hypochlorhydria

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Hypochlorhydria

by Ron Kennedy, M.D., Santa , California

Why is it some people age faster, require more medical attention and

die earlier in life than others? The medical answer has always been

that it is because of " constitution, " or in the most modern

mythological jargon, " It's in your genes. " All this is another way of

saying " We don't know. " (Medical jargon has a lot of ways of

saying " We don't know. " ) I know. Let me tell you about it.

One branch of progressive medicine is nutritional medicine. There is

no category of disease which cannot be helped by the nutritional

approach. By the term " nutritional approach " I mean the use of oral

and intravenous nutrients, as well as the institution of dietary

changes. There is no such thing as a person who is ill from a

degenerative disease process (breakdown of joints, sclerosis of

arteries, cancer, etc.) who also has been optimally nourished his or

her entire life. All degenerative disease has its origin in

malnutrition.

" But, how can people in America be malnourished? " you may ask.

Easily. Eat the typical American diet, and you become borderline

nourished. Do worse than that, and malnutrition appears in the form

of degenerative disease. Many people who eat a perfectly nourishing

diet also are malnourished and end up with degenerative disease. How

can that be?

If the proper food is eaten and the proper nutrient supplements

taken, that is one thing. It is quite another for that food and those

nutrients to be absorbed into the body. Just because something goes

down your esophagus does not mean that it will make it to the cells

of your body. First, it must penetrate the wall of your intestines.

If it does not encounter the proper acid and enzymes, it will not

digest and absorb properly, and you will become malnourished, making

your body fertile ground for the development of infectious and

degenerative diseases.

Normal digestion is a complex cascade of events beginning when food

is placed in the mouth and ending with elimination about 24 hours

later. Normal digestion requires thorough chewing, mixing of food

with enzymes, efficient swallowing, followed by exposure to a large

quantity of acid and enzyme in the stomach. About two hours later,

the chyme (food in the process of digestion) is moved on to the small

intestine where it is bathed in bile, bile salts and more enzymes.

More absorption occurs, and the chyme is mixed with bacteria to aid

in digestion. After being moved to the colon, water is reabsorbed,

and vitamin E is manufactured by " friendly " bacteria.

Digestive disturbance can happen anywhere along the intestinal tract

resulting in less than optimal digestion and a state of relative

malnutrition. Many of these conditions are rare, and it is unlikely

that you or your loved ones are suffering from them. It is possible,

however, and if they are present, your doctor should be able to

diagnose and treat them. While each disease is important, especially

to the well-being of the person who has the disease, my purpose here

is to alert you to a condition which is both common, frequently

undiagnosed and usually untreated: hypochlorhydria.

Hypochlorhydria is the underproduction of hydrochloric acid by the

stomach. Hydrochloric acid, or HCL as it is called, is responsible

for two important functions: (1) it begins the breakdown of protein

by simply frying it in acid, and (2) in the presence of food it

activates an enzyme called " pepsin, " which further breaks down

protein.

For many years, hypochlorhydria was a condition doctors could only

suspect but not diagnose — except with lab tests so difficult to

administer, it was easier to rationalize not making the diagnosis and

not treating the illness. This test involved shoving a tube down the

esophagus and periodically suctioning out the stomach contents after

a meal, so the acidity of those contents could be measured.

So, doctors rationalized a point of view that the disorder is not

worth treating. Therefore, medical students were taught to ignore

symptoms of hypochlorhydria, because the necessary test to make the

diagnosis was more difficult for the patient than the disorder

itself. Medical students do believe what their med school professors

tell them, and this led to a generation of doctors unwilling to

further examine the problem of hypochlorhydria.

However, that situation began to change in the late 1960s with the

invention of the Heidelberg machine. This elegant (but expensive)

device involves swallowing a capsule about the size of a vitamin

capsule. This capsule is an acid-measuring radio telemetry device. It

measures the acidity of the stomach and radios the results to an

antenna which the patient wears like a large belt around the waist

during this one- to two-hour test. While the telemetry capsule is in

the stomach, we challenge the stomach's ability to make acid by

having the subject swallow a teaspoon of water saturated with sodium

bicarbonate. If the stomach is normal, we can see the acidity return

to the stomach. If the stomach is unable to withstand five of these

challenges, we know we are dealing with hypochlorhydria. The ability

to diagnose hypochlorhydria is a wonderful advance in medicine, one

which too few doctors are taking advantage of due to the party line

that hypochlorhydria is not worth treating.

Many people who have too little stomach acid are being treated as if

they have too much. The reason for this is that the symptoms are

similar. Because ten to fifteen percent of the population is

hypochlorhydric, there are many people out there who are being

misdiagnosed and mistreated. A full fifty percent of people over age

60 are hypochlorhydric and, of all the patients coming to a doctor,

up to fifty percent of these have underlying hypochlorhydria. The

image of the overactive stomach is so common, many people are

treating themselves with antacids without even bothering to consults

their physicians.

The view that the action of the stomach on digestion is so

inconsequential as not to merit proper and concise diagnosis and

treatment is, in my view, indefensible. Why would nature have given

us the ability to concentrate HCL in the stomach one million times

more than the surrounding tissues, if it were not needed?

Stomach acid serves many important functions, not only in digestion,

but also in keeping the body free from disease. Many bacteria enter

the body with food. Some of them are not friendly to human life. In a

normal stomach, these bacteria are doused with acid and die. In a

person with hypochlorhydria, these bacteria are escorted into the

small intestine along with a generous food supply. It has been shown

that people with hypochlorhydria have more than their share of

infections. The ever present yeast organism makes its entrance via

the mouth. Many people with the so-called " yeast syndrome " are unable

to get rid of their yeast because the organism continues to reinfect

the body through the mouth.

Frequently, stool analyses of people with hypochlorhydria reveal the

presence of undigested protein fibers. While able to digest enough

protein to live using their own pancreatic enzymes or enzyme

supplements, these people are not getting the full benefit of the

food they eat. The final result is that these people do not feel as

good as they could and have no idea why.

Certain symptoms of hypochlorhydria make life very unpleasant for a

person as well as for other people around. The collection of gas in

the stomach results in frequent burping, a troublesome and

embarrassing symptom. Unexplained bloating, belching and " heartburn "

frequently are diagnosed as symptoms of hyperacidity and wrongly

treated with antacids, when what is really going on is insufficient

acid production. The resulting imbalanced bacterial flora further

down the digestive tract produces a lot of hydrogen sulfide gas, and

this does nothing for your social standing.

Some people have done all they can think of doing for their health:

vitamins, exercise, etc., and still do not feel right due to the poor

nutritional status of unrecognized hypochlorhydria, often combined

with an underactive or overactive production of enzymes by the

pancreas. See pages 178-192.

A voracious appetite may be related to hypochlorhydria simply because

the person is not getting full nutritional value from food eaten. The

body tries to solve this by demanding more food. " I am hungry all the

time " should ring the hypochlorhydria bell.

The " big belly' is a common sight on the streets of America. In most

cases, this is contributed to by hypochlorhydria and a relative

absence of digestive enzymes, which should be derived from raw food.

This combination of circumstances results in excessive eating and

stasis of food in the colon. The excessive eating occurs because

incomplete digestion causes a condition of undernourishment and

hunger. When incompletely digested food reaches the colon, the colon

reacts by slowing down, causing chronic congestion of food in the

colon.

After being stretched like this for a few years, the colon can hold

several gallons of food. Many people are not " fat, " nevertheless,

their big bellies hang on their bodies like giant water balloons,

except it is not water.

Some people with hypochlorhydria report that food seems to sit in the

stomach far too long after a meal. Others say they can eat only a

small amount of food before feeling full. Still others are

constipated while others have diarrhea. Many have no symptoms

referable to the digestive tract.

That is not to say that they have no symptoms, however, because the

number of non-intestinal disorders which are associated with

hypochlorhydria is truly astounding. Because these diseases can be

helped by nutritional means, it is reasonable to consider them

nutritional in origin. Here is a list of those diseases associated

with hypochlorhydria: Allergies

Chronic fatigue

Autoimmune Diseases

Weak nails

Thyroid disorders

Dry skin

Diabetes mellitus

Poor night vision

Gallbladder disease

Hypoglycemia

Asthma

Weak Adrenals

Vitiligo

Rheumatic arthritis

Acne rosacea

Lupus erythematosis

Chronic hepatitis

Given the commonness of the problem, I believe anyone with any of the

symptoms or conditions above should have a Heidelberg test or a test

trial on hydrochloric acid supplementation. While the Heidelberg test

is rather expensive (at present $175), it more than pays for itself

when the proper diagnosis is made.

Alternatively, under your doctor's supervision, you may elect to take

Betaine HCL with your meals. If you are able to do this without a

burning sensation, and if your symptoms are alleviated, this is

sufficient, in my opinion, to confirm a diagnosis of hypochlorhydria.

If the diagnosis is not hypochlorhydria, the Heidelberg test will

pick up the problem if it exists in the stomach or first part of the

small intestine. Hyperacidity, the " Dumping Syndrome " (in which food

passes directly from the stomach into the small intestine),

achlorhydria (the complete absence of stomach acid), gastritis,

gastric ulcer and pyloric insufficiency are all easily seen on the

graph drawn by the Heidelberg machine. Even if the test turns out to

be perfectly normal, this information can be invaluable, because your

doctor does not need to continue to look at your digestive tract for

the cause of your problems.

The standard medical approach to hypochlorhydria has been to ignore

it and say that it makes no difference. This movement in medicine was

partially based on studies using HCL replacement alone. In fact,

there is more missing than hydrochloric acid. The same cells (the

parietal cells) which make HCL also make pepsinogen, which is

converted to pepsin in an acid environment. Therefore, pepsin usually

is also deficient and must be replaced for best results. Most Betaine

HCL preparations come with 30 or 40 mg. pepsin.

An item called " intrinsic factor " may be in short supply, because it

also is made by the parietal cells which produce acid and pepsinogen.

Intrinsic factor makes the absorption of vitamin B12 possible, and

without it B12 deficiency sets in. This disease is called pernicious

anemia.

The hypochlorhydric stomach often makes insufficient amounts of

intrinsic factor and, therefore, it is necessary to give a series of

vitamin B12 injections to get the best result from treatment of

hypochlorhydria.

The question is sometimes asked: what is the root cause of

hypochlorhydria, and what can we do to restore function naturally so

the stomach resumes its function of manufacturing acid? There

probably is a root cause, although we are unaware of what it may be.

I suspect it has something to do with an as yet unrecognized

nutritional deficiency, although I have nothing to back up this

hunch.

There also is the possibility that the parietal cells of the stomach

simply die off before the rest of the organism. Perhaps each

individual has certain cell lines which are destined to die before

the entire organism bites the dust. It also may be that industrial

pollution and the pollution of our food supply with pesticides,

herbicides and preservatives contributes to the early demise of

parietal cells.

Treatment of Hypochlorhydria

We do not yet know the true cause of hypochlorhydria. When we find it

out, we may be unable to cure it, but at least we can now treat the

condition and return the patient to normal functioning.

Once the diagnosis is certain, one of two items can be used: betaine

hydrochloride or glutamic acid hydrochloride. These " carrier

molecules " make it possible to introduce the HCL as a powder in a

capsule and thus avoid damage to your teeth, which occurs with the

liquid form of HCL. These preparations should always contain pepsin

for best results.

The solid tablet form of HCL is to be avoided because it is not as

effective as the powdered form. When you put the HCL into your

stomach with a meal you want it to work then, not later when the

tablet has finally dissolved.

The amount of HCL needed can vary from 30 to 100 grains. The largest

capsules are ten grains, so this means three to ten caps with each

meal. The number per meal can vary based on the quantity and type of

food you are eating, but no exact guidelines can be stated. You

should start with one cap with a meal, and if this is tolerated,

build up with each successive normal meal (whatever is " normal " for

you) until you experience a burning sensation. One cap less than that

dose which produces a burning sensation is your proper dose for a

normal meal. The dosages for smaller or larger meals are adjusted

accordingly.

These may seem like large doses; however, they represent considerably

less acid than a normally functioning stomach can make. I recommend

no more than this, because this amount seems to work. I believe in

using the lowest dose of anything which works.

The lab tests which will reveal the benefit of HCL supplementation

are: (1) stool analysis to demonstrate complete protein digestion,

(2) a blood count to demonstrate correction of pernicious anemia or a

previously iron-resistant form of anemia (due to poor iron

absorption) and (3) x-rays to demonstrate recalcification of certain

types of osteoporosis caused by poor calcium absorption in turn due

to low stomach acid.

In addition, a few weeks of supplementary vitamin B12 intramuscular

injections twice each week usually produces marked improvement in

well-being and a clearing of several symptoms. The B12 is given in

combination with folate, so that folate deficiency is not masked and

left untreated by the injections. B12 and folate together usually

result in more sound sleep, more energy and less anxiety.

As you might suspect, B12 injections are out of vogue with the

medical establishment because of the fact that a seven year supply of

B12 can be stored in the liver. The fact that it can be stored does

not mean that it is stored in this quantity in every individual,

however. Even if B12 is stored in these quantities, this does not

guarantee availability when needed in larger-than-usual quantities.

While it certainly is an inconvenience to supplement stomach acid

with each meal for a lifetime it may be less inconvenient than the

alternatives. It is well-known that hypochlorhydria is associated

with increased risk of stomach cancer, and this may be due to the

conversion of nitrites into cancer-inducing nitrosamines in an

abnormally alkaline stomach. Also, intestinal overgrowth of bacteria

and the incidence of parasitic infections is increased when stomach

acid is low. Risk of cancer, risk of parasites, expected bacterial

overgrowth and remember the always-present yeast organism, ever ready

to become a problem — all adds up to a lot more inconvenience than

popping a few betaine HCL caps with each meal.

See common digestive disorders and digestive insufficiency.

Sources

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