It is estimated somewhere between 15-30% of all Americans experience GERD, more commonly called heartburn, daily or weekly. Glancing at that quickly, that might seem pretty high!
Some of the most common causes of GERD are poor eating habits, pregnancy, hiatal hernias, and low stomach acid levels.
There are a variety of symptoms associated with low stomach acid levels, including:
- Hair loss
- Auto-Immune issues
- Iron deficiency
- Vitamin B12 deficiency
- Chronic fatigue
In GERD, the lower esophageal sphincter, which opens up into the stomach, does not close properly, and food and stomach acid get regurgitated into the esophagus, causing the heartburn, bad breath, gum irritation, and other symptoms that come along with it. If this is not addressed over a long period of time, it can cause some serious damage, including Barrett’s esophagus and esophageal cancer.
Ironically, the conventional medications and over-the-counter drugs for GERD do provide temporary relief of many of these symptoms, but could cause new or more heightened symptoms long-term. It is quite possible you may notice these yourself.
Generally, there are three common types of medications you might take if you experience GERD: antacids, histamine type-2 receptor antagonists (H2 blockers) and proton pump inhibitors (PPIs).
Antacids (like TUMS) are usually the first choice in conventional medicine. These are meant to reduce stomach acidity quickly, giving you short-term relief (usually within minutes), but not getting to the root cause of the problem.
H2 blockers are not as fast-acting as antacids, but their effects tend to last longer. H2 blockers have common names like Pepcid/Pepcid AC, Axid, Tagamet, and Zantac. They work by blocking a substance in the body that encourages acid production in the stomach.
PPIs are the third major class of drugs (commonly seen as Nexium, Aciphex, Prevacid, and Prilosec). They function by permanently blocking an enzyme that tells your stomach to produce acid, H+/K+ ATPase, in the cells that line the stomach wall. One side note here: “permanently” means for the lifespan of the cells that line the stomach wall, which is only a few (3–5) days.
Under normal circumstances, the stomach pH is very low (meaning a high-acid environment), between 1.5 and 2.5. These drugs can raise the stomach’s pH (creating a less acidic environment) by as much as two points. The lower esophageal sphincter is actually pH sensitive, and initiates closing when the stomach pH is below 3.0. If the pH value is chronically high, the sphincter will not close properly.
One of the biggest issues is that these medications do not address the root issue, they are only a Band-Aid. Every time you take antacids, the stomach has to work harder to create more acid to bring the environment back to its normal range (1.5–2.5). What makes this particularly dangerous is when we become reliant on these medications, and only make the problem worse in the long-run.
It could become a harmful downward spiral. Long-term use of these medications can lead to a state of hypochlorhydria (low-stomach acid), and is associated with vitamin B-12 deficiency, autoimmune conditions, SIBO, asthma, diabetes, chronic fatigue, and others.
Along with the overuse of antibiotics, PPIS, and H2 blockers, other causes can include:
- H. pylori infections
- Poor nutrition
- Chronic stress
- Eating to quickly or while moving
- NSAID overuse
- SIBO (Small Intestinal Bacterial Overgrowth)
- Food sensitivities
- The aging process
When stomach acid levels are low, you will not be able to properly breakdown protein in the stomach. Large proteins make their way into the small intestine, and this places a great deal stress on the pancreas to produce enough enzymes to metabolize the ingested food.
Over time, the pancreas wears down, and enzyme stores run thin. This can lead to gut irritation, malabsorption, and maldigestion. Maldigestion refers to our inability to properly break down the food we eat, while malabsorption is our inability to absorb the nutrients we need efficiently. If pancreatic enzymes are not released in sufficient amounts, it can lead to fat and protein malabsorption and maldigestion. When proteins are not broken down properly, then we are unable to breakdown and utilize important amino acids efficiently.
Incomplete digestion can lead to leaky gut syndrome and trigger auto-immune activity in different regions of the body. It can also lead to SIBO and other bacterial overgrowths and mineral depletion throughout the body. A lack of certain minerals inhibits our ability to make stomach acid in the first place, further perpetuating the cycle.
Now… how do we fix it?
Well, first and foremost, we have to address what we are eating. At minimum, you should look into reducing and (ideally) eliminating refined carbohydrates and simple sugars. At the same time, we need to start incorporating more whole foods in their natural, unprocessed forms. These should be mainly vegetables, fruits, nuts, seeds, and whole grains.
Today we live in a world where there is no shortage of food options, but many of them happen to be questionable or even detrimental to our health. Instead, the goal to should be to consume minimally processed, organic foods that are as close to their natural state as possible. These basics give you these baseline of where to get started:
- Eat real foods, withat least 50% of each plate being vegetables.
- Eat a diet primarily of vegetables, fruits, nuts, seeds, lean proteins, and healthy fats.
- Choose pasture-raised, organic, grass-fed, and/or wild animal meats and fish.
- Eat and assortment of different-colored vegetables and fruits (eat the rainbow).
- Drink clean water.
- Eat fermented foods to balance your gut flora, like kimchi and sauerkraut.
- Cut out inflammatory foods, like simple carbohydrates, sugars, processed foods, and candies.
- 80% of the time eat right, allowing yourself 20% “wiggle room.”
- Drink lemon water in the morning, it helps boost metabolism and liver function.
- Look for foods that are high in fiber (whole foods) and low in sugar.
- Eliminate all packaged foods, if possible.
- Be sure to read ALL ingredient labels.
- Never eat out of a box or bag.
- Eat greens at least twice per day.
- Choose organic foods as often as possible.
- Listen to your body!
To take this a step further, it is important to focus on non-GMO organic products, and increase fiber intake and prebiotic foods. Supporting the healthy gut bacteria will help further complicate issues that could potentially lead to SIBO or other gut-related problems. Additionally, it is important to eliminate these foods while going through the healing process:
- Carbonated beverages, sugary drinks or energy drinks
- Artificial sweeteners
- Fried foods
- Vegetable oils, including canola oil
- Spicy foods
- Processed foods
Secondly, we need to address the low stomach acid levels, and bring those levels back up to normal. Personally, I have seen fantastic improvement with Beatine HCl (with pepsin) and digestive enzyme supplementation.
HCl and pepsin will aid the stomach in its role in digestion. Adding HCl to your meal will help reduce the load on the dysfunctional stomach. In terms of dosage, it is going to depend a lot on the individual. Generally, you can start with 1 tablet per meal. If you still experience heartburn, up it to 2, then 3, etc. until you find a dose that is right for you. You are going to monitor this over time. As you stomach begins to heal, you will notice you will have to reduce the dosage.
Additionally, you can try a tablespoon of apple cider vinegar in 4-8oz. of water prior to a meal.
Digestive enzymes help you break down and absorb your food properly. You ever hear the phrase, “you are what you eat?” Well technically, we are only what we are able to absorb. You can start with one pill at the start of meal.
There are certain micronutrients that play key role in the inflammation process, and insufficient amounts of them can promote chronic inflammation. Again, this can have far-reaching consequences, affecting everything from hormone balance, to immune system function, to properly managing stress. Deficiencies in antioxidants (like zinc, selenium, and vitamins A, C, and E), vitamin D, omega-3 fatty acids, magnesium, and certain B vitamins most common. In the case of GERD, certain nutrients like B12 and important amino acids.
Along these same lines, consuming fermented foods frequently can be of benefit. Foods like organic sauerkraut, coconut yogurt, kefir, kombucha, grass-fed raw dairy fermented products, and pickles are great options. Probiotics and enzymes within these foods help to improve your microbiome and enhance HCL production.
Hope this helps!
Though based in research, personal, and clinical experience, the opinions in this article should not be taken as medical advice. Botanical medicine and nutraceuticals should be treated with the same caution and care as pharmaceuticals, as both have the potential for strong, potentially adverse effects and allergic reactions. Please consult a trained, licensed health care practitioner before proceeding.