MGB+/The evidence/16 monographs

The science behind MGB+

Every ingredient in the line: what it is, what it does, why it is there, and the published research behind it, reviewed by physicians who do not work for us.

Rick Pescatore, DO · Board-certified emergency physician · Editor-in-Chief, Emergency Medicine News · 100+ publications

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1

The category is real

The conditions behind chronic bloating, reflux, queasy mornings and the fog that travels with them have a name in medicine: disorders of gut-brain interaction.

They are defined, measured and studied by the Rome Foundation, the international body that sets diagnostic criteria for the rest of gastrointestinal medicine. Its 2026 criteria estimate that 42.2 percent of adults worldwide meet criteria for at least one. The gut and the brain signal each other constantly through nerves, hormones, immune messengers and the microbiome; when that loop runs noisy, symptoms cluster. The clinic stopped treating the two as separate systems. We formulate the same way.

Prevalence describes how widespread these conditions are. It is not a claim that any supplement is needed.

2

What MGB+ is, and what it is not

It is
A daily, over-the-counter supplement built around the gut-brain loop, formulated by a physician to the published evidence, with every ingredient and every dose on the label.
It is not
A drug, or a substitute for one. It does not diagnose, treat, cure or prevent any disease.
If you are under care
For a gastrointestinal condition, MGB+ is meant to sit alongside that plan, not in place of it.
3

The base: vitamin B1 and magnesium

Every formula stands on magnesium glycinate, a well-absorbed form of vitamin B1, and ginger. The B1 is the reason the line exists.

Thiamine is what cells use to turn food into usable energy, and nerve tissue and the gut wall are among the tissues that spend it fastest. The ordinary form is water-soluble and enters through a transporter that gets steadily less efficient as the dose rises. The forms in MGB+ are not limited that way: the human pharmacokinetic literature shows they reach higher blood levels from the same dose, and that is the whole reason the line exists.

GUT INTESTINAL WALL BLOOD Thiamine water-soluble Transporter a queue, and it fills less of each dose Allithiamine fat-soluble Through the membrane no queue to join more of each dose
Schematic, not to scale. Fat-soluble forms of B1 are not limited by the transporter that carries ordinary thiamine, which is why they reach higher blood levels from an equal dose in human pharmacokinetic studies. Clear and Cool carry allithiamine, the form originally identified in garlic. Calm carries benfotiamine, which is a different compound: an S-acyl derivative that is not itself fat-soluble, and which the literature supports on absorption by a different route. The two are not interchangeable and this page grades them separately.
4

The monographs

Sixteen active ingredients across the three formulas. Each entry gives the form, where it sits in the line and at what dose, what it supports, the research behind it, and why it is there. Where a printed brief exists, it is linked with its page and citation count.

Mineral · as magnesium glycinate

Magnesium glycinate

Clear 100 mg · Cool 100 mg · Calm 150 mg
Supports
Normal nerve and muscle function, including the smooth muscle of the gut, and a settled nervous system
The research
Decades of randomised human trials across many uses, and one of the deepest safety records in supplementation. Glycinate is the form with the best absorption and bowel tolerance; oxide and citrate are the forms sold as laxatives.
Why it is here
It is the floor every formula stands on. Nerve tissue and the gut wall are magnesium-hungry, and the glycine it is bound to is itself a calming amino acid.
Cautions
Magnesium binds levothyroxine; leave four hours between doses. Cleared by the kidneys, so ask first if you have kidney disease.
Brief · 9 pages · 22 citations
Vitamin B1 · fat-soluble form

Allithiamine

Clear 75 mg · Cool 150 mg
Supports
Nerve function and cellular energy
The research
Human pharmacokinetic studies show fat-soluble B1 derivatives reach higher blood thiamine levels than the ordinary salt from an equal dose (Bitsch 1991, Greb and Bitsch 1998, Park 2016). A 2026 Frontiers in Nutrition study confirmed allithiamine acts as biologically active B1 in living animals; that study was part-funded by a manufacturer and is cited here for activity, not superiority.
Why it is here
Thiamine is what cells use to turn food into usable energy, and the gut wall and the nervous system spend it fastest. Ordinary thiamine enters through a transporter that gets steadily less efficient as the dose rises (Smithline 2012); the fat-soluble form first isolated from garlic crosses the membrane without that queue.
Brief · 11 pages · 23 citations
Vitamin B1 · S-acyl derivative

Benfotiamine

Calm 100 mg
Supports
Nerve function and cellular energy
The research
Thirty years of clinical literature of its own. Human pharmacokinetic studies show benfotiamine raises blood thiamine several times more efficiently than the ordinary salt (Bitsch 1991, Greb and Bitsch 1998, Xie 2014), and randomised trials in nerve symptoms established its safety at doses well above ours.
Why it is here
A different compound from allithiamine, with a different literature, chosen for Calm on purpose. It is not fat-soluble (Volvert 2008) and it is never described that way on this site.
Brief · 9 pages · 17 citations
Botanical · Zingiber officinale

Ginger root extract

Clear 100 mg (20% gingerols) · Cool 100 mg (4:1) · Calm 100 mg (4:1)
Supports
A settled stomach, normal gastric emptying and a normal nausea response
The research
Dozens of randomised human trials for nausea and for how quickly the stomach empties, summarised in more than one meta-analysis. The best-studied botanical for the stomach in the whole of the literature.
Why it is here
Every formula carries it because every pattern in the line runs through the stomach at some point in the day.
Cautions
Mild antiplatelet activity: mention it if you take a blood thinner. Pregnancy dosing is a decision for your own clinician.
Brief · 12 pages · 31 citations
Fatty acid amide · palmitoylethanolamide

PEA

Clear 300 mg
Supports
The body’s handling of everyday abdominal discomfort
The research
Multiple randomised human trials. PEA is a mast cell stabiliser the body makes on its own, and the 2026 Rome consensus on pharmacology lists it, with polydatin, among compounds with supporting trial data for abdominal pain.
Why it is here
Mast cells sit in the gut wall and fire the signals behind bloating and discomfort. Calming them is the most direct lever in the Clear formula, and 300 mg is the full clinical dose.
Brief · 11 pages · 23 citations
Botanical · Cynara scolymus

Artichoke leaf extract

Clear 150 mg, standardised to 5% cynarin
Supports
Comfort after meals, bile flow and the digestion of fat
The research
A randomised trial in functional dyspepsia (Holtmann 2003), open-label work in IBS-like symptom patterns, and decades of use for post-meal fullness across Europe.
Why it is here
Post-meal heaviness and bloating are a bile and fat-digestion story as often as a gas story. Artichoke addresses that side directly.
Brief in preparation
Botanical · Crocus sativus stigma

Saffron extract

Clear 30 mg, 4:1
Supports
A steady mood
The research
Multiple randomised trials and meta-analyses for mood at roughly 30 mg a day, the dose used here.
Why it is here
The brain half of the gut-brain pairing. Bloating and fog travel with low mood far more often than either travels alone, and saffron is the best-evidenced botanical for mood at a dose a capsule can carry.
Cautions
The combination with prescription antidepressants has not been studied; the insert asks.
Brief in preparation
Botanical · Asparagus racemosus

Shatavari root extract

Clear 150 mg, 4:1
Supports
A protected gut lining and a steadier stress response
The research
Well over a thousand years of continuous use in Ayurvedic medicine for the stomach lining and for the stress response, and a modern laboratory and animal literature on both.
Why it is here
In a gut-brain formula a protected lining and a steadier stress response are the same job, and shatavari is the one botanical in the line that has been used for both, together, for longer than any of the others.
Brief in preparation
Trace mineral · as lithium orotate

Lithium

Clear 5 mg elemental
Supports
A steady mood, at a nutritional amount
The research
Lithium occurs naturally in mineral springs and in drinking water, and the human literature on trace-dose lithium and mood is observational across whole populations.
Why it is here
A nutritional amount for the brain side of the formula. Nothing about this dose resembles prescription lithium.
Cautions
Anyone whose lithium level is monitored should ask before starting.
Brief in preparation
Resin · Pistacia lentiscus

Mastic gum

Cool 500 mg
Supports
The stomach lining, indigestion and upper-gut comfort after meals
The research
Two thousand years of use for the stomach, harvested by hand on one Greek island, and human trials in dyspepsia and in Helicobacter pylori carriage over the last thirty years.
Why it is here
The largest single dose in the line, because burning and after-meal reactivity are a lining problem before they are anything else.
Cautions
A tree-nut relative and the one allergen in the line. That disclosure sits on every surface that sells it.
Brief · 11 pages · 20 citations
Botanical · inner-leaf gel, 200:1

Aloe vera

Cool 100 mg
Supports
Soothing the upper gut
The research
Human trials in IBS-like symptom patterns and a long record of use for the stomach and the gut lining.
Why it is here
Inner-leaf gel concentrated 200 to 1, with the outer-leaf latex that acts as a laxative left out. It coats where mastic works.
Brief in preparation
Botanical · deglycyrrhizinated licorice

DGL licorice extract

Cool 80 mg
Supports
The stomach’s own protective mucus
The research
Human trials in dyspepsia and fifty years of use for the stomach lining.
Why it is here
Licorice root with the glycyrrhizin removed, so you keep the part that supports the mucus layer and lose the part that raises blood pressure and drops potassium.
Brief in preparation
Chelate · polaprezinc

Zinc L-carnosine

Cool 5 mg
Supports
The gastric mucosal barrier
The research
A prescription medicine for the stomach lining in Japan since 1994, with human data on protection and repair of the gastric mucosa.
Why it is here
It adheres to the stomach wall rather than washing through, which is the property that made it a drug. Five milligrams of zinc, a modest amount on its own.
Cautions
If you already take a zinc supplement, add the totals; long-term high zinc lowers copper.
Brief · 13 pages · 25 citations
Terpene · from black pepper, cloves and copaiba

Beta-caryophyllene

Calm 100 mg
Supports
A settled gut-brain stress response
The research
A deep laboratory and animal literature. It binds directly to a receptor on the immune cells of the gut wall that governs inflammation and the stress response, with no effect on the mind.
Why it is here
The lead ingredient in Calm. Queasiness that keeps its own schedule is a stress-signalling problem as much as a stomach problem, and this is the one dietary compound that speaks to that receptor directly.
Brief · 13 pages · 22 citations
Botanical · Curcuma longa, 95% curcuminoids

Turmeric root extract

Calm 80 mg
Supports
A calm, settled stomach and a healthy inflammatory response
The research
Thousands of published papers and many randomised human trials, including in dyspepsia. The most studied botanical for the inflammatory response on earth.
Why it is here
Curcumin is poorly absorbed on its own, which is why piperine sits beside it.
Cautions
Mild antiplatelet activity, and it stimulates bile flow: the insert asks about blood thinners and gallstones.
Brief in preparation
Alkaloid · Piper nigrum, 95% piperine

Piperine

Calm 5 mg
Supports
Absorption of the curcumin beside it
The research
In a human pharmacokinetic study piperine raised circulating curcumin twentyfold (Shoba 1998), by slowing the liver enzymes that clear it.
Why it is here
Five milligrams doing the work of a much larger turmeric dose.
Cautions
Those same enzymes clear many prescription medicines, so piperine can raise their levels too. Anyone on a dose-sensitive prescription checks first.
Brief in preparation
5

The published record

Three steps in the clinical literature, each independently verifiable. They establish that the gut-brain target is real and guideline-recognised. They are not evidence for any supplement.

2019

Neuromodulators show effect in functional gut presentations

Emergency physicians documented durable relief of refractory nausea, cyclic vomiting and chronic abdominal pain using dopamine-antagonist medicines in patients unresponsive to conventional antiemetics. The mechanism proposed: dopamine blockade at the brainstem region governing nausea, altered gut motility, and reduced central amplification of visceral signals. The implication is structural. The gut and the brain operate as one circuit.

Pescatore R. What to D.O.: Neuroleptic and Psychotropic Drugs for Abdominal Presentations. Emergency Medicine News, November 2019.

2024

GRACE-4 formalises gut-brain treatment in emergency medicine

The Society for Academic Emergency Medicine published an evidence-graded guideline recommending dopamine-antagonist therapy for a severe cyclic vomiting syndrome. It was the first time a major emergency medicine body codified treating a gastrointestinal syndrome through the nervous system.

Borgundvaag B, et al. GRACE-4. Academic Emergency Medicine, 2024. Pescatore R. GRACE-4 as a Call to Action. Emergency Medicine News, August 2024.

2026

Rome V defines the category and quantifies it

The Rome Foundation’s 2026 criteria classify these conditions as disorders of gut-brain interaction and estimate that 42.2 percent of adults worldwide meet criteria for at least one. The same consensus, in its pharmacology chapter, lists PEA with polydatin among compounds with supporting trial data for abdominal pain.

Drossman DA, Chang L, Tack J. Gastroenterology 2026;170:1083-1098. Palsson OS, et al. Gastroenterology 2026;170:1408-1416. Camilleri M, et al. Gastroenterology 2026;170:1152-1170.

6

Standards and interests

Doses track the literature

Each ingredient is included at an amount consistent with the research behind it, and the amounts are printed on the label.

Every amount is on the label

Each ingredient is listed with its amount. Nothing is grouped into a blend.

Independent testing, every batch

Every batch is tested by an outside laboratory for potency, heavy metals and contaminants. A certificate of analysis is available on request.

Claims stay within the evidence

MGB+ supports normal gut-brain function. It does not diagnose, treat, cure or prevent any disease, and no page on this site says it does.

Interests, disclosed
  • The formulas were designed by Rick Pescatore, DO, who founded and owns BellyMD. He profits when they sell.
  • The clinical reviewers named below are unpaid and hold no equity. Suzanne Enright is Dr. Pescatore’s mother-in-law, and is listed as such.
  • No ingredient supplier funds this site or the briefs.
  • Where a cited study was funded by a manufacturer of the ingredient it studied, the monograph says so.
7

Who reviewed it

Practising clinicians who reviewed the BellyMD framework and the evidence behind the formulas. None is paid for endorsement.

Joshua D. Niforatos, M.D., M.T.S.

Cleveland Clinic

Emergency physician and meta-researcher. His JAMA Internal Medicine work on evidence quality shapes how clinicians evaluate the research behind supplements.

Sergey M. Motov, M.D.

Maimonides Medical Center, Brooklyn

Emergency physician whose 2015 Annals of Emergency Medicine trial changed how emergency departments treat pain at the bedside.

Patrick Reeves, M.D.

Brooke Army Medical Center

Army pediatric gastroenterologist. Built the Clinical Action Plans toolkit that brings structured gastrointestinal care to military families.

Suzanne Enright, M.Ed.

Behavior analysis

Behavior analyst and clinician. Decades of designing individualised care plans for children and adults living with chronic illness, and leading the multidisciplinary teams that deliver them.

Related to the founder by marriage
The people who built this
The science behind MGB+Revised September 2026support@belly-md.com