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Acid reflux and the Histamine & Mast Cell Connection

Updated: Mar 22

Acid reflux or indigestion. Heartburn. GERD (Gastroesophageal Reflux Disease).

It can leave you feeling like you're on fire. Literally and figuratively.

When GERD is present, your stomach produces an excess amount of stomach acid. This acid can climb back up your esophagus. That's what's behind that burning feeling or sour taste.

It is a very uncomfortable situation, and one that if left to persist, can have some long lasting impacts on the rest of your physiology including your esophagus, throat and nasal passages.

There are other possibilities behind acid reflux or heartburn. It could be due to a hiatal hernia, or sometimes an inability to make enough hydrochloric acid (hypochlorhydia) as well. (1)

First things first: get your acid reflux checked by your Medical Team. It is important to know what is at the root of your digestive ills, in order to best support what's behind that throat-on-fire feeling. It is also imperative to rule out other more serious health matters that may be behind the burning feeling.

By the Numbers

It is estimated that acid reflux is a fairly common issue for around 20% of the population (2). In Canada alone, the evidence shows that people who struggle with reflux or GERD lose about 16% of their work time, all due to the symptoms associated with this diagnosis (3).

The medication typically prescribed in this scenario are proton pump inhibitors (PPIs): they account for a large portion of the drugs prescribed in Canada, more than 11 million separate prescriptions in this country alone. (4)

What is going on?

What Reflux Looks Like

According to the Mayo Clinic, potential symptoms correlated to indigestion, heartburn or reflux include:

  • A burning sensation in your chest (heartburn), usually after eating; may worsen at night

  • Chest pain

  • Difficulty swallowing

  • Regurgitation of food or sour liquid

  • Sensation of a lump in your throat

If you have nighttime acid reflux, you might also experience:

  • Chronic cough

  • Laryngitis

  • New or worsening asthma

  • Disrupted sleep

Reflux as a Sign Your Sink is Overflowing

Acid reflux, though uncomfortable, could be a sign your body is sending to let you know that your histamine sink is full and now overflowing. (Check out why we think the sink analogy is a good explanation of histamine and mast cell mediated symptoms here.)

Does it surprise you to know that acid reflux can be a histamine clearance issue?

Histamine plays an integral role in digestion. It stimulates the production of hydrochloric acid in your stomach, helping to make the pH more acidic in your stomach to turn your protein-digesting enzymes 'on'. This is a crucial piece of the digestion puzzle – you need the right pH to set the stage, as your entire digestive process is governed by proper pH levels.

The increased acidity in the stomach sets off a series of chemical reactions throughout the digestive system. This includes the pancreas secreting bicarbonate and various enzymes, as well as the gallbladder releasing bile. These processes rely on an adequate pH level allowing you to digest optimally.

But What if You Are Making Too Much?

In some cases, an excess of histamine can over-stimulate the stomach to release excess hydrochloric acid.

An abundance of hydrochloric acid renders the chyme (the partially digested food exiting the stomach) highly acidic, potentially contributing to irritation along the gastrointestinal tract.

This can be one of the contributors to inflammation in the intestinal lining, further compounding your body's inflammatory load.

The more inflammation you have, the more compounds your mast cells can release including histamine and other inflammatory chemical mediators. This becomes an ongoing inflammatory cycle.

Steps to Take

Begin by monitoring your diet to determine if specific foods are exacerbating your acid reflux or heartburn. Take note to see if your symptoms increase when you consume high histamine foods. (Read more on high histamine foods here.)

Some people, when looking for solutions to the reflux problem, they may start with antacids or H2 blockers like Pepcid AC, Zantac or Tagamet. Antacids work by neutralizing stomach acidity. The H2 blockers work by blocking the H2 histamine receptors in the stomach, inhibiting the excessive release of histamine which in turn, now inhibits stomach acid production. These are all over-the-counter solutions that a Pharmacist can help you with.

If you consult with your family doctor, you may be prescribed a Proton Pump Inhibitor (PPI); these are the most common prescribed medication to help alleviate the problem.

There's Another Solution

When acid reflux is in the picture, bringing in a low histamine diet can help alleviate symptoms very quickly. If you understand that histamine in the foods you eat has the potential of triggering your mast cells to release more histamine (thus, driving more stomach acid production), now it will make sense that a low histamine, mast cell stabilizing dietary approach becomes instrumental in addressing what's at the root of your heartburn.

It's important to team up with a knowledgeable practitioner to figure out why your body is struggling with too much histamine. While sticking to a low histamine diet can ease your symptoms, it doesn't solve the underlying problem of why your body is having trouble clearing histamine or making too much of it.


Ready to get started on getting to the root of your heartburn or GERD? Consider joining us at our next The Histamine Connection class. It's a free class we host online every month or so, and it's the perfect place to start.

In the class, we'll help you make that histamine connection for yourself, and get you started on solutions to reduce what's driving your symptoms. Register for the next class by visiting this page.  Let's get you feeling better!

203 views2 comments


Dear HH, thank you for this useful information. I was diagnosed with histamine intolerance and GERD, and my functional practitioner actually advised me to increase my stomach acid by taking betaine hcl capsules, so I’m a bit confused after reading your article that I might be on the wrong path? Would be very helpful to hear your thoughts!

thank you,


Replying to

Hi Nienke - Apologies we only saw your question here now. Betaine HCL capsules for some of us can help, and others will make us feel worse. If they don't sit well with you, now comes the invitation then to see if it may potentially be a histamine mediated problem instead.

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