Why Stomach Acid is Good for You
by Jonathan Wright, MD and Lane Lenard, PhD M.
Evans and Company
Tums, Rolaids, Nexium, the purple pill: if the endless stream of TV, print, and online ads for medication to reduce stomach acid is any indication, we are facing an epidemic of excessive stomach acid. We are absolutely drowning in it and should ask our doctors for prescriptionstrength drugs to lower it. How else could we account for the fact that over-the-counter and prescription medication to treat heartburn, GERD, and other forms of indigestion are among the top selling drugs? Contrary to what we’ve been led to believe, Drs. Jonathan Wright and Lane Lenard argue that these conditions have little to do with eating and drinking acidic foods and beverages, or lying down too soon after a meal. The biggest factor in indigestion, they say, is not too much stomach acid, but too little.
If this sounds illogical, it’s only because many of us are unfamiliar with the anatomy and physiology of our own digestive tracts. It makes sense that too much stomach acid would cause the discomfort we associate with indigestion, but a quick primer on the digestive process reveals that rather than making our stomachs less acidic, we want to make sure our stomach acid is plentiful and strong. When it’s not, indigestion is only one among myriad conditions that result. The authors give an A-to-V list of health complications that are the direct and indirect results of insufficient acidity—everything from acne to vitiligo—and if there were more common conditions with the letters X through Z, they would have included those, too.
How does reduced stomach acid cause indigestion? While food begins its mechanical and chemical breakdown in the mouth (courtesy of chewing and salivary enzymes), the major breakdown of food starts in the stomach. Specifically, protein triggers the release of stomach acid (hydrochloric acid, or HCl). HCl is designed to “get things going,” so to speak. The very strong acid is supposed to start breaking things down to a point where they can pass along into the small intestine, the next stop on the digestion train. Food isn’t supposed to remain in the stomach for very long. The HCl should be strong enough to do its job, crank things up, and hand the baton to the duodenum. When HCl isn’t strong enough, or there’s not enough of it to go around, food stays in the stomach longer than it should. Proteins putrefy, carbohydrates start to ferment, and this is what produces bloating, discomfort, and the gas that “refluxes” back into the esophagus. So acid-reducing and blocking drugs are simply band-aids. They do nothing to address the underlying cause. In fact, by merely suppressing the symptoms and allowing the sufferer to continue eating as before, they lay the groundwork for slow-growing, long-term health complications. The authors pull no punches in calling pharmaceutical companies to the mat for their whack-amole approach to treating individual symptoms and marketing yet more drugs for the conditions the acid blockers eventually create: “Never lose sight of the fact that pharmaceutical companies are not in business to cure diseases, but rather to make money for their stockholders. Once a patient is cured, that patient doesn’t need to buy any more drugs. But if his or her symptoms are suppressed, they may be ‘hooked’ on the drugs for life.”
Strong stomach acid accomplishes several things: it activates protein-digesting enzymes and helps us absorb vitamins and minerals like calcium, zinc, iron, folate, and B12. Wright and Lenard offer detailed—and shocking—explanations of the role of insufficient HCl in anemia, osteoporosis, depression, memory loss, and other conditions caused by deficiencies in these nutrients. Further, strong HCl destroys pathogens and triggers subsequent steps in the digestive cascade that are signaled by the proper degree of acidity. The authors explain that “normal stomach function is like the first domino in a row: if it doesn’t fall as it should, the rest won’t, either.” If digestion in the stomach is compromised, then the breakdown and absorption of nutrients in the stomach and beyond won’t be optimal. In fact, they can be reduced to the point where even if someone is consuming a nutrient-dense diet, they can suffer both sub-clinical and overt deficiencies because they’re not assimilating those nutrients. As the authors put it, “If, because of inadequate stomach acid, our breakfasts, lunches, and dinners aren’t being digested, then we can’t absorb the amount of nutrients from that food that Nature intended. How can we expect to stay healthy if we have chronically poor nutrient absorption due to incomplete digestion?”
Furthermore, the physical problems that can manifest from poor stomach acid are only one side of the coin. We know that individual amino acids (particularly tyrosine, tryptophan, and phenylalanine) are required to make neurotransmitters that facilitate stable moods and psychological balance. If, due to insufficient stomach acid, we don’t break down proteins properly, we will not be able to absorb these critical molecules. Thus, there’s a logical link between low stomach acid and depression, anxiety, and other debilitating mood imbalances. This link is compounded when we think about the role of fatty acids in mood stabilization. Low stomach acid will not trigger the correct environment for pancreatic enzymes to function optimally in breaking down fats. Sub-optimal fat digestion means we won’t benefit from the anti-inflammatory properties of omega-3 fats, nor the wide array of beneficial effects of fats for fertility, skin health, immunity, etc.
Things get even more interesting when Wright and Lenard address allergies, food sensitivities, and autoimmune conditions. Their book was written in 2001, and even though some doctors had been talking about the issue of “leaky gut” decades earlier, it seems that with the resurgence of the Specific Carbohydrate Diet and the popularity of the GAPSTM protocol in the last couple of years, these authors were at least a few years ahead of their time. They acknowledge the compromised physiology of a leaky gut but also contend that if digestion were working full-steam (courtesy of good stomach acid), food molecules would be broken down properly earlier on and fewer large, semi-undigested particles would reach the parts of the small intestine where they’re absorbed and pass into the bloodstream, triggering sensitivities and autoimmune reactions.
Beyond this, too little stomach acid can lead to other compromised health situations, many of which are becoming more common: parasitic infection, yeast overgrowth, and overgrowth of pathogenic bacteria. Again, the connections are clear: strong stomach acid is designed to neutralize food-borne pathogens. Also, if foods are not broken down properly, opportunistic bacteria in our GI tracts feed off of them, leading to microbial imbalances in the gut and all the consequences that result.
The authors do an excellent job of addressing a host of conditions that result from too little stomach acid, many of which conventional doctors don’t associate at all with digestion. They explain this is because “many of the potential accompaniments of long-term acid suppression, including asthma, allergies, skin disorders, rheumatoid arthritis, insomnia, osteoporosis, gastrointestinal infection, depression, and many, many others, can take years or even decades to develop. They would seem to have nothing to do with stomach acid and, therefore, would rarely, if ever, be reported.” They further note that while some of these conditions take a long time to manifest, clinical trials of most acid-lowering drugs generally last only months, making it easy for drug companies to ignore (at best) and cover-up (at worst) any long-term complications. Moreover, they have little interest in exposing flaws in their research. As the authors put it, “It’s going to be a long time before conventional medicine gives up its antacid/acid-blocker cash cow.”
Besides too little acid, another cause of digestive distress is a weakened lower esophageal sphincter (the ring of muscle between the esophagus and stomach). According to the authors, other things that can weaken this sphincter and cause heartburn and GERD are NSAIDs, calcium channel blockers, beta blockers, and many other OTC and commonly prescribed drugs. So our modern, fast-paced age of stress, chronic dehydration, and popping pain pills and blood pressure medication like they’re candy is a recipe for heartburn and indigestion.
Wright and Lenard lay out many strategies for preventing indigestion, none of which require a prescription or a trip to the corner drugstore. A grocery store, maybe, and possibly a health food store with a reputable supply of herbs. Why? Their suggestions include taking apple cider vinegar or lemon juice a little while before meals to ramp up stomach acidity. They also recommend herbs and other natural digestive supports, including ginger, turmeric, bitters, probiotics, and digestive enzyme supplements. (No mention of bone broth or fermented foods, but a helping of sauerkraut can work wonders! Also no mention of properly preparing grains or legumes to facilitate digestion.)
While the authors’ entire premise is that low stomach acid is the culprit behind a laundry list of medical conditions, they do give a nod to some commonly cited remedies: eating smaller meals; not eating before bed or otherwise reclining; wearing loose-fitting clothing around the abdomen; and avoiding foods that can be esophageal irritants: coffee, spicy foods, acidic foods (tomatoes, citrus), and carbonated drinks.
The biggest weakness I find with this book is that in an otherwise fantastic guide to the debilitating effects of low stomach acid and natural ways of remedying it, the authors completely avoid addressing why stomach acid might be low. Improving it via herbs and enzymes is nice, but that does nothing to illuminate the causes of low acid in the first place. The big guns of digestion come out in the stomach, but digestion really starts in the mind, long before we taste our first bite. The mere smell—and, according to some research, even the thought—of food, triggers saliva production. It signals to our brain that we’re about to receive food and prepares the entire orchestra of the GI tract to start warming up. Stomach acid is suppressed when we’re stressed out and hurrying through meals. From a biological standpoint, feeling anxious is a sign that we’re in a dangerous situation, and during times of danger, digestion is not the body’s first priority. The familiar “fight-or-flight” mechanism causes most of our blood and energy to be shunted away from the GI tract and toward the muscles and lungs, which would help us run for our lives. Digestion’s second stop is the mouth. We need to chew thoroughly and allow our saliva to mix with the food until it’s almost liquefied. Not only does this bring the physical and chemical breakdown of food further along, but it makes the stomach’s job easier: the more thoroughly the food is chewed when it reaches the stomach, the more surface area the enzymes have to work. Proper chewing is like giving the stomach a head start. It’s a shame the author makes no mention of being calm, being hydrated, and chewing sufficiently. The stereotype of the stressed-out, busy executive wolfing down her lunch and barely chewing before she runs off to her next meeting and then spends the rest of the day popping antacids is based in physiological truth.
This book is a must-read for anyone suffering from any type of indigestion as well as medical conditions of unknown etiology. There’s a chance that simply boosting stomach acid can have profound effects upon health. I also recommend it for healthcare professionals. Conditions typically treated via expensive, invasive, and harmful procedures and drugs might be improved by something as low-tech as lemon juice.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Fall 2013.