07 Feb Is Low Stomach Acid The Elephant In The Room?
These days in the clinic I am seeing more and more patients including children, that are experiencing upper digestive complaints like indigestion and heartburn, who have been prescribed medications by their GP such as Nexium, Pariet, Losec, Somac or Zoton. These types of medications are called proton pump inhibitors (PPI) and as the name suggests, are designed to inhibit your gastric acid secretions to help with symptom control. The problem is our gastric acid, known as Hydrochloric acid or HCl, is secreted in our stomachs to do several important roles that are crucial to digestion and nutrient absorption. If we inhibit this secretion for too long, we can open the door to a myriad of other digestive complaints that may develop into more chronic health conditions.
Why is stomach acid important?
The breakdown and absorption of food is complex, but we don’t really give it much thought beyond our dinner plate. The reality is that there is a well-orchestrated set of processes that occur after you eat your first mouthful of food to the time you pass a bowel motion. This process helps your body to extract the nutrients out of your food.
In the stomach, we secrete hydrochloric acid (HCL) for several reasons such as:
To digest your protein
HCL initiates protein digestion by converting a substance called pepsinogen into the enzyme pepsin. Pepsin is responsible for breaking apart our protein into smaller molecules which is much more readily absorbed by the small intestine. Without adequate HCL secretion protein digestion is not efficiently initiating and allows undigested larger protein molecules to be absorbed into the systemic circulation which can trigger food sensitivities and intolerances.
To assist with carbohydrate & fat digestion
HCl also supports the digestion of carbohydrates, fats and vitamins A & E, by stimulating the release of pancreatic enzymes and bile into the small intestine. This allows them to be broken down further into vitamins and minerals the body can use.
To support vitamin & mineral absorption
The bioavailability and release of vitamins and minerals such as folic acid, ascorbic acid, beta-carotene and iron, are enhanced with HCL secretion. In contrast, low HCl can reduce the absorption of certain minerals and trace elements such as calcium, magnesium, zinc, copper, chromium, selenium, manganese, vanadium, molybdenum and cobalt leading to mineral deficiencies in the body.
To protect us from pathogens
As well as breaking down and absorbing vital nutrients, HCl also plays a role in maintaining a sterile environment in the stomach. It does this by neutralising orally ingested pathogens to act as a barrier, preventing bacterial and fungal overgrowths of the small intestine. Research has shown that Escherichia coli (E Coli) is inactivated when the stomach acidity is high and conversely when it is low, it is associated with conditions such as Small Intestinal Bacterial Overgrowth (SIBO) and candida.
There is also a strong correlation between low stomach acid and an increased risk of a Helicobacter pylori (H. pylori) infection, which is a major cause of gastritis, gastric ulcers, gastric carcinomas and B-cell gastric lymphomas.
What are some symptoms of low stomach acid?
Symptoms will often present several hours after eating and can include;
- a desire to eat when not hungry
- a sense of fullness after meals
- bloating under the ribs
- undigested food and fibres in your stool
- food sensitivities
In 2018 I was lucky enough to train with Dr Steven Sandberg-Lewis a Naturopathic Gastroenterologist who taught me some functional gastrointestinal techniques to assess areas such as gastric acid secretion. So, when seeing a client for the first time I often utilise these techniques to give me clues on their HCL and pancreatic secretion status.
How can I improve my levels and provide symptom relief?
There are some common natural alternatives and habits that you can use to help improve your stomach acid levels instead of going on medications like PPIs. These include;
Take bitter herbs before meals
Herbs such as gentian (Gentiana lutea) have been used in Europe as a digestive aid for centuries, especially in formulas such as Swedish Bitters. Gentian contains the bitter substances gentiopicrin and amarogentin, which act on our taste bud receptors to stimulate the secretion of saliva in the mouth and hydrochloric acid in the stomach. Bitter herbs are more effective if taken before meals as they prime the digestive system for food
Consume fermented foods before meals
Fermented foods such as sauerkraut, beet kvass and/or apple cider vinegar can also prime the digestive system for food. They are best consumed 10 minutes before meals and do a similar job to bitter herbs.
Avoid drinking beverages with meals
Consuming fluids with meals dilutes your HCl concentration and reduces the acidity of the stomach. This can impair digestion and promote bacterial overgrowths.
Check your zinc status
Zinc is essential for HCl production. As zinc is used for over 200 biochemical functions in the body and, if we do not consume enough in our daily diet, we can often fall short and stomach acid production may be impaired. Zinc levels can be determined in several ways from red blood cell testing to examining the health of your nails and should be considered if you have symptoms that indicate low stomach acid.
Supplementing with Betaine Hydrochloride and pepsin
Betaine hydrochloride (HCl) and pepsin are nutritional supplements that have been used safely for many years to restore normal gastric acidity and support your digestive function. The timing and dosing of supplements like these are dependent on your symptoms and their severity.
So…where to from here?
As HCl production also naturally declines as we age, it is important to instil daily habits that promote acid production sooner rather than later. Depending on the severity of your symptoms you may find using one or more of the above recommendations can help support your acid production and provide symptom relief.
If your symptoms are severe or you need help coming off mediations like PPIs, it is a good idea to work with a trained practitioner to achieve optimal results.
To discuss this further contact me on 9339 1999 to book a free 15-minute scoping session on how I can help you.