Betaine HCl: How To Take This Digestive Aid for Low Stomach Acid

Don’t Make This Common Mistake When Taking Betaine HCl

New research suggests that low stomach acid may play a role in the development of SIBO (small intestinal bacterial overgrowth). Low stomach acid can also lead to nutritional deficiencies and may put you at greater risk for food poisoning and other gut infections.

Hypochlorhydria, or low stomach acid, is often found in those who are older, have autoimmune disease, or take proton pump inhibitor medication.

The good news is that it’s easy to correct your stomach acidity with betaine HCl, an over-the-counter digestive support.

Betaine HCl: Pills forming an image of a stomach

What Is Betaine HCl?

Betaine is a nutritional compound extracted from food sources like grains or beets. Betaine HCl is an acidic version of betaine that works in the same way as hydrochloric acid (HCl) in your stomach.

As a dietary supplement, betaine HCl is sometime combined with digestive enzymes such as pepsin or protease to help with protein digestion.

Betaine HCl: Digestive Acid HCl Capsules in a bottle

Why Low Stomach Acid Is a Problem

A healthy stomach produces about 3 to 4 quarts of gastric juice per day [1]. Made up of mostly hydrochloric acid, gastric juice breaks down the food you eat before it enters the small intestine.

Most of what we know about low stomach acid comes from clinical studies involving drugs that reduce stomach acid. Research into these drugs provides insights into the risks of hypochlorhydria [2 Trusted SourcePubMedGo to source, 3 Trusted SourcePubMedGo to source, 4 Trusted SourcePubMedGo to source] and suggests that, over the long term, inadequate stomach acid can:

Low Stomach Acid and SIBO

New research by Dr. Richard McCallum adds a new twist to existing research that associates low stomach acid and SIBO.

Dr. McCallum obtained samples of bacteria from the jejunum (middle of the small intestine) of patients with SIBO [11]. Using DNA testing, he found that bacteria in the jejunum of SIBO patients is similar to oral bacteria and not similar to bacteria in the large intestine. This finding counters the common belief that SIBO is caused by bacteria flowing upward from the colon into the small intestine.

Dr. McCallum suggests that stomach acid plays an important role in killing bacteria before it enters the small intestine. This function may be impaired in SIBO patients.

Who Is at Risk for Low Stomach Acid?

Betaine HCl: A smiling doctor talking to an old male patient

Only 2% of the population in the United State is documented as having low stomach acid [12 Trusted SourcePubMedGo to source]. However, testing for hypochlorhydria is not common, and inferential data suggests the actual numbers are likely much higher.

These health conditions increase the likelihood you have low stomach acid:

Betaine HCl: How To Take This Digestive Aid for Low Stomach Acid - Risk%20Factors%20for%20Low%20Stomach%20Acid Landscape %209%20x%2016 01 L

What’s the connection between autoimmune disease and stomach acid? Up to 50% of autoimmune patients also launch autoimmune attacks against the parietal cells in their stomach lining. This leads to inflammation of the cells responsible for acid secretion in a condition known as atrophic gastritis. Over time, this medical condition can impair your stomach’s ability to release digestive acids [15 Trusted SourcePubMedGo to source].

These autoimmune conditions have been associated with autoimmune gastritis and low stomach acid: [16 Trusted SourcePubMedGo to source, 17 Trusted SourcePubMedGo to source, 18 Trusted SourcePubMedGo to source, 19, 20 Trusted SourcePubMedGo to source, 21 Trusted SourcePubMedGo to source, 22 Trusted SourcePubMedGo to source, 23, 24 Trusted SourcePubMedGo to source]:

  • Rheumatoid arthritis
  • Type 1 diabetes
  • Celiac disease
  • Crohn’s disease
  • Autoimmune thyroid disease [25 Trusted SourcePubMedGo to source]
  • Sjögren’s syndrome

Treating H. pylori infections may help with stomach acidity. One clinical trial showed that eradicating an H. pylori infection can normalize the antibodies associated with stomach autoimmunity. However, not all studies agree [26 Trusted SourcePubMedGo to source]. Two studies have shown that vitamin B12 injections can help to reduce stomach autoimmunity [27 Trusted SourcePubMedGo to source].

Another factor that can lead to low stomach acid is overuse of Proton pump inhibitors (PPIs). PPIs are among the most commonly used drugs in the world. About 15 million people in the United States use PPIs every year [28]. While short-term use of acid-lowering medications (PPIs) can be very helpful in the treatment of peptic ulcers, long-term use carries all of the risks of hypochlorhydria including bacterial and fungal overgrowths.

How Do You Know If You Have Low Stomach Acid?

Low stomach acid doesn’t always result in digestive symptoms. However, some people with hypochlorhydria will experience symptoms like burping, bloating, feeling excessively full after eating, reflux, heartburn, and indigestion.

What’s confusing is that these symptoms may also be a sign of too much stomach acid. It’s common for people to try to treat digestive symptoms like heartburn and indigestion with over-the-counter antacids. This can be harmful if your symptoms are actually caused by low stomach acid.

Testing for low stomach acid isn’t very common right now. However, if you are over the age of 65, have an autoimmune condition, or have one of the other risk factors for low stomach acid, you can try taking betaine HCl and monitor your response.

Testing for Hypochlorhydria

There are tests available for hypochlorhydria. However, they are not commonly used and may not be completely reliable.

A serum gastrin test can be used if you’re not taking PPI medication. According to some practitioners, a test result higher than 75 pg/mL could indicate that you would benefit from supplementing with betaine HCl. However, one study found no correlation between serum gastrin levels and gastric pH [29].

An endoscopy can show if you have atrophic gastritis (inflammation of the stomach lining). You can also ask for antibody tests if you suspect stomach autoimmunity. These tests are for antiparietal cell antibodies and intrinsic factor antibodies.

Using Betaine Hydrochloride

A woman taking a pill while eating

While there hasn’t been a lot of research into the use of betaine HCl, two studies show that this supplement is effective for increasing stomach acid, acts quickly, and has a short-term effect of just over an hour [30 Trusted SourcePubMedGo to source, 31 Trusted SourcePubMedGo to source].

Unlike probiotics, which can be taken at any time, the timing of your digestive acid supplement is very important. Betaine HCl should be taken on an empty stomach, just before you consume a meal.

There’s no established daily value for an HCl supplement, and I recommend being conservative about dosing. A trial period of 1 to 2 weeks will help you to determine if Betaine HCl is helpful for you.

Take 1 to 3 capsules before each meal.

  • If you feel burning or have any other side effects, stop taking the supplement.
  • If you notice any improvements in your symptoms, continue to take Betaine HCl.
  • If there is no improvement in your symptoms after two weeks, stop taking the supplement.

Avoid using betaine HCl if you have peptic ulcers.

Never Do This With Betaine HCl

There’s a common recommendation for establishing the dosage of digestive acids that I do not recommend. This misguided approach suggests that you increase your dose until you feel a burning sensation and then decrease your dose slightly. For example, if you felt a burning sensation in your stomach after taking eight pills, your ideal dose is seven pills.

But if you feel burning in your stomach, you may be damaging your stomach lining.

This approach can lead to taking very high doses of betaine HCl. I’ve seen patients who had been taking as many as 15 capsules of digestive acid per meal. If you have a healthy stomach lining, you may never feel burning. A very high intake of stomach acid supplements may lead to an increased risk of peptic ulcers.

When to See a Healthcare Professional

It’s not unusual for a patient with a thyroid autoimmune disease like Hashimoto’s to also have low stomach acid and SIBO. This is a complex medical condition, and patients can benefit from seeking the advice of a functional health care professional.

Better Digestive Health and Wellness

Low stomach acid production can make it difficult to absorb nutrients from your food and may pave the way for bacterial and fungal overgrowths in your intestinal tract.

Fortunately, taking Betaine HCl, a supplementary form of digestive acid, can be very helpful for this condition. When taken just before a meal, Betaine HCl gives your stomach acid levels a boost and helps you more effectively break down food and absorb nutrients.

By restoring stomach acidity levels, Betaine HCl can also help to destroy harmful bacteria in your stomach before they enter your digestive tract. For people with low stomach acid, Betaine HCl should be part of an overall approach to managing and preventing SIBO and other types of gut dysbiosis that can rob you of your good health.

➕ References
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