There is mounting evidence that drug treatment for GERD does not come without potentially serious risk. Such studies suggest that these drugs increase the risk of osteoporosis, depression, serious digestive tract infection, flu, irritable bowel disease and nutrient deficiencies such as vitamin B12 as well as important minerals. Although research has demonstrated these potential consequences, it does not take a multi-million dollar study to be able to reason that medications that interfere with acid secretion in the stomach will also interrupt nutrient absorption while making it easier for harmful organisms such as C. difficile to grow and cause havoc in our digestive tracts.

GERD occurs when the digestive juices back up into the esophagus, which results in an irritation to the fragile lining of the esophagus. The chronic irritation to the esophagus potentially results in a pre-cancerous condition called Barrett’s esophagus and then, left unchecked, to esophageal cancer. This process of progression sounds horrible and, drug companies would have you believe, imminent if left untreated.  Research, however, does not support this seemingly rational and unquestionable connection. In fact, a recent review of the data suggests that the connection between GERD and Barrett’s esophagus is so weak that the reviewing scientists felt that the widespread practice of screening patients with GERD, using endoscopy, was not warranted. Other researchers found that patients who were suffering with nighttime symptoms, as well as obese patients, were at a higher likelihood of having GERD progress to Barrett’s and ultimately to cancer. These patients may be the ones who require endoscopy as a screening tool.

What causes GERD?

A common characteristic of GERD is what is known as a relaxed lower esophageal sphincter (LES Valve). This sphincter acts as a door between the esophagus and the stomach. In a healthy person, the door slams tightly shut after food enters the stomach; however, in someone with GERD, this door may not shut snuggly, which can lead to reflux of stomach contents and ultimately irritation of the esophagus. The better question is, “what causes this doorway to remain slightly ajar?”  There are number of reasons for this:

1. Portion size – People who eat large quantities of food can cause the stomach to expand well beyond the normal stretched size. Regular exposure to this degree of stretch can cause a deformity in the doorframe so that a gap remains, even when the door is shut. Portion size of food can have an immediate and a more long-term effect. If you eat a large meal right now, the stretching of the stomach can immediately cause symptoms; long-term exposure to such large portion sizes can result in a deformity in the doorframe even when the stomach is empty. Both of these situations can be remedied by eating smaller quantities.
2. Mint – Mint has a relaxing effect on the esophageal sphincter, you may want to avoid using mint candies and gum if you suffer with GERD.
3. Deep fried food – These foods slow the movement of food from the stomach to the intestines, this increases the likelihood of contents moving into the esophagus.
4. Late night eating – This increases the likelihood that food will be in the stomach while your body is in a horizontal position.
5. Medications – There are many medications that can cause problems with GERD: Calcium channel blockers, beta blockers (metoprolol, Toprol XL, etc.), NSAIDs (Ibuprophen, Naproxen, Advil, Aleve) , aspirin, nitrates, anti-depressant medications, bisphophonates (Fosamax, Actonel, Boniva, etc.) and progesterone.
6. Excess weight, especially central obesity.
7. Food allergies and sensitivities. Although this is an underappreciated cause of reflux disease, it is important to note and it may be worthwhile to look for offending foods and precede with eliminating these foods from the diet.  These food sensitivities can be worsened by acid suppression through the use of medications like Nexium, Prevacid, Tums, etc.
8. Stress is a major cause of GERD. When you are stressed, the digestive tract does not function properly. This can result in a poorly functioning LES valve and more reflux.
9. Other factors – There are other factors that have been linked to GERD such as: Smoking, spicy food, citrus, tomato products, caffeine, alcohol and chocolate.

Isn’t GERD Caused by Too Much Acid in the Stomach?

Although there is a condition, called Zollinger-Ellison Syndrome, where the stomach produces excess acid, this condition is quite rare. In fact, many doctors have discovered that 9 out of 10 people, who suffer with reflux, actually do not produce enough acid to trigger the closure of the LES valve. In addition, when stomach juices do not reach a particular acid level, the food contents sit stagnant and the food begins to putrefy and rot. As the food sits, it ferments and causes excess gas to form. This bubbling action can further worsen reflux by pushing the contents of the stomach into the esophagus.

So what do we do about it?

1. Have a careful assessment of medications and request your doctor remove or alter any medication listed above that may be linked to reflux. Please note, most doctors and pharmacists do not know about the link between these medications and reflux.
2. Learn about and implement a food elimination diet to try and pinpoint certain food triggers. Wheat, gluten and dairy are common culprits.
3. Replace acid in the stomach. It is a little known fact that a lack of acid in the stomach may be responsible for the reflux. This goes contrary to the conventional belief about what causes GERD; excess acid and poor sphincter tone. See our article about Betaine HCl Therapy for GERD. Taking an enzyme along with the Betaine HCl could result in further improvements.
4. Take an Enzyme – Plant enzymes work throughout the entire digestive tract to break down the food that we consume. Through the use of enzymes, we can decrease the time it takes to move the contents of the stomach from the stomach to the intestines. A potent enzyme that we commonly recommend is OrthoDigestzyme V. What makes these enzymes so powerful is the fact that they work through a broad range of acid levels. If the pH within your digestive tract is off, these enzymes will still work. This will often improve transit times and decrease gas and bloating.
5. DGL Ultra – This is a chewable form of licorice that helps to coat, soothe and stimulate healing in the esophagus and stomach. Chew 1 tablet before each meal and at bedtime.
6. Acid Assist – For symptomatic relief and/or in serious cases of GERD, Acid Assist is a chewable tablet that forms buffered foam on top of the stomach acid. This allows normal digestion to occur beneath the foam while preventing acid from jumping into the esophagus. This is to be used as needed to control symptoms while you are working to rebalance the body.

Back in the early nineteen sixties, a navy surgeon, by the name of Dr. Judah Folkman, happened upon a discovery that would revolutionize the way that we view cancer development in the human body. While testing the impact of preserved blood on fast growing tumor cells (a model used to mimic fast growing tissues of wounds) he noticed that cancer cells that would normally ravage the body of a living mouse, could only seem to grow to the size of the tip of a ball point pen in a Petri dish. He wondered why the same tumor cells didn’t replicate with the same level of aggression in a Petri dish as they did in a living creature. After all, he had taken great care to mimic the conditions of living tissue.

After dissecting the large tumors from the living creatures and comparing them to the tiny tumors from his Petri dish experiment, he noticed only one difference between the two tumors; the large tumors from the mice were filled with thousands of tiny networks of blood vessels while the tumor cells from the Petri dish experiment had no such blood supply. From this experiment, he hypothesized that the cancer cells could not develop into a large tumor mass unless and until it had developed a network of small blood vessels called capillaries to feed the cells.  This process of blood vessel development was named “angiogenesis”.  Said another way, if we could prevent cancer cells from developing a blood supply of their own, we could stop cancer growth in its tracks and even cause existing tumors to regress! Furthermore, if tumor cells could not develop a blood supply, they would not be able to metastasize.

Dr. Folkman’s hypothesis and experiment was met with ridicule and rejection from the medical community. In fact, after discussing with a colleague his worry that his research would get picked up and stolen by other researchers, his colleague replied, “You are totally protected against intellectual theft. Nobody will believe you!”

Dr. Folkman continued his experiments, and over the years, his hypothesis went on to be accepted.  His research led to the development of a new class of medication called anti-angiogenesis drugs. Since then, other anti-angiogenesis medications had come to market. Unfortunately, the clinical results were somewhat disappointing; some tumors responded quite well, while others responded partially or not at all.

William Li, founder of The Angiogenesis Foundation, a non-profit organization dedicated to the advancement of anti-angiogenesis therapies and lifestyles, believes that the main reason that the medications are not living up to their potential is because we are getting to people too late in the game, after the cancer is fully developed and situated.  He believes that if we can use non-toxic tactics to prevent the small cluster of cancerous cells from forming a blood flow in the first place, we can prevent tumors from developing altogether. This would be what Dr. Folkman calls, “Cancer without disease”.

We All Have Cancer

It is a well-known fact that we all have these microscopic cancer cells throughout our bodies. In fact, research that looked at healthy men and women who had died in car accidents, discovered that 40% of women between the ages of 40-50 have these microscopic tumors within their breasts and 50% of men, between the ages of 50-60, have these micro-tumors in their prostates. It is even more disturbing that virtually 100% of men and women in their 70s have micro-tumors in their thyroid! The only thing preventing these people from developing the disease of cancer is the fact that the tumor cells had not developed a blood flow yet. The question is, “what can we do to prevent those harmless micro-tumors from ever developing a blood flow?” Dr. William Li believes that he has the answer…

Eat to Starve Cancer

The anti-angiogenesis medications, used to treat existing tumors, do not come without side effects. These side effects, although fewer than conventional chemotherapy, would make them inappropriate tools for preventing angiogenesis in micro-tumors. There is good news, however, researchers discovered that nature offers an abundance of natural compounds with potent anti-angiogenesis activity. Best of all, rather than blocking angiogenesis altogether, they normalize it. Disease begins when the growth of blood vessels occur unimpeded by the natural systems of checks and balances within the body. These natural anti-angiogenesis compounds appear to regulate and normalize the angiogenic balance within the body.

Angiogenesis is Essential to Health

Once we reach adulthood, it is generally accepted that blood vessels stop growing. There are three situations, however, that seem to defy this rule: menstruation, pregnancy and injury/wounds. During menstruation, pregnancy, and injury, the body produces protein chemicals that act as fertilizer for blood vessels; this stimulates the growth of new capillaries. When we injure ourselves, blood vessels grow beneath the scab to bring nutrients and oxygen to the damaged area in order to repair the damage. After the wound has healed, the body produces anti-angiogenesis compounds that stop the growth and prune back the blood vessels if needed. This process is tightly controlled; when angiogenesis is not well controlled, many diseases can arise.

Angiogenesis Gone Haywire

There are two ways that angiogenesis can become problematic; you can either have too few or too many blood vessels growing in a particular area of the body. In the case where there is too little angiogenesis, you see diseases such as:

• Wounds that won’t heal
• Heart disease
• Stroke
• Neuropathy
• Hair loss
• Erectile Dysfunction

In cases where there is too much angiogenesis, you see diseases such as:

• Cancer
• Blindness
• Psoriasis
• Endometriosis
• Obesity
• Rosacea
• Alzheimers

Cancer – The Ultimate Disease of Excess Angiogenesis

Although there are many diseases that can be connected to angiogenesis, abnormal blood vessel growth is a hallmark of all solid tumors. It is an accepted theory that one key to controlling cancer growth, especially metastatic and aggressive cancer, is to shut down the process of angiogenesis within the diseased tissue without affecting the healthy tissue.

Cancer’s Weakness

Generally speaking, blood vessels are stable and resilient tissues. Blood vessels found in tumors, however, appear to be built in a hurry. Their structure and architecture is disorganized and fragile, which makes them more susceptible to anti-angiogenesis therapies than normal tissues. This weakness may prove to be one of the greatest advantages that we have over this deadly foe.

Nature’s Advantage

When the scientists discovered the presence of proteins that promote angiogenesis, they realized that nature, with all of its systems of checks and balances, must also make proteins that inhibit angiogenesis. They first discovered these compounds in the urine of mice, which were resistant to cancer; they named this compound angiostatin. They then began to find compounds with similar activity in the foods that we eat, such as fruits, vegetables and tealeaves. Researchers have made great strides in defining which foods appear to have the most potent anti-angiogenesis activity. A non-exaustive list is provide below:

1. Green Tea
2. Strawberries
3. Blackberries
4. Blueberries
5. Raspberries
6. Oranges
7. Grapefruits
8. Lemons
9. Apples
10. Pineapples
11. Cherries
12. Red grapes
13. Red wine
14. Bok Choy
15. Soybean
16. Ginseng
17. Maitake
18. Licorice
19. Turmeric
20. Nutmeg
21. Artichoke
22. Lavender
23. Pumpkin
24. Sea Cucumber
25. Tuna
26. Parsley
27. Garlic
28. Tomato
29. Olive Oil
30. Grape Seed
31. Dark Chocolate

Of these foods, the ones that appear to have the most potent anti-angiogenesis activity include (in order of potency):

1. Soy extract
2. Artichoke
3. Parsley
4. Berries
5. Soy
6. Garlic
7. Red grapes
8. Brassica
9. Citrus
10. Lavender
11. Green tea
12. Glucosamine
13. Turmeric
14. Tea

(Lists taken from a lecture by Dr. Li during a TED conference)

Power Resides in the Synergy

According to Dictionary.com, “Synergy” is defined as “The interaction of two or more agents or forces so that their combined effect is greater than the sum of their individual effects.” In a study on the anti-angiogenesis activity of tea, researchers tested the ability of three different types of tea to inhibit blood vessel growth. In this study, they determined that they all had anti-angiogenesis activity, however, of the three, Earl Grey appeared to be the most potent. The researchers then decided to combine the two weaker teas and test the anti-angiogenesis activity of the mixture. They discovered that the combination of the two weaker teas resulted in more inhibition of blood vessel growth than the stronger Earl Grey tea. According to Dr. Li, this shows the presence of what is called “Nutritional Synergy” meaning, smaller quantities of many different nutrients and phytochemicals is likely superior to high quantities of fewer nutrients.

Future of Anti-Angiogenesis Studies

Currently, there is mounting laboratory and animal research that is confirming the anti-angiogenesis activity of foods. Using a special test tube model of blood vessel growth, Dr. Li and his organization is working to map the anti-angiogenic activity of common fruits, vegetables, herbs and teas. The ultimate goal is to form a menu of foods that are likely to inhibit this key step in the growth of abnormal cells into metastatic tumor masses.

One study, published by Harvard Medical School, tested the effect of dietary lycopene (a red pigment found in foods such as tomatoes, berries, etc) on the risk of prostate cancer. They determined that men, who consumed the most lycopene-containing foods, enjoyed the lowest incidence of prostate cancer. The researchers then tested the tumor biopsies for the presence of blood vessels. They discovered that of the men who went on to develop prostate cancer, the more lycopene they consumed, the lower the density of blood vessels in the tumor. This finding suggests that even when lycopene fails to completely inhibit angiogenesis, is appears to slow the growth and potentially decrease the virility of the existing tumor mass.

Obviously, more research needs to be performed to confirm the legitimacy of the laboratory and animal findings. I believe that there is sufficient data, in combination with epidemiological research showing an inverse relationship between fruit/vegetable intake and cancer risk, to start to incorporate larger quantities of the foods, which have anti-angiogenesis activity.

Using These Findings

The rules are simple:

1. Consume many servings of vegetables, fruits, and spices
2. Eat a variety of fruits and vegetables; choose them based on color and spectrum
3. Choose fruits that are lower on the glycemic index (lower sugar content)
4. Drink a variety of teas including: green tea, Earl Grey, jasmine and white tea.

Supplements for Prevention of Angiogenesis

Many people have been asking me about herbs and nutritional supplements that may give them a leg up on this issue. Although we do not have research on specific supplements, as they pertain to angiogenesis, I suspect that whole-food, freeze-dried extracts of fruits, vegetables and herbs will provide a spectrum of concentrated anti-angiogenesis compounds. I personally use a variety of whole food fruit, vegetable, mushroom and nutritional extracts for their broad benefits. This research has solidified these products as part of my long-term supplement plan. Below I list the supplements that I feel would provide the greatest anti-angiogenic activity; it should be noted that every one of these food-products offer multiple health benefits, in addition to being great means of protecting against angiogenesis:

1. Berry Greens by New Chapter – There are many whole food formulas on the market, I chose this formula because it is highly concentrated, has a good number of plants with certified anti-angiogenic activity, can be found in either capsules or powder and is readily available. I recommend 6 capsules per day or one tablespoon per day as a supplement to a healthy diet. If you get few fruits and vegetables in the diet, or you have a history or high risk of cancer, I would recommend doubling this dose.
2. PolyResveratrol-SR by Thorne Research – This formula combines resveratrol, pterostilbene, a highly absorbed curcumin, a highly absorbed green tea extract and quercetin. These compounds have anti-aging, anti-cancer and anti-angiogenic activity. The recommended dose is one capsule twice daily (although higher doses may be even more effective).
3. Vitamin D – Aside from vitamin Ds other anti-cancer qualities, it also appears to inhibit angiogenesis. Recommended doses are 2,000-4,000 iu per day.

Conclusion:

Normalizing angiogenesis within the body appears to be a critical step in the maintenance of healthy cells. After listening to a 20-minute lecture by Dr. William Li of the Angiogenesis Foundation, and researching the topic in depth, I am convinced that this may be one of the most important findings in medical history. I look forward to the results of Dr. Li’s research on the anti-angiogenesis activity of various foods and will continue to keep you updated as new research is published on the subject. 

In this study, researchers gave 51 diabetics who suffer with neuropathy a dose of vitamin D that equates to just over 2,000 IU daily. After three months the treatment group enjoyed significant decreases in neuropathic pain. All patients who were enrolled in the study had low blood levels of vitamin D at the start of the study and researchers noted significantly increased blood levels by study’s end. These increases in blood vitamin D correlated with decreases in nerve pain.

Comment by Dr. Ray Hinish

Vitamin D appears to play an important role in preventing nerve damage and maintaining healthy pain receptors. In addition, it is believed that adequate vitamin D levels result in improved nerve repair and growth. Over the last few years vitamin D has moved up the ranks of natural medicine to reach superstar status. This is just one more notch in the belt of vitamin D. Remember, always choose natural vitamin D3, also called cholecalciferol. I recommend NOW Vitamin D3 1,000 IU .

Interview with Mark Sisson, author of The Primal Blueprint.