Gut Health - Carolina Total Wellness

April 1, 2019May 20, 2019

How to Support Optimal Stomach Acid for Good Digestion

842 stomach acid

When we go to the doctor with symptoms of acid reflux, gas, bloating and heartburn, typically the diagnosis of high stomach acid is based purely on symptoms — not a lab test for stomach acid levels — resulting in a prescription for antacids, histamine type 2 receptor agonists (H2 blockers), Proton Pump Inhibitors (PPIs), or even surgery.

For many people, these drugs only worsen the problem.

Antacids reduce stomach acid temporarily, then more acid is automatically produced to bring the stomach back to its intended pH level. This only treats the temporary symptoms and does nothing to fix the actual problem.

H2 blockers block a substance in the body that encourages acid production in the stomach. They work more slowly than antacids and are intended to last for longer periods of time. On the down side, they stop production of pepsin, a digestive enzyme necessary for breaking down protein.

Proton pump inhibitors permanently block an enzyme that tells your stomach to produce acid.

All of these methods are linked to serious side effects and can even contribute to the root causes of continued chronic low stomach acid and other serious health conditions.

5 Ways to test stomach acid levels

Because hypochlorhydria isn’t well known to most patients, many never trace it back to their chronic health condition and they continue to suffer.

The good news is multiple options exist for testing stomach acid levels, which will help you create a clear game plan for remedying the situation at its foundation.

1. Gastric acid secretion test. Highly invasive and expensive, this test is typically done if a patient is diagnosed with a stomach ulcer. It can be helpful to track if anti-ulcer medication is working and to see if material from the intestines is coming back into the stomach.

2. The Heidelberg Stomach Acid Test. Considered the gold standard test for hypochlorhydria, a small capsule with a radio transmitter is ingested to measure the pH of the stomach as you drink a solution with baking soda (reduces acidity). The baking soda will naturally neutralize the HCL in the stomach. If the body does not return it to normal, it’s a sign of hypochlorhydria.

This test provides a graph showing your specific stomach response to the baking soda challenge, and can help determine if you have hypochlorhydria, hyperchlorhydria (high acid), or achlorhydria (complete lack of acid). At a cost of about $350, this test is not covered by most insurance plans.

3. CBC and CMP. These are common factors on a metabolic blood panel, typically covered by insurance. A skilled clinician can diagnose hypochlorhydria by taking into account these lab results in combination with your symptoms.

4. Betaine HCl challenge. An at-home test considered to be quite reliable, however false positives are possible, so it’s recommended to repeat the test three times. The betaine HCl costs about $20. If you have low stomach acid, you can then take it to help restore your HCl levels.

Buy Betaine HCl with pepsin.
Eat a high-protein meal containing at least 6 ounces of meat (veggies are allowed with this).
In the middle of the meal (not the beginning) take one betaine HCl pill.
Finish the meal and observe what happens.

Possible outcomes:

1. You notice no symptoms. This is likely a sign of low stomach acid.

2. Indigestion. Burning, heat, or heaviness in your chest likely indicate adequate stomach acid levels.

It is recommended to repeat the betaine HCl challenge two or three times to confirm your results. Three positive tests are a good indication of low stomach acid.

False positives are possible if:

You consume too little protein. A low protein meal doesn’t require much acid, so the betaine HCl can cause too much increase in acid.
You took the capsule before the meal, which can cause indigestion.
You have esophageal sphincter dysfunction. A hiatal hernia or poor esophageal sphincter tone can cause increased indigestion symptoms. Rule this out with a medical exam if you suspect it.

5. Baking soda stomach acid test. While not as accurate as the above tests, this is a free at-home test you can use to get an indication of your stomach acid levels. The results can vary from person to person depending on interpretation of the results. Some use it as a baseline measure and to track changes over time.

First thing in the morning, before eating or drinking anything:

Mix ¼ tsp baking soda in 4 to 6 ounces of cold water.
Drink the baking soda solution.
Time how long it takes for a burp to occur. Time it for up to 5 minutes

If you have not burped within five minutes, it may be a sign of insufficient stomach acid. Early and repeated burping may be due to too much stomach acid (do not to confuse this with small burps from swallowing air when drinking the solution). Any burping after 3 minutes is an indication of low stomach acid levels.

Associated tests

Low stomach acid can be associated with other health issues that have far-reaching consequences. If you suspect low stomach acid, ask our office about testing for the following:

B12 levels: Intrinsic factor is a glycoprotein in the stomach necessary for absorption of vitamin B12. When stomach acid is too low, intrinsic factor can’t do its job. This results in vitamin B12 deficiency, which is a serious health concern.

Homocysteine levels: Stomach acid is important for proper absorption of vitamin B12, a key factor in methylation that keeps inflammatory homocysteine at the right levels. When B12 is low, homocysteine elevates.

Supporting healthy stomach acid

Eat protein foods at the beginning of your meal to stimulate the digestive enzymes necessary for digesting protein.

Chew thoroughly. This is one of the most important parts of digestion. Food proteins need to be broken down to be properly digested.

Limit liquid intake during meals until at least 30 minutes after a meal to allow for proper stomach acid production, pathogen sterilization, and protein metabolism.

Stay hydrated between meals to support proper gut motility; this pushes the contents of the intestines out of the body instead of back into the stomach. This is very important for those who are prone to SIBO.

Betaine hydrochloride supplements help support healthy gut function and safely restore normal gastric acidity. (Do not confuse betaine HCl with anhydrous betaine, a methyl-donor nutrient taken to control homocysteine levels.)

Always take the betaine HCL either half-way through the meal or right at the end of the meal. Taking it before a meal may create a false experience of heartburn and can turn off stomach acid production for this meal. Caution: Do not take HCL if you are taking any NSAIDs such as ibuprofen, Tylenol, or aspirin.

HCl with pepsin. Add these to your diet when you consume protein. When you feel warmth in your stomach, that means you are taking enough. Then back it down a notch and monitor your response. Some people need one capsule, others need more as everyone is unique.

Pepsin. Typically used in conjunction with HCl, pepsin is considered very safe when administered to assist digestion.

Digestive enzymes help to break down food proteins. Make sure to get a high-quality blend.

Apple cider vinegar. One tablespoon in a bit of water right before a meal can help with digestion.

Fermented foods such as sauerkraut, kimchi, pickles, pickled ginger, and water kefir contain organic acids, enzymes and probiotics to assist with proper digestion. They are also anti-microbial and fight H. pylori, arch enemy of stomach acid production.

Taking the time to improve your stomach acid levels will make a huge difference in your symptoms and quality of life. Please contact my office for more help.

March 4, 2019May 20, 2019

New Study Shows Processed Foods Shorten Your Life

838 processed foods shorten life

A new study shows regularly eating processed foods — the staple of most western diets — can shorten your life. In functional medicine, we know from the published research that a diet based on processed foods also will significantly increase your chances of suffering from chronic disease. Common chronic diseases tied to diet include diabetes, obesity, heart disease, autoimmune diseases, high blood pressure, dementia, and Alzheimer’s.

The study was conducted in France and published in the JAMA Internal Medicine journal. It tracked almost 45,000 adults, most of them in their late 50s at the start of the study. Researchers followed the health and the diet of the subjects over a period of eight years.

On average, the subjects derived about a third of their calories from processed foods. The processed foods researchers looked at included the following:

Instant noodles
Instant soups
Breakfast cereals
Energy bars and drinks
Chicken nuggets
Ready-made meals and snacks
Packaged snack foods
Any foods made using industrial processing

During the course of the study, more than 600 subjects died, primarily from cancer and cardiovascular disease.

In looking at the deaths, the researchers adjusted for general health, socioeconomic status, and influencing behaviors, and compliance with a healthy diet.

However, even after all that, they still found that every 10 percent increase in consuming processed foods was linked with a 14 percent higher chance of early death.

Why eating a lot of processed foods leads to chronic disease and earlier death

In considering the link of processed foods to risk of earlier death, the authors suggest the following possibilities:

High-temperature processing may form contaminants. High-heat food processing can alter protein structures so that the body sees them as inflammatory. In functional medicine we know that high temperatures also make industrial oils used in food processing toxic to the brain and body.

Additives may be carcinogenic. Food additives are synthetic chemicals that are foreign to the human body. Chemical food additives bind with food proteins to create new molecules that the immune system recognizes as an invader. Many synthetic chemicals are also simply difficult for the body to metabolize and eliminate, thus raising inflammation and the toxic burden. Many additives have also been linked to brain-based symptoms and disorder. Simply put, food is no place for synthetic chemicals that have little safety vetting.

Packaging of prepared foods can lead to contamination. The industrial nature of the packaging process can introduce harmful toxins into the food itself. Also, if you are gluten-free, eating packaged foods is always a crap shoot as they are most likely contaminated with gluten due to multiple foods being processed on the same equipment.

What we know about processed foods in functional medicine

Those were the concerns listed by the researchers. In functional medicine we are aware of other reasons processed foods cause chronic disease and raise the risk of an early death.

Industrial oils. The brain is made of primarily fat and the fats you eat determine the health of your brain. The oils used in food processing are industrial seed oils that are generally rancid due to their very unstable molecular structure. These oils contribute to poor neuron structure and integrity and thus cause overall brain health to suffer. They are also generally inflammatory. Additionally, processed foods that contain hydrogenated fats are especially problematic for the brain and body and linked with cognitive decline, heart disease, and inflammation.

Poor fatty acid ratio. The oils used in processed foods are very high in omega 6 fatty acids. Human health requires a ratio of omega 6 to omega 3 fatty acids (such as from nuts and cold-water fish) of at least 4:1 though 1:1 is even better. Sadly, most Americans eat a ratio of 25:1 thanks to processed foods. In other words, way too much omega 6. This puts the body in an inflammatory state that promotes obesity and chronic disease.

Too many processed carbohydrates. One of the biggest promoters of chronic disease and dementia is unstable blood sugar from eating a diet too high in processed carbohydrates. Processed and packaged foods are predominantly grain-based and/or sugary and very high in carbs. This sends blood sugar on a tail spin every time you eat them, promoting inflammation and the chronic disease process.

Gluten. Most packaged and processed foods are wheat-based and thus loaded with gluten. Many people have undiagnosed gluten sensitivity or celiac disease that keeps their body in a constant state of inflammation, thus promoting chronic disease. Gluten is linked with 55 diseases so far, most of them autoimmune.

Eating a whole foods diet with basic real-food ingredients is one of the best things you can do to turn your health around. For more advice on a whole foods diet, please contact my office.

February 26, 2019May 20, 2019

Gut Bacteria Play a Role in Anorexia and Other Eating Disorders

837 anorexia and gut microbiome

People with eating disorders such as anorexia simply do not experience hunger and satiety in the same way people who have a healthy relationship with food do. New research suggests that the composition of gut bacteria, or the gut microbiome, may play a role in the behavioral aspects of anorexia and eating disorders. For instance, previous research shows a connection between mood disorders such as depression and poor gut microbiome diversity. Less than half of people with eating disorders fully recover, showing that conventional treatments are failing untold numbers of people, the vast majority of them women.

The study showed that patients with anorexia had lower diversity of gut bacteria than healthy individuals. They also found that the less diverse the gut microbiome was the more depression and anxiety patients suffered. The researchers also found that as a patient with anorexia began eating again their gut bacteria diversity was partially restored, which in itself aided in recovery.

Alterations in the gut microbiome can affect how a person’s body functions, how they think, feel, and behave, and how they interact with others.

The gut microbiome is critical not only to regulating mood and behavior, it also plays a vital role in regulating metabolic function, appetite control, and weight.

A better understanding of the role of the gut microbiome in anorexia can help researchers forge new directions in treatment around determining target weight goals, how fast the anorexic patient should gain weight, and what type of diet the anorexic patient should follow to best support the brain’s role in eating disorder behaviors.

The researchers are now investigating whether targeted probiotics could ease the renourishment and refeeding phase of anorexia recovery — many patients struggle with gastric and abdominal distress when reintroducing foods. Customized probiotic therapy could also support the mental and emotional aspects of recovery from an eating disorder.

Gut bacteria targeted in eating disorders

Past research has also shown a link between the gut microbiome and eating disorders, which affect an estimated 5 to 10 percent of the population. A 2015 study from France showed gut bacteria plays a role in eating disorders.

The study looked at mice who had an inflammatory reaction to a protein made by gut bacteria. In essence, the mice responded to these bacteria as if it were an allergy or sensitivity. This immune response caused eating disorders in the mice.

The gut bacteria that triggered this reaction is very similar in structure to a hormone called alpha-Melanocyte-stimulating hormone (a-MSH). a-MSH is a satiety hormone that tells you when to feel full. When the immune system attacks the gut bacteria similar to a-MSH, it also attacks the a-MSH due to their structural similarity. This immune reaction can then dysregulate signals around feeding, energy usage, and anxiety.

When the immune system mistakenly attacks the body

This study is evidence of a “cross-reactive” immune reaction, in which the immune system confuses something in the body with something infectious and attacks both. This is a very common mechanism in autoimmune reactions, such as with Hashimoto’s hypothyroidism, type 1 diabetes, or multiple sclerosis.

The research suggests that some eating disorders may have an immune reaction driving the psychological disorder.

Tips on addressing eating disorders nutritionally

Although eating disorders are highly complicated and require intensive, sometimes multi-faceted therapeutic approaches, it’s still important to be mindful of nutritional strategies to support the brain and the gut microbiome:

Eliminate processed carbs and sugars as they trigger addictive tendencies metabolically.

Keep blood sugar stable to curbing cravings, food obsession, and relentless hunger. You may need to eat small, frequent meals that include protein initially.

Base your diet on plenty of vegetables and a wide, ever changing diversity of vegetables. This will increase the diversity of your gut microbiome, which promotes psychological health and stability.

Supporting your brain chemicals, or neurotransmitters. Neurotransmitters affect your mood, thoughts about yourself, behavior, energy levels, and other aspects of how you feel and function. For instance, you may need serotonin or dopamine support. Serotonin is the neurotransmitter that allows us to feel joy and stave off depression. Dopamine, on the other hand, is necessary to feel self-worth, motivation, and to not experience constant cravings. Both serotonin and dopamine have been shown to play a role in eating disorders. If you have been starving yourself, binging and purging, undereating, or affecting your diet in other ways due to an eating disorder, there is a strong possibility you may be deficient in either one or both of these important neurotransmitters.

Ask my office for more advice on how to support a healthier approach to balanced approach to recovering from eating disorders.

January 24, 2019May 20, 2019

Gut Bacteria and the Heart

832 gut bacteria and the heart

Unhealthy gut bacteria are a bigger risk for atherosclerosis, or hardening of the arteries than smoking, cholesterol levels, obesity, or diabetes. Atherosclerosis is the leading cause of heart disease.

That’s because the root cause of heart disease is inflammation. In fact, most modern health disorders are rooted in inflammation, including arthritis, diabetes, obesity, dementia, depression, and inflammatory bowel disease. Cardiovascular disease is no exception.

So where do gut bacteria come in? Researchers have discovered an unhealthy microbiome — the term given to our inner garden of gut bacteria — is pro-inflammatory while a healthy gut microbiome is anti-inflammatory. Unfortunately, Americans have the unhealthiest gut microbiomes studied thus far.

A recent study found that women experiencing hardening of the arteries also showed less gut bacteria diversity while women with healthy arteries showed healthier gut bacteria. A diverse array of gut bacteria is linked with better health.

The study also found that in healthy subjects, diverse and healthy gut bacteria produced more indolepropionic acid (IPA), a neuroprotective antioxidant that also has been shown to lower the risk of diabetes.

The gut microbiome and high blood pressure

It turns out there is more to high blood pressure than reducing your salt intake. Researchers have found high blood pressure, which increases your risk of heart disease and stroke, can also be linked to the gut microbiome.

The key is in a compound called propionate, one of several short-chain fatty acids (SCFAs) produced by healthy gut bacteria. Scientists are learning that SCFAs such as propionate and butyrate are instrumental to the health of the brain and body in many ways, with propionate being specific to the cardiovascular system.

How to foster a heart-healthy gut microbiome

Although taking propionate may help, it won’t do much good if it’s battling a minefield of infectious and inflammatory gut bacteria. Just as healthy gut bacteria produce SCFAs that are good for us, bad bacteria produce the highly inflammatory compound lipopolysaccharide (LPS).

The key to a heart-healthy gut microbiome is to eat about 25–30 grams of fiber a day via a very diverse array of vegetables and modest amounts of fruit (fruits are high in sugar and too much sugar is inflammatory).

It’s the diversity of vegetables that matters most, with research increasingly confirming that a diverse gut microbiome is what lies behind good health and a lower risk of disease.

Switch up the vegetables you eat regularly and shop at world markets unfamiliar to you to try new types of produce. Even a teaspoon of different new veggies each day is enough to help colonize the friendly bacteria that will work to keep your heart healthy.

In this fiber-rich environment, supplementing with SCFAs such as butyrate and propionate can help boost your gut bacteria to produce even more of their own SCFAs.

Additionally, make sure to keep your blood sugar stable by eliminating sugars, sweeteners, and processed carbohydrates, avoid foods that cause an immune reaction in you (for example, gluten and dairy do for many people), avoid toxin chemicals in your foods and body products that can kill good bacteria, and exercise daily — exercise has been shown to positively influence your gut microbiome.

Ask my office for more advice on how to cultivate an optimal gut microbiome and detoxify bad bacteria.

Category: Gut Health