Is It Really GERD?

by | Mar 16, 2018 | Gut Health | 0 comments


In the US alone, 20% of population has GERD.  And just about anyone who comes for a visit with me depends on antacids or PPI (proton pump inhibitor) on some level.  

GERD is increasing by the decade.  Between 1998 – 2005, hospitalization due to GERD  increased 216​​​​​​​​%, according to the  National Institute of Diabetes, Digestive, and Kidney Disease.

For those of us with Autoimmune conditions, according to the Clinical Medicine: Gastroenterology journal, ​​50% of Lupus patients report discomfort related to GERD.


Common Diagnostic Tests

  • Upper GI series X-rays: These are taken after you drink a barium solution. This procedure can detect ulcers, hiatal hernias, and other abnormalities.
  • Endoscopy: A fiber-optic tube is passed down your throat to assess your esophagus and stomach.
  • Esophageal monitoring: Measures acid levels in your lower esophagus for 24 hours.
  • Manometry: Measures esophageal pressure when you swallow.

​​​​Common Treatments include:

  • Antacids and other over-the-counter medications
  • A histamine antagonist, such as cimetidine, is available over-the-counter
  • Proton-pump inhibitors (PPI) reduce the amount of acid your stomach produces
  • A prescription medication called sucralfate forms a protective film on the surface of your esophagus and stomach
  • Metoclopramide is a prescription medication that helps your esophagus to contract efficiently and your stomach to empty faster

As you can see, it’s a cumbersome process to not only get diagnosed but also for treatment.  Most patients that end up with medications to treat become dependent on them.

Want a different solution that actually gets to the root cause and more importantly, what can you do about it?​

Testing for low stomach acidity

A normal stomach acid level creates a pH of 1.5-2.5, but we know that as we age, the cells in our stomach produce less stomach acid, known as HCL.  

Approximately 50% of people over the age of 60 have low HCL, and by age 85, 80% of relatively healthy people have low stomach acid.

As mentioned above, common interventions for GERD, such as PPI, actually work to lower HCL.  Such medications increase the stomach pH to 3.5 or higher.  

This in turn inhibits pepsin, which is a potential irritant to the stomach but also essential for the digestion of protein.  

Also, stomach acid is necessary to absorb many minerals from our foods.  

In addition, it provides defense against H. pylori, parasites, and other infections.  Without adequate acid, we potentially leave ourselves open to decreased immune protection and a variety of other health issues.

Overgrowth of bacteria in the small intestine occurs in people aged 60-80% and in 40% in those over 80 years old.  

Adequate HCL is necessary to absorb vitamin B12 from food.  If you don’t have enough HCL and you end up taking an antacid, you may be causing a deficiency in B12.

B12 deficiency can cause weakness, fatigue, and nervous system problems.  ​​​​​​​​​​​​​​Sound familiar?

What’s more is that the Vitamin C levels are also low in those with poor stomach acid.  It’s important to note that several minerals are required for an acidic environment for absorption, including iron, calcium, magnesium, zine, and copper.  

Key is that symptoms of not enough acid mimic those of too much acid.

Low stomach acid may be caused by:  pernicious anemia, chronic H pylori infection, longer-term treatment with PPI (prilosec and the likes), autoimmune conditions, stress, antibiotic use, and autoimmune gastritis​​​​.

What are symptoms of low stomach acid?

  • Bloating, belching, burning, and flatulence immediately after meals.​
  • A sense of fullness after eating
  • Indigestion, diarrhea, or constipation
  • Multiple food allergies
  • Nausea after taking supplements
  • Itching around the rectum
  • Weak, peeling, and cracked fingernails
  • Dilated blood vessels in the cheeks and nose 
  • Acne
  • Iron deficiency
  • Chronic intestinal parasite or abnormal flora
  • Undigested food in stool
  • Chronic candida infection
  • Upper digestive tract gassiness


Diseases associated with low stomach acid

  • Addison’s Disease
  • Asthma
  • Celiac Disease
  • Chronic Autoimmune Disease
  • Chronic hives
  • Gluten sensitivity
  • Diabetes
  • Eczema
  • Gallbladder Disease
  • Graves Disease
  • Hepatitis
  • Hyper or Hypo Thryorid
  • Lupus
  • Myasthenia Gravis
  • Osteoporosis
  • Pernicious Anemia
  • Psoriasis
  • Rheumatoid Arthritis
  • Rosacea
  • Sjogren’s Syndrome​


Self Testing

  1. Take 350-750 mg capsule of Betaine HCL with a protein – containing meal
    • A normal response would be discomfort- heartburn.
    • If you don’t feel a burning sensation, begin taking two capsules with each protein containing meal.
  2. If there’s no reaction after 2 days, use up to 5 capsules (check with your healthcare professional) with each meal if necessary.
    • The dosage may seem large but a normal functioning stomach produces considerably more.
    • You’ll know you’ve taken too much if you experience tingling, heartburn, diarrhea, or any type of discomfort, including any feeling of unease, digestive discomfort, neck ache, backache, headache, or any other symptoms.
    • If you happen to feel tingling, burning, or other symptoms, you can neutralize the acid with 1 tsp baking soda in water or coconut/almond milk.
  3. When you reach the point of having such symptoms, reduce the dosage down by 1 capsule until discomfort disappears.
  4. Once you come to a comfortable dose, continue the dose until your next appointment with your healthcare provider.
  5. Remember, smaller meals will require less dose, so adjust accordingly.


This treatment will allow you to regain your normal HCL, especially if you had a mild HCL deficiency.

If this is you, simply decrease the number of capsules you’re taking until such symptoms disappear.

If you had moderate to severe HCL deficiency, the improvement may take some time so in order to improve nutrient absorption, it’s important to be consistent with your HCL supplementation.

***Precautions:  If you have peptic ulcer disease, HCL can irritate sensitive tissue and can be corrosive to your teeth; there for, capsules should not be emptied into food or dissolved in beverages.  Always follow up with your healthcare provider.
Need help with dosage and Betaine supplementation?  Please call 678-335-5566 or email us at [email protected] for our provider code to enable you to order from our specialty nutraceutical partner.
All above information adapted from the Institute of Functional Medicine all rights reserved.

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