Hypochlorhydria - Stomach Acid Deficiency

[monotonic]

I've had enough trouble with this that I think this condition deserves its own thread. I didn't actually think I had this problem at first, until I tested supplementation and discovered the difference. Here is a summary of my understanding of the problem:

Stomach acid (HCl) has a number of functions:

1: Sterilize the stomach to prevent infections from foreign pathogens. Else, SIBO, parasites, raw food entering gut, etc.
2: Digest food in concert with Pepsin to absorbable forms. Else, multiple deficiencies, malnourishment, including Zinc deficiency which prevents your body from producing HCl - it is a self-feeding condition, making supplementation mandatory (and additional zinc supplementation helpful).
3: GI irritation from raw, unsterilized food particles entering the gut, causing dysbiosis, malformed stools, leading to constipation, diarrhea, bloating, foul stools and so on.
4: The stomach valve opens when the stomach gets acidic enough, but if there is no stomach acid, food can sit like a rock in the stomach for hours until you vomit or the stomach valve opens. Imagine you throw your meal into a blender, spit into it, and let it sit in a yogurt incubator at body temperature for 4 hours. PBPM affectionately refers to this as a rotting mass of chyme - this is what finally enters your intestine if you don't puke it out.

Even amidst this, on the ketogenic diet, I felt great. With the exception of all the symptoms above, and treating them became a difficult regimen that limited my activities through the day.

So, I have stomach acid deficiency and this caused me terrible symptoms when going Keto for the first time (which I thought at first was potassium depletion). At the time I started researching it, I couldn't find much helpful information, except to test your HCl tolerance and supplement as necessary. I got 2 bags of Betaine HCl, and was up to 14 1g capsules PER MEAL at one time. My HCl tolerance eventually decreased, and I got down to one capsule, but then I stopped and the problem came back. I was suddenly up to 6 capsules again and so I quickly ran out of the few capsules I had left. It seems my tolerance has lowered to 6 capsules permanently, which is a good sign, but I still have symptoms.

I am learning now that I should have chosen a supplement that contained Pepsin. Maybe I wouldn't have needed so many capsules? I will be ordering more soon, and barring an H. Pylori stomach valve infection, maybe it will work this time. PBPM states that an H. Pylori infection needs to be cleared before the stomach can produce gastric acid again.

For any of you who think you may have hypochlorhydria, here are some articles to start out with. It is important to read them all if you plan to supplement:

http://www.medical-library.net/hypochlorhydria.html
http://scdlifestyle.com/2012/03/3-tests-for-low-stomach-acid/
http://scdlifestyle.com/2013/10/4-common-betaine-hcl-mistakes/

So, hopefully I missed something, and there is more I can do to try to recover from this. Anyone else with experience here?

 

[H-KQGE]

Thank you very much for starting a separate thread on this difficult condition. Although the information is on the forum, it's very handy to access it here. I don't know how much more info that there can be currently, you seemed to have covered at least the basics & key parts, from what I can tell. It really is quite complex & tricky. I'm sure there's more folks on the forum that have these issues, many that are difficult to rectify when such things as leaky gut is present.

The assorted comments on those links just highlight how much ignorance there is over this area of health, i.e. digestion, nutritional deficiencies etc. I feel for people who were given drugs that exacerbated the condition (comments from your links) & I remember my experience years ago with that awful omeprazole drug (along with others that included nasal sprays for poor breathing. I can't recall the name but my breathing was almost instantly worse & I got this loose phlegm type thing that was difficult to resist swallowing, ugh)

Ill definitely keep checking back on those links as I get HCL with pepsin & do the tests. Maybe Gaby can offer some (more) insight?

 

[Gaby]

These are good points and suggestions. I do believe we have covered this subject on several different occasions. But don't remember anyone emphasizing H.pylori as much, which can be treated with antibiotics. Granted symptoms and signs have to be really bad in order to decide to go through a diagnosis and treatment protocol like that. I was hoping that with dietary changes and supplementation, the body would just take care of this bug when it is present. But maybe some people do need the extra antibiotic help and subsequent re-population of the flora. I think that culturelle (lactobacillus rhamnosus) is a good one to consider for this re-population: http://www.health-matrix.net/2013/04/16/lactobacillus-gg-and-its-potential-role-in-tolerance-development/

Other people that are having extra difficulty getting their stomach acid online do have autoimmune diseases: chronic atrophic gastritis. I'm not sure if we have covered this one in the forum, but I know of someone struggling with this condition. It is quite tricky to deal with. Some mainstream info here:

_http://en.wikipedia.org/wiki/Atrophic_gastritis

What I would recommend is more and less covered. With each meal: digestive enzymes (a good complex), pepsin, betaine hydrochloric acid, and ox bile. Adding organic apple cider vinegar to each meal will also help digest food. To protect the stomach in case of atrophy, a person can buy aloe vera to take orally as needed. Don't take alkaliners such as sodium bicarbonate and magnesium close to meals (1 hour before and 2 hours afterwards). It will only further impair the acidity in the stomach. Getting DGL (Deglycyrrhizinated) supplements to keep in stock or in case of stomach pain is a good idea:

_http://www.huffingtonpost.com/julie-chen-md/dgl-supplements_b_2976260.html

Think of it as the process a lifetime-vegetarian has to go through in order to recover much needed digestion to digest nutrient-rich foods.

Avoiding any single MOLECULE of grains is important. Just one molecule is enough to trigger an autoimmune reaction that will take at least 6 months to calm down. People have to be VERY careful with "organic" labels. They are crap for the most part with gluten additives even when it says "gluten-free". If there is a grain mentioned, it probably is NO good. Same with lactose and other additives such as maltose. Staying away from GMO foods like the plague is essential as well. There are animal studies of irreversible gut damage linked with GMOs. Other than what Laura mentioned here: http://www.sott.net/article/271156-Happy-New-Year-2014. They use additives like this even in "organic" labels.

People need to make sure to have restorative sleep, even if they have to take 6 mg of melatonin plus 5 HTP to "knock them down real good." Making sure the whole room is pitch dark and to have no weird lights before going to bed. Using sublingual melatonin is better. In case of stomach atrophy, getting a good sublingual complex B vitamin is the way to go. Also checking for supplements that are sublingual to see if it can get through into the body.

If people are not sleeping well, health is not going to progress despite the good dietary efforts and supplementation. We haven't discussed this anymore since a lot of members have recovered so to speak. But I do know there are some at the initial stages that are having trouble and have missed the extensive discussions we had of good restorative sleep. Initially, supplements did helped to finally get that sleep. Others are trying bodywork and other therapies to see if they can get there. I synthesized the supplement part here: http://www.health-matrix.net/2010/09/03/boosting-your-happy-brain-chemistry-with-5-htp/. With the diet, this problem kind of sorted itself out. But those with severe autoimmune conditions do need all the help they can get.

My 2 cents!

 

[nicklebleu]

I will be ordering more soon, and barring an H. Pylori stomach valve infection, maybe it will work this time. PBPM states that an H. Pylori infection needs to be cleared before the stomach can produce gastric acid again.

I am actually not sure if H. pylori infection is a valid concept - I am a bit skeptical. It might well be a red herring. Initially doctors only treated H. pylori when the patient tested positive. Meanwhile they test, but if the patient is negative but has symptoms they treat anyway - and with good results. It may be that the cocktail does something other and the H. pylori is just an incidental finding.

People need to make sure to have restorative sleep, even if they have to take 6 mg of melatonin plus 5 HTP to "knock them down real good." Making sure the whole room is pitch dark and to have no weird lights before going to bed. Using sublingual melatonin is better.

I also found that taking a good dose of magnesium really helps with sleep, FWIW.

 

[H-KQGE]

Thanks for your input Gaby. I was recently contemplating re-introducing probiotics for a while but I thought that getting the right supplements for digestion would be a better start. Finding supplements without binders & fillers is still tricky, especially that pesky hydroxypropylmethylcellulose that seems to form every other capsule. They can be opened up of course but I'm still weary of hidden stuff.

I've read the threads on sleep, keto diet, autoimmune & the sites to get the best "clean" supplements & more, so I'm pretty sure I need to up my levels of certain supplements such as b-vitamins. I was actually reading the health matrix on the weekend & I went straight out after to get some ALA & milk thistle, which I had been searching for for quite some time. I currently have an enzyme mix that contains cellulose, protease & lipase amongst others but I would still prefer HCL with pepsin. The only ones I keep seeing have the corn crap I mentioned & most times there will be either one or two no-no substances mixed in, I don't fancy adding to my woes just because of a dodgy carrier agent.

I have ACV in my stock (not ready for broth yet with my leaky gut) with my meals so I don't know if say, marinating meat in ACV will be too much as well, either as I am now (not marinating) or when I get HCL. I'll definitely try & find sublingual supplements for sure but I wouldn't be surprised to see stuff like maltodextrin in there. Sleep-wise I think I'm ok since I'm no longer a chronic insomniac & this I put down to the help on those threads on magnesium (priceless) & sleep. My circadian rhythm must be off though since I start work pre-dawn, this means that my only recourse is to go to bed very early in the evening. This has worked so far this year (my first in over 15 consecutive years of insomnia) & I can't stand these artificial lights so I'm regularly in darkness anyway.

I have some of those symptoms on the list on the health matrix such as shyness, workaholic self-criticism/guilt, but none are anything like they used to be (hey I like dark weather!) but I'll consider 5HTP. I'm bookmarking this page & the links & I'll read-up on these things since they seem to apply to me more now. Thanks again.

 

[lilyalic]

Thanks for putting this thread up.

I seem to be struggling with digestive issues, totally out of the blue. At first I thought it may be a histamine intolerance, but now I'm thinking otherwise as I'm doing everything possible to stay off certain foods etc. Maybe it's a bit of both. I take around 3-4 HCL tablets with meals, sometimes ox bile and pancreatic enzymes too.

The indigestion started as "panic attack" symptoms - then diarrhea, throwing up, severe stomach cramps. Now after a week of eating NO fat - just carbs and little bits of meat, added with HCL, zinc, B vitamins, DAO etc... I'm not throwing up and there's no diarrhea but I still get pains, not just in the stomach in the chest area, more like a giant pressure around that area with the odd sharp pain - but this is a few hours after I've eaten now whereas compared to last week it was straight afterwards.

That's what brought me onto Helicobacter Pylori& hypochlorhydria

I saw what Laura said about drinking cabbage juice to kill the critters - but then I thought that would effect my histamine levels

Treatment


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.

http://www.medical-library.net/hypochlorhydria.html



EDIT: added...

After reading those articles I would say that the food I now tend to get the most discomfort from it fat. When I was keto-adapted before all this happened, and now bam - issues with digesting.

 

[Gaby]

That's what brought me onto Helicobacter Pylori& hypochlorhydria

There are tests to determine if H.Pylori is one of your main issues. I personally would not hesitate undergoing the eradication antibiotic treatment if dietary and supplementary measures don't work.

I know someone who ended up in the emergency room with severe tummy problems. He was having issues for months on end... Until he was diagnosed with H. Pylori and took antibiotics to eradicate it. He feels much better now. The antibiotics are very similar to the ones of the autoimmune protocol, if not the same.

This particular person used to drink a lot camel's milk in his native country, but when he emigrated, he took dairy products instead. That probably knocked down his immune system.

 

[nicklebleu]

I agree with Gaby, get H. pylori tested.

However there is one caveat - the test is not 100% accurate and if symptoms persist it might be reasonable to go through the eradication protocol despite the negative test (as some recent studies have shown to be beneficial).

And of course trying to reduce stressors is a big one too - which I know you are already up to!

Best wishes

 

[lilyalic]

I agree with Gaby, get H. pylori tested.

However there is one caveat - the test is not 100% accurate and if symptoms persist it might be reasonable to go through the eradication protocol despite the negative test (as some recent studies have shown to be beneficial).

And of course trying to reduce stressors is a big one too - which I know you are already up to!

Best wishes

I had a feeling the auto-immune protocol would be beneficial for me considering issues I've had. Though when researching it, I thought there is no way my doctor would agree/help me considering all 3 of the ones I've seen mis-diagnosed me and didn't seem to bothered. Also, the cost of the protocol and the side effects when not being able to take time off work just seem a little impossible.

Forgive me if I'm just being stupid here, but when looking over it again I couldn't find the exact doses/ medications, the protocol basically. I'm having a brain-fog/ ill day.
I got Metronidazole, Allopurinol, Prednisone & Doxy. Doing a little research on those atm.

Huxley purchased "Why can't I get better" and "Plague time" so they'll be useful to read before considering any of the protocols!

Thank you :)

 

[lilyalic]

I went to the doctors again yesterday and demanded a h.pylori blood test along with some liver function tests. The doctor tried to prescribe me antacids, but I refused.

Last night I was vomiting alot, and was in severe pain. I really will have to just eat carbohydrates. I'm just wondering whether a coffee enema will help or make something worse?

 

[Gaby]

I went to the doctors again yesterday and demanded a h.pylori blood test along with some liver function tests. The doctor tried to prescribe me antacids, but I refused.

Last night I was vomiting alot, and was in severe pain. I really will have to just eat carbohydrates. I'm just wondering whether a coffee enema will help or make something worse?

You can try aloe vera and sodium bicarbonate as anti-acids in between meals. Then, apple cider vinegar with your meals. See if it relieves it.

I'm sorry if you are stuck with arrogant and incompetent people as doctors. When you're sick, it is the worst experience to go through that. But as a strategy, perhaps you can go for another opinion, a different doctor and say that you've been on anti-acids and it has been of no of help. You're sick and vomiting a lot, then bring up the H.Pylori testing again.

Hang on!

 

[lilyalic]

You can try aloe vera and sodium bicarbonate as anti-acids in between meals. Then, apple cider vinegar with your meals. See if it relieves it.

I'm sorry if you are stuck with arrogant and incompetent people as doctors. When you're sick, it is the worst experience to go through that. But as a strategy, perhaps you can go for another opinion, a different doctor and say that you've been on anti-acids and it has been of no of help. You're sick and vomiting a lot, then bring up the H.Pylori testing again.

Hang on!

I've been taking sodium bicarbonate and ACV with, and in-between meals. I'll try aloe vera too. I found that chewing on ginger helps sometimes. Fortunately after nagging the doctor, he did put through for the tests after being like "OK OK" (I felt like I was being treated like a nagging child)- another doctor I seen just went on about how much doctoring experience she has and that I disrespected her. Yes it is VERY frustrating when they really don't listen to you, and just sit and type in front of a computer.

I even said to him that I had been trying anti-acids, he clearly didn't listen. The mainstream doctoring system really is BS. I'm hoping something comes back from the blood tests.

Thanks Gaby!