Gabapentin & acid reflux

[Silveryogi]

I have just started taking Gabapentin for my RLS and I’m suffering really bad acid reflux, to the point that it is difficult to eat or drink anything. Is this likely to be a side effect of Gabapentin (as it isn’t listed as a common side effect)?

[SueJohnson]

It can be a side effect. Most antacids make RLS worse. A safe one to take is Gaviscon. Most side effects disappear after about a month.

[Silveryogi in reply to SueJohnson]

thank you!

[Frizbotch in reply to SueJohnson]

I too am having acid reflux after starting gabapentin for my RLS. The gabapentin (800mg tablet in the evening before bed) has really helped my RLS but the acid reflux started after about 6 weeks on the gabapentin. I will try Gaviscon and would like to know when you suggest taking it and at what dose. Also I like to stop eating after 3 pm (I’ve been restricting eating to an eight hour window 7am-3pm for a couple of years). Is it ok to take gabapentin on an empty stomach or could that be exacerbating the acid reflux? Thank you!

[SueJohnson in reply to Frizbotch]

Ask your doctor on the dose and timing of gaviscon. You can take gabapentin on an empty stomach. Most people do. I doubt that taking it on an empty stomach would be exacerbating your acid reflux. If you are taking 800 mg all at one time though, you should divide the dose since it isn't well absorbed above 600 mg. Take 600 mg 1 to 2 hours before bedtime and 200 mg 2 hours before that. You may find you only need 700 mg as a result.

[Joolsg]

Just enter gabapentin and acid reflux into search engine and there are numerous people reporting it as a side effect. Also report it via Yellow Card report in UK or FDA adverse side effects in US because unless we report these side effects, they are not listed on the meds leaflet.Be wary about taking PPI gastric pills to counter the acid reflux as they worsen RLS for the majority.

Try taking a good probiotic like VSL or Symprove and try Gaviscon or magnesium based antacids, taking them 2 to 3 hours before the gabapentin as magnesium can affect gabapentin absorption.

[Silveryogi in reply to Joolsg]

thank you!

[SueJohnson in reply to Silveryogi]

Antacids can interfere with the absorption of iron and magnesium needs to be taken 3 hours before gabapentin as it interferes with the absorption of the gabapentin. And magnesium needs to be taken 2 hours apart from iron.

[SueJohnson in reply to Joolsg]

Magnesium based antacids will reduce the absorption of gabapentin so better not to take them.

[Hidden in reply to Joolsg]

Hi Jools, I had to report back on something to you. I think probiotics do help with reflux/heartburn though as usual I doubted you. I’ve been taking Kimchi for months (4?) now and about a month ago noticed a dramatic drop in reflux/heartburn which I was completely certain was due to a moderate sized hiatal hernia, yet I now truly believe the gut microbiome is also somehow involved, but it may take 3 months to see any improvement. Zinc worked well, after the fact, but in no way ever prevented reflux.

The kimchi has done nothing for the RLS sadly, which is seemingly worse since I had Covid this past October - to the point I’ve been taking double and even triple the amount of iron. However, while I was taking berberine for about a month, the RLS seemed vastly improved, almost from day one, but the stuff really (really) slows down motility, so I stopped about three or four weeks ago and I never quite took it everyday anyways. Last night was the straw that broke…so I’m back on the berberine…at half the dose. And yes, I was even taking a stool softener and fiber to no avail. If I have to I will go in for the stronger stuff - Miralax. I want to get in a solid 3 months of berberine.

Sounds like you continue to do well which pleases me to no end. Xx

[Joolsg in reply to Hidden]

Kimchi is both a pre and a probiotic. I take kimchi and kefir on top of a good probiotic. Symprove really has helped me. I had started to get acid reflux and severe heartburn taking Buprenorphine and couldn't bear to stop it as it's the only thing that has stopped my severe RLS.

I'm delighted you continue to find ways to resolve your RLS. Keep up the research.

[Hidden in reply to Joolsg]

I should add Symprove to the repertoire. And yes, the hunt never ends.

[Hidden in reply to Joolsg]

multiplesclerosisnewstoday....

I owe you one. Life is so much better without reflux.

[Joolsg in reply to Hidden]

Thanks SalemLake. I had already started berberine supplements after reading one of your helpful posts a while back.I will now definitely continue as I had to stop my MS drug, Ocrevus, because it depletes B cells and I don't make any antibodies to Covid. Vaccines are completely ineffective while on the MS drug and the risk of severe illness is too great.

I have switched to a keto diet (supposed to help brain diseases) & supplements and Berberine will now remain top of my supplements.

Sleep well.

[Hidden in reply to Joolsg]

Jools, this is kind of a huge deal, not only in terms of RLS, but also MS. The above article is based strictly on results from lab rats. You are a human trial for berberine. I, for one, would love to hear how you think the berberine is affecting your MS and RLS and motility? 🙄

I advise not taking the berberine at night. It is allegedly a D2 receptor antagonist and D1 agonist. It’s what we with RLS probably need, but taken at night it runs the risk of making your symptoms worse. Which brings me to my final point 😅. How will you ever know if the berberine is helping your RLS unless you put off taking the buprenorphine one night??? With the MS, I assume there are certain blood tests and markers which will show the effect that dropping the Ocrevus (and being on berberine) has had on your MS. Actually, if you believe all the hype around berberine, then right now you should be feeling pretty darn good… the best you’ve felt in years?

[Joolsg in reply to Hidden]

I have no intention of stopping Buprenorphine because my RLS is caused by spinal cord damage. Supplements will make no difference to it. The MS, on the other hand, can be helped a little, but not a lot, by diet and Supplements.I take berberine in the morning alongside Symprove, vitD3, selenium, B12.

My MS is worse off Ocrevus because my B cells have repopulated. Diet & supplements help a little, but cannot stop the disease attacking the brain & spinal cord. Only the aggressive DMTs do that.

The only thing that will help in the future is specific anti virals targeted at Epstein Barr virus, which is the cause of MS.

Hopefully, as more research is done into Long Covid, effective anti virals will be produced. Covid reactivates Epstein Barr virus which triggers both MS and ME/CFS.

[Hidden in reply to Joolsg]

Well, this is where we disagree. Yes, the lesions on your spinal column interrupt that weak stream/neurotransmission of dopamine that is headed for your peripheral nervous system. That weak transmission is, of course, caused by your/our lousy D3 receptors. Make them less lousy and the stream will be stronger and more able to push past those lesions. That’s why the DAs helped you, at least initially. The DAs make the signal stronger. The majority of people with MS do not have RLS. Their normal dopamine transport system pushes right past those lesions like nothing.

There is a point of no return, however. It is my understanding that 100% of people with traumatic spinal cord injuries have RLS. In other words, if there is a complete blockade of that signal, that is headed for the peripheral nervous system, then you’re gonna get RLS, no matter how big, shiny and great your dopamine receptors are. Not even DAs will do anything for these people. This isn’t you. The DAs did help you, which tells me that up-regulating your receptors should theoretically be of benefit to you.

[Joolsg in reply to Hidden]

30% of people with MS have RLS. Probably those with spinal lesions. Not everyone with MS has spinal lesions.I will be sticking with Buprenorphine as it's the ONLY thing that has stopped the severe RLS. All other diets, ferrous bisglycinate and injectafer infusions did nothing.

[Hidden in reply to Joolsg]

I think 30 to 35% of the general population is pre-disposed to RLS, period. I emailed directly with the scientist who trialed Injectafer for Dr. Early. He made it sound like he did it as a favor. He was trialing it for anemic pregnant women I believe. He told me that it always seems that around 30 to 35% of the anemic population also report symptoms of RLS. Same is true for late stage kidney disease. Maybe if the medical community realized that it’s more like 35% of the population that technically has RLS and not the reported 5 to 10% there would be more funding.

I would never suggest you stop the Buprenorphine, nor would I ever stop the iron. I am willing to wait later in the evening one night to see just how bad the RLS still is. But the iron always kicks in after just one hour and then I can sleep. I’m not sure if the same is true with Buprenorphine.

[Hidden in reply to Joolsg]

This too: spandidos-publications.com/...

news.unchealthcare.org/2023...

[Amrob in reply to Hidden]

Can you please tell us more about your berberine experiment Salem Lake. Eg how much you take and when. I have searched "berberine" in this group but can't see any previous posts by you on the subject.

[Hidden in reply to Amrob]

Hi Amrob. For quite a while now, I’ve believed that what we with RLS need to do is ANTAGONIZE our receptors (by day) with a benign substance. There are a lot of dopamine antagonists (or quasi ones) out there. Benedryl, melatonin, and basically most of the drugs we tell people not to take are dopamine antagonists, directly or indirectly so.

Berberine was the seemingly healthiest one out there. I have taken it off and on since over a year ago. healthunlocked.com/rlsuk/po... And actually, as I recall, I was looking more for people who had augmented on DAs. I was looking for something they could take that would help them return to baseline quicker. Prior to getting Covid I myself was trialing berberine partly to see its affect on my RLS and mostly to avoid statins. It did lower my cholesterol. It was hard to say about RLS because mine is relatively mild. I was taking 500mg of it in the morning and adding quercetin to make it more bioavailable. Then TeddiJ found a bioavailable one called Toniq.

After I had Covid my RLS seemed remarkably worse and the berberine helped almost immediately. Then after I stopped,, the RLS started to get worse again. So now I am back on. I would like everyone reading this to try Berberine with their doctor’s permission. And I would like everyone to stop eating at night and eat a light dinner. Then in a few months I want us all to compare notes. And I would like people to research and find other ways we can up-regulate our receptors. Just because we find a drug that takes away the symptoms of RLS doesn’t mean we can get complacent. Complacency is dangerous, especially for people like us.

[Amrob in reply to Hidden]

Thanks for sharing that SalemLake.

I'm sure most of us would take a cure over a drug that treats the symptoms any day, but whatever way, it's always a relief to find something that works.

I find early dinners and not eating afterwards definitely helps reduce symptoms.

[Hidden in reply to Amrob]

It’s a “cure” of sorts. This is probably a bad comparison - if you have small biceps then the trick is to lift weights, but if you stop for too long they will go back to being small. I assume the same is true for us and up-regulating our receptors. If we find something that works then we have to keep up with it for the rest of our lives. My all time favorite RLS story/cure is this one: Mikisot 2 months agoListen man. Don't waste your time with medications. You can't achieve the nessesary treatment. I suffered RLS for many years and tried different methods and medicines to cure this shit. NOTHING! RLS continued to drive me crazy. Last year I entered Internet and learned about "Intermittent fasting" It was something new for me and seemed hopeful. I didn't hesitate much and changed my daily routine applying this kind of fasting. I decreased my calory intake in half and consumed my food two times a day. Morning 8h and afternoon 15h - 16h. The expected result didn't come soon. My body resisted much and I suffered many irritabilities, sleepless nights. After two weeks torture things got better and I felt relaxation. So I went on this way until all RLS symptoms disappeared. Sometimes later I felt trembling my legs and nervous convulsions. I continued to maintain this strict regime of feeding. At last (after 42 days) RLS disappeared totally. Not a hint or sign of this syndrome. Intermittent fasting works pretty good.

Well Amrob, my way I guess is the lazy man way. A dopamine antagonist by day and a 12 to 14 hour fasting window from about 7pm to 9am. AND, the thing is, you don’t necessarily have to stop taking your drug of choice. It’s not mutually exclusive. You may find you need less of the drug or can stay at a low dose by doing this.

[Amrob in reply to Hidden]

I think i may have missed something SalemLake. Do you mean the berberine 'cure' is your favourite story, or did you intend to share a link?

[Hidden in reply to Amrob]

just added the story. Go back

[Amrob in reply to Hidden]

Thanks Salem. Intermittent fasting may be one to try.

[Stdorn]

Same here but it seems to come and go.

[VJ29]

I have also just started taking it and have noticed indigestion issues. I take lanzaprozole anyway so will need to look at suggested alternatives .

[Silveryogi in reply to VJ29]

yes I already take Lanzaprozole too. I think I need to speak to my doctor if it persists; there’s no point in taking a drug if it solves one issue but causes another

[SueJohnson in reply to Silveryogi]

If you take iron be aware that lansoprazole is a proton pump inhibitor and can interfere with the absorption of iron.

[SueJohnson in reply to VJ29]

If you take iron be aware that lansoprazole is a proton pump inhibitor and can interfere with the absorption of iron.

[VJ29]

I know but I'm goi.g to see how it's goes as if the gabapentin solving the RSL I will try a different solution for reflux I think

[Silveryogi]

the problem is that mine is so severe, that I’m struggling to eat and drink at the moment. This is like nothing I have experienced before - actual pain in my throat, cough etc. I’ll give it a few more days to see if it settles down, then I’ll have to go back if necessary

[jilk in reply to Silveryogi]

silveryogi I had to eliminate most foods to get results i eventually went carnivore for a few months which healed my gut then discovered gaba glutamate. recommend trying no starchy foods, then dairy bless you i know how hard and isolating this can be good luck finding YOUR solution

[Silveryogi]

thank you!

[Jadawyn]

Apple cider vinegar (1tsp-1tbsp) in warm water before meals helps tremendously. I add 1 tsp lemon juice to make it more palatable, some don't.