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The common drivers: A weak or loose LES A hiatal hernia (part of the stomach pushing up through the diaphragm) Eating large meals, especially within three hours of bed Excess abdominal weight pressing on the stomach Smoking (which relaxes the LES) Pregnancy Certain medications, including some blood pressure drugs and asthma inhalers I tell patients this all the time: if you have reflux and youve never had a proper workup, youre treating a symptom and ignoring the engine

Dietary deficiency Vegans can develop vitamin B12 deficiency because vitamin B12 is most often found in animal products

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Used together, they complement each other's time-release characteristics, giving you both availability and intensity of GH in circulation