Poor stomach acid (high pH), otherwise known as hypochlorhydria, has been responsible for reduced vitamin and mineral absorption, reduced protein digestion, and food allergies.1 Furthermore, low pH (high acidity) is a critical defense mechanism against pathogens consumed from food. High pH can be attributed to several causes including the advanced age, bariatric surgery, and the use of proton pump inhibitors (increase pH or alkalinity).2,3 Ultimately, such events are likely to negatively influence stomach acidity.
If individuals are suspect of hypochlorhydria (poor acidity), and testing confirms the same, interventions should be implemented to restore normal stomach pH levels generally considered to be between 1-2.3(419) Betaine hydrochloride (BHCL), an over the counter nutraceutical, has the capacity to almost fully dissociate enabling it to acidify gastric fluids. As a means of testing the degree of impact of BHCL’s effect upon poor stomach acidity, Surofchy et al4 performed an open label crossover clinical study; 9 subjects were assigned, randomly, to 1 of 16 possible 4-period crossover sequences to evaluate the impact and relationship of food and gastric pH with BHCL supplementation.4(1)
Subjects were provided with varying doses of BHCL: 1500 mg, 3000 mg, and 4500 mg.4(1) Such doses were used to determine the ability of said nutraceutical to adequately re-acidify gastric fluids and pH after the deliberate elevation of pH induced by food consumption.4(1) Of particular interest was the dose of BHCL to return pH to normal ranges; only the 4500 mg dose was able to counter the strong gastric buffering of food when compared to the other conditions: 1500 mg, 3000 mg, and a control group which did not receive any BHCL.4(6) Such results are relevant as they remind nutritionists and researchers that higher doses of BHCL might be required amongst individuals with poor stomach acidity.
In conclusion, poor stomach acid (high pH), otherwise known as hypochlorhydria, has been responsible for reduced vitamin and mineral absorption, reduced protein digestion, and food allergies. If individuals are suspected to have poor stomach acidity (i.e., if they are on antacids or are od advanced age), testing for hypochlorhydria may be indicated. Most importantly, if choosing nutraceuticals like BHCL to facilitate increases in acidity, it is equally important to choose the correct dose to yield such an outcome, and such a dose might be higher than initially suspected.
References
1. Pizzorno J, Katzinger, J. Clinical pathophysiology: A Functional Perspective. Coquitlam, BC: Mind Publishing Inc; 2012.
2. Kenney WL, Wilmore JH, Costill DL. Physiology of Sport and Exercise. 5th ed. Champaign, IL: Human Kinetics; 2012.
3.Lord RS, Bralley, JA. Laboratory Evaluations for Integrative and Functional Medicine. 2nd ed. Duluth, GA: Genova Diagnostics; 2012.
4. Surofchy DD, Frasetto LA, Benet LZ. Food, acid supplementation and drug absorption- A complicated gastric mix: A randomized control trial. Pharm Res. 2019;36(155):1-10. doi:https://doi.org/10.1007/s11095-019-2693-5.
-Michael McIsaac