Natural Remedies, Herbs and Supplements for Acid Reflux, Heartburn and GERD, Ranked by Evidence
The natural remedies with the best evidence for acid reflux are melatonin, deglycyrrhizinated licorice (DGL) and aloe vera syrup, and even their evidence is modest next to the two non-herb measures that actually work: losing weight if you carry extra, and raising the head of the bed. Melatonin at 3 to 6 mg relieved heartburn in several small trials, including one where it matched omeprazole over 8 weeks; a licorice flavonoid extract reduced dyspepsia and reflux scores by about half versus placebo in a 50-patient trial; and aloe syrup reduced heartburn, regurgitation and belching about as well as omeprazole in a 79-patient Iranian trial. Probiotics, ginger, psyllium and curcumin have early but genuine data.
This guide is for adults with occasional or mild heartburn, regurgitation and that burning behind the breastbone after meals or at night, who want to reduce how often it happens and how much antacid they use. It is honest about the fact that most reflux herbs have one or two small trials, that popular products such as apple cider vinegar and betaine HCl have none, and that lifestyle changes outperform everything on the list. Alginate (Gaviscon), which forms a raft on top of the stomach contents, is a pharmacy product rather than a herb but is mentioned because it is the most useful thing you can buy without a prescription.
See a clinician rather than a supplement if you have trouble or pain swallowing, vomiting, black or bloody stools, unexplained weight loss, anaemia, heartburn more than twice a week for more than a month, or symptoms starting after 50. Those are alarm features for Barrett's oesophagus, ulcers or cancer and need an endoscopy. Chest pain that spreads to the arm or jaw, or comes with sweating or breathlessness, is a heart problem until proven otherwise. Nothing here replaces a proton-pump inhibitor when one is needed to heal an inflamed oesophagus.
Quick answer
- Melatonin — 3–6 mg at night relieved heartburn as well as omeprazole in an 8-week trial; tightens the lower oesophageal sphincter
- DGL licorice — 75 mg of a licorice flavonoid extract twice daily halved dyspepsia and reflux scores versus placebo in 30 days
- Aloe vera syrup — 10 mL daily reduced heartburn and regurgitation about as well as omeprazole in a 4-week trial
- Probiotics — 79% of 13 trials reported fewer reflux symptoms, mostly regurgitation and bloating (2020 systematic review)
- Ginger — speeds gastric emptying by about 25%; good for nausea and fullness, weak for burning
- Head-of-bed elevation and weight loss — the two best-proven measures; a 10% weight loss resolved reflux in 65% of people in one study
The 9 best herbs and supplements for acid reflux
Ranked by the strength of human evidence. Strong = multiple trials or a meta-analysis. Moderate = a few small trials. Preliminary = early or animal data.
Melatonin
Moderate evidenceThe gut makes far more melatonin than the pineal gland, and it raises lower oesophageal sphincter pressure and protects the mucosa. A 2010 Egyptian trial of 36 GERD patients found 3 mg of melatonin at night for 8 weeks relieved heartburn and regurgitation and raised sphincter pressure, with results similar to omeprazole and best when combined with it; a 2006 trial of 351 people found a melatonin-B-vitamin-amino acid formula at 6 mg cleared symptoms in 100 percent by day 40 versus 66 percent on omeprazole, though that trial was not blinded. The trials are small and from a few groups, but they agree.
- Key evidence
- Kandil 2010 RCT (n=36) vs omeprazole; Pereira 2006 open-label trial (n=351)
- Studied dose
- 3–6 mg at bedtime for 4–8 weeks; the GERD trials used 3 mg plain melatonin
- Best for
- Night-time heartburn, especially with poor sleep
- Cautions
- Morning drowsiness and vivid dreams. Interacts with fluvoxamine (raises melatonin levels), warfarin, blood-pressure drugs and immunosuppressants. Avoid in pregnancy and autoimmune disease without advice. Buy a product with a verified dose; US gummies often contain far more than the label says.
Licorice flavonoids increase mucus secretion, inhibit H. pylori and calm inflammation in the stomach lining, and removing glycyrrhizin takes away the blood-pressure problem. A 2012 Indian trial of 50 patients with functional dyspepsia found 75 mg of a glycyrrhizin-free licorice extract (GutGard) twice daily for 30 days reduced the global symptom score, including heartburn and upper abdominal burning, by about 50 percent versus placebo. Older studies in the 1970s and 1980s found DGL healed gastric ulcers about as well as early acid drugs. It is a reasonable mucosal protectant rather than an acid reducer.
- Key evidence
- Raveendra 2012 placebo-controlled RCT of GutGard (n=50)
- Studied dose
- 380–760 mg of DGL chewed 20 minutes before meals, 2–3 times daily, or 75 mg of GutGard twice daily, for 4–8 weeks
- Best for
- Burning and upper abdominal discomfort after meals; people with gastritis
- Cautions
- Choose DGL, not whole licorice: glycyrrhizin raises blood pressure and lowers potassium and interacts with diuretics, digoxin and corticosteroids. Even DGL products can contain traces, so check labels if you have hypertension. Avoid medicinal licorice in pregnancy.
Aloe inner-leaf gel is anti-inflammatory and soothing on mucosa, and the acemannan polysaccharides may reduce acid secretion. A 2015 Iranian trial randomised 79 GERD patients to 10 mL of decolourised aloe syrup, omeprazole 20 mg, or ranitidine 150 mg for 4 weeks and found aloe reduced heartburn, regurgitation, flatulence, belching, nausea and vomiting significantly, with a somewhat smaller effect than omeprazole but no serious side effects. That is the only trial, so this stays at Moderate rather than Strong, but it is a proper head-to-head comparison.
- Key evidence
- Panahi 2015 RCT vs omeprazole and ranitidine (n=79)
- Studied dose
- 10 mL of decolourised, purified inner-leaf aloe syrup (5 mg polysaccharides per mL) once daily for 4 weeks
- Best for
- Mild to moderate reflux with bloating and belching, in people avoiding acid blockers
- Cautions
- Use purified, decolourised inner-leaf products only: whole-leaf aloe contains aloin, a laxative that causes cramps and was listed as a possible carcinogen in animals. Can lower blood sugar and potassium. Avoid in pregnancy and with diuretics or digoxin.
Probiotics (Lactobacillus and Bifidobacterium strains)
Preliminary evidenceProbiotics may speed gastric emptying and reduce the gas that distends the stomach and triggers reflux. A 2020 systematic review of 13 trials found 79 percent reported benefit on reflux symptoms, most consistently for regurgitation, belching and bloating, but the trials used different strains and most lacked placebo arms. A 2022 Korean placebo-controlled trial of 100 adults found a Lactobacillus-Bifidobacterium mix reduced reflux symptoms and PPI use over 8 weeks. Treat this as plausible and low-risk rather than proven.
- Key evidence
- Cheng and Ouwehand 2020 systematic review (13 trials)
- Studied dose
- Multi-strain Lactobacillus and Bifidobacterium product at 1–10 billion CFU daily for 8–12 weeks
- Best for
- Reflux that comes with bloating, belching and irregular bowels, and people on long-term PPIs
- Cautions
- Generally safe. Avoid live-bacteria products if you are severely immunocompromised or have a central line. Some people get more gas in the first week. In small intestinal bacterial overgrowth, probiotics can worsen bloating.
Ginger speeds gastric emptying, and a stomach that empties faster has less to reflux. A 2008 trial in 24 healthy volunteers found 1,200 mg of ginger halved gastric emptying time and increased antral contractions, and a 2011 trial found the same in 11 patients with functional dyspepsia. Its direct reflux data are thin, but ginger is the best-studied natural remedy for nausea, with Cochrane-level evidence in pregnancy, so it suits reflux that comes with nausea, early fullness and slow digestion. In people with a mechanically weak sphincter it occasionally makes burning worse.
- Key evidence
- Wu 2008 crossover trial on gastric emptying (n=24); Hu 2011 in functional dyspepsia
- Studied dose
- 1–1.5 g of dried ginger powder daily in divided doses before meals, or 1 g fresh ginger steeped in hot water
- Best for
- Reflux with nausea, early fullness and slow gastric emptying; pregnancy nausea with heartburn
- Cautions
- Doses over 4 g a day can cause heartburn themselves. Ginger has mild antiplatelet activity; use with care on warfarin or before surgery. May lower blood sugar and blood pressure slightly. Up to 1 g a day is considered safe in pregnancy.
Soluble fibre forms a gel that may slow the backflow of stomach contents and improve sphincter tone, and higher fibre intake is linked to lower reflux in population studies. A 2018 Russian trial gave 36 GERD patients with low fibre intake 5 g of psyllium three times daily for 10 days and found the number of reflux episodes on 24-hour pH monitoring fell significantly, lower oesophageal sphincter pressure rose, and heartburn frequency dropped from about 4 to 2 episodes a week. A single small trial, but with objective measurements, which is rare in this field.
- Key evidence
- Morozov 2018 trial with pH monitoring (n=36)
- Studied dose
- 5 g of psyllium husk in 250 mL water three times daily before meals, with plenty of fluid
- Best for
- Reflux in people who eat little fibre, or who also have constipation
- Cautions
- Must be taken with enough water or it can swell in the throat or gut; avoid if you have swallowing problems or bowel narrowing. Take other medicines 1–2 hours apart. Start low to limit bloating.
Curcumin is anti-inflammatory and protects the gastric lining in animal models, and a 2023 Thai trial published in BMJ Evidence-Based Medicine randomised 206 patients with functional dyspepsia to curcumin 500 mg four times daily, omeprazole 20 mg, or both for 28 days and found all three groups improved similarly on dyspepsia scores, with curcumin alone non-inferior to the PPI. That trial was in dyspepsia (upper abdominal pain, fullness, burning) rather than confirmed reflux, and had no placebo arm, so it is suggestive rather than definitive for heartburn.
- Key evidence
- Kongkam 2023 RCT of curcumin vs omeprazole in functional dyspepsia (n=206)
- Studied dose
- 500 mg of curcumin 4 times daily (2 g/day) for 4 weeks, or 500–1,000 mg/day of an enhanced-absorption extract
- Best for
- Burning and fullness in the upper abdomen rather than classic heartburn; people who also want its joint benefits
- Cautions
- Curcumin itself can cause reflux and nausea in some people, especially on an empty stomach. It increases bleeding risk with warfarin and antiplatelets, may lower blood sugar, and should be stopped 2 weeks before surgery. Avoid with gallstones or bile duct obstruction. Rare liver injury reports with high-dose products.
Slippery elm bark is mostly mucilage, which swells into a gel that coats the oesophagus and stomach lining and may stimulate protective mucus. That mechanism is well understood and the herb is in most 'reflux tea' blends, but there are no randomised trials for heartburn: the human data consist of small studies in irritable bowel and one trial of a demulcent throat tea. It belongs on the list because it is safe, cheap and makes physiological sense, not because it is proven.
- Key evidence
- Traditional use; mechanism established, no reflux RCTs
- Studied dose
- 1–2 teaspoons of bark powder stirred into warm water after meals and at bedtime, or 400–500 mg capsules 3–4 times daily
- Best for
- A raw, burning throat or chest after a reflux episode
- Cautions
- Coats the gut, so take other medicines 1–2 hours apart. Otherwise very well tolerated and considered safe in pregnancy. Choose sustainably harvested bark.
Marshmallow root polysaccharides form a protective layer on mucous membranes, and laboratory studies show they reduce inflammatory signalling in epithelial cells. The European Medicines Agency recognises it as a traditional remedy for mild gastrointestinal discomfort and irritation of the throat, and it has 2,000 years of use for 'burning stomach'. There are no controlled trials in reflux. Like slippery elm, it is a sensible demulcent for the burning rather than a treatment for the reflux itself.
- Key evidence
- EMA traditional-use monograph; no reflux RCTs
- Studied dose
- 2–5 g of root as a cold-water infusion (steep 1–2 hours) up to three times daily, or 5–10 mL syrup as needed
- Best for
- Throat and chest burning after a reflux episode, including in pregnancy
- Cautions
- May slow absorption of other medicines; separate by 1–2 hours. May lower blood sugar slightly. Some syrups are high in sugar.
How to choose
- Before any supplement, do the two things with the strongest evidence: raise the head of your bed 15 to 20 cm and, if you carry extra weight, lose some of it. In the Nurses' Health Study, every 3.5 kg gained raised reflux risk, and losing it reversed it.
- If heartburn is mainly at night, start with melatonin 3 mg at bedtime for 4 weeks. It has the most direct trial evidence and helps sleep as a side benefit.
- If the burning is after meals and sits in the upper abdomen, use DGL chewed before meals; add curcumin if you also have fullness and bloating.
- If reflux comes with nausea or early fullness, ginger before meals suits you better than a demulcent. If it comes with belching, bloating and irregular bowels, try a multi-strain probiotic for 8 weeks.
- For immediate relief of an episode, an alginate (Gaviscon-type) is the most effective over-the-counter option and is safe in pregnancy; slippery elm or marshmallow can be used alongside for a raw throat.
- If you have had heartburn more than twice a week for over a month, any alarm symptom, or you are relying on daily antacids, see a doctor. A short course of a PPI heals oesophagitis in ways no herb does, and an endoscopy rules out Barrett's.
What to skip
Apple cider vinegar
The claim that heartburn is caused by too little acid has no supporting trials, and no trial has tested vinegar for reflux. Acetic acid is itself a reflux trigger, erodes enamel, and has caused oesophageal burns when taken undiluted. Skip it.
Betaine HCl and digestive enzymes
Betaine HCl adds acid to a stomach that, in most reflux, has normal acid in the wrong place. The only modern study showed it re-acidifies the stomach in people on PPIs, which is the opposite of what reflux sufferers want. Enzyme blends have no reflux trials.
Peppermint oil and peppermint tea
Peppermint relaxes the lower oesophageal sphincter and is a well-documented heartburn trigger; even enteric-coated capsules for IBS list reflux as a side effect. It is excellent for IBS cramps and the wrong choice here.
Baking soda
It neutralises acid for a few minutes, then the stomach rebounds. Each teaspoon carries about 1,200 mg of sodium, and there are case reports of stomach rupture after large doses on a full stomach. An alginate or a calcium antacid is safer.
Safety and when to see a clinician
- See a clinician if you have difficulty or pain swallowing, persistent vomiting, black or bloody stools, unexplained weight loss, anaemia, heartburn more than twice a week for a month, or new symptoms after age 50. These need an endoscopy before any supplement.
- Chest pain with exertion, or spreading to the arm, jaw or back, with sweating or breathlessness, is a heart emergency, not reflux, until proven otherwise.
- Melatonin interacts with fluvoxamine, warfarin, blood-pressure drugs and immunosuppressants. Curcumin and ginger add to bleeding risk with warfarin, aspirin and clopidogrel and should be stopped before surgery.
- Use DGL, not whole licorice: glycyrrhizin raises blood pressure, lowers potassium and interacts with diuretics, digoxin and steroids. Use decolourised inner-leaf aloe, not whole-leaf, to avoid aloin.
- Demulcents (slippery elm, marshmallow, psyllium) and aloe can reduce absorption of other medicines; take thyroid medication, antibiotics and other drugs 1–2 hours apart.
- In pregnancy, alginates, ginger up to 1 g a day, slippery elm and marshmallow are considered safe; avoid medicinal licorice, aloe, high-dose curcumin and melatonin unless your midwife agrees. Do not stop a prescribed PPI without discussing it; rebound acid for 2–4 weeks is common and should be tapered.
What matters as much as any herb
- Raise the head of the bed by 15 to 20 cm with blocks or a wedge, not extra pillows. A 2023 meta-analysis of 5 trials found it reduced night-time reflux symptoms and acid exposure; sleeping on your left side helps further because the stomach then sits below the oesophagus.
- Lose weight if you carry extra: in a 2013 study of 332 overweight adults, an average 13 kg loss resolved reflux completely in 65 percent and reduced it in a further 15 percent. This is the single strongest lever for most people.
- Finish eating 3 hours before lying down, and keep evening meals smaller. Late meals roughly double night-time acid exposure in monitoring studies.
- Identify your own triggers rather than cutting everything: fatty meals, alcohol, coffee, chocolate, mint, carbonated drinks and tomatoes are the common ones, but the evidence that blanket avoidance helps is weak. Keep a one-week diary.
- Stop smoking and loosen the waistband. Nicotine relaxes the sphincter, and tight clothing and abdominal pressure push stomach contents up. Diaphragmatic breathing training reduced reflux and PPI use in a 2012 trial, and is free.
Frequently asked questions
What is the best natural remedy for acid reflux?
Raising the head of the bed and losing excess weight beat any supplement. Among herbs and supplements, melatonin 3 mg at night has the most direct trial evidence, DGL licorice and aloe vera syrup each have one decent trial against omeprazole, and an alginate from the pharmacy gives the fastest relief of an actual episode.
What relieves heartburn fast at home?
An alginate antacid (Gaviscon-type) works within minutes by floating a gel raft on top of the stomach contents. Standing up, sipping water, chewing sugar-free gum for 30 minutes (it increases saliva, which neutralises acid) and a slippery elm or marshmallow drink for the burning all help. Baking soda works but rebounds and is high in sodium.
Does apple cider vinegar help acid reflux?
No trial has ever tested it, and the theory behind it, that reflux comes from too little stomach acid, is not supported by measurements in reflux patients. Vinegar is acidic enough to trigger heartburn and damage tooth enamel. It is the most popular remedy on the internet and one of the least justified.
Is DGL licorice safe for daily use?
Deglycyrrhizinated licorice removes the compound that raises blood pressure and lowers potassium, so it is much safer than whole licorice and has been used for months in ulcer studies. Check that the product is genuinely DGL, and if you have high blood pressure or take diuretics, monitor your pressure in the first weeks.
Can melatonin really help GERD?
Several small trials say yes. Melatonin increases the pressure of the lower oesophageal sphincter and protects the lining, and 3 mg at night for 8 weeks relieved heartburn about as well as omeprazole in a 36-patient trial, with the best results when the two were combined. The trials are small, so treat it as a reasonable thing to try, especially if you also sleep badly.
Which tea is best for acid reflux?
Chamomile, ginger, licorice (DGL-based) and slippery elm or marshmallow blends are the sensible choices; they are soothing, caffeine-free and do not relax the sphincter. Avoid peppermint, strong black or green tea and coffee, all of which can trigger reflux. Drink it warm rather than hot and not immediately before lying down.
When should I see a doctor about heartburn?
If it happens more than twice a week for a month, if you need antacids most days, or if you have any alarm symptom: trouble or pain swallowing, vomiting, black stools, weight loss, anaemia, or symptoms starting after 50. Long-standing reflux can cause Barrett's oesophagus, which needs monitoring, and persistent symptoms sometimes turn out to be something else entirely.
References
- Kandil TS, Mousa AA, El-Gendy AA, Abbas AM. A study of the effect of melatonin in patients with gastroesophageal reflux disease. BMC Gastroenterology (2010)View source
- Pereira Rde S. Regression of gastroesophageal reflux disease symptoms using dietary supplementation with melatonin, vitamins and aminoacids: comparison with omeprazole. Journal of Pineal Research (2006)View source
- Raveendra KR, Jayachandra, Srinivasa V, et al.. An Extract of Glycyrrhiza glabra (GutGard) Alleviates Symptoms of Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Study. Evidence-Based Complementary and Alternative Medicine (2012)View source
- Panahi Y, Khedmat H, Valizadegan G, Mohtashami R, Sahebkar A. Efficacy and safety of Aloe vera syrup for the treatment of gastroesophageal reflux disease: a pilot randomized positive-controlled trial. Journal of Traditional Chinese Medicine (2015)View source
- Cheng J, Ouwehand AC. Gastroesophageal reflux disease and probiotics: a systematic review. Nutrients (2020)View source
- Wu KL, Rayner CK, Chuah SK, et al.. Effects of ginger on gastric emptying and motility in healthy humans. European Journal of Gastroenterology & Hepatology (2008)View source
- Morozov S, Isakov V, Konovalova M. Fiber-enriched diet helps to control symptoms and improves esophageal motility in patients with non-erosive gastroesophageal reflux disease. World Journal of Gastroenterology (2018)View source
- Kongkam P, Khongkha W, Lopimpisuth C, et al.. Curcumin and proton pump inhibitors for functional dyspepsia: a randomised, double blind controlled trial. BMJ Evidence-Based Medicine (2023)View source
- Singh M, Lee J, Gupta N, et al.. Weight loss can lead to resolution of gastroesophageal reflux disease symptoms: a prospective intervention trial. Obesity (2013)View source
- Eherer AJ, Netolitzky F, Högenauer C, et al.. Positive effect of abdominal breathing exercise on gastroesophageal reflux disease: a randomized, controlled study. American Journal of Gastroenterology (2012)View source
- Gastroesophageal reflux disease (GERD) — diagnosis and treatment. Mayo Clinic (2024)View source
- Heartburn and acid reflux. NHS (2024)View source
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Ask about acid refluxThis guide is educational and is not medical advice. Herbs and supplements can interact with prescription medicines and are not regulated like drugs. Talk with a clinician or pharmacist before starting anything new, especially if you are pregnant, breastfeeding, have a chronic condition, or take medication.