Hypochlorhydria

Question 1

Hypochlorhydria

Answer 1

Hypochlorhydria = low stomach acid production characterised by a fasting gastric pH above 3.0 (1.5–3.0 is considered normal)

Question 2

Hypochlorhydria: Key signs and symptoms

Answer 2

• Gas and bloating (often <30 minutes after eating), heartburn, sensation of fullness after meals, foul smelling stools, diarrhoea, nausea after taking supplements, food allergies, brittle nails.
• Nutrient deficiencies (malabsorption) e.g., iron, zinc, folate and B12

Question 3

Achlorhydria

Answer 3

Achlorhydria = absence of stomach acid → gastric pH >7.0

Question 4

Hyperchlorhydria

Answer 4

Hyperchlorhydria = a gastric pH <1.5, normally without consequences unless other conditions present; e.g., GORD.

Question 5

Implications of hypochlorhydria

Answer 5

• Reduced mineral absorption (e.g., calcium ↓bone density, iron → anaemia) and poor protein digestion = small intestinal protein putrefaction.

‒ Protein putrefaction creates polyamines which are implicated in colorectal cancer.

• Higher pH means reduced protection from bacterial infection, facilitating H. pylori survival in the stomach and allowing bacteria to proliferate in the small intestine (SIBO).
• Reduced gastric activity results in poor pancreatic juice and bile flow, as well as less intrinsic factor, reducing B12 absorption

Question 6

Natural approach to hypochlorhydria

Answer 6

• Chew thoroughly, avoid overeating and drinking with meals.
• Apple cider vinegar (1–2 tsp) diluted in a little water before meals.
• Zinc and B6-rich foods.
• Bitter foods and herbs stimulate digestive secretions (incl. HCl):

‒ Bitter greens e.g., rocket, chicory, dandelion leaf, watercress. ‒ Herbs: Gentian, dandelion, goldenseal, barberry bark stimulate the Vagus nerve (although energetically cold).

‒ Alternative herbs: Fennel seed, cardamon, citrus peel, ginger (these are energetically ‘warming bitters’, so good if excess cold / aggravated Agni / Spleen Qi deficiency)

Question 7

Supplementing with Betaine HC

Answer 7

Supplementing with Betaine HCl: a basic protocol for suspected meal-time hypochlorhydria.

• Begin by taking 1 capsule containing 350–750 mg Betaine HCl with a protein-containing meal (>500 kcal+).
• If no discomfort (tingling / burning), increase mealtime dose by 1 capsule every 2 days (max. 3 g) until dose results in tingling or warm sensation, then reduce dose by 1 capsule.
• Use this dose at subsequent meals.

Administration of HCl / Pepsin is contraindicated with some drugs and in peptic ulceration. HCl can irritate sensitive tissues and can be corrosive to teeth. Capsules should NOT be emptied into food or dissolved in beverages. Betaine HCl should not be given on an empty stomach unless followed immediately by consuming a meal. Smaller meals will require a smaller dose. Betaine HCL with added pepsin may have a better effect.