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One of the recent topics I have covered in my coursework with the Nutritional Therapy Association is digestion. In the book Why Stomach Acid Is Good For You by Dr. Jonathan Wright, I have come across a lot of information that I believe is relevant to those suffering with autoimmune disease and dealing with digestive difficulties (considering leaky gut — probably all of us!). Here I will answer some key questions on the topic of stomach acid.
Why is stomach acid important?
Stomach acid is responsible for optimizing gastric pH and triggering the action of pepsin, an enzyme that is needed to break protein down into amino acids and peptides. If the pH of the stomach is not optimal, then nutrients are not broken down into absorbable components and protein digestion is compromised. Stomach acid also prevents bacterial and fungal overgrowth. When it is properly acidic, bacteria that are ingested along with food don’t stand a chance. It acts as an acid buffer to protect the body from pathogens that enter our bodies.
I thought too much stomach acid was the problem — how can it be a problem of too little?
Unfortunately, instead of being actually checked for stomach acid levels, anyone who goes to the doctor complaining of heartburn or GERD gets sent home with a prescription for an acid-blocking or proton-pump inhibiting drug. What is incredible is that the symptoms of having too little stomach acid can be the same as having too much – which medically is rare. When actually tested for stomach acid levels, most people with these problems actually have low stomach acid. The job of the pyloric sphincter (valve that lets food from the stomach into the small intestine) is to make sure the food is properly acidified before it passes on to the next phase of digestion. When a person has low stomach acid, that valve doesn’t want to led the food pass because it is not at the proper pH. This causes food to sit and putrefy in the stomach, and eventually pushes up on the lower esophageal sphincter causing symptoms of reflux and heartburn.
What kind of problems can low stomach acid contribute to?
Low stomach acid, or hypochlorhydria, can be responsible for a myriad of problems. First, low acid levels mean lower absorption of nutrients such as amino acids, iron, calcium, folic acid, vitamin b12, zinc, and others. The impact of this can be great – a person could be eating the most nutritionally complete diet, but if they don’t have sufficient stomach acid, a lot of these nutrients can go to waste and not end up being properly assimilated into the body. It can also make us more vulnerable to bacterial infections, parasites, and fungal overgrowth. Low stomach acid is associated with allergies, depression, anemia, stomach cancer, skin problems, gallbladder disease, osteoporosis, autoimmune disease, and accelerated aging.
How does stomach acid relate to autoimmune disease?
According to Dr. Wright’s research, people with autoimmune disease tend to have low stomach acid, poor digestion, and multiple food allergies. In his book, he talks about how he is surprised when he has a patient with autoimmune disease that does not have low stomach acid! Allergic reactions cause the gastric and intestinal linings to become inflamed, decreasing the secretion of stomach acid and causing allergic reaction symptoms elsewhere on the body (as on the skin). Prolonged exposure to allergens or irritants contributes to leaky gut, or intestinal permeability, which is already a well-researched feature of autoimmune disease. These proteins that are able to pass through the intestinal barrier can cause a person’s autoimmune symptoms to worsen. It is very important that those with autoimmune disease maintain the correct gastric pH so that their proteins get properly broken down and don’t end up in the blood stream. The byproducts of bacterial overgrowth in the small intestine (SIBO) can harm the intestinal lining even further, promoting a leaky gut even when allergens have been removed from the diet.
How do I know if I have low stomach acid?
Chances are, if you have had problems with heartburn or indigestion in the past (especially if you have taken proton pump inhibitors for long periods of time) you could have low stomach acid. The risk is higher for those who have malabsorption, vitamin and mineral deficiencies, digestive problems, autoimmune disease, or have been vegan or vegetarian. It is important to work with a provider to determine if you have low stomach acid before trying supplementation with HCL.
How can I increase my production of stomach acid?
Once you have carefully determined that you have low stomach acid with the help of a practitioner, you have a few ways to help your body make more or supplement. Bitters are natural herbs that stimulate the stomach to make more acid. They need to be taken in small doses and tasted in order to have the medicinal bitter effect. Some of the herbs include caraway, dandelion, fennel, ginger, goldenseal, milk thistle, peppermint, and yellow dock. If that doesn’t work, taking a couple of tablespoons of apple cider vinegar or lemon juice at the beginning of a meal can help acidify the contents of the stomach. If you are quite low on stomach acid, supplementary HCL tablets may be beneficial. If you are planning on supplementing with HCL, I highly recommend working with a medical practitioner to ensure that it is safe for you to do so.
My personal experience with low stomach acid:
When I was deep in my illness I was struggling desperately with multiple vitamin and mineral deficiencies. I was very low on iron, b12, and vitamin d, among other things. I had been vegan for a long time, and my digestion was very weak. No manner of supplementation was helping any of my deficiencies. My practitioner had me do a HCL test, and we found that I had one of the worst cases of low stomach acid that she had ever seen in her practice. She put me on supplemental HCL, and I felt that my digestion was improving. Then I started eating meat, and I suddenly needed half the amount of pills I had been taking. This made sense because zinc and b1 are required for stomach acid production, and both nutrients can easily be deficient in a vegan diet. I got a blood test and my vitamin and mineral status was back to normal, for the first time in years. I believe that my autoimmune diseases as well as being vegan for so long contributed to my low stomach acid. I still take HCL supplements, but nowhere near the quantities that I did before. I believe that getting my stomach acid on track has been a huge part of ensuring that the nourishing diet that I eat gets all the way to my cells.