Heartburn is a painful burning sensation experienced in the abdomen and chest area due to the reflux of acid and other stomach contents in the oesophagus.
This reflux is a result of relaxation of the lower oesophageal sphincter or the LES, triggered usually by poor diet and lifestyle.
Though heartburn is a very common disorder of the gastrointestinal tract and can be treated easily, its ignorance can lead to a more complex and chronic form called gastro oesophageal reflux disease (GERD) .
Arginine and ascorbic acid mixture for heartburn treatment
Arginine is an amino acid amongst many others, which is the chemical building block of proteins. It is normally obtained from diet and is necessary for body to make proteins.
Arginine is found in red meat, fish poultry and dairy products.
It is also made commercially for medicinal purposes and as an essential supplement. L-Arginine is used for heart and blood vessel conditions including congestive heart failure, chest pain, high blood pressure and coronary artery disease.
It is also used to treat dementia and male sterility along with erectile dysfunction.
Recently, research has proposed several novel medical uses of Arginine apart from the conventional ones.
These include treatment of inflammation, nausea, common cold, kidney transplant, heartburn and boosting the immune system. L-Arginine has been shown to be effective for heartburns where it is proposed to function via different modes of action .
However, only Arginine supplementation or Arginine along with any other beneficial amino acid can be harmful in the sense of per-oxidative damage.
This means that amino acid supplements activate the reactive oxygen and reactive nitrogen species, which cause oxidative damage to the tissues, exacerbating the pain and inflammation.
To prevent this, a novel formulation of L-Arginine along with Ascorbic acid or Vitamin C is found to be effective.
This mixture is useful in treating heartburns nausea and other stomach discomforts via the properties of L-Arginine and the oxidative damage is prevented or neutralized by the anti-oxidant properties of Ascorbic acid .
L-Arginine and Ascorbic acid mixture reduces oxidative damage
L-Arginine is usually supplemented in disorders involving reduced Nitric Oxide synthesis. Ingestion of L-Arginine replenishes the Nitric Oxide production as L-Arginine is a raw material for production of Nitric Oxide in the body.
However, it also causes inflammation and a stringent feeling in the stomach because of the Nitric Oxide as it is one of the initiators of reactive oxygen species which cause the free radical damage.
Addition of Ascorbic acid has been supposed to remove this stringent feeling in the stomach due to only Arginine intake and maximise the beneficial effects of the same .
Arginine and Ascorbic acid reduces Inflammation
In a controlled smooth muscle cell tissue culture experiment, a culture of cells was induced with chemicals/cytokines such as Interleukins and Tumor Necrosis Factors which induce inflammation.
This was then subjected to the 20 mg/ml Arginine and Ascorbic acid mixture.
The results demonstrated a remarkable reversal of the inflammatory response in these cells and a sharp reduction in the inflammation induced death of cells.
Not much has been found about the mechanism of the anti-inflammatory properties of this mixture, but it indeed can be considered a novel complementary medication for treatment of diseases like heartburn, where acid induced inflammation is a common phenomenon .
L-Arginine leads to decrease in Lactic acid deposition and increase in detoxification mechanism
Due to poor oxygen intake, the efficiency of respiration in the tissues decrease, thereby reducing their efficiency.
This is true for all types of tissues including gastro intestinal tract where a good blood flow and efficient oxygen supply is necessary to produce enough energy for a good digestion.
However, if the tissues don’t get enough oxygen, they turn to a different inefficient pathway of energy production which increases the deposition of a by-product called lactic acid.
Also, inefficient digestion cannot breakdown the food completely, leaving the partially digested food in the form of lactic acid.
In stomach, lactic acid is one of the major causes of heartburn as it decreases the pH of the stomach further and causes the burning sensation.
A study on muscles and lactic acid deposition due to insufficient oxygen supply showed that L-Arginine effectively reduced the accumulation of lactic acid and increased the capacity of the tissues to tolerate low oxygen tensions for a longer amount of time.
This helps in reduction of production of lactic acid on the whole .
For heartburn, it can be effective for neutralizing the excess lactic acid produced due to poor digestion and low oxygen supply, ultimately ameliorating the reflux.
However, further research is yet to be done on the effects of L-Arginine directly on the stomach tissue and lactic acid production.
L-Arginine increases oesophageal motility
Oesophageal motility is an important factor determining the development of the symptoms of acid reflux.
Due to low motility of the oesophagus, food cannot pass down to the stomach properly causing change in pressure and acid reflux.
This also increases ulceration, inflammation and damage to oesophageal mucosa.
Experimentation on rats has shown that L-Arginine uptake increases the peristalsis or motility of the oesophagus via an increase in the nitric oxide mediated signalling pathway.
This improves food digestion and reduces the symptoms of oesophagitis and acid reflux .
L-Arginine heals ulcers
Gastric ulceration is a major cause of pain in the oesophagus caused due to acid damage in the mucous of the gut.
L-Arginine has been shown to increase the nitric oxide and polyamine mediated blood flow in the ulcer margins, enhancement of the serum gastrin levels that help in better digestion, increased synthesis of the protective mucosal layer and increased healing by formation of more blood vessels.
The overall effects of these phenomena cure the ulceration and alleviate pains caused due to acid reflux .
Dosage and Consumption of L-Arginine or L-Arginine/Ascorbic acid Mixture
The mixture of Arginine and Ascorbic acid to be taken for heartburn is prepared by mixing the two ingredients in a specific concentration.
The Ascorbic acid to Arginine ratio in the mixture should be kept 1/5 to 20. This means that in 20 parts of Arginine powder, 1/5th of the total Ascorbic acid powder should be added.
Other weight ratios of the two compounds such as 1/5th to 1/4th can also be used .
Arginine is possibly safe if taken orally, administered as shot or applied on skin, short term.
It can cause some side effects such as bloating, abdominal pain, diarrhoea, low blood pressure and allergies .
Ascorbic acid, if taken with Arginine has its own effects and safety issues. It is not at all safe for kidney patients, for stone and severe diarrhoea .
Not enough is known about the effects of L-Arginine or ascorbic acids or the mixture of both to be taken during pregnancy.
However, Arginine is possibly safe when taken by mouth during pregnancy for a short term . Vitamin C however, is not as safe to be taken during pregnancy or breast feeding.
The maximum dose during gestation to be taken is not more than 2000mg/day which is also not well researched.
Thus the mixture of Ascorbic acid and Arginine for heartburn should be avoided during pregnancy and breast feeding or should be consulted to a doctor before taking it .
Both Arginine and Ascorbic acid are possibly safe for infants and children when given by mouth in appropriate amounts for a short period of time.
Arginine can be fatal if given in high dose. Ascorbic acid when taken by mouth should not be higher than 400 mg/day for infants and children.
The mixture of Arginine and ascorbic acid to be given for heartburn for children should be first tested in small amounts for infants and children or a doctor should be consulted before administering them the dose.
If just Arginine is to be given, the dose should be 261 mg/kg added to oral feedings per day for infants up to the first 28 days of life , .
Arginine is one of the least toxic amino acids and so is Ascorbic acid.
The food intake of Ascorbic acid usually exceeds to that of Arginine.
In most people, just Arginine proves harmful because of Arginine ascorbic acid imbalance. Arginine intake by food thus is very low.
Hence, another way of taking Arginine and preventing oxidative damage is by eating food that provides ample vitamin C while the Arginine medication is going on .
The food sources containing vitamin C are citrus fruit juices, kiwi fruit, mango, papaya, strawberries, raspberries, broccoli, Brussels sprouts, tomatoes and spinach amongst many others .
The ascorbic acid/Arginine mixture in the ratio of 0.5/8 or more, by weight, can be stored under low humidity for a long time or at least a year without browning .
Precautions and side effects
Arginine should never be taken with anti-hypertensive drugs as it increases the effect of these drugs to lower the blood pressure excessively.
It should also not be combined with anti-diabetic drugs, medications to increase the blood pressure, Viagra and medications that slow blood clotting.
Ascorbic acid is harmful when taken when certain medications containing estrogens or antacids are taken regularly.
It should also not be taken in combination with medications for cancer and HIV.
Summary
Arginine/Ascorbic acid mixture is a new concept developed as a complementary medicine to treat heartburns.
L-Arginine is useful to treat heartburn alone but poses the danger of oxidative damage, which is removed by adding ascorbic acid to the supplement.
Though both Arginine and ascorbic acid have little or no side effects, intake of the mixture for heartburn treatment is not a well researched subject and care should be taken before taking it in large amounts or regularly.
The composition should also be consulted with the doctor or the pharmacist before consumption.