Androgens and acid reflux, peptic ulcer

[Dead]

Learning about the gut histamine/androgen connection surprised me, so I thought I'd share what I learned about androgens and acid reflux and peptic ulcer, as it is not discussed often. If anyone has any useful information including anecdotes on what's worked for them with respect to AAS-induced acid reflux or peptic ulcer, please share!

Gastric mucosal susceptibility and ulcerogenic effects
acid reflux; peptic ulcer
Androgens are ulcerogenic and enhance the susceptibility of gastric mucosa to the peptic action of gastric juice [1]. Estrogens are protective: females appear to be protected against both gastric hypersecretion and peptic ulcers in those periods in their lives when circulating estrogens are high [1].

Pronounced sex difference in acid reflux and peptic ulcer
The sex difference in the male rat excreting lesser free histamine than the female is ascribed to the sex-related efficiency in the male for metabolic inactivation of histamine via methylation as the principal catabolic pathway [2]... Testosterone increases the proportion of methylhistamine in urine [2]. The female kidney, most pronounced in pregnancy, forms more histamine, and in pregnancy, the activity of histidine decarboxylase (histamine formation capacity of tissues, especially kidney and fetal tissue) is markedly increased [2].

Estrogen provokes a dose- and time- dependent increase in histamine excretion. Progesterone does not alter histamine excretion. Testosterone provokes a striking dose- and time- dependent decrease in histamine excretion. Testosterone virtually abolishes kidney histidine decarboxylase activity.

Histamine and the gut
Histamine serves a function in gastric acid secretion via the H₂ receptors (H₂R). H₂R antagonists potently inhibit acid (HCl) secretion [3].

Gastric mucosa is markedly rich in histamine, and there is a selective accumulation of histamine related to acid secretory cells. Gastric acid secretion is strongly stimulated by histamine and a number of methyl histamine analogs, including n(Me)histamine, n'n'dimethyl histamine, and 4-(Me)histamine [3].
- cimetidine antagonizes histamine by competitive inhibition of H₂ receptors (H₂R) located in gastric parietal cells ⇒ ↓gastric acid secretion & volume & acidity

Histamine interacts with other stimuli of gastric acid secretion: there is potentiation in the parietal cell between histamine, acetylcholine, and gastrin [3]. Other stimuli of gut acid secretion include: food, caffeine, distension, vagal, and other cholinergic agents [3].


Relevant organs
Gastric (stomach) muscle contracts with H₁R stimulation & relaxes with H₂R stimulation
- Gastric emptying is unaffected by H₂R antagonists
Pylorus:
- Histamine has unclear effects on, but does affect, phasic contractions of the pyloric sphincter (frequency, amplitude, duration) via neural & myogenic H₁R
Intestine:
- Ileal contraction with histamine is a classic H₁ effect
Gallbladder:
- H₁R mediate gallbladder contraction by histamine; H₂R mediate gallbladder relaxation
...Blockade of H₂R augments the response to [hormonal agents], suggesting that histamine may modify the response to this class of agents [including androgens?]
[3]

Cimetidine ✖
Tagamet

- cimetidine antagonizes AR by cytosolic binding & inhibits gastric acid secretion
- antagonizes H2 histamine receptor-mediated gastric acid secretory response
- stimulates plasma prolactin

Also:
- binds cytochrome P-450 as a type II ligand, inhibiting its function, causing reduced metabolism of exogenous pharmacological agents (via cyt. P-450)
- alters hepatic metabolism of estrogens (↓2- & 16α- hydroxylation of E₂
- alters hepatic metabolism of androgens (↓formation of polar metabolites [hydroxylated derivatives], producing a marked increase in 3-androstenediol, the fully reduced androgen)
- ↓6β-, 7α-, and 16α- hydroxylation of T (20, 21) [4]

Ranitidine, Famotidine, Nizatidine ✓
Zantac, Pepcid, Axid

Ranitidine and famotidine (2d gen. H₂R antagonists) do not affect cytochrome P-450 metabolism, androgen nor estrogen metabolism [4].

Nizatidine did not antagonize AR, had a less potent and consistent effect on plasma prolactin increase.

______________________________
References:

[1] Kowalewski, K., Schier, J. F., & Chmura, G. (1970). Effect of Sex Hormones on Gastric Secretion and on Gastric Mucosa in Oophorectomized Histamine Stimulated Rats. Digestion, 3(1), 13–19. doi:10.1159/000196983
[2] HENNINGSSON, S. S. G., & ROSENGREN, E. (1972). Alterations of histamine metabolism after injections of sex hormones in mice. British Journal of Pharmacology, 44(3), 517–526. doi:10.1111/j.1476-5381.1972.tb07288.x
[3] Hirschowitz, B. I. (1985). Histamine and the Gut. Allergy and Asthma Proceedings, 6(1), 21–27. doi:10.2500/108
854185779048942
[4] Galbraith, R. A., & Jellinck, P. H. (1989). Differential effects of cimetidine, ranitidine and famotidine on the hepatic metabolism of estrogen and testosterone in male rats. Biochemical Pharmacology, 38(12), 2046–2049. doi:10.1016/0006-2952(89)90507-8

Uh keep taking the stuff power through it and no more reflux. Worked for me… I’m joking btw don5 do what I did. Also milk. Tums is calcium gluconate I think… so milk

 

[Type-IIx]

Uh keep taking the stuff power through it and no more reflux. Worked for me… I’m joking btw don5 do what I did. Also milk. Tums is calcium gluconate I think… so milk

What gives you the worst reflux of the injectables? Tren?

 

[Zeus45]

Omeprazole 20mg a day works great for acid relux. Stay away from harsh orals like anadrol and dianabol. Don't use Tren either it gives awful acid reflux.

 

[Marcus17]

Omeprazole 20mg a day works great for acid relux. Stay away from harsh orals like anadrol and dianabol. Don't use Tren either it gives awful acid reflux.

you should google side effects of omeprazole

 

[Zeus45]

you should google side effects of omeprazole

i have no side effects.

 

[ruxin32424]

Specifically, H2 receptor antagonists seem to help, particularly Zantac (ranitidine), Pepcid (famotidine), and Axid (Nizatidine), are preferable to Tagamet (cimetidine) which acts as an antiandrogen and alters estrogen metabolism. Also, omeprazole is an efficacious medication from a different class of medications (proton-pump inhibitors) with efficacy.

Any thoughts on Esomeprazole? I used to have chronic almost unbearable GERD for years (without the AAS) and ran thru the gambit of zantacs, prilosecs, prevacids and tums before nexium fixed everything. Even with AAS nexium 24hr clear minis keep me 99% symptom free.

 

[RomanMVP]

So, any thoughts as to why L-Glutamine works for AReflux? Works as well for me as any OTC medication.

 

[Type-IIx]

So, any thoughts as to why L-Glutamine works for AReflux? Works as well for me as any OTC medication.

Interestingly, I don't believe its mechanism is understood. It does dose-dependently decrease the severity of gastric lesions in response to histamine, and this is not related to the lessening of corrosive action of gastric acid & pepsin.

 

[Type-IIx]

Any thoughts on Esomeprazole? I used to have chronic almost unbearable GERD for years (without the AAS) and ran thru the gambit of zantacs, prilosecs, prevacids and tums before nexium fixed everything. Even with AAS nexium 24hr clear minis keep me 99% symptom free.

Perfectly good proton pump inhibitor... Just do note that chronic (long-term use) increases susceptibility to bacterial infections, reduces absorption of iron & vitamin B12, and contributes to low magnesium and calcium that can contribute to osteoporosis/fractures later in life. And if you ever stop using it suddenly, you're likely to suffer rebound symptoms, so you'd want to taper off gradually.

 

[Drexyl]

May be off topic here, maybe not. I'm 46 now, irresponsible steroid use late teens early 20's, orals only. Total test was 795 at 40 years old, then after an unfortunate incident with a prescription my testosterone kept tumbling all the way down to 375. Although this isn't horrible, I felt pretty bad and had ED. Now I drank heavily for years, and still smoke some cigarettes, however, I never had any type of reflux or indigestion issues until the use of androgens and anabolics. I can be even more specific and say it started during a run when I introduced equipoise. I do eat a pretty clean diet, only trt at the moment which will be changing soon, it's time. Now for me, and I could but choose not to, a few times a week I'll chew up some tums (I recommend the new tropical flavor) or alka seltzer in the evening and the issue subsides almost instantly. I'm also a very gassy person by nature, always have been. Impressive burps and farts. I'd be curious of your age and lifestyle history? This could just be an issue you're going to have as your body ages. Best wishes buddy

 

[lilhawk]

One thing that corrected constant GERD for me was treating my sleep apnea. It's a major contributing factor for GERD.

 

[Drexyl]

One thing that corrected constant GERD for me was treating my sleep apnea. It's a major contributing factor for GERD.

Interestingly enough, and thank you for the reminder, when mine started I had began the prescribed use of a cpap machine, I think it can go either way when you introduce continuous positive air pressure, in non medical terms it may keep things open down there that should be shut.

 

[ruxin32424]

Perfectly good proton pump inhibitor... Just do note that chronic (long-term use) increases susceptibility to bacterial infections, reduces absorption of iron & vitamin B12, and contributes to low magnesium and calcium that can contribute to osteoporosis/fractures later in life. And if you ever stop using it suddenly, you're likely to suffer rebound symptoms, so you'd want to taper off gradually.

Appreciate the info very much obliged. I will start researching ways to increase iron & b12 absorption as well supplementing mag/cal.

 

[Rido]

Appreciate the info very much obliged. I will start researching ways to increase iron & b12 absorption as well supplementing mag/cal.

Its better to use h2 blockers like pepcid. PPIs were pushed by the pharma industry years ago and that influence heavily played a role in primary practice. They are now educating new healthcare professionals to go against it due to the increased problems associated with it.

other concern is that PPI is a "CYP drug" which will interact with alot of other "CYP" drugs

 

[BigNattyMcGee]

Ok - wasn't sure if resurrecting an older post would be frowned upon, but my experience lately seems directly related to this. So, to keep it in one conversation. . .

I started logging how often I took OTC reflux meds about a month ago - what kind, amount, when I took them, etc. I mostly have used an H2 blocker because that was what the drug store had.

What I found in my notes was a pattern where I would start feeling 'off' - perhaps some fatigue, lower energy, a 'heaviness' in my body (not sure what this is and I can't really describe it any better than this. . .). These would show up along with, perhaps a day or so before, the usual reflux symptoms: sour belches, slight burning in the throat, waking up at night wondering if that is lava trying to crawl back out of my throat, etc.

The last couple of times I felt 'off' - I took an H2 blocker as an experiment. I figured if I didn't need it probably no harm done. But, both times I felt better. Way better. Like a 180 degree turn around better - and I never got to the usual reflux symptoms.

My guess is - that my reflux is impacting my sleep quality before I am noticing the usual 'heartburn' symptoms.

I am curious if others have had similar findings? I'd be interested in what others have experienced.

Thanks Meso!

 

[Pinnacle Elements]

The first time I ran tren I had to stop short because I was getting the worst acid reflux. I’m talking like I’d wake up in the middle of the night with burning pain in my torso & try to vomit.

This write up came just in time to confirm my theory.

So is the idea too much androgenic activity can cause this? Like if I’m running tren & mast & proviron for example?

 

[Pinnacle Elements]

Ok - wasn't sure if resurrecting an older post would be frowned upon, but my experience lately seems directly related to this. So, to keep it in one conversation. . .

I started logging how often I took OTC reflux meds about a month ago - what kind, amount, when I took them, etc. I mostly have used an H2 blocker because that was what the drug store had.

What I found in my notes was a pattern where I would start feeling 'off' - perhaps some fatigue, lower energy, a 'heaviness' in my body (not sure what this is and I can't really describe it any better than this. . .). These would show up along with, perhaps a day or so before, the usual reflux symptoms: sour belches, slight burning in the throat, waking up at night wondering if that is lava trying to crawl back out of my throat, etc.

The last couple of times I felt 'off' - I took an H2 blocker as an experiment. I figured if I didn't need it probably no harm done. But, both times I felt better. Way better. Like a 180 degree turn around better - and I never got to the usual reflux symptoms.

My guess is - that my reflux is impacting my sleep quality before I am noticing the usual 'heartburn' symptoms.

I am curious if others have had similar findings? I'd be interested in what others have experienced.

Thanks Meso!

Hey! Check out my post above. I didn’t read this far down but exactly like your describing being woken up at night by fire in my whole torso. Awful.

Would happen everytime I ate too. It was miserable until the Tren A cleared my system.

3 tums before bed was the only way to get a full night sleep and not be tortured to the point of considering the ER.

 

[BigNattyMcGee]

The first time I ran tren I had to stop short because I was getting the worst acid reflux. I’m talking like I’d wake up in the middle of the night with burning pain in my torso & try to vomit.

This write up came just in time to confirm my theory.

So is the idea too much androgenic activity can cause this? Like if I’m running tren & mast & proviron for example?

I am not sure of the physiological mechanism by which AAS seem to increase the rate of acid reflux symptoms - but yes. That is definitely my experience - and Tren and most orals seem to do so more than other AAS ("the injectables").

@Type-IIx - do you happen to have any thoughts on PPIs and how they might impact androgens and estrogens? From re-reading the threads, it seems an H2 blocker would be preferred?

 

[Eddie.]

@Type-IIx - do you happen to have any thoughts on PPIs and how they might impact androgens and estrogens? From re-reading the threads, it seems an H2 blocker would be preferred?

I would highly appreciate any info regarding PEDs and PPIs and if they affect nutrient absorption etc. I'm 12 years on low dose esomeprazole (10mg/day) and can't stop it, withdrawl hits literally very hard. Tried almost everything.. Apparently my kidney markers and magnesium, zinc, calcium and B12 levels are good (they say long term use affect these).

 

[AlistairASP]

This is very informative thread. I have never got GERD by AAS before. However, I heard it from my friend especially trenbolone user.

I hope this information can greatly contribute to anyone who suffer GERD from AAS use.

Thank you!