SIBO - Page 2

Thiamine for Fibromyalgia, CFS/ME, Chronic Lyme, and SIBO-C

37.5K views

The Road to Thiamine

In August 2020, I was at my wits end. I had developed gastroparesis in March 2020, after 10 days of metronidazole (Flagyl), for a H. Pylori infection and SIBO-C symptoms. After seven days, I developed the symptoms usually associated with the intake of this drug – nausea, confusion, anxiety, paranoid thinking and mild gastroparesis symptoms. I no longer had bowel movements initiated by my body and had to use enemas twice a week. This state continued and worsened until the end of July 2020, when I also had a surgery for stage 4 endometriosis.

I managed to stay alive those months by eating an elemental diet (90%) and a few bits of solid food such as white rice, goat cheese, or lean meat. After the surgery, however, my gastroparesis got worse. I contacted my family doctor at the end of August and told her that I could no longer eat any solid food without severe nausea and that I need to be in a hospital to be fed intravenously or with a gastric tube. She agreed that my situation demanded immediate attention and she wrote me the referral for an inpatient hospital admission.

I was lucky though that at that exact time, I stumbled upon the low oxalate diet mentioned by a member of a Facebook group. I joined the Trying Low Oxalate (TLO) group on Facebook and read what researcher Susan Owens wrote about oxalates. I started implementing it and realized that small portions of low oxalate food every 2-3 hours were accepted by my body. In a few weeks my gastroparesis symptoms were reduced and my belly pain diminished.

From the Low-Oxalate Diet to Discovering Beriberi Disease

At some point in September 2020, while researching oxalates, I found Elliot Overton’s videos on oxalates and I listened to them. I also read his articles on this website where he talks about allithiamine, a thiamine supplement that contains something called TTFD, as being something radically different in terms of its unparalleled effects on the human body. I was skeptical, because I had spent about 20,000 euro on supplements in the previous four years, each of them being promoted as health-inducing by big names in the field of chronic Lyme disease, MTHFR, CFS/ME, SIBO and so on, while their effects on my health were only partial and temporary at best.

I decided that this would be the last supplement I’d buy. The worse would be losing 40 euros and I had already spent too much on worthless treatments. I took 150 mg allithiamine + magnesium + B2 + B3 for 3 weeks and I was less tired, could move more around the house, and overall was feeling much better, even my extreme light sensitivity was subsiding. Then I stopped taking it, not sure it was doing anything. That’s when I knew that it had worked and that I needed it badly. I took the same dosage for another 2 weeks. The next three weeks I had to wait to receive it from the USA, and I was again completely bed ridden.

However, I used this time to read most of Dr. Derrick Lonsdale’s book on thiamine deficiency. I became convinced that I had dry beriberi and that most of my neurological symptoms were caused by thiamine deficiency. I also noticed that the dosage is highly individual and some individuals needed very high doses of thiamine per day in order to function.

I now understood, why 2015 was the year I became bedridden for most than 90% of the time: I spent 6 months in a very hot Asian country, as part of my master degree studies. The energy requirement to deal with the hot weather and the demanding job depleted my already low thiamine levels. At that time, I was on my way to diabetes as well. I had fasting blood sugar levels of 120 mg/dl. I could no longer assimilate/use carbs in the quantities my body required (70% of the daily caloric intake) and I was always hungry and always thirsty. Looking back on my childhood and my ever-declining health from 2008 onwards, it was clear to me that I had problems with thiamine.

The Astonishing Effects of Thiamine

In December 2020, I increased my thiamine dosage to 300 mg per day and I was astonished at the changes I experienced – an 80% reduction across all my symptoms and some even completely disappear.

Mid-January, I decided to increase my allithiamine dosage to 450-600 mg because I felt like my improvements were stagnating. I also noticed that during the days I was more physically active (meaning: I cooked food for longer that 10-15 minutes, my energy levels were higher when I was taking more allithiamine and I didn’t experience the typical post-exertional malaise I was used to in the past). I also noticed that taking allithiamine alone in high doses doesn’t work so well and that the active B complex capsules and the B3 I was taking did have an important part to play in how I felt.

In the beginning of February, I was craving sugars so badly, that I gave in and bought a cake for my birthday. I ate two slices and discovered that my mental confusion, the brain fog and generally poor cognitive skills improved “overnight”. I was astonished, since I had been led to believe that “carbs are bad”, “sugar is bad” and “gluten is bad” and that the problem was with the food itself rather than with my body missing some vital nutrients. I didn’t experience any side effects from the gluten either, even though my food intolerance test shows a mild reaction to gluten containing cereals.

By February 20th, this high-dose allithiamine ‘protocol’ and the ability to eat carbs again, eliminated all of my symptoms of SIBO-C/IBS-D/slow transit constipation, endometriosis, CFS/ME, fibromyalgia, constant complicated migraine with aura, severe food intolerances, including a reversal of my poor cognitive skills. I was able to discuss highly philosophical concepts again, for one hour, without suffering from headaches and insomnia.

Early Metabolic and Mitochondrial Myopathies

On February 21st, I decided to go for a walk. I walked in total that day 500 meters AND walked up four flights of stairs, because I live on the 4th floor without an elevator. By the end of that day, my disease returned and I became bedridden again. I could not believe it. This was the only thing I did differently. I just walked slowly.

And so I searched the internet for “genetic muscle disease”, because my sister shares the same pattern of symptoms. A new world opened before my eyes. I found out that in the medical literature, exercise intolerance, post-exertional malaise and chronic fatigue are well known facts and are described in conditions known as “myopathies”. That there are several causes for myopathy and that they can be acquired (vitamin D or B1 deficiency, toxic substances impacting the mitochondria, vaccines and so on) or inherited. It was also interesting to find out that while doctors manifestly despise and disbelieve CFS/ME symptoms, they are not utterly unknown and unheard of or the product of “sick” minds.

When I read this paper, although old and maybe not completely accurate in the diagnostics, I understood everything about my health issues.

I remembered my mother telling me that my pediatrician said he suspected muscular dystrophy when I was one years old, because I could not gain weight. I weighed only 7 kg at the age of one year, but he wasn’t convinced and so no tests were done in communist Romania. In addition to being overly thin, throughout my childhood, I always had this “limit” that I couldn’t go past when walking uphill or if I ran up a few flights of stairs, no matter how fit and in shape I was. Otherwise, I would develop muscle weakness such that my muscles felt like jelly. I would become completely out of breath, which I now know is air hunger. I couldn’t climb slightly steeper slopes without stopping 2/3 of the way up. My heart would beat very hard and very fast. I would feel like I was out of air and collapse. I first experienced this at the age of 5-6 and these symptoms have been the main feature of my physical distress since.

Because of these symptoms, I have led a predominantly sedentary lifestyle with occasional physical activity, never daily, apart from sitting in a chair at school. I didn’t play with classmates for more than 5 minutes. I couldn’t participate in physical education classes. Any prolonged daily physical activity led to general weakness, muscle cramps, prolonged muscle “fever”, and so I avoided them.

Now, I know why. Since reading this article, I was able to present my entire medical history to a neurologist and my symptoms were instantly recognized as those of an inherited mitochondrial or metabolic myopathy. I am currently waiting for the results of the genetic tests ordered by the neurologist, which will make it possible to get the right types of treatments when in a medical setting.

Before Thiamine: A Long History of Unexplained Health Issues

In addition to the problems with gaining weight and inability to be active, I had enuresis until 9 years old, along with frequent dental infections, and otitis. I had pain in my throat every winter, all winter and low blood pressure all the time. At 14 years of age, I weighed about 43-45 kg. I remained at that weight until age 27. I had a skeletal appearance. I also had, and continue to have, very flexible joints. For example, my right thumb is stuck at 90 degrees, which I have to press in the middle to release. I can feel the bone repositioning and going into the joint. This happens at least once a week.

My diet was ovo-lacto-vegetarian diet, with 70% of the calories coming from carbohydrates from when I was able to eat until 2015. In 2015, I could no longer process carbohydrate due to severe thiamine deficiency.

Since the age of 18, I have had quasi-constant back pain in the thoracic area. I have stretch marks on thighs, but have had no sudden weight gain/loss. Among the various diagnoses I had received before the age of 18 years old:

  • Idiopathic scoliosis – age 18. No treatment.
  • Iron deficiency anemia – at 18. Treatment with iron-containing supplements. No result.
  • Frequent treatments for infections (antibiotics)
  • Fasting hypoglycemia (until 2015).

The Fibromyalgia Pit

In 2008, my “fibromyalgia” symptoms began, although looking back at my history, many of these symptoms were there all along. I made a big change in my physical activity levels and this began my 12 year decline in health. In 2008, I started my philosophy studies at the university and decided to get more “in shape” by walking daily to and from the university. A total of 6 km per day.

  • Constant fatigue, no energy.
  • Worsened back pain.
  • Weak leg muscles at the end of the day.
  • Frequent nightmares from which I could never wake up. I felt like I couldn’t find my way out of sleep. After waking up, I would sit down and after 10 minutes I found that my head had fallen on my chest and I had fallen asleep involuntarily, suddenly.
  • Sensations of waves of vibrations passing through me from head to toe, followed by the sensation of violent “coming out” of the body and out-of-body experiences.
  • Heightened menstrual symptoms.
  • Fairly frequent headaches.

Over the summer, I recovered completely as I resumed my predominantly sedentary lifestyle. Then, in the fall, I began walking to and from university again, and my symptoms just got worse. This cycle continued for the next few years. My symptom list expanded to include:

  • Migrating joint pains.
  • Frequent knee tendinitis.
  • Pain in the heels.
  • Generalized pain, muscles, joints, bones.
  • Frequent headaches.
  • Sleep disturbance with insomnia beginning at 2-3am every night.
  • Frequent thirst, increased water intake (3-4 l/day).
  • Frequent urination, especially at night (woken 2-3 times).
  • Bumping my hands on doors/door frames.
  • Unstable ankles.
  • Painful “dry” rubbing sensation in hip/femur joint.
  • Prolonged angry spells.
  • Memory problems (gaps).
  • Difficulty learning new languages.

I underwent a number of tests including, blood tests, X-ray + MRI of the spine, and a neurological consultation. All that came back was high cholesterol (180 LDL, 60 HDL), low calcium, iron deficiency anemia, scoliosis, and hypoglycemia. No treatment was offered.

From February 2010-August 2010 I had a scholarship in Portugal. Philology studies interrupted. I was using public transport to go to classes, which were about only 3 hours a day. I required bed rest outside classes with only the occasional walk. I had a complete remission of all symptoms in July 2010 when I returned home and resumed my sedentary lifestyle. This was the last complete remission.

From August 2010 – December 2010, I resumed day courses at both universities and resumed the walking.

All of my symptoms were aggravated enough that by December I was bedridden. I stopped attending classes due to back pain in sitting position. I wrote two dissertations lying in bed. Once again, I sought medical advice and had a number of tests and consultations with specialists. I was diagnosed with peripheral polyneuropathy and “stress intolerance”, fibromyalgia. The treatment offered included:

  • Medical gymnastics: aerobics, yoga and meditation presumably to get me in shape and calm me down.
  • Calcium and iron supplementation, gabapentin, and low-dose mirtazapine.

The physical activity worsened symptoms, as it always does. The mirtazapine improved my sleep. I took it for 2 weeks and then stopped because I was gaining weight extremely fast.

From 2011 – October 2012, I was almost completely bedridden. I had to take a year off because I couldn’t learn anything, my head hurt if I tried.  The physical symptoms improved after about a year, as did the deep and total fatigue. I tried to get my driver’s license in 2012, but failed. I couldn’t remember the maneuvers and the order in which to perform them. I couldn’t concentrate consistently on what was happening on the road. There was too much information to process very quickly.

From 2012-2015, I was getting my master’s in France. This aggravated all of my symptoms of exertion, both physical and intellectual. In 2013, I underwent general anesthesia for a laparoscopic surgery due to endometriosis, after which something changed in my body and I never fully recovered to previous levels of health. I took another year break between the two years of master’s studies. I couldn’t learn anymore. Symptoms relieved a bit by this break. After three months in Thailand for a mandatory internship, in one of the most polluted cities in the world, I got sick and developed persistent headache, with very severe cognitive difficulties. At this point, 90% of my time was spent in bed.

A general anesthetic in the autumn of 2015 for a nose tumor biopsy was the “coup de grâce”. Since then, I only partially recovered a few hours after a fluid infusion in the emergency ward and a magnesium infusion during a hospital stay in Charites Berlin in 2016. Other improvements: daily infusions of 1-2 hours with vitamins or ceftriaxone.

How I Feel Since Discovering Thiamine

In order to recover from the crash I experienced in February, I increased my B1 (TTFD) intake mid-March and made sure I was eating carbs every three hours, including during the night. I need about 70% of my total caloric intake to come from carbs.

I am currently taking 1200 mg B1 as TTFD, divided in 4 doses, 600-1200 mg magnesium, 500 mg B2/riboflavin, 3 capsules of an active, methylated B vitamin complex, 80-200 mg Nicotinamide 3X per day and 1-2 capsules of a multi-mineral and a multi-vitamin. I make sure I eat enough proteins, especially from pork meat, because it contains high amounts of BCAAs and helps me rebuild muscles.

I walked again the last week of April 2021, 500m in one day, because of a doctor’s appointment. I did not experience a crash that day or the following days. I did not have to spend weeks recovering from very light physical activity.

I can now use my eye muscles again, and read or talk with people online. I can cook one hour every day without worsening my condition.

After 5 years of constant insomnia, only slightly and temporarily alleviated by supplements, I can finally sleep 7.5 hours every night again. I no longer wake up 4-5 times a night.

My wounds are healing and my skin is no longer extremely dry and cracked.

My endometriosis, SIBO-C, gastroparesis, food intolerances, “fibromyalgia” pain, muscle pain due to hypermobility, are all gone.

And to think that all of this was possible because of vitamin B1 or thiamine, in the form of TTFD and that I almost didn’t buy it, because I no longer believed in that ONE supplement that would help me!

I will always be grateful for the work Dr. Derrick Lonsdale, MD, researcher Chandler Marrs, PhD and Elliot Overton, Dip CNM CFMP, have done so far in understanding, treating and educating others about chronic illnesses. More than anything, more than any physical improvement I experienced so far thanks to their work, what I gained was truth. Truth about a missing link, multiple diseases being present at one time and about why I have been sick my entire life.

Physical Symptoms and Diagnoses Prior to Taking Thiamine

  • Fibromyalgia and polyneuropathy diagnostic and mild, intermittent IBS-C since 2010;
  • Endometriosis symptoms aggravating every year, two surgeries, stage 4 endometriosis in 2020;
  • Surgeries under general anesthesia severely worsened my illness and set my energy levels even lower than they were before;
  • CFS/ME symptoms, hyperglycemia/pre-diabetes, constant 2-3 hours of insomnia per night and constant 24/7 headache since 2015, following an infection and during my stay in a very hot climate;
  • POTS, Dysautonomia, Post Exertional Malaise Symptoms from minor activities, starting with 2016;
  • Increased food intolerances (gluten, dairy, sugar/sweets, histamine, FODMAPs, oxalates, Sulphur-rich foods), to the point of eating only 6 foods since 2018;
  • Chronic Lyme disease diagnostic based on positive ELISA and WB test for IgM, three months in a row, in 2017;
  • Weight gain and inability to lose weight after heavy antibiotic treatment, skin dryness, cracking, wounds not healing even for 1.5 years, intolerance to B vitamins and hormonal preparations, since 2017;
  • Complicated migraine symptoms and aura, light intolerance, SIBO-C and IBS-D, slow intestinal transit, following a 4 month period of intermittent fasting that made me lose 14 kg, living in bed with a sleep mask on my eyes 24/7, severe muscle weakness, since 2018;
  • Two weeks recovery time after taking a 10 minute shower;
  • Gastroparesis, living on an elemental diet, in 2020;
  • All my symptoms worsened monthly, before and during my period.

Treatments Tried Prior to Thiamine

Gluten, dairy, sugar/sweets, FODMAPs, histamine, oxalate, Sulphur-rich foods/supplements free diets; AIP, SCD, Wahl’s protocol, candida diets; high dose I.V. vitamins and antibiotics, oral vitamins and antibiotics, liver supplements and herbs, natural antibiotics (S. Buhner’s protocol), MTHFR supplements, alkalizing diet, essential oils, MCAS/MCAD treatment, SIBO/dysbiosis diets and protocols, insomnia supplements, and any other combination of supplements touted as helpful for such symptoms.

And this is just what I remember top of my head. Their effect was, at best: preventing further deterioration of my body, but healing was not present.

Additional Literature

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter.

Image by Gordon Johnson from Pixabay.

This case story was published originally on May 11, 2021. 

The Thiamine Connection: From POTS to Wernicke’s and Everything in Between

28.1K views

Cushing’s Syndrome With a Pituitary Tumor

As a pharmacist, I always believed I had a good handle on most health conditions and the proper steps for diagnosis. It wasn’t until my daughter became very ill in 2014 that I would learn that not all conditions are so simple. After many months of dealing with her mystery illness and through much study, I came upon Cushing’s Disease, which is a condition of excess cortisol production. All of her symptoms seemed to coincide with this disease. She had insomnia, central weight gain, substantial stretch marks, a buffalo hump, flushing, anxiety, difficulty concentrating, muscle weakness, constipation and diarrhea, extreme fatigue and several others. However, her labs were not so clear cut. After two months of rigorous testing and a confirmation of a pituitary tumor on an MRI, she had a diagnosis and a surgery date.

At first, her surgery seemed to be very successful. Her anxiety, flushing, and fatigue went away. Stretch marks stopped appearing and the old ones began to heal. She showed improvement for awhile, and then her health began to decline again. Some of the old symptoms were returning. Then, she developed new symptoms similar to what are seen in the condition referred to as POTS, or postural orthostatic tachycardia syndrome. She had low blood pressure, orthostatic hypotension, temperature dysregulation, and many others. Her pathology report had always troubled me since her surgery and I wondered if the excess cortisol production was actually due to an underlying stress not yet identified.

As I began my journey into functional medicine, I became more aware of the microbiome and what a vital role it can play in our health. I studied small intestinal bacterial overgrowth (SIBO), small intestinal fungal overgrowth (SIFO), and dietary induced vitamin and mineral deficiencies. Each of these areas were clues that I needed in order to put together all the pieces of this incredibly intricate puzzle.

Maybe It Was Thiamine Deficiency

It was not until I came upon a book entitled “Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition” that all the pieces really started to fall into place. Could a thiamine deficiency be the underlying cause for all of this? I began to wonder if it was not just the surgery that improved her health, but also the IV of vital nutrients that maybe her poor body was unable to absorb. Magnesium is always given prior to brain surgery which activates thiamine into its active form. And, I’m sure her IV nutrition would have contained vitamins such as thiamine. This would have explained some of the improvements we saw that seemed to have no explanation.

We started a regimen of high dose thiamine along with a stronger gut healing protocol for SIBO and SIFO. I wanted to make sure we alleviated any issues that could cause malabsorption of thiamine. Within 3 months on thiamine, my daughter’s lab work improved dramatically. For the first time, she had normal levels of platelets and serum calcium. Also, her cholesterol dropped 35 points and was finally within normal range. Many other markers of concern also showed great improvement. She also had no more symptoms of POTS. Finally, I had found my answer.

I became obsessed on obtaining as much information I could about this deficiency. I researched the mild to severe symptoms and how this nutrient deficiency was prevalent in so many disease states. At this point, I had no idea that this information, which was helping my daughter, would prove to be life-saving knowledge for my grandmother.

Acute Onset Wernicke’s Syndrome In a Hospitalized Elderly Woman

I faced my worst nightmare recently, watching my 90 year old grandmother undergo a descent into severe thiamine deficiency. She has been in the hospital for a bad fall that fractured several ribs and gave her a lung puncture. In addition to the infection from the lung puncture, she had a UTI and then developed pneumonia. All of these factors increased her risk of thiamine deficiency due to the infection, which is clearly stated as a source of thiamine deficiency in the literature.

When I finally made it to the hospital, I could see that she had progressed to Wernicke’s encephalopathy. This was absolutely horrifying. She had severe eye paralysis and it was as if she was looking straight through me. She could not focus her pupils on my face at all. She was able to focus only for one split second and then a tear rolled down her cheek. I literally thought I was going to pass out. I had been studying all the symptoms to look out for in severe thiamine deficiency and now it was staring me in the face. I knew without a shadow of a doubt this was what was wrong, but I wondered “will the doctors listen to me?”

I had asked them several days prior to give her IV thiamine and I was under the impression that they were administering it, but they were only giving her an oral dose of 100 mg daily per the recommendations of one of the physicians. She went into respiratory distress in front of me and I had to agree to let them put her on a ventilator. They wanted to check a thiamine level before giving, and I said that was not always accurate according to studies. I had to beg the nurse practitioner that night to give her something and she agreed to a 100mg injection. I finally saw the doctor the next morning and she agreed to one of the accepted regimens for Wernicke’s Encephalopathy which is 200mg IV three times daily. She agreed that there was no real risk to giving it to her and I was grateful that she trusted my recommendation. I went home and waited for a miracle.

Thankfully, the next day she woke up from this coma-like state. Two days later she was off the ventilator and able to speak with me showing incredible improvement. She has been confused on and off since this incident, but according to studies, this may last for weeks or possibly months. She is 90, so I know this has been very hard on her frail body and her recovery will probably take much longer than a younger person.

Both Chronic and Acute Thiamine Deficiency Go Unnoticed

I hope this was a real wake up call to the staff at the hospital where she is staying. How many other people are suffering from this condition and it goes unnoticed? How many people are dying that could be saved? This is not a rare condition and is certainly not limited to alcoholism. My grandma has not had alcohol in years. She had low thiamine levels going into the hospital, and the infection just pushed her over the edge.

I had prayed for years to determine what could be causing my daughter’s health issues and I believe there was divine intervention that finally led me to thiamine deficiency. To be given this knowledge which is helping to heal my daughter and soon afterward be able to utilize it to save my grandmother’s life is absolutely incredible.

My daughter was suffering from a long term, chronic, mild to moderate thiamine deficiency and my grandmother was experiencing a severe acute deficiency. Both of these can be difficult to diagnose due to the perception that this is a rare condition and typically only affects alcoholics. We need awareness and I am committed to sharing this information with anyone who will listen.

The Progression to Wernicke’s Encephalopathy and Respiratory Distress

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter. 

This article was published originally on April 30, 2020. 

The Importance of Stomach Acid: Why Antacids Could Make You Sick

26K views

Stomach acid is a necessary and vital part of digestion. Yet, stomach acid has become enemy number one in the United States. We are a nation reliant on our proton pump inhibitors (PPI), acid reducers and antacids. Many think they cannot live without these medications but many of the symptoms of low stomach acid actually mimic those of excessive acid or Gastroesophageal Reflux Disease (GERD). A very common misunderstanding is if you have GERD/acid reflux, you have too much stomach acid. Quite the opposite is true. Low stomach acid will cause the lower esophageal sphincter to remain open, causing stomach acid and contents to reflux into the esophagus.

Jonathan Wright, MD of the Tahoma Clinic in Washington state and author of Why Stomach Acid is Good For You has conducted 25 years of stomach acid testing on a variety of test subjects. Time and again patients suffering from heartburn and GERD almost always had low, not high, stomach acid. He found very few people with excess stomach acid and was found only in a few rare conditions like Zollinger-Ellison syndrome. GERD was hardly ever associated with too much stomach acid.

Though the most common treatment for GERD is a prescription for some sort of acid-reducing medication, it is well accepted in the literature that GERD is caused by an increase in intra-abdominal pressure (IAP). Acid reflux occurs when pressure causes stomach bloat, pushing stomach contents, including acid, through the LES into the esophagus. What may cause this, besides low stomach acid, is overeating, obesity, bending over after eating, lying down after eating, and consuming spicy or fatty foods.

9 Reasons Why Stomach Acid is Important

  1. Kills harmful bacteria and viruses. We pick up viruses and bacteria from our hands, utensils, food, beverages, kissing, etc. Our stomach acts as a gatekeeper for a healthy immune system when our stomach acid kills these buggers. Unlike every other part of our body, a healthy stomach is sterile because the acidic pH kills foreign invaders. Many infections, like c diff and h pylori, can be the result of low stomach acid.
  2. Prevents small intestinal bacterial overgrowth (SIBO). Stomach acid that makes it to the duodenum (the first part of the small intestine) will help combat bacteria that has transiently found itself in the small intestine, either from the large intestine or the stomach. Bacteria does not belong in the top portion of the small intestine and an overgrowth can cause horrible symptoms.
  3. Activates the digestive enzymes, pepsin, necessary for digesting protein. Without it you may end up with amino acid deficiencies.
  4. Signals the pancreas to release the enzymes amylase, protease, and lipase. These enzymes are critical to break down proteins, fats, and carbohydrates. Carbohydrate malabsorption can cause excessive gas and contribute to SIBO.
  5. Triggers motility in the small intestine. Small intestine motility is needed to move food along. Slow motility of the small intestine can contribute to SIBO and cause pain.
  6. Is crucial for the absorption of micronutrients. Calcium, magnesium, iron, folate and vitamin B12 depend upon stomach acid for proper absorption. Stomach acid is essential for the breakdown and absorption of these nutrients. Low stomach acid has been linked to iron anemia, b12 pernicious anemia, osteoporosis, and magnesium deficiency.
  7. Reduces food to small particles for easier digestion in the small intestines. When food is not chewed properly or broken down by stomach acid, large particles have been linked to leaky gut syndrome and even celiac disease.
  8. Can prevent gastroparesis (slow gut motility). Stomach acid “turns on” the lower pyloric valve to release food into the small intestine. Low stomach acid will cause food to stay in the stomach longer.
  9. Triggers sphincter of Oddi motility. The sphincter of Oddi is a muscular valve area between the duodenum and the biliary and panacreatic ducts. It is the gatekeeper for the flow of bile and pancreatic enzymes. Studies have shown stomach acid triggers this sphincter to open and close properly. Low stomach acid may very well contribute to a painful disorder called sphincter of Oddi dysfunction (SOD).

Even though all of this is true, doctors rush to overprescribe drugs to reduce stomach acid. I blame the pharmaceutical industry. Doctors these days are putting way too much trust in what their drug reps are selling them instead of facts from a functional medicine/whole body approach. Worse is drug reps will only tell one side of the story, rarely rattling off the numerous and potentially life threatening side effects. Keep in mind the “cure” for low stomach acid is not found on a prescription pad.

Before I was diagnosed with SOD and chronic pancreatitis, it seemed every time I went to a gastroenterologist they would prescribe an acid reducing drug, though there was no proof my problem was from excessive stomach acid. Low stomach acid is rarely tested by gastroenterologists, certainly none of mine offered such testing. The SOD caused me to alternate with excessive bile and a shortage of bile. I also would get bile reflux into the stomach. Bile acid is actually more neutral in ph than acidic. Therefore, bile will neutralize stomach acid. I always felt worse when I’d take an acid reducer so one day I read about low stomach acid and started on a regimen to increase my stomach acid. The results have been miraculous. I feel better, have gained back much-needed weight and muscle, and bloodwork for nutrients has improved.

Three Types of Acid-Reducing Medications

Not all antacids are the same. Here is a breakdown of the three types of antacids:

  1. Proton pump inhibitors (PPIs) are medicines that work by reducing the amount of stomach acid made by glands in the lining of your stomach. Examples: Omeprazole (Prilosec and Zegerid), Esomeprazole (Nexium), Lansoprazole (Prevacid), Rabeprazole (AcipHex), Pantoprazole (Protonix), and Dexlansoprazole (Dexilant).
  2. H2 blockers are medicines that work by reducing the amount of stomach acid secreted by glands in the lining of your stomach. Examples: Famotidine (Pepcid), Cimetidine (Tagamet), Ranitidine (Zantac), and Nizatidine (Axid).
  3. Antacids are agents that neutralize the gastric acid and raise the gastric pH. Examples: sodium bicarbonate, calcium bicarbonate, aluminum hydroxide, magnesium hydroxide, and Sucralfate (Carafate).

Dangers of Acid-Reducing Medications

PPIs are by far getting the worst press lately. Studies show PPIs have been linked to many chronic and deadly health conditions, including: dementia and Alzheimer’s disease, increased heart attack risk, increased pneumonia risk, weakening of the immune system, weight gain, and the hundreds of ailments linked to the reduction of the absorption of important nutrients, vitamins and minerals. Just one of these pills is capable of reducing stomach acid secretion by 90 to 95 percent. Taking high and frequent doses of PPIs, which most doctors recommend, causes a state of achlorydia (no stomach acid). Chronic use of PPIs has been shown to decrease extracellular concentration of adenosine, resulting in an increase in inflammation in the digestive tract which can exacerbate Crohn’s disease and ulcerative colitis.

It isn’t just PPIs that cause health problems, any of the other drugs reducing stomach acid are suspect. Many people who take antacids not only suffer from more chronic health problems than the average person, but they never actually cure their acid reflux in the process. Without making the proper dietary changes necessary to balance stomach acid, those who take antacids consistently, and for long periods of time, will progressively become more and more unhealthy. In particular, stomach acid can cause atrophic gastritis which can lead to serious disorders like stomach cancer.

Stopping the Vicious Cycle of Low Stomach Acid

Relying on acid-reducing medication causes a vicious cycle of constantly needing to neutralize symptoms, which in turn creates a low stomach acid environment, which in turn causes the LES to stay open and pyloric valve to spasm shut. This equates to more and more reflux and more and more antacids. The best thing to do is stop the cycle!

First: Get Proper Testing

The gold standard medical test for low stomach acid is the Heidelberg Stomach Acid Test. You will have to swallow a radio transmitter in the form of a pill. Then you will drink a solution of sodium bicarbonate (baking soda). The transmitter will record the ph levels of your stomach as long as it stays in your stomach. At the end of the test, a graph will show your response to the baking soda solution. In my opinion, this test should be the first test conducted before an endoscopy or prescribing an acid-reducing medication. An endoscopy does not accurately gauge stomach acid ph but many doctors prescribe medications to lower stomach acid based on physiological findings that may or may not be due to excessive stomach acid—most cases not!

There are two at-home tests for stomach acid. The first is the Baking Soda test. Mix 1/4 teaspoon of baking soda in a small cup of cold water first thing in the morning before eating or drinking anything.

After drinking the solution, time how long it takes you to belch. If your stomach is producing adequate amounts of stomach acid you’ll likely belch within two to three minutes. Early and repeated burping may be due to excessive stomach acid unless it is the light burps from swallowing a little air. Any belching after 3 minutes indicates a low acid level. This test isn’t foolproof but may be a good indicator to ask for the Heidelberg test or to try the second at-home test.

The second at-home test is the Betaine HCL test. Buy some Betaine HCL with pepsin (I like Country Life brand). Eat a high protein meal of at least 6 ounces of meat or meat alternative (this is very important or the test will not be accurate). In the middle of the meal take 1 Betaine HCL pill. Finish your meal as normal and pay attention to your body. Either you won’t notice anything, which means you likely have low stomach acid levels. Alternatively, you may at some point within the next hour or two feel some stomach distress like heaviness, burning, or hotness. These are signs you likely have enough stomach acid. If you do get some burning, don’t worry as it will pass in about an hour. You can also mix up a ½ teaspoon of baking soda and drink it to help stop the discomfort. Do NOT do this test if you take NSAIDs or Corticosteroids as they increase the chances of stomach ulcers when taken with betaine hcl. Consult a physician before trying this test or supplementing with anything. Obviously this test, like the baking soda test, is not foolproof so I recommend repeating the test a few times.

Second: Consider Treating Naturally

The only time I had heartburn was when I was pregnant. It was terribly painful and I thanked God every minute for acid reducers. I don’t know what I would have done without them. Honestly, I needed that medication periodically during that time in my life. However, I haven’t needed them any other time. That being said, I am NOT advocating for anyone reading this to go off their meds. Always discuss medication changes with your doctors. My experience was that mainstream doctors were close-minded to the discussion of low stomach acid or of natural remedies. I got more help from a naturopath and functional medicine practitioner. I suggest seeking a consult with one of these practitioners but do try to discuss your concerns with your doctors.

There are several ways to go about treating low stomach acid. They are all easy and cheap.

  • My therapy of choice is taking one 600 mg. Betaine HCL with pepsin pill with every protein meal. Some people need more but I seem to do ok with just one. You will know when you reached your threshold when the amount of pills causes some burning.
  • Drink an apple cider vinegar (ACV) solution of 1 or 2 teaspoons of ACV with a small glass of water with each meal. Alternatively, you could drink some pickle juice or kombucha tea—a fermented probiotic drink.
  • Consume a small amount of bitters with each meal. Bitters send a signal to your stomach to produce acid.
  • Develop better food hygiene. Eat a healthy, whole foods, clean diet. Don’t overeat. Just because the restaurant gives you a huge plate of food doesn’t mean you have to eat it all. Save some leftovers. Chew food thoroughly. Some say to chew 32 times and count as you chew to make sure you are doing it.
  • Avoid lying down after eating and relax upright.
  • Don’t bend over after eating.
  • Purchase a bed wedge. I found mine on Amazon and it has an elevation of 12”. You can find all different shapes and sizes. I recommend buying one with a washable cover.

Begin balancing your stomach’s acidity level will take time but will pay off with optimal wellness in the end!

We Need Your Help

Hormones Matter needs funding now. Our research funding was cut recently and because of our commitment to independent health research and journalism unbiased by commercial interests we allow minimal advertising on the site. That means all funding must come from you, our readers. Don’t let Hormones Matter die.

Yes, I’d like to support Hormones Matter.

Sources

Benson, J. (2012) Avoid the dangers of proton pump inhibitors (PPIs) and treat your acid reflux naturally. Natural News. http://www.naturalnews.com/036336_PPIs_acid_reflux_side_effects.html

Carstensen, M. (May 11, 2016). The Link between Heartburn Drugs and Dementia. New York Posthttp://nypost.com/2016/05/11/the-link-between-heartburn-drugs-and-dementia/

Huaqing Ye, J. and Rajendran, V. Adenosine (2009). An immune modulator of inflammatory bowel diseases. World Journal of Gastroenterology. 15(36): 4491–4498. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2751993/?tool=pubmed

Johnson, D. and Oldfield, E. (2013). Reported Side Effects and Complications of Long-term Proton Pump Inhibitor Use. Clinical Gastroenterology Hepatology.11(5):458-464. http://www.medscape.com/viewarticle/804146.

Wright, S. 3 Tests for Low Stomach Acid. SCD Lifestyle Website. http://scdlifestyle.com/2012/03/3-tests-for-low-stomach-acid/

This article is for informational purposes only. It is not intended to diagnose, treat, cure, or prevent any disease. Please discuss all medication issues with your physician. 

Image by Brett Hondow from Pixabay.

This article was published originally on Hormones Matter on May 17, 2016.