A Key to Healthy Digestion: the Mystery of "The Gray Man" and Low Stomach Acid

A Key to Healthy Digestion: The Mystery of "The Gray Man" And Low Stomach Acid

By Jonathan V Wright, M.D,

,,Gray I r rue Tenotra. CLrNrc, he was known as the "Did anyone ever actually measure your stomach-acid -fa. Man." He got the nickname after our staff agreecl production?" they had never seen anyone with his skin tones. His vis- "No..,bnt the symptoms sure have gone away since ibie I skin was devoid of any pink tones, had scarcely any blocked aIl that acid out." brown, and instead was a peculiar whitish-gray. I,ve not "And a river will dry up if we stop all the rain,,, I saicl. seen anyone like hirn befbre or since. "Maybe that's an advantage for a littie while if the river The Gray Man hadn't come in to find out why he has been overflowing, but what happens if we stop looked gray-although his wife had mentioned it to him the rain permanently?" 'oa time or two." Actually, he explained, he didn't have He thought for a moment. "Permanently?,' any symptoms or ilinesses but was just plain tired. Really tired! "At ieast seven years. "Quite a drought. Fufiher questioning turned up little but the fatigue. In Nothing would grow.', the past, he'd had chlonic indigestion and inter- mittent but persistent heartburn. He noted that both symptoms had gone on for over 20 years and that he'd taken "plenty of those Tums and Rolaids and other antacids" since his 40s. However, he re- ported he hadn't had any indigestion or heafibum problems at all since he'd started taking Tagamet every day since it came out. Now that I mentioned it, he guessed he had been taking Tagamet for seven years by now. "You know that stomachs are naturally de- signed to secrete enough acid to turn even large meals into the equivalent of soup?" 1asked. "Yeah, I know tiiat in general, but all the doc- tors told me that indigestion and heartbum are due to too much acid," he replied,

WEtt BerNc lounus www.w e llb ei.n gj o ur nal.c om. NovemberlDecember 20ll g "Right. And if we shut off or neutralize our stomach's natural acidity for Amla, Vitamin C & more than brief intervals, there are similar consequences. First, we don't break down foods as wel1, and many nutrients, especially essential amino Disease Prevention acids, certain minerals, and at least two B vitamins, aren't made as available by natural acid digestion as they usualiy are, and aren't properly absorbed into THr Avm rnurr has been used our bloodstreams. So our cells don't have the normal amounts of nutrients for for thousands of years in nourishment. Second, when that acidified soup ernpties out of the stomach into Ayurvedic medicine to treat vari- the upper small intestine-the duodenum-it triggers the secretion of hor- ous ailments, and Western re- tnones that in turn stimulate the pancreas and galibladder to make or release search is proving why this small fruit is so powerful. Amla is also lT"1_:-"11::::l::::illl'"i"ll?:x#":bi;H:rr;#*1";,y#y- produced, and the next stages in digestion known as lndian gooseberry, Hypochlorhydria don't work as well as they should either. Embelica officinalis, and Ama- This makes another whole group of nutri- lika.lt's Sanskrit name, Amalika, (low or no stomach ents less available to our cells." means "slrstainer of health." acid) is one of the ooSo it's like a cascade of events. If the Amla is one of the three foods most common diges- acidity isn't there, then other parts of di- used in the common digestive gestion aren't triggered properly either." supplement Triphala. Alone it is tive malfunctions, "Exactly. And we don't even know if we used to treat high blood sugar, it's often accom- know absolutely all the 'cascades' in the promote skin health, normalize & digestive stream." body function, balance the endo- panied by other, "No wonder I'm tired. I've literaliy crine system, improve immunity, unrel ated, dried up a lot of my digestion for years. inhibit LDL oxidative damage, seemingly Why didn't anyone tell me about this?" promote longevity, and slow cel- health problems 'oDon't know. It's all right there in the lular aging as well as protect the basic textbooks for rnedical students. But body from radiation exposure. that's not all: The same basic textbooks list a third consequence of low or no Amla contains antimicrobial and stomach-acid production. Let's think about it this way: What happens if I put antibacterial diterpenes, poly- bacteria or parasites into an acid in a test tube?" phenols, alkaloids and a number 'oNot sure, but I'd guess a lot of them die." of benzenoids, and a very high "Right. They die and turn into a minor protein supplement. Textbooks of dose of vitamin C. gastroenterology actually call stomach acid the acid barier to intestinal-tract Because this fruit contains infection. Also, everyone knows that farther down the intestinai tract is home tannins it retains most of its to a wide variety of micro-organisms-sometimes called intestinal micro- vitamin content when dried. flora-that help with digestion, secrete a few important vitamins, and generally Studies have shown results behave themselves. But if the acid-alkaline balance, technically calied the pH, suggesting amla's effectiveness isn't just right, then many of the friendly micro-organisms literaliy die out and in the orevention of LDL oxida- are replaced by not-so-friendly germs, At best, these unfriendly micro-organ- tion and atherosclerosis as well isms aren't as helpful to us as the friendly ones. Worse, some of them excrete as inhibition of the production of substances toxic to our own body cells, that are absorbed and spread all around AGEs. The pro-collagen char- our bodies," acteristic of this fruit is due to its The Gray Man shifted uncomfoftably in his chair. "So not only have I been toxins from my gut to enter ability to inhibit collagenase, the semi-starving myself but also maybe encouraging end result being that it benefits my system?" collagen synthesis and protects against its degradation, making Researchers attribute the tongevity of the people of the Caucasus region and their it useful as a cardiovascular pro- ability to reproduce untit late in life to the consumption of fermented milk foods with tective agent and an anti-aging probiotic bacteria. Traditionally, kefir is prepared by fermenting cow, goat or sheep's food/supplgment. m1k at room temperature overnight. The kefir grains are a complex combination of and bacteria. This combination of life promoting micro-organisms Sources: www. ayu rvedicdietsolu- beneficiatyeasts benefits that are tions.com/Amalaki.php and http:// and nutrients present in kefir offers many of the digestive health www.amlaextract.info; see also a/so assocla ted with yogurt, as they share some of the same bacteria of the Lacto- "Reversing Heart Disease with a Vi- bacillus and Streptococcus specles. Vol. 20, Diet; The real secret to good health, ideal weight and tamin," Well Being Journal, -Ana Luque in The Yogutt No. 4; www.wellbeingjournal.com. long I ife, wvwv. myyogurtdiet, com.

Wur BuNc JouautL I0 NovemberlDecember201l www.w eLIb eingj ournal,com "Afraid so." "Could blocking my normal stomach function be the basis for this fatigue?" Signs of Low HCL "Very likely. Let's work on restoring normal digestion as much as possible, make up for at least seven years of unintended malnutrition, and, if necessary MnNv pRrtrlrrs wrrH low stomach work to restore normal gut flora. Then we'11 see." acidity or no stomach acidity "I guess the first thing is to stop this Tagamet. But then I'11 have indigestion frequently report bloating, belch- and heartburn all over again, won't I?" ing, or burning immediately after "Most of the time there are natural ways to stop indigestion and heartbum meals; a feeling that food just sits without blocking stomach acid." in the stornach not digesting; and "How?" an inability to eat more than a small o'First, amount of food without feeling full. we need to find out if your stomach really does make too much acid. Many of them are constipated, Chances are very high-over 90 percent-that it doesn't, and that the real but others have diarrhea culprit is likely underproduction of stomach acid, along with some of that small and some amount of acid turning up in the wrong place, causing burning. Let's wait until even have normal bowel function. we do a test or two." Not everyone has all these symptoms-many have just one or two, Inadequate Digestion And some individuals with no stom- You can eat allthe right ach acid at all have no symptoms. foods but still slowiy There are other physical signs starve to death. Like the often found in people who suffer overwhelming percent- from low stomach acidity, such as age of individuals with weak, easily broken, and peeling indigestion and heartburn, fingernails; hair loss (in women); the Gray Man found, gassiness in the upper abdomen; after some testing, that and unusual dilation of the capillar- his stomach had actually ies in the cheeks and on the nose been underproducing (in a nonalcoholic). acid for all those years. A long list of diseases frequently Hypochlorhydria (low associated with low stomach acid- or no stomach acid) is ity includes diabetes mellitus, an one of the most common underactive or overactive thy- digestive malfunctions, roid, childhood asthma, eczema, gallbladder and it's often accompa- disease, osteoporosis, rheumatoid nied by other, seemingly arthritis, chronic hives, lupus erythematosus, weak adre- unrelated, health problems. Unfortunately, inadequate digestion becomes even nals, chronic hepatitis, vitiligo, and more frequent with age. So, even if you're following the best possible diet plan rosacea. in general or for a particular ailment, if the food you're eating is incompletely lf you're suffering from some of digested or assimilated, your body won't get the nutrients possible from it and the symptorns or diseases men- it won't be effective. tioned above and suspect that your Think about it. Our bodies are made up of 60 or so essential nutrients (essen- problem is poor digestion, talk to tial being defined as nutrients without which we'd sooner or later drop dead); your doctor about the possibility of how healthy can you be if your body isn't absorbing even those one of nutri- hypochlorhydria. Wright, M.D. ents? And what if a dozen or more nutrients are in short supply? If our foods -J, and supplements don't encounter the proper acid and enzymes, they won't digest and absorb, which will cause malnutrition. In essence, you could be eating all you need but still starving yourself. Many people who have too little stomach acid are being treated as if they have too much-probably because the symptoms are similar. Ten to 15 percent of the population suffers frorn hypochlorhydria, and most people are being mis- diagnosed and mistreated, A full 50 percent of people over 60 are hypochlorhy- dric, and most of them are being treated for the opposite problern. Why in the world would you want to take antacids or acid blockers when WELI BEING JOURNAL your stomach is already weak and not digesting adequately? It's easy-symp- tom rehef. It also just so happens that this phenomenon is making drug compa- $25 for one-year; $18 in PDF. nies very richl ifdoctors aren't prescribing high-strength antacids, people are See page 48 or just getting them over the counter and often popping several a day. www.wel lbei n gj o u rn al.com

Wnu Buuc Jounu,cr www.w e llb e in gj o urncLl.c om. N oven'tberl D ecem.ber 20 I l 11 Multirnillion-dollar promotions to the public were launched to drive horne Omega-3s the point that heartburn and indigestion are caused by too mucir acid, which can be blocked by antacid products with minirnal risk. Oddly enough, the FDA and has never required the companies advertising these products to docurnent their claims that indigestion is actually caused by over-acidity, Macular You can be tested for hypochlorhydria and other possible stomach malfttnc- De,generation trons. I recommend direct measurement of gastric acidity by radiotelemetry using the Heidelberg capsnle. At present, it's the best test available 1br fr-rnctional A RrcsNr sruDY suggests that determination of the stomach's ability to secrete acid nonnally. I also use other regularly consunring fish and the iaboratory clues to heLp my diagnosis. One is a mineral analysis of a hair speci- omega*3 fatty acids found in them me1. lf six or more nutrient minetals are low, excluding sodium and potassitttl, may significantly decrease risk of your stomach-acid leve1 shor-rld be checked. The other test routinely done in our age-related macular degenera- laboratory is on a stool specimen, to check for completeness of digestion. It's tion (AMD), ihe primary cause not unusual to find an excess of undrgested meat flber in sttch au analysis. Ar-rd of blindness in seniors. Using tneasurement of the stomach acid in those cases usually discloses an ir-rsuffi- data from the Women's Health clency. Study, researchers tracked 38,022 Once the problem is fbund, I recommend treatmgnt with hydrochlorrc acid female health professionals over (which can be dangerous, ltowever, and should be used only with careful super- a 10-year period and found those vision). pepsiu with the highest intake of docosa- I've found that hydrochioric acid when used in conjunction with usLt- pepsin is ltsually hexaenoic acid (DHA), an ome- aliy gives the best results. And unless you're sensitive to it, acid. Powdered preparations of hydrochloric ga-3 fatty acid in fish, were 3B% recommended with hydrochloric acid capsules are much more effective than the solid tabiet fonns. Some indi- less likely to develop AMD than in viduals may have pain, burning, or additional stomach problems when using those with the lowest DHA intake. hydrochloric acid; when that's the case, I find that small, gradually increased Higher intake of eicosapentae- quantities of lernon juice or viuegar can usualiy do the same job. noic acid (EPA), another omega-3 To minimize even minor side ei'fects, I always start with just one capsule (5, fatty acid, showed similar results. 7.5, or 10 grains) taken just before meals. Afler two or three days, if there are In addition, women who con- no problems, I suggest increasing tlie dosage to two capsules before meals {br sumed one or more servings of another two or three days and then to three capsules. Tl-re dose is gradually in- fish per week had a 42ok lswer creased in this fashion until the recommended amount is reached. The amount risk of AMD than those who ate of hydrochloric acid that's usually effective for adults is at least 40 to 10 grains fish less than once per month. of betaine hydrochloride (or glutarnic-acid hydrochloride) with pepsiu per Researchers Wm. G. Christen, meal. That's about four to seven 1O-grain (B to 14 5-grain) capsr,rles per meal. Sc.D., of Brigham and Women's Tl-re Gray Man followed this treatment program aucl as long as he kept it up Hospital and Harvard Medical controlled his indigestion and indigestion symptoms. I-Iis program also includ- School, observed that "this lower ed replacement digestive enzymes, intestinal flora "noflnalizers" (also called risk appeared to be due primarily probiotics), and supplements of amino acids, vitamins, and minerals. to consumption of canned tuna The Gray Man's skin color siowly retnrned to the normalbrown and pink fish and dark-meat fish." They slcin tones. As his grayness turned to normal slcin color, liis nickname faded concluded that regular coRsump- away too, and was replaced by only his first natne, John. FIis fatigue also tion of DHA, EPA, and fish "may waned and was replaced by increased energy. His wife noted irnprovetnents itr be of benefit in primary prevention mood and attitude. Six months later, he declared himself "back to nortlal." of AMD." The study was published The only thing entirely atypical about the Gray Man's (John's) case was his on-line in the Archives of Ophthal- skin color. As noted above, I've nevet seen anything like it before or since. But mology on March 14,2011. the rest of the story-indigestion and heartburn caused by r"rnderproduction of Sources: "Dietary Omega-3 Fatty norrnal stomach acid-is absolutely typical. A Acid Intake Associated with Reduced If you would like to find a doctor in your area who is using tlte Heidelberg pH diagnos- Risk of Age-Related Macular Degen- tic system, yoll can check the manuf-acturer's website, www.phcapsi,rle,com to see a llst eration in Women," JAMA and Ar- of practitioners who are using the ecluipment. Tahoma Clinrc in Renton, Washington, chiyes news release, March 14, 201'1 , is also accepturg patients who would like to liave theit stornach acid levels tested in http://pubs.ama-assn.org;'lDietary acldition to full heaith workups "Tahoma-Clinic-style" (www.tahomaclinic.corn, ol call Omega-3 FattyAcid and Fish lntake 425-264-0059 for mote inlbrmation). and lncident Age-Related Macular Degeneration in Women," Archives This article is excerpted by permission from the book I4rh1, Stontcrch Acid i.s Good./br of Ophthalmology, online as of March You,by Jot'i,qruau V Wrucur, M.D., aud Le.Ne LeN,'rru, Pn.D., and is available ouline, in or contacting the Tahoma Clinic Dispensary (www.tahomadispensary. 1 4, 2011, doi: 1 0. 1 001 /archopthal- bookstores, by mol.201'1.34. colrl, ol call 888-893-6878).

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