Stomach Acid - Misunderstood and Over Prescribed in America

Are you taking antacids or Proton pump inhibitors? PPIs reduce the production of acid by blocking the enzyme in the wall of the stomach that produces acid. What if the cause of your heartburn was not too much stomach acid? What if the problem was low stomach acid? Imagine if improving your gut health and making a few simple lifestyle changes would eliminate that burning sensation and other symptoms?

SYMPTOMS OF LOW STOMACH ACID

Common symptoms and disorders of low stomach acid:

Heartburn
GERD (gastroesophageal reflux disease) when the esophageal sphincter does not seal tightly)
Indigestion and bloating
Burping, belching, or gas (flatulence) after meals
Excessive fullness or discomfort after meals
Constipation and/or diarrhea
Digestive issues
Chronic intestinal infections
Undigested food in stools
Food allergies, intolerances, and sensitivities
Acne
Chronic fatigue
Mineral and nutrient deficiencies (including iron and/or vitamin B12 deficiency)
Dry skin and hair or hair loss
Weak or cracked nails
Asthma
Depression
Osteoporosis
Any autoimmune disease diagnosis

My hypochlorhydria diagnosis

Back in 2006, after a couple of years on the Raw Foods diet, my body was depleted of Vitamin B-12, Iron, and the enzymes necessary to digest a regular meal and I was producing little to no stomach acid. There are different tests your doctor can perform, and my doctor used the Heidelberg Stomach Acid Test which is a very accurate test.

This test works by using a small capsule with a specific wireless electronic transmitter that records the pH of the stomach as you drink a solution with small amounts of baking soda. Baking soda is sodium bicarbonate which has hydroxide (OH-) ions that reduce acidity.
The baking soda will naturally neutralize the HCL in the stomach. If the acid does not return to normal after the baking soda is swallowed than that is a positive test for hypochlorhydria (2).

This gastric acid secretion test showed that I indeed had very low stomach acid, borderline achlorhydria. My doctor advised me to supplement my digestive system by taking betaine hcl.

Unexplained Stomach Pain

Fast Forward 11 years later, I started having some unexplained stomach pain that was NOT accompanied by any other symptoms, not even nausea or diarrhea. Just excruciating stomach pain. After ruling out the obvious, no elevated white blood cell count, negative for Helicobacter Pylori, negative for other bacteria, parasites, etc. the doctor didn't know what was wrong with me but prescribed a PPI (antacid) anyway. Even though he had NO PROOF that I was producing too much stomach acid.

I knew that over the years I had not been producing enough stomach acid and couldn't imagine any reason why I would suddenly start overproducing stomach acid. I asked the PA on what basis had he decided that I needed an antacid. To this, he said I needed to take this prescription to allow my stomach to heal. (from what???)

At this point, I explained to him that I had previously been diagnosed with hypochlorhydria and that I was concerned that taking an antacid would keep me from being able to digest my food.

After this comment from me, the PA became agitated because I was questioning him. He said, “well, you can either take the PPI, or you can continue to suffer. You could end up seeing a gastroenterologist who will stick a tube down your throat.” (scare tactics) I thanked him for his time and repeated that I preferred not to take the PPI. He rolled his eyes at me and left the room.

Imagine a world where physicians actually continued to explore until the cause was found

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I'm not a doctor, and I take my health very seriously. Being very in-tune with my body, I find it important to know WHAT we are treating BEFORE we begin treatment. In this case, there was no evidence that extra stomach acid was causing the problem. In fact, I had been suspecting that I wasn't properly digesting my foods, most likely from the lack of enzymes and HCL (hydrochloric acid) that I had been previously diagnosed with.

Over Prescribed America

I had already read a couple of books on the subject in the past as well as a few articles explaining how antacids are highly overprescribed in America.

When you take PPIs, which significantly reduce the amount of acid in your stomach, it impairs your ability to properly digest food.
Reduction of acid in your stomach also diminishes your primary defense mechanism for food-borne infections, thereby increasing your risk of food poisoning.
Additionally, if you fail to digest and absorb your food properly, you will not only increase your risk of stomach atrophy but also nearly every other chronic degenerative disease.
These drugs have also been linked to an increased risk of pneumonia, and result in an elevated risk of bone loss. The risk of a bone fracture has been estimated to be over 40 percent higher in patients who use these drugs long-term.

Even though all of my tests came back normal and my stomach acid had NOT been tested. I had refused to accept the prescription but the doctor still called it into my pharmacy. The pharmacy sent a recorded message every day for three days to remind me. Finally, I called them back (which is quite a hassle) and informed them that I would not be wasting my money on the prescription!

During the months leading up to my diagnosis of hypochlorhydria back in 2006, I experienced several annoying symptoms. Within three weeks of taking HCL and Digestive Enzymes all of the symptoms completely disappeared. Why? Because we need stomach acid.

We need stomach acid to:

Digest proteins and break them into the amino acids that are used to build the various types of tissues and structures in the body.
Stimulate digestive enzymes and bile produced by the pancreas and intestines. These substances are vital for the breakdown of carbohydrates and fats.
Act as a first defense against invading yeasts, bacteria, and parasites that will otherwise make it past the stomach and cause infections.
Properly absorb some minerals and nutrients, such as iron, copper, zinc, calcium and vitamin B12. Low stomach acid has been associated with anemia and vitamin B12 deficiency.

To put it bluntly, if stomach acid is low, everything is going to be out of order, from the stomach to the small intestine and on down the line. Without stomach acid, we are thrown into a vicious cycle:

Low Stomach Acid: A Vicious Cycle

There are two main consequences of low stomach acid:

You become protein malnourished. When your stomach acid is low, you are not able to digest protein. Improper digestion of protein creates toxins in your intestines that can set the stage for illness and disease. Improper digestion of protein also creates acidic blood, since protein is by nature acidic.
You become mineral deficient. As your blood becomes more acidic, it will look for minerals from anywhere in your body, in order to get your blood to its more ideal alkaline state. Acidic blood robs your body of minerals, even taking minerals from your bones (which is important to know if you want to prevent osteoporosis).

Low stomach acid eventually creates a vicious cycle: low stomach acid = low minerals = acidic blood. This cycle continues because acidic blood further creates low minerals and low stomach acid.

In spite of this, acid blockers are one of the Top 10 Prescribed drugs in America. That's ironic considering upwards of half Americans produce too little stomach acid. Low stomach acid is a common problem in developed nations, according to Jonathon Wright, MD author of Why Stomach Acid is Good For You: Natural Relief from Heartburn, Indigestion, Reflux and GERD.

Risks of blocking stomach acid

What are the risk factors of blocking stomach acid? How about a higher risk of developing kidney stones, and an even increased risk of chronic kidney disease. That's not all.

According to Dr. Thomas Sehested, the leader of a study by the American Society of Nephrology (ASN):
“… We would recommend that people should not take these drugs unless there is a clear indication for them. Many people are taking them unnecessarily or they are continuing to take them long-term when they don’t need to. I would urge doctors to review their patients on PPIs and look at why they are taking these drugs and consider whether they really need them or if they could take a lower dose.”
If this new research isn’t enough to make you consider a more natural option for managing your heartburn, take a look at some of the other dangers of PPIs:
– Long term use of PPIs has been found to increase the risk of gastrointestinal infections, osteoporosis, and pneumonia.
– Long term use of PPIs has been associated with higher risk of developing dementia.
– Blocking the stomach from making hydrochloric acid can decrease your body’s ability to absorb certain nutrients, including calcium, folic acid, iron, magnesium, and vitamin B12.
– Although many people (including physicians) believe that PPIs will reduce the risk of getting esophageal cancer, recent research has found that long term use of PPIs may actually increase the risk of developing cancer of the esophagus.
– People may become “addicted” to PPIs. This is because long term use lead to a problem called “rebound hyperacidity,” which essentially means that when the drug is stopped, the heartburn comes raging back… stronger than it ever was before.
– Taking PPIs does nothing to treat the underlying causes of heartburn. Feeling better temporarily often leads people to ignore these underlying factors, including obesity, and makes them less likely to makes changes to their diet and physical activity regimens.

Just take the pill…

Yet this Physicians Assistant wanted me to blindly take PPIs with absolutely no proof that I needed them. That is irresponsible and quite frightening. I have never taken an antacid, much less an acid blocker and probably never will need to! Although, some people may actually NEED to take PPIs the number is far smaller than those who are prescribed these blockers.

PPIs, the most powerful class of antacid drugs, were actually designed to treat a very limited range of severe problems, such as bleeding ulcers, Zollinger-Ellison syndrome (a rare condition that causes excess stomach acid production), and severe acid reflux, where an endoscopy has *confirmed* your esophagus is damaged. PPIs were *never intended* for people with heartburn, and according to Mitchell Katz, director of the San Francisco Department of Public Health, “about 60 to 70 percent of people taking these drugs have mild heartburn and shouldn't be on them.” (source)

However, if someone is taking an antacid, it is strongly advised that they not stop abruptly. According to Dr. Mercola:

You should NEVER stop taking proton pump inhibitors cold turkey. You have to wean yourself off them gradually or else you’ll experience a severe rebound of your symptoms, and the problem may end up being worse than before you started taking the medication.
Ideally, you’ll want to get a lower dose than you’re on now, and then gradually decrease your dose. Once you get down to the lowest dose of the proton pump inhibitor, you can start substituting with an over-the-counter H2 blocker like Tagamet, Cimetidine, Zantac, or Raniditine. Then gradually wean off the H2 blocker over the next several weeks.

Do you produce too little or too much stomach acid? It's easy to find out, here's an article that explains how to test yourself at home. Also, this article could help. Next time you feel a little heartburn, try drinking a large glass of water, according to this article it could help. What can you do if you know you are producing too little stomach acid?

INCREASE YOUR STOMACH ACID, HEAL YOUR DIGESTION
Here are the 3 key ways to increase your stomach acid:

Reduce or eliminate sugar. Replace mineral-depleting sugar and sweeteners with Stevia.

Add fermented foods and drinks to your diet. Fermented foods and drinks keep you looking and feeling healthy from the inside out. Such as:

Cultured vegetables – A delicious, vitamin, mineral and probiotic-rich, raw, fermented food.

Young coconut kefir – Full of minerals and probiotics, this is a fermented drink you can easily make at home.

Super Spirulina Plus – Thought of as one of the “world's healthiest foods,” the fermented spirulina in Super Spirulina Plus is a perfect protein and an almost immediate energizer anyone suffering with adrenal fatigue.

Eliminate processed foods. (3)

As for my stomach pain, for the most part, it went away on its own after a 3-day bone broth cleanse. No meds, just good ‘ole Chicken Soup. Digestive enzymes and HCL back to my supplement regiment have helped whenever I eat a meal. My Wellness doctor (not the one who prescribed the acid blocker) and I are discussing doing some other tests and perhaps a cleanse. The goal is to get to the root cause.

Certainly, I'm not advising anyone to ignore their doctors' advice. I am an advocate for open conversations between physician and patient where the patient is may ask why and is given a reasonable answer. Health information should be provided by the doctor to the patient, especially when requested, not shamed for wanting to know. Is this what we call healthcare?

Imagine a world where physicians actually continued to explore until the cause was found instead of just prescribing the run of the mill prescription and never giving the patient another thought.

Most medications have side effects and while they are necessary in certain cases, it's irresponsible to prescribe them to a patient without proper testing.

Ultimately, I am responsible for my health, and as this physician's assistant demonstrates, I'm just another number in his waiting room.

My course of action was to rule out h. pylori infection, bacterial overgrowth, test stomach acidity levels again at home, and implement a smart supplementation regiment to combat my low levels of stomach acid.

Other tips that may help

Chew food to assist your digestive tract
Consider your digestive health

The information in this post is not medical advice. If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment immediately. Never disregard professional medical advice or delay in seeking it because of something that you have read on this blog, website, or in any linked materials.