“There are a lot of internet health sites recommending hydrochloric acid (HCl) tests and betaine HCl supplementation. They claim that many of us have HCl deficiencies because of our consumption of high protein and/or processed foods. Do you recommend the HCl deficiency test and betaine HCl supplementation? If not, what do you recommend for gut health?”
Hydrochloric acid (HCl), produced by the parietal cells, is a major component of gastric acid produced in the stomach. Gastric acid lowers the pH of the stomach which creates a natural barrier against microorganisms, stimulates the release of digestive enzymes, and begins the breakdown of proteins.
Microscopic view of parietal cells
An HCl deficiency (hypochlorhydria) or no HCl production at all (achlorhydria) are both legitimate health concerns, especially with chronic use of proton pump inhibitors (e.g., Prilosec, Prevacid, Nexium, etc). HCl production does decline as we age (especially after 60), but HCl deficiencies are uncommon in otherwise healthy adults and children, and there is no evidence that diet has a direct negative effect on HCl production. If you are experiencing frequent gastrointestinal distress – burping, bloating, indigestion, gas, etc. – we recommend seeing a healthcare professional to determine if you have an HCl deficiency.
For those that don’t know, the “HCl deficiency test” or “HCl trial” involves taking as many as seven 200 mg betaine HCl capsules – preferably ones for sale on the website recommending the test – with every meal until you feel a “warming or burning” sensation in your stomach. This test has never been validated, is not supported by science, and is not recommended or used by a single competent gastroenterologist. In fact, a burning sensation in the stomach is indicative of excessive acid production and over time (some gurus recommend a year or more of betaine HCl supplementation) could lead to gastric ulcerations. Another questionable test is the Heidelberg test. In this test, you swallow a pill that measures the acidity of the stomach and transmits the results back to a computer. The pill is then passed and eliminated normally. The Heidelberg test is uncommon and there is not much support for its use, so we don’t recommend it.
There are, fortunately, several ways to accurately test HCl production in order to determine hypochlorhydria. Gastric endoscopy and gastric suctioning, both of which involve putting a tube down your throat and into your stomach, are two of the more common testing methods used by gastroenterologists. Another common and reliable test is for hydrogen potassium ATPase pump antibodies or antiparietal cell antibodies. These tests are used to reveal pernicious anemia which is associated with hypochlorhydria.
Gastric endoscopy. Source: National Cancer Institute
Gastrointestinal health testing can also reveal an HCl deficiency. A possible indicator of hypochlorhydria is an overgrowth of pathogenic organisms (dysbiosis) in the gastrointestinal tract. Normal HCl production creates an acidic environment in the stomach which prevents the growth of bacteria. If HCl production is deficient, it is possible that pathogens, especially H. pylori, can survive and thrive. Nutrient deficiencies – particularly of iron, calcium, vitamins B1, B12, and D – can also indicate hypochlorhydria, though deficiencies of these nutrients are associated with numerous other pathologies.
For optimal gut health – without any knowledge of your gastrointestinal health – we recommend a diet high in fresh fruits, vegetables, and other good sources of fiber in addition to a probiotic supplement to support the growth of beneficial bacteria and the elimination of pathogenic bacteria like H. pylori. We also highly recommend a comprehensive gut health analysis in order to determine any digestion or GI issues, as well as a comprehensive food sensitivity panel to reveal any sources of food-borne inflammation.
In the event that you do have an HCl deficiency, betaine HCl supplementation may be warranted; otherwise, it’s just another unnecessary practice propagated by misinformed internet health gurus, or, more likely, those looking to make a quick buck.
“Are there any interesting or effective new supplements you guys are testing or that you recommend?”
We’re always testing new products on ourselves and passing the good ones on to our clients. Here are some of the new supplements we’re currently looking at:
Ubiquinol. CoQ10 is a great supplement for increasing energy (especially as you age), it’s a strong antioxidant, and it can play a beneficial role in preventing cardiovascular disease and hypertension. The problem is the common form of CoQ10 – ubiquinone – isn’t absorbed very well. Ubiquinol is the reduced form of CoQ10 (the form your body utilizes more easily) and can raise blood levels of CoQ10 five to eight times as much as ubiquinone.
Glycine-propionyl-L-carnitine (GPLC). Despite our best efforts to educate consumers otherwise, and despite a lack of clinical evidence demonstrating any benefit to healthy, active, adult humans, L-arginine supplements are still being pimped as the best “pump” producers on the market. Well, where L-arginine stumbles, GPLC shines (so far). Initial studies have shown that GPLC can induce vasodilation and increase blood flow even in healthy, previously trained individuals! These effects can be beneficial to people with a variety of chronic diseases as well as to athletes, bodybuilders, and weekend warriors.
D-aspartic acid. The very limited research available on D-aspartic acid reveals that it is a potent stimulator of leutinizing hormone (LH), which means it can significantly increase testosterone. We can tell you from personal experience and testing that D-aspartic acid definitely has positive effects on testosterone. In fact, we plan to release our own D-aspartic acid supplement by the end of the year.
Dihydroquercetin. Quercetin has been a popular supplement for some time, but dihydroquercetin remains relatively unknown. This is unfortunate because dihydroquercetin is a powerful antioxidant and anti-inflammatory that supports immune system function, increases cardiovascular health, and can help prevent several chronic, degenerative diseases. It can also enhance the efficacy of supplemental vitamin C. Dihydroquercetin is right up there with resveratrol, curcumin, fish oil, and a few other supplements that are “must haves” for anyone looking to improve their overall health and prevent disease.
