In today's video, I'm going to discuss whether or not to supplement with stomach acid support
while you have IBS or SIBO, so stay tuned. If you're new here, welcome. My name's
Amanda Malachesky. I'm a certified functional nutrition health coach and a digestive and allergy
detective. For weekly videos on how to make sense of diet and supplement advice for IBS and SIBO,
please consider subscribing and be sure to hit the bell to be notified when I post a new video.
Stomach acid supplementation seems to be one of the most confusing and vexing
options for people with gut health challenges, and it's especially so for a lot of my viewers
and clients. As an IBS and SIBO health coach and someone who also wrestled with SIBO for
many years, I know that there's a right time and a place for stomach acid supplementation,
but it's not right for every time or every place. So let's dive into this question to help
you make appropriate choices for your situation. First of all, stomach acid is an essential key to
healthy digestion. It helps protect your stomach from incoming pathogens. It helps your body absorb
vitamin B12 and iron, and it also is essential to help break down your proteins that you eat
in your food down into pieces that your body can actually absorb and use. Digestive problems like
constipation, reflux, and heartburn, and in some cases diarrhea and certainly bloating or slow
digestion or feeling of heavy digestion are all indicators that your digestion may need a little
bit of extra stomach acid to do its job well. But how do you know if you really need it? And
is it specifically indicated for IBS and SIBO? Let's dig into this a little bit.
The general answer to this question, which actually holds true no matter which
digestive supplement that you're talking about, is that it depends. For some of you,
it will make all the difference in the world and would be the thing that really turns things
around for you. And for others, it may not help at all and maybe even make things worse. Let's
break down some of the situations in which stomach acid might be indicated to go along with your IBS.
First of all, there's a couple of situations that are a pretty good indicator that you may
be deficient in stomach acid. One is if you are anemic, so this means that your iron as shown
on a blood test is low. This is because, like I said, stomach acid helps your body absorb iron,
so if you're low in iron, this is a sign that you may be deficient in stomach acid.
A second situation that may indicate a need for additional stomach acid support is if
you have an autoimmune diagnosis or multiple autoimmune diagnoses. This includes things like
Hashimoto's thyroiditis, or type 1 diabetes, or lupus, or any manner of autoimmune disease.
This is because autoimmune diseases can often also go along with stomach autoimmunity. You can get a
little bit of an autoimmune attack on the area in the stomach that produces the stomach acid,
and this is more likely to be the case if you also have other autoimmune diseases.
A third good indicator that you may be low in stomach acid is if your vitamin B12 level is low.
It's pretty rare to see it really low on a blood test, but if you have
some kind of result here that suggests that you may be low in B12, this is also another signal.
Finally, if you're over 65 years old. As we age, we naturally produce less stomach acid. So
if you're over 65 and you have Hashimoto's and you're low in iron, it's a pretty good indicator
that you actually may need some stomach acid. Just by the fact of being 65 and older and having
digestive symptoms, this is a good indicator that you may need some stomach acid support.
Those are some situations that just suggest when you might really be thinking this is necessary.
But really the simplest way to assess whether or not you need stomach acid is to actually try
and supplement with it and see if your symptoms improve. I talk all about how to do this in this
video here, How to Increase Your Stomach Acid For Digestive Health. Basically you can choose either
between using some lemon juice or apple cider vinegar and some water before meals, or you can
supplement with a capsule called Betaine HCL. But here's the deal with this: Everything that
you try, whether it's a diet, a supplement, a behavior, a medication is what I call an
iterative action experiment. By doing this you're testing whether a particular underlying cause
is involved in your symptoms or not. In this case, you would be testing whether or not
low stomach acid is contributing to your symptoms, whether they be bloating, constipation, diarrhea,
gas, whatever it is that you're experiencing that you're having trouble with. If your IBS improves
with the addition of the stomach acid support, you can then conclude that low stomach acid was part
of the problem that was driving your symptoms, and that for at least your digestion does better with
it, so it's something that you may need to add to your ongoing calm digestion plan to feel better.
Now, there's also this test floating around out there that I'm sure you've heard of,
which involves using a quarter to a half teaspoon of baking soda in a glass of water first thing in
the morning. The idea is you drink this down and the baking soda reacts with your stomach acid to
produce bubbles and gas. If you burp within 15 or so minutes of drinking down this water, that this
indicates that you have sufficient stomach acid. So you can definitely perform this test if you'd
like. There's nothing wrong with it. It's not generally harmful. Just keep in mind that the
results are pretty mushy. It's not very scientific and may not give you very clear results.
Ultimately, the best test is actually just to try the supplementation and see how you
respond. If you do well with it, then you can keep going. If you don't do well with it,
then you can move on to other possibilities that might be involved with your symptoms.
That's the general answer to the question of, should you supplement with stomach acid for IBS
and SIBO. Maybe. Maybe it's about 50/50. For about half of you, it might be really awesome.
For the rest of you, it may not really make much of a difference or it might make things worse.
In addition to this, there's a couple of particular situations where you definitely would
not want to supplement with stomach acid. I really want to make sure to talk about those as well.
Situation number one where you would not want to supplement with stomach acid at all,
would be if you have active ulcers, if you have diagnosed with gastritis by an endoscopy,
by your gastroenterologist, or if you have, or suspect that you have an H. pylori infection.
Ulcers are very closely related with H. pylori infection, so if you have active ulcers,
chances are you also have an H. pylori infection. And because H. pylori affects
not only the stomach, but basically everything downstream of the stomach, there can also be a
pretty clear correlation between H. pylori infection and IBS and SIBO
symptoms. In this situation, especially if you have ulcers or the gastritis,
stomach acid supplementation obviously may cause some additional discomfort, or burning, or pain,
and so would definitely not be advised. The H. pylori bacteria
lives in the stomach lining by burrowing into the stomach lining. And in that area of the stomach,
it actually reduces the acid production there and it prefers that kind of environment. And so if you
have a H. pylori infection, this often signals that your stomach acid is a little on the low
side. You don't want to supplement with stomach acid while you have this H. pylori infection,
because it may encourage it to burrow even deeper into the lining of your stomach.
So you would wait on supplementing stomach acid until you had cleared that H. pylori infection,
and that you've treated and then retested and seen that, okay, I don't have H. Pylori anymore. Again,
that's active ulcers, gastritis or currently diagnosed, or suspected H. pylori infection,
you should not supplement with stomach acid. All right. Here's another situation where you
should not supplement with stomach acid. This is a surprising one that I just recently learned.
I was listening to an interview with Dr. Mark Pimentel, who is the preeminent SIBO researcher
at Cedars-Sinai. I saw him on a podcast interview. He was saying that his team had discovered
that supplementing with Betaine HCL specifically can make hydrogen SIBO much worse. This was kind
of surprising because for years stomach acid has been presented as a first line option for
digestive problems of all kinds, because again, if your stomach acid isn't working well, it can
affect your digestion all the way downstream. What Dr. Pimentel has recently learned, this is very
important, that if you have been diagnosed with hydrogen SIBO, you should not be supplementing
with Betaine HCL until you are clear of SIBO. This probably doesn't necessarily apply
to using the more gentle food supports like lemon juice and apple cider vinegar in moderation,
but we should be careful and conscientious about again, just like I was mentioning in
the beginning, evaluating how your body feels when you use those supports. And if there's
evidence that it's not working for you, then you would back off of that supplementation.
All right. One more situation where supplementing with stomach acid may not be a good idea is if
you have heartburn or reflux. In a lot of ways, this seems intuitive, right? If you have burning
sensation in your chest or your throat or your stomach, you probably shouldn't supplement
stomach acid. But what's counterintuitive here is that in about half of cases, more or less,
I've found that supplementing stomach acid with heartburn helps people. And then in roughly the
other half of people, it actually makes it worse. Heartburn and reflux is no different
than any of these other digestive symptoms where the underlying causes for people are different.
For some people, it really may correlate with low stomach acid. And for others,
it may signal that there's too much stomach acid, or there's just too much injury to the tissues to
tolerate supplementing with stomach acid. This is one of those situations where test
driving stomach acid support carefully and gently and starting with a low amount and
evaluating how you feel is actually the best solution to figure out which camp you're in.
Does it help you, or does it hurt you? If it makes things worse, then you'll want to
direct your attention to investigating other possible underlying causes of those symptoms.
What I'm finding is that in a lot of heartburn and reflux cases, SIBO is
actually an underlying cause. If you think about it makes sense that like a bacterial overgrowth
in the small intestine may be causing excess gases, and those gas pressures can be pushing
upwards and just creating an upward movement of material and gas and pressure and bloating into
the stomach and putting pressure on the diaphragm and on your esophagus. I'm finding that a lot of
the solutions that I suggest for IBS and SIBO sometimes are helpful for people with reflux.
Again, if you are a reflux or heartburn sufferer, you can try actually supplementing just to
evaluate whether you're one of the people for whom the reflux is triggered by low stomach acid
or whether it's actually part of the problem. After hearing what I've said in today's video,
I'm curious if you will be trying out stomach acid supplementation. Tell me about it in the comments.
Are you someone who's needing a little more help figuring out how to use gut healing supplements,
or diets to resolve your IBS or SIBO symptoms? If so, I want to let you know that the doors
for my calm digestion method program are open right now. I want to invite you to
book a free 45 minute discovery call to see how I can help you go from food anxiety and
supplement confusion to a confident plan for calm digestion. You can book that call by
going to confluencenutrition.com/contact, and I will absolutely leave a link for that below
this video. You can just scroll down there and click there to fill out the brief intake form
and pick a time that works for you. I look forward to meeting some of you and hearing
more about what's going on for your digestion. If you like this video, please click like and
consider subscribing, and go ahead and pass it on to somebody else who you know who you think
might benefit from it. I will look forward to seeing you all next time. See you.