything to heal.

Can Reflux Cause More Reflux?

You must stop reflux to heal reflux.  The reason, as the reflux doctor explained, is that “reflux creates more reflux,” because of the damaged valve, which continues allowing reflux to enter the esophagus, where it doesn’t belong, and continues damaging the value that needs to be closed for true healing. So, if you have nerve damage, and you manage to heal the nerve damage, you’re still screwed unless you also heal the now damaged valve, which is not easy to do once the damage is established, whatever the cause.  It’s just that simple.

So, What Now?

Despite these many challenges, I’m doubling and tripling down on everything that used to help my reflux, and experimenting with minor modifications daily in my “never give up” effort to finally heal from reflux.

For those reasons, I’m still:

1. Taking Pepcid plus Reflux Gourmet, in varying amounts, every day.
2. Eating the same foods (no more experiments, most of which, in the past, have failed & worsened reflux), which means I’m eating an extremely limited, low-acid, low saturated fat diet.
3. Eating smaller meals, especially dinner (my dinner is exactly 5 spoons full).
4. Eating a very early (5 p.m.) dinner.
5. Sleeping almost completely upright.
6. Never laying flat, even for sex (which I’ve almost completely stopped having because of reflux, more on that later).
7. Avoiding social outings because of the immunity problems that I believe the nutritional issues have caused, and because my reflux becomes uncontrollable if I get sick (and, again I believe because of nutritional issues, I can’t recover from illness for months, despite what should be strong health).
8. Injecting 5 mg of B12 every other day, with hopes that I will be able to stop the injections, if I can ever stop taking Pepcid and eat normal foods again.
9. Taking a list of supplements to offset the other nutritional deficiencies caused by this entire situation.
10. Living in a chronic state of low ferritin, as a distance runner, because I cannot tolerate any iron supplements, and I’m not willing to take even more medical risks with iron infusions.

I know, those things aren’t good.  But here we are.

Major Setbacks That Prevented My Reflux from Healing

Things that have caused major reflux setbacks over the last three years, which all put me right back at square one (or worse):

1. Not following the strictest version of the diet from day one (in the beginning, I was combining the diets from two books – one of which wasn’t strict enough for me).
2. Constipation caused by too much medication and foods that were too hard to digest.
3. Eating portion sizes that were just slightly too large.
4. Eating dinner just a little too late.
5. Eating unpermitted food too soon after tapering.
6. Trying and failing with various supplements that were supposed to help reflux and/or the nutritional deficiencies that this diet + medication have caused.
7. Doctor prescribed medications that caused bad reflux (in one case, last year, this effect lasted for 9 months before I realized prescribed hormones were causing reflux and preventing healing despite strict adherence to everything else).
8. Trying foods suggested by supposedly gastro trained nutritionists.
9. Eating foods or recipes suggested in leading reflux books and Facebook communities (which I can’t recommend you try).
10. Just a few months ago, an extended vacation at elevation in pColorado (not recommended for anyone with reflux), and
11. Numerous viral illnesses, pretty much one after the other all last year (2023), which all make reflux much worse.
12. Whatever was happening with my nutritional status caused by this horrible diet + medications through all of these events.

So, I encourage you to learn from my mistakes — otherwise you might find yourself hitting “rock bottom,” as I finally did, and then doing everything listed below because you finally realize (and accept) that nothing else will work.

Hitting Rock Bottom with Reflux

Speaking of rock bottom, I think, for some people, they simply must reach rock bottom with reflux to decide that they must PERFECTLY follow the guidance. I hit that point over two years ago – but I kept receiving and following bad advice (such as certain foods, supplements, and medications).  So, you need to avoid those problems. However, if you wait too long to figure this out, then your body may not respond as well as it might have in the beginning, to the healing protocol.  Very sadly for me, mine has not been.

I still haven’t fully conquered reflux.  So, I want to address one obvious question:

Why Should You Listen to Someone Who Hasn’t Healed Their Reflux?

I can’t possibly summarize the many twists and turns over the last 3+ years, with my reflux treatment.  But I’ll just say that I have had periods of steady improvement, including several times tapering off Pepcid successfully.  Those have all been followed by major setbacks that I would only subsequently discover were caused by known reflux triggers. For example, I was able to stop Pepcid on the day that I received my first B12 injection (I suspected possibly a B12 deficiency was causing the nerve damage that was causing reflux).  I stayed off the Pepcid for several weeks, and was doing great, slowly expanding my diet. So, all good. But then an alternative medicine doctor suggested, for my remaining bloating, that I try taking 6 apple cider vinegar gummies. I knew from my extensive research that was probably a bad idea (so shame on me for listening to him). But he was handing them to me with his white coat in his fancy office. And I figured – I mean how bad can they really be?  Maybe they would help the remaining bloating (which I later learned was constipation caused by the reflux gourmet that I was still taking). Anyway, as soon as the gummies went down my throat, I knew instantly that I had made a gigantic mistake. I had terrible pain right at the base of my esophagus, and that night had to resume high doses of Pepcid.

And that’s just the first of several similar stories.

So, I have healed, then I have had setbacks.

Bottom Line

I have made a lot of mistakes along the way, which slowed down my progress in healing.

I have consulted countless experts, including the two leading reflux experts in the country, numerous gastro docs, a couple of exceptional nutritionists, many holistic & alternative MDs & other healthcare providers.

Through it all, my own self-guided learning and experimentation helped me at least as much as the MD advice. I’ve spent many thousands of dollars trying products, many of which were useless. But the protocols and products described on this site were the ones that worked the best for me, and I still use all of these things daily.

I hope my mistakes can help you skip the numerous innocent mistakes I’ve made.

Finally, please check back, as this site is under development.  If you have a question, feel free to leave a comment and I will try to respond.  And please – if you are even further down your journey and think you have some advice that might help me, I want to hear from you!