As you’re walking past the café’s, delis, and bakeries in town and you realize that your digestion process is activated. You sense the increase in saliva production and the gurgling and churning of your stomach because this process starts in the mind. This is a valuable physiological process as it prepares the mouth and stomach to receive and process information and nutrients in the form of food by activating acid production and digestive enzyme activity.
Among many of the critical ‘moving parts’ in the digestion process one of them is the gentle and necessary increase of stomach acidity. Many deal with hypochlorhydria or achlrohydria, a condition in which there is a remarkable decrease in stomach acid production. This can be caused by an array of things ranging from chronic anti-acid drug therapy, by-pass surgery, a poor diet of processed foods, and even auto-immunity. As such, low stomach acid can make the digestion / absorption process less effective and negatively impact the growth of critical gastrointestinal bacteria. From a nutrient standpoint, most notable concerns are a decrease in pancreatic enzyme activation, the lack of breakdown of protein and the absorption of calcium, iron, and vitamin B12.
In terms of HCl’s role in GI flora population, when low acidity allows the introduction of potentially pathogenic microbes to the lower intestine, the patient is now at risk for disruption of the gut ecology. This state of dysbiosis has been theorized to contribute to enterocyte damage and be a contributing factor to a leaky gut and even autoimmune challenges.
The decrease in pancreatic enzyme activation is a basic physiologic mechanism that is disrupted with low acidity. When there is not adequate HCl introduced into the duodenum, Cholecystokinin, which stimulates the pancreas to release digestive enzymes, is not triggered and released as part of a functional digestion process. This can have a negative effect downstream on nutrient liberation, absorption and utilization.
The nutrient malabsorption is well documented and something to pay close attention to with patients complaining of fatigue. When B12 and iron are not being absorbed properly, laboratory tests may appear normal from the body’s attempt to maintain homeostasis, but the patient may present with the prodromal signs of fatigue due to the subclinical deficiency created by the lack of HCl.
Incorporating natural supplemental acids can be a very effective step in activating natural digestive acids for healthier digestion and absorption. Betaine HCl is one naturally occurring acid found in grains and beets that has been used for centuries as a digestive ‘bitter’ or tonic. When timed well and in the correct dosage, betaine HCl naturally acidifies the stomach so that digestion can be optimal both mechanically and chemically. Given the gut’s connection and ability to cross talk to so many other bodily systems, it makes sense to ensure you start off with the right amount of acidity.
Beasley DE, Koltz AM, Lambert JE, Fierer N, Dunn RR. The Evolution of Stomach
Acidity and Its Relevance to the Human Microbiome. PLoS One. 2015 Jul
29;10(7):e0134116. doi: 10.1371/journal.pone.0134116. Review. PubMed PMID: 26222383
Yago MR, Frymoyer AR, Smelick GS, Frassetto LA, Budha NR, Dresser MJ, Ware JA, Benet LZ. Gastric reacidification with betaine HCl in healthy volunteers with rabeprazole-induced hypochlorhydria. Mol Pharm. 2013 Nov 4;10(11):4032-7. doi: 10.1021/mp4003738. PubMed PMID: 23980906