I believe proper digestion is vital to addressing the epidemic of autoimmune diseases in this country. Digestion is the ability to take what isn’t you and turn it into you by breaking it down, assimilating the useful components, and disposing of the rest. It’s a complicated sequence of secretions, hormones, enzymes, and bacteria, and the proper balance of these substances is important.
A key part of the process is hydrochloric acid (HCl), or stomach acid. The complete absence of HCl in the stomach is called achlorhydria, and an insufficient amount is called hypochlorhydria. If HCl is not present at the proper levels, the digestive process is disrupted from beginning to end—with one or more autoimmune diseases as a possible outcome.
Essentially, HCl sterilizes your stomach and food by killing most pathogens on contact, which means it prevents the overgrowth of yeast, fungi, and bacteria in your upper GI tract (an exception appears to be H. pylori bacteria). When you have enough HCl, pathogens and parasites just become part of a meal for your body. But when you have insufficient HCl, your body can become the meal.
In addition to sterilizing, HCl denatures proteins so that the digestive enzyme pepsin can break them down further. In fact, without enough HCl, the enzyme pepsinogen that is secreted in the stomach can’t be converted into pepsin, leading to poor protein absorption and impaired metabolism that then affects the body’s other enzymes, hormones, neurotransmitters, and so on.
Additionally, proper HCl levels signal the release of secretin, a hormone that then aids in the proper functioning of enzymes from the pancreas that are needed for the digestion of fat and carbohydrates. In other words, a person with low HCl isn’t able to digest any foods adequately and so has difficulty absorbing minerals, vitamins, and other nutrients from those foods.
It’s easy to see how the scenario of little or no HCl can start a whole cascade of health compromises that can lead to severe health problems. I believe that the majority of people in their sixties and older who have multiple health complaints (particularly autoimmune diseases) should have their doctors consider hypochlorhydria as a contributing factor.
Because it hasn’t been well researched, most doctors don’t realize how common hypochlorhydria is in their patients. We do know, though, that over 30 percent of people over sixty have atrophic gastritis (which means that little to no HCl is being made), and that’s just one reason for low HCl levels.
The Purple Pill and Other Autoimmune Perpetrators
They used to call it “heartburn” and treat it with antacids such as Rolaids, Pepto-Bismol, Tums, and so on. Then they started calling it “GERD” (for gastroesophageal reflux disease) because the pharmaceutical companies developed prescription drugs that didn’t just neutralize stomach acid, but inhibited its production. Now it’s been shortened to “acid reflux”—I guess because people weren’t considering GERD a problem that they recognized and weren’t buying the drugs.
Whatever we want to call the condition that is the result of stomach acid entering the esophagus, the current fashion is to use either over-the-counter or prescription drugs to address it. Along with antacids, the expensive methods preferred by conventional medicine include proton pump inhibitors (such as Nexium, Prevacid, and Prilosec) and H2 blockers (such as Pepcid and Zantac).
While these drugs may be appropriate for a few people who need to get some temporary relief, they are actually a setup for disease for nearly everyone. Even if they help with the discomfort of heartburn or acid reflux, they are the wrong treatments because it’s rare for the stomach to actually produce too much acid on a long-term basis. When you think of all that HCl does for you, it makes no sense to try to limit its production or neutralize its effects.
Even worse is the fact that the symptoms of low HCl levels are strikingly similar to the symptoms of high HCl levels. That’s right, you can have the same symptoms with either too little or too much stomach acid, which means that low acid is often diagnosed as either high acid or an ulcer, unless the doctor runs a test to confirm which end of the acid spectrum the symptoms are coming from.1
By following the drug companies, most doctors just diagnose too much acid after a patient reports one or more of the following complaints: indigestion, heartburn, chest pain, diarrhea, flatulence, abdominal pain, or cramps. The tests that truly reflect acid levels are rarely ordered, unless the doctor actually suspects hypochlorhydria.
A diagnosis of high acid is almost always made based solely on the symptoms and the influence of the slick drug ads. However, proton pump inhibitors can lead to headaches and lung infections, and H2 blockers can cause confusion, diarrhea, and erectile dysfunction—and these adverse effects are from drugs that may have been incorrectly prescribed in the first place.
Suppress Stress for More Slime
Another possibility when it comes to a diagnosis of too much acid could actually be a faulty mucus barrier. Mucus is the slime that covers many tissue surfaces to keep them moist and to protect them from harm. Two of the jobs of the stomach’s mucosal barrier are to prevent HCl from eating the stomach and to provide another barrier to pathogens.
A gastric ulcer can develop if this barrier breaks down. Forty years ago, a patient with an ulcer was told that stress was the likely cause. Lately, conventional doctors and researchers have been saying that stress is no longer a culprit. Instead, they believe that most peptic ulcers (of which gastric ulcers are one type) are thought to be caused by an infection of H. pylori in the gastrointestinal tract. However, most people with H. pylori never develop ulcers, so there is clearly more going on, including reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) and food allergens.
Despite the current emphasis on H. pylori, stress can indeed contribute to the formation of peptic ulcers. Stress overworks the sympathetic nervous system that, in turn, affects the production of mucus, causing a breakdown of the barrier that allows HCl and H. pylori to attack weak spots. Supporting the parasympathetic system can help keep your gut sublimely slimy.
For rebuilding the barrier and easing the pain, I’ve had great success with licorice in a deglycyrrhizinated form known as DGL. It has been shown to promote mucin production and protect your stomach lining while soothing irritated tissues. However, it appears that DGL must be chewed for it to work, which means you should make sure you can handle it since the flavor is intense.
However, my top recommendation for supporting your mucosal barrier is Ulcinex. It’s based on a traditional Chinese formula of nine herbs, and it’s designed to relieve heartburn and indigestion, quiet dyspepsia, relax reflux symptoms, and support healthy flora and digestion. I recommend taking two tablets thirty minutes before each meal. For additional support, you can also take one tablet between meals.
Low Stomach Acid Causes the Body to Attack Itself
As I mentioned earlier, it’s rare to actually have too much stomach acid. If your mucosal barrier is strong, there really shouldn’t be a problem. However, low stomach acid is a real possibility, and it will alter your body’s metabolism and cause you to be functionally malnourished, which in turn means increased oxidative damage, inflammation, waste buildup with increased toxin absorption, and altered immune response (such as autoimmune diseases). There is no complete explanation for why we get autoimmune diseases. However, we know that bacterial and microbial overgrowth in the gut and intestinal barrier can leak into the bloodstream and cause immune sensitivity and hyperreactivity.
If improperly digested foods, pathogens, or even cells from your own intestinal wall enter your bloodstream, your immune system has to attack and eliminate them. In the case of food, your immune system is literally finishing the job that should have been done by the digestive system. One of the problems with the immune system disposing of foods is that the cellular structures of some foods are similar to some of the cellular structures in your body. Similarly, perceived pathogens may actually be some of your own cells that shouldn’t be in the bloodstream. Either way, your immune system will be programmed to think of some of your own cells as invaders that it will attack more vigorously the next time it encounters them. The consequences can be dire since autoimmunity, allergies, and inflammation are all potential outcomes.
Additionally, some of our microflora share antigenic determinants with our healthy, normal tissues. Even intestinal yeast overgrowth can have systemic effects and play a role in autoimmunity due to yeast antigens translocating to other parts of the body. We know, for instance, that autoimmune arthritis can be activated by intestinal infections of Yersinia, Salmonella, and other enterobacteria, with further evidence showing bacterial antigens discovered in the synovial cells of joints.
This evidence has led to the theory that the immune system is attacking cells that are hiding bacteria or other pathogens. For instance, some people may have infections that are hiding in their own cells. As the body attempts to eliminate the infection, it attacks its own cells and is then programmed to see them as invaders as well. The process may differ from that for other forms of autoimmunity, but the effects are the same.
We have been conditioned to think of stomach acid as a bad thing. However, based on my own clinical experience, I can assuredly state that many patients with a variety of autoimmune diseases can markedly improve their condition by improving their HCl, which means either getting off the antacids, proton pump inhibitors, and other acid reflux drugs or addressing hypochlorhydria if the body really isn’t making enough stomach acid.
Increasing Your HCl Levels
For anyone with an autoimmune disease (or anyone who suspects that they might have low stomach acid), I recommend supplementing with betaine hydrochloride. It’s listed under different names, depending on the manufacturer. The Vitamin Shoppe (http://www.VitaminShoppe.com) calls their version “Betaine HCl with Pepsin,” while TwinLab calls it “Betaine HCl Caps” and Solaray simply calls theirs “HCl with Pepsin.”
The treatment strategy is to gradually increase the amount of betaine HCl you take until you truly have too much acid in your stomach, then back down slightly to the correct maintenance dose. Betaine HCl has been used safely for over one hundred years, and it’s often combined with pepsin—which I recommend as well. All three of the brands I mentioned above contain pepsin, even though TwinLab doesn’t say so in the name of their product.
If you currently have a peptic ulcer, do not supplement with betaine HCl or pepsin. You need to heal your peptic ulcer first by taking plant digestive enzymes (without protease) and by rebuilding the mucosal barrier in the way I discussed earlier. After the peptic ulcer problem is cleared up, then consider the betaine HCl program.
People with a history of ulcers, gastritis, stomach pain, or heartburn must be closely supervised when taking betaine HCl. Also, people taking NSAIDs, cortisone-like drugs, or other drugs that may cause a peptic ulcer should not use betaine HCl.
Finally, if you’ve been taking antacids, proton pump inhibitors, or other acid blockers for a while, wean off them slowly before following the betaine HCl supplementation program since the possible rebound effect can be significant and painful.
Getting with the Program
I recommend this simple and straightforward protocol for taking betaine HCl. Take one capsule (500–700 mg of HCl with 100–175 mg of pepsin) at the beginning of your first complex meal that contains protein and fat (not with a simple meal of mostly carbohydrates, such as salad, soup, or fruit). Take two capsules at the beginning of your second complex meal, three capsules at the beginning of your third complex meal, and so on. Keep adding an additional capsule with each meal until you get heartburn or irritation.
On your next meal after irritation was achieved, take one capsule less than the amount that caused the irritation—this will be your maintenance dose. Whenever you have a meal of mostly carbohydrates, take only one-third to half of your full dose.
Most people with low acid will have symptoms that they should notice an improvement in as they take betaine over several days or weeks.2 The symptoms may not go away immediately, but they should not get any worse. If the symptoms do get worse, then you either have an ulcer that needs to be addressed, or you might be one of the rare people who truly has too much HCl. If supplementing with betaine HCl is right for you, you should experience better digestion, health, energy, and the gradual relief of many complaints.
Also be aware that as your body’s normal acid production resumes, you will again experience the irritation that helped you identify the proper dose. When this irritation recurs, reduce your dose by one capsule with each meal until the irritation is no longer recurring—which means that you may eventually end up not taking any betaine at all. Later, if the low acid symptoms or digestive problems come back, start the betaine HCl program again from the beginning.
One final note for those people who have acid reflux because of a malfunctioning sphincter: improving your HCl and avoiding food allergens should help as well.
** This article is one of 101 great articles that were published in 101 Great Ways to Improve Your Health. To get complete details on “101 Great Ways to Improve Your Health”, visit http://selfgrowth.com/healthbook3.html
Marcus Laux, ND, is a licensed naturopathic physician who earned his doctorate at the National College of Naturopathic Medicine in Portland, Oregon. He has been clinically trained in acupuncture, homeopathy, and physical medicine, among other healing modalities. He also writes a monthly newsletter, Naturally Well Today, which brings his readers the best of new healing methods and traditional healing wisdom. For more information, visit http://www.DrMarcusLaux.com.