That miserable feeling in your chest strikes again and you reach for the only remedy you know: antacids. You’ve heard countless times from TV commercials and doctors that your problem is excess stomach acid. I’ve often wondered how doctors, with their extensive education and training in human physiology, could believe that as we age we manufacture more of anything (except wrinkles and ear hair). Generally, hormone levels, bone density, taste, smell, collagen production, bladder volume, eyesight, blood production and immunity all decline with time. The same is true of digestive power.
Based on testing thousands of patients, Dr. Jonathon Wright, MD estimates that at least 90% of American adults have low stomach acid and that high stomach acid is rare. Occasionally, stomach acid is released at the wrong time (instead of when you eat) which could also contribute to this painful problem. If in doubt ask your doctor to perform the Heidelberg test to determine the status of your stomach acid.
GERD (Gastroesophageal Reflux Disease) happens when the lower esophageal sphincter (LES) at top of the stomach does not close properly. This allows fermenting stomach contents to rise (reflux) into the esophagus causing inflammation and pain. If the pH of stomach acid isn’t low enough (between 1.5 and 3) it interferes with the ability of the LES valve to function properly, therefore triggering GERD. The longer undigested food remains in the stomach the more acid is steadily released causing it to become caustic when it refluxes.
Other possible contributors to a malfunctioning LES are overeating, overweight, pregnancy, hiatal hernia, alcohol, caffeine, hot peppers, tomatoes and other foods, as well as medications which we’ll discuss in detail.
Symptoms such as throat irritation, the feeling of a lump in your throat, hoarseness, chronic coughing and asthma may result from the open LES valve allowing the protein digesting enzyme pepsin to splash into the esophagus and larynx.
Symptoms of GERD may also include: Difficulty or pain when swallowing, burping or belching, chronic irritated or sore throat, inflamed gums, bad breath, erosion of tooth enamel, morning hoarseness or laryngitis.
*Medications: What doctors often fail to tell patients is that some of the OTC or prescription medications they are taking may be directly causing and/or aggravating the problem of acid reflux/GERD. Addressing the cause is essential, because adding another drug to counteract the side effects of other medications leads to worse health outcomes. Shutting down production of stomach acid ultimately creates many more problems than it solves.
Acid-reducing meds, while they relieve discomfort, are potentially very harmful. If you take them please discuss with your doctor how to wean yourself off of them safely, unless you are also taking a medication that is the cause of the acid reflux problem. That will require a deeper conversation with your physician. If you have ulcers or inflammation there are well-known herbs that can ease the pain and speed healing of the stomach lining.
Use of Proton Pump Inhibitors (PPIs) (Prolosec, Aciphex, Prevacid, Dexilent, Protonix) which block acid completely is associated with low levels of magnesium. Since most people are already magnesium deficient this is a big deal. Minerals require an acid environment in the stomach in order to be assimilated. Patients taking PPIs for long periods of time showed an increased risk of heart attacks. Undesired weight gain and muscle loss is also associated with long-term use of PPIs.
PPIs increase the risk of a potentially deadly Clostridium difficile (C diff) infection of the colon. Long-term use (12 months or longer) and/or high doses may increase your risk of osteoporosis-related fractures of the hip, wrist, or spine due to impaired calcium, magnesium and protein assimilation. Other side effects of long-term use are kidney disease, dementia, nutritional deficiencies, infections and/or pneumonia.
Currently, more than 20 million Americans are taking acid-blocking medications costing over $14 billion annually. This is one of the most profitable drug categories in the world and was never intended or approved for long-term use.
People taking H2 blockers (Axid, Pepcid, Tagamet, Zantac) which partially block acid, are likely to experience side effects too, such as difficulty sleeping, ringing in the ears, headaches, dry mouth, painful skin problems, constipation/diarrhea, trouble urinating, vision changes, difficulty breathing, chest tightness, confusion, agitation, hallucinations and/or suicidal thoughts. (2019 update: Zantac has been recalled due to the presence of a known cancer-causing chemical NDMA.)
If you take antacids (Tums, Rolaids, Maalox, Mylanta) which partially reduce acid, on a regular basis you may want to consider following the suggestions to improve digestion later in this article that will help prevent future symptoms and enhance your (digestive) health overall.
As long as you are taking acid blocking or reducing medications and your stomach function is impaired there is no path to better health. But I have good news: there are remedies to regain a fully functioning stomach and digestive system at any age. They are natural, easy and inexpensive. Find a functional medicine doctor who will work with you to get this issue resolved if your symptoms are severe or advanced.
Drug Interactions: Please check with your pharmacist for a list of known side effects of the medications you are taking, along with potential drug interactions. Due to lowered stomach acid some drugs can’t work properly.
Important: it is not advised to stop taking these drugs (except antacids) “cold turkey”. Please discuss this with your doctor or pharmacist so that you can wean off them gently. Then you can begin supplementing with more powerful digestive aids that will assist in getting your digestive system back on track and keep it there.
Begin with these practices that should be healthy habits for us all:
- Sit down and relax before eating. Avoid eating standing up, in the car or when feeling stressed.
- Take smaller bites and then chew each bite 20-30 times before swallowing so that the food entering the stomach is smaller. Put the fork down between bites.
- Eat protein foods first.
- Stop eating before you feel full. An overfilled stomach can’t function properly.
- Avoid drinking beverages during and within 60 minutes after meals, except for a few sips to swallow supplements and cleanse the mouth.
Plant-based enzyme capsules may be safely supplemented with the first bite of a meal. These should include protease, amylase and lipase to digest protein, carbohydrates and fats respectively. Plant-based enzyme supplements won’t increase acidity in the stomach, but will help to break down food within a wide pH range. This will help to improve nutrient assimilation while in the process of weaning off of the acid-blocking drugs. You would benefit from continuing the use of these enzymes when eating cooked foods.
Avoid eating within 2-3 hours of bedtime to avoid trying to sleep with a full stomach.
Chewing papaya enzyme tablets can help soothe occasional heartburn symptoms quickly and safely.
Smart Supplementation for Healthy Digestion
Lemon and ACV: Once you are off the medications that suppress stomach acid you can begin to add fresh lemon water or raw apple cider vinegar water to your pre-meal regimen. (The water should be room temperature because cold water interferes with digestion.) Drinking the juice of half a lemon in 8 ounces of water or 1 tbs. of vinegar in 8 ounces water 15-20 minutes before starting your meal will gently increase the acidity in the stomach. (Drink through a straw if concerned about tooth enamel.)
Take Digestive Bitters prior to each meal. Bitters have been used for centuries to stimulate healthy digestion.
Supplement with **Betaine HCL with pepsin pills with meals that contain protein from meat, poultry, fish, eggs, dairy and/or beans or legumes. It will mimic the acid production we had when young and possibly “prime the pump”, waking up the stomach’s ability to produce more stomach acid at the right time. (Fruit and vegetables don’t require much acid to be digested.)
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You will have to experiment with the dosage of this supplement. Most people require more than one or two pills to get the job done. Here is a link to a site with instructions on how to determine the dosage that will be most effective for you. https://drnatashaturner.com/wp-content/uploads/2014/01/HCL-Challenge_New.pdf
**“People that are “high risk” shouldn’t take Betaine HCL without supervision. You’re high risk if you’re consuming any anti-inflammatory medicines. Examples of those are: corticosteroids, aspirin, Indocin, ibuprofen (Motrin, Advil) or other NSAIDs. These drugs can damage the GI lining and supplementing with HCL could aggravate it, increasing the risks of bleeding or ulcer.” From “Why Stomach Acid is Good for You” by Dr. Jonathon Wright, MD
The mineral salt sodium chloride (Natrum Mur) plays an important role in hydrochloric acid production. If you tend to retain water, crave salt, feel thirsty despite drinking water and/or are prone to hay fever or watery eyes you would benefit from taking it consistently to observe its effects. Other mineral salts (aka cell salts) such as Kali Mur, Nat Phos, Nat Sulph and Silica may prove helpful too. Research the deficiency symptoms to find the one that best fits your needs.
It is best to learn about your own unique biochemistry based on a Hair Mineral Analysis. An experienced practitioner can inform you (based on the test results) during a consultation whether or not supplementing with HCL is appropriate for you. A person with sluggish adrenals and thyroid tends to have weaker digestion and so may benefit from longer term supplementation.
*Medications that can cause or increase acid reflux and worsen GERD include:
- Anticholinergics, such as oxybutynin (Ditropan XL), prescribed for overactive bladder and irritable bowel syndrome
- Tricyclic antidepressants ( amitriptyline, doxepin, others)
- Calcium channel blockers and nitrates used for high blood pressure and heart disease
- Narcotics (opioids), such as codeine, and those containing hydrocodone and acetaminophen (Lortab, Norco, Vicodin)
- Progesterone
- Quinidine
- Sedatives or tranquilizers, including benzodiazepines such as diazepam (Valium) and temazepam (Restoril)
- Theophylline used for COPD or asthma (Elixophyllin, Theochron)
*Medications and dietary supplements that can irritate your esophagus and cause heartburn pain include:
- Antibiotics, such as tetracycline
- Bisphosphonates taken orally, such as alendronate (Fosamax), ibandronate (Boniva) and risedronate (Actonel)
- Iron supplements
- Quinidine
- NSAID Pain relievers, such as ibuprofen (Advil, Motrin IB, others) and aspirin
- Potassium supplements
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2761557/
https://www.mayoclinic.org/diseases-conditions/gerd/expert-answers/heartburn-gerd/faq-20058535
https://www.healthline.com/health/gerd/h2-blockers#side-effects