Almost half of the U.S. population suffers from heartburn at least once a month and in 2010 there were 53.4 million prescriptions for generic Prilosec (that doesn’t even include over the counter medications!) and millions more for other antacids and acid blockers like Tagamet and Zantac.
According to Dr. Jonathan Wright, M.D., co-author of “Why Stomach Acid Is Good For You – Natural Relief from Heartburn, Indigestion, Reflux & GERD”, chances are 90% or higher that the real culprit is LOW stomach acid production. So, why the burning and reflux?
Your stomach can actually hold food for up to 13 DAYS! But it shouldn't. When the pH of the stomach is not acidic enough, emptying of the stomach isn't properly signaled and food can sit in the stomach. As that undigested food sits in the stomach, lactic acid is produced from two processes:
Putrification (from undigested proteins) and fermentation (from undigested carbs)
The lactic acid byproduct from the rotting food left in your stomach can easily cause gas, bloating, heartburn and reflux.
In this case, the use of antacids and acid blockers to address digestive disorders can be extremely harmful in the long term and is a poorly used "band-aid" approach to stop symptoms.
THE IMPORTANCE OF HCL
Next to chewing your food, having healthy levels of Hydrochloric Acid (also called HYPOCHLORHYDRIA) in your stomach is the next important piece to improving your digestion and restoring your gut health. Actually, chewing your food completely helps to stimulate the production of HCl in your stomach! WIN WIN!
Hydrochloric Acid (HCl) is essential to unlocking perfect digestion.
In order to break down food properly (especially protein) and extract the nutrients you need to fuel every aspect of your body, the stomach must maintain a very low pH and acidic environment. For instance, vitamin B12 requires HCl in the stomach to be properly absorbed and utilized. So does proper iron metabolism. Without these vital nutrients being unlocked, you are more susceptible to anemia and will probably experience chronic fatigue. Minerals like calcium, magnesium, iron, zinc, copper, selenium, and boron are poorly absorbed in an alkalized stomach.
HCl activates gastric sequencing and gall bladder function.
As the stomach reaches the proper pH, it "clocks in" other organs of the digestive system to begin their work. Here is the link between HCl levels and gall bladder function ... or lack thereof in most cases ...
The acidic stomach signals the release of two important chemicals to continue the support of the digestive process:
- CCK: tells the gallbladder to squeeze and promote bowel motility and movement
- SECRETIN: tells the liver to start replacing bile that was just squeezed out of the gall bladder
It aids in the process of methylation.
Methylation is responsible for making bile, urine, DNA, cell walls, energy, and so many other things. In order for these functions to be carried out, certain substances must "donate" something called a methyl group. Think of it like calling long distance ... remember when we used to have push the "1" before the area code and phone number to reach far away places? The methyl group is the "1". Without it, the call can't go through. So here's where methylation relies on HCl: the majority of methyl donors are made in an acidic stomach. No acidic stomach = no methyl donors.
It is also the front line defense against unwanted bacteria and parasites.
The acidity level of the stomach should be close to 1. Very ACIDIC. Alkalize the stomach ... open Pandora's box. Neutralizing the stomach allows bacteria, viruses and other pathogens and parasites to survive the stomach and enter the gut where they can really wreak havoc.
The extremely acidic environment is your body's best defense against food poisoning and can help protect you from a chronic, often "asymptomatic" case of a parasitic infection that can lead to leaky gut and a host of other health problems. Not to mention, it prevents problems with H. Pylori ... which is not a good infection to have (and most people don't even know they have it!)
H. Pylori is the first recognized bacteria as a Grade I Carcinogen by the World Health Organization
and it is strongly associated with Stomach Cancer and Pancreatic Cancer!
ARE YOU AT RISK
Needless to say, if you have taken antacids or protein-pump inhibitors in the past, you're at a pretty high risk of having hypochlorhydria.
Do you consume large amounts of liquid, enjoy a drink before your meal or consume a diet high in processed, "dead" food? You're at risk. Love sugar? At risk.
If you're an avid meat eater and have been for a long time, you also have a higher risk since it can be overwhelming to your stomach to breakdown large amounts of meat on a regular, long-term basis. Certain blood types are more supportive to consuming high amounts of protein, while others do not.
Or maybe you've lost your taste for meat or have bad breath. That's the smell of the undigested protein rotting in your stomach!
Do you crave sour stuff like citrus, sauerkraut and grapefruit juice and they agree with your stomach, you may have low HCl levels.
Elderly? Stomach acid production decreases naturally with age which is a major cause to so many digestive related issues in the elderly and why they eat so little food.
As you could guess, there is a lot of factors that can lead to one problem. Here is a list of common complaints and conditions associated with low HCl:
Common Associated Symptoms
Common Associated Conditions
TESTING FOR STOMACH ACID
Personally, I feel anyone that is challenged with their digestive system or experiencing any of the associated symptoms listed above should consider evaluating HCl levels in their stomach. And if you have been diagnosed with one of the above issues, you really need to get on it ...
We can often tell from bloodwork if there is a deficiency in hydrochloric acid and therefore a need to support this vital component to digestion. If your labs indicate a Total Protein and/or Globulin level outside of the optimal range, issues with B12 or iron metabolism, changes to normal levels of chloride, and/or an increase in creatinine and stress on the kidneys, you most likely have an HCl need.
To confirm, my go to resource is the Betaine HCl Loading Test. But you do have a few options to consider:
Baking Soda Stomach Acid Test
This test works by drinking baking soda and creating a chemical reaction in your stomach between the baking soda (sodium bicarbonate) and hydrochloric acid (HCL). The result is carbon dioxide gas that causes burping. There are many variables to control and not a lot of science to back this test.
Betaine HCL Challenge Test
The most reliable test you can perform at home with a bottle of Betaine HCl with Pepsin ... and the only cost is for the supplement (~$20). Cannot be done if you have an ulcer and is highly recommended to work with an educated practitioner in case of any reactions or on certain medications.
Heidelberg Stomach Acid Test
The gold standard medical test for low stomach acid which costs about $400 and is not covered by insurance. Requires you to swallow a small capsule with a radio transmitter that records the pH of your stomach as you drink a solution of Sodium Bicarbonate.
Please Note: NSAIDs and Corticosteroids increase the chances of ulcers in the stomach and, together with Betaine HCL, increase the risk of gastritis. Consult a physician before trying these tests or supplementing.
P.S. If your Globulin levels are above 3.2, inflammation of the stomach is likely and you may need to take GASTRAZYME (by Biotics Research) before being able to handle HCl supplements. At this point, dietary modifications are strongly recommended in conjunction with therapeutic treatment.
INDICATORS ON BLOODWORK
A Complete Metabolic Panel can be completed very inexpensively (like $5-$10) that can provide indications of low HCl levels and the need to support this vital component to digestion.
Here are a few trends or things to look for:
- Chloride less than 100
- CO2 greater than 30
- Total Protein outside of the optimal range of 6.8-7.4
- Globulin outside of the optimal range of 2.4-2.8
- Issues with B12 or iron metabolism
- Increase in creatinine and stress on the kidneys
Keep in mind that these variations are not all inclusive and can indicate other issues. Working with a functional medicine practitioner that is trained in interpreting bloodwork from a wellness perspective is very helpful here.