Getting to the Root of Low Stomach Acid
Stomach acid is good for you! A normal stomach acid level creates a pH of 1.5 to 2.5. But as we age, the parietal cells in the stomach lining produce less hydrochloric acid (HCL). In fact, half of people over the age of 60 have hypochlorhydria (low stomach acid), and by age 85, 80 percent of the healthy people tested had low stomach acid. Use of acid-blocking medications increases stomach pH to 3.5 or higher. This inhibits pepsin as well (an enzyme necessary for digesting all protein) and can be irritating to the stomach. Stomach acid is also necessary for absorption of many minerals (e.g. magnesium, iron). In addition, stomach acid provides our first defense against food poisoning, H. pylori, Candida, parasitic and other gut infections. Without adequate acid, we leave ourselves open to decreased immune resistance.
Hypochlorhydria has been associated with many common health problems. Overgrowth of bacteria in the intestinal tract occurs in at least 20 percent of people aged 60 to 80 and in 40 percent of people over age 80. Adequate HCI is necessary for the absorption of vitamin B12 from food; B12 deficiency causes weakness, fatigue, and nervous system problems. Vitamin C levels are also low in people with poor stomach acid. Several minerals require an acidic environment for absorption, including iron, calcium, magnesium, zinc, and copper. Acid is critical for the breakdown of protein bonds in the stomach, and poor acid content in the stomach causes indigestion. The symptoms of hypoacidity often mimic those of hyperacidity.
Hypochlorhydria may be caused by a variety of other issues, including a very poor diet, pernicious anemia (caused usually by insufficient Vitamin B12), chronic H. pylori infection (the bacteria that causes almost all gastritis and ulcers), and long-term treatment with proton pump inhibitors (like Prilosec®).
Common symptoms of hypochlorhydria (one suffering with this may only have a few of these)
• Bloating, belching, burning, and flatulence immediately after meals
• A sense of fullness and/or fatigue after eating
• Indigestion, acid reflux, diarrhea, or constipation
• Multiple food allergies
• Nausea after taking supplements
• Asthmatic symptoms (e.g. wheezing, not environmentally triggered)
• Itching around the rectum
• Weak, peeling, and cracked fingernails
• Dilated blood vessels in the cheeks and nose (in non-alcoholics)
• Iron deficiency
• Overall fatigue
• Chronic intestinal parasites or abnormal flora
• Undigested food in stool
• Chronic candida infections
• Upper digestive tract gassiness
Diseases associated with hypochlorhydria
• Addison's disease
• Celiac disease
• Chronic autoimmune disorders
• Chronic hives
• Chronic Anxiety and/or Depression
• Dermatitis herpetiformis (herpes)
• Gallbladder disease
• Graves disease
• Hyper- and hypothyroidism
• Lupus erythematosus
• Myasthenia gravis
• Pernicious anemia
• Rheumatoid arthritis
• Sjögren’s syndrome
Self-testing and treatment for low stomach acid (hypochlorhydria)
1. Begin by taking one capsule of hydrochloric betaine (HCl with pepsin) in the middle of a protein-containing meal (not at the beginning and not after the meal – specifically in the middle). A normal response in a healthy person would be discomfort—basically light heartburn or an overly warm sensation in the center of the chest. If you do not feel a burning sensation, begin taking one capsules with every protein-containing meal for 2 full days (6 meals).
2. If there are no reactions after 6 meals, increase the number of capsules with each meal to two
3. Continue increasing the number of capsules every 2-3 days, using up to eight capsules with each meal if necessary. These dosages may seem large, but a normally functioning stomach manufactures considerably more. You’ll know you’ve taken too much if you experience tingling, heartburn, diarrhea, or any type of discomfort including a feeling of unease, digestive discomfort, neck ache, backache, headache, or any new odd symptom. If you experience tingling, burning, or any symptom that is uncomfortable, you can neutralize the acid with 1 tsp baking soda in water or milk.
4. When you reach a state of tingling, burning, or any other type of discomfort, stop taking capsules or the rest of that day. The following day, resume but cut back by one capsule per meal. If discomfort continues, discontinue HCl and consult with your healthcare professional.
5. Once you have established a dose (either 8 capsules or fewer, if warmth or heaviness occurs), continue this dose.
6. With smaller meals, you may require less HCl, so you may reduce the amount of capsules taken as you learn more about how your unique body responds.
7. Individuals with very moderate HCl deficiency generally show rapid improvement in symptoms and have early signs of intolerance to the acid. This typically indicates a return to normal acid secretion.
8. Individuals with chronically low HCl/pepsin typically do not experience such quick improvement, so to maximize the absorption and benefits of the nutrients you take, it is important to be consistent with your HCl supplementation. Try to be patient as your body heals.
Precautions: Administration of HCl/pepsin is contraindicated in peptic ulcer disease or gastritis. HCl can irritate sensitive tissue and may corrosive to teeth; therefore, capsules should not be emptied into food or drinks.
When you have adequate stomach acid, you will have good absorption of all your nutrients and address a common true, root cause of dis-ease in the body.
With appreciation to the Institute of Functional Medicine