Oh, My Aching Stomach: High or Low Stomach Acid?
Do you have any of the following, or think that these come with aging?
- Undigested food in your stool
- Acid reflux
- Nausea after eating large portions of meat
- Bad breath
- Hair loss
- Nutrient deficiencies
Do you ever feel like “I’m hungry all the time?” Or “Ugh, I feel like I’ve got a brick in my stomach” after eating?All of the above are related to your gut and most commonly, your stomach. Although digestioninitiates in the mouth, the stomach is the next place digestion resumes. Just how important is the stomach? It is one of many important organs involved with assimilating, absorbing, and utilizing nutrients increasing their bioavailability.6Calcium, magnesium, iron, zinc, vitamin B12, C, A, and E all rely on proper stomach acid for proper absorption. The stomach is responsible for storing and churning food, secreting Pepsin and Pepsinogen to digest protein, secreting HCL (stomach acid), to activate enzymes to breakdown protein, kill pathogens, and produce mucous to protect the stomach wall. Stomach acid is also a crucial part of the immune system. Because the acid barrier of the stomach easily and quickly kills any bacteria and other bugs that enter the body through food or liquids, it provides additional first line defense against food born bacteria and microbes. 4 It also prevents bacteria in the intestines from migrating up and colonizing the stomach.In addition, stomach acid is a biofilm buster and is necessary in the methylation process.
So, who hasn’t had in their lifetime heart burn or acid indigestion? While the standard treatment of care has commonly been the “Purple Pill” Prilosec, Prevacid, Mylanta, or others, these OTC’s and prescription’s main goal is to eliminate acid completely because the cause is presumed to be too much stomach acid. In 2009, there were 110 million prescriptions filled for acid suppressing drugs. 11 Something is clearly not working. Antacids do not treat the cause. They are temporary and in most cases only makes things worse over time.Consider a recent study from the Journal of American Medical Association that stated 65% risk of vitamin B12 deficiency in those who took proton pump inhibitors. 3These drugs often contain among other toxins, aluminum, a neurotoxin.
The problem is not too much acid, rather it is due to insufficient acid in the stomach.10The stomach is supposed to be acidic. 12Hypochlorhydria, or low stomach acid, is a frequently overlooked problem that is linked to other diseases like stomach cancer, asthma, low thyroid, and rheumatoid arthritis. 8 The symptoms are very similar to high stomach acid which is why all symptoms are treated equally. People with Celiac, IBS, or Chrohn’s Disease are at higher risk of having stomach acid problems. If you have experienced gas and bloating within 1-2 hours after a meal, then it is very likely that you are suffering from insufficient stomach acid along with small intestinal bacterial overgrowth.
If the stomach is supposed to be acidic, how does low stomach acid happen?
With numerous causes of low stomach acid, consequences ensue if left unchecked for a period of time. Low stomach acid or insufficient HCl is associated with many physical problems. Some of these include iron deficiency, osteoporosis (resulting from decreased calcium absorption), food allergies, leaky gut, depression, gallstones, low thyroid function, skin afflictions such as eczema, psoriasis, depression, asthma (80% of asthmatics are HCl deficient), splitting nails, tooth and periodontal disease, increased bacteria, yeasts, and parasites.
Additionally, sufficient hydrochloric acid is responsible for creating methyl groups. Why is this important? A methyl group is a hydrocarbon group processed in the liver during the detoxification process that allows the cells of your body to use the food or nutrients that you consume. Methyl groups are important for normal cell replication of DNA and repair of damaged DNA. With depleted methyl groups, you express mutated genes which can lead to a host of autoimmune disorders, depression, cognitive decline, and increased levels of inflammation. HCl breaks food down, but by itself, it cannot methylate a cell. HCL needs a buffer in the form of potassium to do this.
How can low stomach acid be associated with gallstones? Well, HCL secretion triggers pepsin. If HCl levels are depressed, so can pepsin. Less pepsin means less pepsinogen and then less cholecystokinin which stimulates the release of bile. This means less pancreatic enzymes and less bile. Eventually, this can lead to gallbladder dysfunction and may impede protein synthesis and lead to amino acid deficiencies.And the domino affect continues.
Next, food allergies can occur if foods are partially digested. These partially digested food particles gain access to the body via blood vessels. The immune system may then be activated to target the suspected proteins. The undigested proteins can also provide food for the harmful bacteria that was not quenched in the stomach due to low HCL, leading to small intestinal bacterial overgrowth, leaky gut, and further food sensitivities.
Another situation that transpires is excess growth of bacteria. Many bacteria enter the body with food. In a normal stomach, the bacteria are doused with HCL and die. Without adequate HCl, the bacteria grow and collect gas in the stomach. That gas is escorted “down the pipe” in the small intestine along with food, continues to grow, and produces a lot of hydrogen sulfide gas5…….which has to go somewhere! Also, if the acid/alkaline balance isn’t right, many unfriendly uninvited guests called microbes or microorganisms take host. They also excrete substances that are toxic to our cells………and to our friends….. and prevent nutrients from absorbing. We literally are starving by taking acid suppressing drugs. These toxins enter your entire GI tract and eventually the body. The acid suppressing drugs may have put out the fire, but not solved the problem to your symptoms of heartburn or chronic fatigue.
How does one know if they have sufficient stomach acid?
There are several ways to measure this. First, it is important to know that just looking at the esophagus or just the stomach is not a true indicator of HCl production. The body works in concert so all parts must be looked at. One way is through a test called the Heidelberg Radiotelemetric test. This is accurate, but rather expensive. Another is with stool analysis which is also useful for measuring protein digestion status. Simple blood tests such as BUN, phosphorus, serum protein, globulin and albumin can also be used to assess stomach acid status. Checking your urine or saliva pH is another simple in-home test. Other tests include testing for nutrient deficiencies as well as nutrition response testing. Home testing with baking soda or Apple Cider Vinegar are popular, but not always the most accurate. It is best to work with a practitioner who understands stomach acid.
What are the alternatives to controlling low stomach acid?
First, realize that the standard model of healthcare has created a medical specialty of x,y,z drug for x,y,z symptom. Many scientific journals have clearly established the interconnectiveness of our human physiology. Diet is crucial to balancing the stomach acid. Second, remove the irritants. Caffeine, acid foods such as sodas, alcohol, fatty foods, and hot spicy foods are some of these triggers. Increase vegetables at every meal; not just dinner. Drink water before meals; not during as this can dilute necessary enzymes. Eat smaller meals and chew thoroughly. Remember to sit when eating rather than eating on the run. Next, support the gastrointestinal tract with specific enzymes and nutrients unique to each individual case. Correcting stomach acid can often yield dramatic improvements in other areas of health.
Oftentimes we hear that people are not getting the results with stomach acid that they had hoped for and in desperation they turn to harmful prescription drugs to end their suffering. There are several reasons for this disappointment. First, we have to remember that every person’s body is unique. Second, we have to understand the physiology behind stomach acid; hence, the writing of this article. Next, we have to look at three of the most common mistakes people make dealing with stomach acid.
1). Taking the incorrect dose. If your unique body type requires six capsules of HCL and you are only taking one, you may be missing the benefits. It is therefore important to work with a skilled practitioner that can customize the dose for each person. Conversely, if you require one capsule and you are taking six, you may not feel well afterwards.
2). Using HCL supplement when you shouldn’t. Anyone who is on prescription or OTC NSAIDS such as aspirin, ibuprofen, or corticosteroids should not be taking supplemental HCL as the drugs themselves can initiate damage to the gastrointestinal tract and HCL may further aggravate the lining.
3). Taking HCL with the wrong food. Since protein simulates stomach acid production more than any other food, it is best taken after a meal of cooked protein.
If you’ve made several diet and lifestyle changes and you’re still not seeing the results you want, low stomach acid might be your quandary. At Center for Holistic Health & Nutrition, we work with the body’s natural physiology to restore healthy gastric functioning.
- Cater RE 2nd. Helicobacter pylori as the major causal factor in chronic hypochlorhydria. Med Hypothesis Dec 1992 Vol39(4):367-74
- Haas, Elson, MD. http://www.healthy.net/Health/Article/Hydrochloric_Acid/1863
- JAMA. 2013 Dec 11;310(22):2435-42.
- Johnson, L.R. Regulation of pepsin secretion by topical acid in the stomach. Am J Physiol 1972 Oct;223(4):847-50.
- Kennedy, Ron M.D. Hypochlorhydria: The Doctor’s Medical Library. Dec 2014
- Peterson, W.L. The Influence of food, beverages and NSAIDs on gastric acid secretion and mucosal integrity. Yale J Biol Med 1996 Feb;69(1):81-84.
- Reasoner, Jordan. 4 Common Betaine HCl Mistake.http://scdlifestyle.com/2013/10/4-common-betaine-hcl-mistakes
- Siebecker, Allison, ND. Small Intestine Bacteria Overgrowth; The case of the perpetual patient. ndnr, March 2011. www.ndhealthfacts.org
- Wright, Jonathan, MD. Why Stomach Acid is Good for You. The Rowman and Littlefield Pub. Group, Inc. 2001
- Wright, Steve.Hypochlorhydria: 3 Common Signs of Low Stomach Acid. http://scdlifestyle.com/2012/06/hypochlorhydria-3-common-signs-of-low-stomach-acid/
- Yago, Marc Anthony. Gastric re-acidification with betaine HCl in healthy volunteers with rabeprazole-inducted hypochlorhydria. Mol Pharm Nov 4, 2013;10(11):4032-37.
Christine Andrew, CNC, CTT, FMP is a certified nutrition consultant, certified thermography technician, and a functional medicine practitioner. She operates a natural healthcare practice, Center for Holistic Health and Nutrition,at 348 Cernon St. Ste A in Vacaville. She can be reached at www.individualizedwellness.net or www.christineandrew-cnc.com.