When organs get older, they usually don’t work as well as they did when they were younger. We don’t run as fast at age 47 as we did at 27; our vision and hearing are usually less acute in our 70s than in our 30s. Our skin is less elastic at 53 than at 23. Why should our stomachs be any different? Why should stomachs become more active with age, rather than less? As Mr. Spock would say, “That’s illogical!”
What do stomachs do? While digesting breakfast, lunch, dinner and snacks, the stomach makes an extremely powerful acid, hydrochloric acid. The stomach also makes pepsin, a protein-digesting enzyme, and a factor (originally termed “intrinsic factor”) that combines with vitamin B12 and is necessary for B12 absorption. The hydrochloric acid that healthy stomachs make is one million times stronger than the mild acidity of blood or saliva. A tough, stringy piece of meat becomes meat soup after digestion in the stomach. That’s normal!
After 30, 40 or more years of digesting or attempting to digest everything we put in our stomachs – not just food, which the stomach is designed to handle, but also refined sugar, caffeine, distilled alcohol, grease and oxidized oils, fluoride and chlorine from water, chemical flavorings and colorings, pesticides, herbicides – you get the idea, no? – why would anyone except an antacid salesman or the average gastroenterologist imagine that our stomachs would make more acid, more pepsin, and digest things more efficiently as we get older? Common sense says that after 30 or 40 years, the stomach slows down, just like the rest of us, and makes less acid, less pepsin, and digests things less efficiently.
We’ll pause here to point out that the “overacidity” theory of peptic ulcers has been rather thoroughly debunked. Thanks to Dr. Barry Marshall, we now know that “the helicobacter(s) (i.e., Helicobacter pylori bacteria) did it.” Let’s also note here that there is an extremely rare syndrome named after Drs. Zollinger and Ellison, which indeed features abundant hyperacidity at any age, but again, it’s extremely rare.
So when you get past 35, 40, 45, and start to develop indigestion, it’s highly likely that the indigestion is due to a weaker stomach, not a stronger one, a stomach making less acid, less pepsin. The very word “indigestion” implies lack of digestion, not overdigestion. Why in the world would we want to take “antacids” or “acid blockers,” when our stomachs are weak and not digesting adequately already?
The answer’s in two words: symptom relief. We know that if we have “heartburn,” unthinkingly attributed to “overacidity,” taking an “antacid” or “acid blocker” relieves symptoms. So why isn’t that the right thing to do?
Let’s try an analogy. If we get a headache, we take an aspirin. The headache disappears. Does that mean the headache was due to a lack of aspirin? Of course not! In the tradition of Western allopathic medicine, we’ve taken away only the symptoms. We’ve just covered up the problem; we haven’t discovered what the cause actually is.
Think for a moment: if you’ve ever seen a doctor about “heartburn” and indigestion (or know someone who has), did you actually have a test to determine that your stomach was making too much acid? Ninety-nine percent of the time, the answer is “no.” Perhaps an X-ray or even gastroscopy to check for an ulcer, but a test for over- or underacidity is rare.
Since 1976, I’ve checked literally thousands of individuals complaining of “heartburn” and indigestion for stomach acid production using a commercially available, extremely precise, research-verified procedure. Overacidity is almost never found, especially in those over age 35. The usual findings are underacidity (from “just a little under” to no acid at all) or normal acidity, in which case the indigestion symptoms are caused by something else. The majority have underacidity (as might be expected in a no-longer-young stomach) and I advise them to take capsules containing hydrochloric acid and pepsin with each meal. The supplemental hydrochloric acid and pepsin not only relieve the symptoms but actually improve digestion. (A good parallel is hormone replacement when our hormone levels drop, another common happening when we’re somewhat older.)
So why do we have a burning sensation, sometimes severe, along with indigestion, if our stomach acid is low? And why should underacidity symptoms be relieved by “antacids” or “acid blockers,” which presumably would worsen a condition of underacidity?
Would you believe that in 1997 there’s no research being done to answer this question? (If anyone out there has research grant funds available, I would be happy to determine the answer!) The most recent research I’ve been able to locate was done in 1887 or 1898. That’s right, 100 years ago. At that time a doctor trying to answer the same question put a tube into the stomachs of heartburn sufferers, sucked out the contents, and found very little or no hydrochloric acid, acetic acid, butyric acid. He pointed out that these small amounts of acid don’t digest anything, but, he guessed, they could cause pain. Of course, antacids would neutralize them.
This might explain why antacids relieve symptoms, but it still doesn’t explain why acid blockers, like Tagamet, Zantac, Pepcid, Prilosec, and their clones, which can prevent hydrochloric acid secretion entirely, would do the same thing. I’ll admit that I don’t have a clue either (although that research grant would help).
I can say that in 24 years of nutritionally oriented practice, I’ve worked with thousands of individuals who’ve found the cause of their “heartburn” and indigestion to be low stomach acidity. In nearly all of these folks, symptoms have been relieved and digestion improved when they’ve taken supplemental hydrochloric acid and pepsin capsules, available in every natural food store. (Certainly it would be preferable that our stomach production of hydrochloric acid and pepsin be restored on its own, but a reliable way to do this hasn’t been found.)
And that takes us to the above-noted acid-blocking drugs on the market. By remarkable coincidence, shortly after their patents expired, they must have become much safer, since the requirement for a prescription disappeared. Multimillion dollar promotions to the public were launched to drive home the point that “heartburn” and indigestion are caused by too much acid, which can be “blocked” (with these products, of course) at minimal risk. (Oddly enough, the FDA has never required the companies advertising these products to document their claims that indigestion and “heartburn” are actually caused by overacidity.)
In case you missed last month’s column, let’s briefly review: without adequate hydrochloric acid to activate pepsin, protein can’t digest properly, and any of up to eight essential amino acids may become deficient. It’s been my clinical observation that calcium, magnesium, iron, zinc, copper, chromium, selenium, manganese, vanadium, molybdenum, cobalt, and many other “micro-trace” elements are not nearly as well absorbed by individuals taking “acid-blocking” drugs. A small amount of research shows that vitamin B12 absorption is decreased by Tagamet, and there’s every reason to expect the other “acid blockers” do the same. Folic acid doesn’t absorb well when stomach acid is low. When any one or any combination of these nutrients is reduced, enzyme systems, cells, tissues, and organs can’t repair themselves. In other words, the more we take Zantac, Pepcid, Tagamet, or even Tums or Rolaids, the more we accelerate our aging!
So, if you develop indigestion or “heartburn,” don’t be fooled by the myth of “acid indigestion.” Find out what the problem really is, and correct it. You’ll be helping to slow, not accelerate, the aging process.
-Jonathan V. Wright, MD