How to Know If You Need HCl Hydrochloric Acid Supplementation

Summary

In this informative video, Dr. Russo explores the role of hydrochloric acid (HCL) in digestion, discussing the prevalence of low stomach acid and its impact on nutrient absorption and gut health. He outlines symptoms that may indicate a need for HCL supplementation and provides a simple protocol for determining if HCL is beneficial. Dr. Russo emphasizes the importance of considering risk factors, such as age and autoimmune conditions, and suggests prioritizing dietary changes and foundational therapies before supplementing with HCL.

Takeaways

• 🔍 The prevalence of low hydrochloric acid (HCL) in the stomach is quite low, with studies showing it ranges from 2% to 15%, varying with age and health conditions.
• 🍲 HCL is essential for digestion as it ionizes minerals, allowing for their absorption, and helps in the conversion of pepsinogen to pepsin, which digests proteins.
• 💊 There is a lack of substantial research on the benefits of HCL supplementation for conditions like reflux or IBS, despite its common recommendation.
• 👨‍⚕️ Symptoms like burping, reflux, indigestion, and bloating may indicate a need for HCL supplementation, but these should be considered alongside other risk factors and health history.
• 👴 Age is a significant risk factor for low stomach acid, with prevalence increasing as one gets older, particularly noticeable after the age of 40.
• 🚫 Long-term use of acid-lowering medications like PPIs can contribute to low stomach acid levels, but short-term use for conditions like ulcers can be beneficial.
• 🌡 The optimal pH range for pepsin activity is narrow, highlighting the importance of maintaining the correct stomach acidity for proper digestion.
• 🛡️ Adequate stomach acid also serves as a defense mechanism against bacterial overgrowth and certain infections.
• 🧪 While lab tests for low stomach acid exist, they are not always reliable or necessary, and symptomatic improvement is a more practical indicator of need for HCL.
• 📈 The approach to HCL supplementation should be evidence-guided and empirical, starting with a low dose and gradually increasing based on symptomatic response.
• 🍏 Dietary changes, such as a low FODMAP diet, should be tried before HCL supplementation to address symptoms that might be resolved without the need for ongoing supplementation.

Q & A

What is the cephalic phase of digestion?

The cephalic phase of digestion begins when you first see or smell food, preparing your body for the digestive process even before the food reaches your stomach.

What role does hydrochloric acid (HCL) play in the stomach?

Hydrochloric acid (HCL) in the stomach helps ionize minerals like calcium, magnesium, and iron, allowing them to be absorbed later. It also helps in the decoupling of vitamin B12 from animal protein and activates the enzyme pepsinogen into pepsin for protein digestion.

Why is the correct pH level in the stomach important for digestion?

The correct pH level in the stomach, around 1.5 to 2, is crucial for activating the enzyme pepsinogen into pepsin, which is essential for protein digestion. Being too acidic or too basic can reduce the efficacy of this enzyme.

How does stomach acid contribute to the body's defense against infections?

Adequately acidified stomach contents can protect against fungal and bacterial overgrowth as well as parasitic infections, serving as one of the body's first lines of defense.

Can stomach acid affect the efficacy of probiotics?

No, studies suggest that stomach acid does not detract from the efficacy of probiotics, even when taken with food. Heat-killed probiotics have been found to be as efficacious as intact ones.

What is the purpose of sodium bicarbonate in the small intestine?

Sodium bicarbonate is released to buffer the acidic chyme from the stomach, allowing for non-burning entry into the small intestine and setting the optimal pH for the activation of many pancreatic enzymes.

How common is low stomach acid among the population?

Low stomach acid is not very prevalent. In young people under 55, it's less than 2%, and even in elderly populations, it ranges from about 5 to 12 percent, although some studies have reported higher numbers.

What are some risk factors for having low stomach acid?

Risk factors for low stomach acid include being over 65 years old, having an autoimmune condition, a history of H. pylori infection, long-term use of acid-lowering medications, and having any form of anemia.

What is the recommended protocol for determining the appropriate dosage of HCL supplementation?

The recommended protocol starts with one capsule per meal for a few days, then increasing to two capsules per meal if no improvement is noticed. If there's still no response by four capsules per meal, it's likely that the body is producing sufficient HCL. If burning or discomfort occurs, it may indicate that the dosage is too high.

Why is it important to trial HCL supplementation after foundational therapies?

Trialing HCL supplementation after foundational therapies like dietary changes, probiotics, and addressing any diagnosed conditions helps to isolate the effects of HCL and ensures that any symptomatic improvements can be clearly attributed to the HCL supplementation.

What are some symptoms that might indicate a need for HCL supplementation?

Symptoms that might indicate a need for HCL supplementation include burping, reflux, indigestion, bloating, sustained fullness, and a history of anemia.