I’m very sad to say this is Danny Roddy’s last show. The next episode will have a new host, and a new name – we’re finally switching over to Revolution Health Radio.

In this “Goodbye Danny Roddy” episode we discuss:

• Is it possible to be healthy if you don’t eat a Paleo diet?
• What might cause gastritis after starting a Paleo diet?
• How can I reduce iron overload without drugs?
• Is there any evidence to support “food combining” principles?
• Should a Paleo diet cure rheumatoid arthritis?
• What’s a good alternative protein source for people who can’t afford grass-fed animal products?
• Is adrenal fatigue real?

Full Podcast Transcript:

Danny Roddy: Hello everyone and welcome to the Healthy Skeptic Podcast. I am Danny Roddy of DannyRoddy.com and with me is Chris Kresser, health detective and owner of ChrisKresser.com. Chris, I am sad to say but this is my last podcast with you ever.

Chris Kresser: Danny! Say it ain’t so! Yeah, we’re gonna miss you.

Danny Roddy: It’s been real. I’ve enjoyed every second it. But yeah, I think it’s time for me to move on from the popular Paleo paradigm.

Chris Kresser: You only really care about hair.

Danny Roddy: For the listeners, if anybody has ever been to my website they’ll quickly realize that I am obsessed with hair loss. So I just feel like, you know, I am short-chaining the show and I am not so interested at what Paleo men ate and I know you aren’t either, Chris. I am not even interested in looking at nutrition from an angle anymore. I am really just interested at what diet provides relief from hair loss and if that diet includes tree bark then it includes tree bark.

Chris Kresser: Hmm, yummy! When is your big book coming out? You are going to give us a real date this time, right?

Danny Roddy: I am super excited to announce that it will be out November 28th.

Chris Kresser: Wow, just in time for the holidays. Grow your hair back. Good timing.

Danny Roddy: Exactly.

Chris Kresser: Well, we’re going to miss you, Danny. I know a lot of people wrote in to say they are sad that you are leaving. I am definitely sad you are leaving. I wish you luck in your endeavors. We are all waiting for “Hair like a Fox”with bated breath. So, how about sending me a free copy? Do I get some kind of benefits like that at least?

Danny Roddy: I am going to send you a signed digital copy.

Chris Kresser: Ok. Piracy-free.

Why are some people finding success eating non-Paleo?

Danny Roddy: Ok, that kind of leads us into your first question. Let me bring it up for a second. This one is from Darius and he asks “Chris, everyone wants to know your thoughts on why some people are finding success with non-Paleo eating such as Don Matesz and Ray Peat?”What do you think about that, Chris?

Chris Kresser: I am not surprised that people find success with non-Paleo eating. I have a lot of friends who are really healthy and don’t eat a Paleo diet. Could they be healthier if they ate Paleo? Maybe, it’s hard to say unless they actually did. I am not so myopic in my approach to think that the Paleo diet is the only way that somebody can be healthy, the only approach to nutrition that`s valid. I just think that in my experience it happens to be the best starting place for most people. That’s really, you know I hope I have not given the impression that I am really, really dogmatic about the Paleo diet, because what I advocate is not even technically Paleo. I think dairy, particularly grass-fed, fermented, full-fat dairy is really healthy when it is well tolerated. I think white rice is pretty well tolerated by a lot of people, sourdough buckwheat, you know that recipe for those buckwheat pancakes, which I eat a couple of times a week. I am not technically on a Paleo diet, but Paleo is just a convenient term for describing the template or the basic set of guidelines that I think are an appropriate starting place for most people. It does not surprise me at all that other people follow other approaches and are healthy. I think there is a lot more to health than diet as I have tried to communicate on my blog in the 9 Steps to Perfect Health series, we often talk about that on the show, things like stress management and pleasure and movement and exercise, spending time outdoors, taking care of your gut health, a lot of this stuff is in some cases just as significant as a contributor to health and in some cases even more. I think we talked about the beer and pizza story a while back.

Danny Roddy: Good story!

Chris Kresser: So, great! I am all for Don for doing whatever diet works for him. I might take issue with some of the kind of anti-Paleo posts he has been doing lately. Not because I feel offended by it, but because I don’t agree with his interpretation of some of the research that he has presented. I don’t really take part in those debates, because I think it’s a waste of time. Generally, I am just happy that Don has found a way that works for him. Anybody that finds something that makes them feel good and works for them, that’s great. I will add one caveat though, which is time will tell, you know, how this goes for Don. You know I was a vegan at one point and I felt great for a little while until everything just went off the rails. So who knows, who knows?

Danny Roddy: So you are not going to take issue with my tree bark diet?

Chris Kresser: Tree bark and low-fat ice cream and OJ? As long as you wash it down with OJ and low-fat ice cream, I won’t take issue with it.

Gastritis after starting a Paleo diet?

Danny Roddy: So do you want to go to the next question?

Chris Kresser: Sure. Let’s start from the top.

Danny Roddy: Ok, this one is from anonymous. Gastritis after starting a Paleo diet. And that’s what, irritation to the gut lining?

Chris Kresser: Yeah this was a question that we said we answered in a previous podcast, but neglected to. Or at least I put it in the show notes and I guess we did not get to it and there has been a few requests to talk about it. So any -itis is inflammation, right? So anytime you see -itis after a root that we’re talking about inflammation of that part and –gast, G-A-S-T, we are talking about the stomach. So the basic interpretation of that, it is a generalized term and it is often used very generally but it means inflammation of the stomach, inflammation of the stomach mucosa, often associated with ulcer, but not always.

So the question as I recall was “Why would someone get gastritis after starting a Paleo diet when they did not have it before?”There are a few possibilities; I just give you my impression. The most honest answer is I don’t know for sure. It’s a case-by-case basis. Some of the things that I would think about and look for would include stomach acid deficiency. If you don’t have enough stomach acid and you eat a lot of protein, like people do on a Paleo diet, especially if they are switching over from like a vegetarian diet, which a lot of people do. A lot of my patients that I talk to, it’s a very familiar story that someone was a vegetarian or a vegan and they switch to a Paleo diet. So you take someone who has been eating almost no animal protein, certainly no meat for a significant period of time, their stomach acid production might decline, because stomach acid is required to digest protein and if they are not eating a lot of protein and things that require stomach acid production, perhaps their stomach acid will decline and then they start eating those things and those proteins don’t get digested well in the stomach and they putrefy. God, I love that word. And that putrefaction can potentially irritate the stomach lining and cause gastritis. So that’s one possibility. Similar possibility would be people who have issues with fat digestion. Maybe a sluggish gall bladder and they are not breaking down fats as well as they should be and again this is common for people who are coming from a low-fat, whole grain “heart-healthy”approach and they start eating a Paleo diet with loads and loads of fat and then they get stomachache and feel terrible. That often to me can be a sign of problems with fat digestion. Of course one way to test that out is to just for a few days eat a higher carb, lower fat Paleo diet, with a lot of starchy tubers and more fruit and less fat and see how you feel. Another potential issue depending on what kind of Paleo diet somebody is eating, one thing that seems to be gaining in popularity is raw food Paleo, where people are eating a lot of raw meat. The truth is there is a risk to eating raw meat. There is a risk to eating any food, but eating raw meat there is a risk of getting a pathogen, especially if your gut flora is already compromised in some way, or your stomach acid is low and you are not able to defend against pathogens like that. So those are three possibilities, they are the most likely ones but there are others too.

Donny Roddy: I ate some two-month-old raw eggs and I had to go home from work.

Chris Kresser: Ouch!

Danny Roddy: I broke them into the glass like I do every morning and they smelled really weird.

Chris Kresser: So why the heck did you eat those things?

Danny Roddy: They were pastured so I did not want to waste them. I was like Ajonis does this every day, you can do it one day. And I did. I got to work and I felt really, really loopy.

Chris Kresser: Oops. Yeah, there are consequences to our actions.

How do I handle iron overload without taking drugs?

Danny Roddy: Ok, that was good stuff. Ok, This next one is from Felix. This is a Facebook question. “I would like to know about handling iron overload without taking drugs.”We have already talked about this a little bit but why don’t you expand on that, Chris?

Chris Kresser: Yeah, I am just getting fascinated with this topic. I know I am moving a little more slowly than normal on the blog series. I am going to write about this a big series, because I am involuntarily becoming somewhat of an expert in it, just simply because I see it all the time. This week, for example, I had three patients with probable hemochromatosis. That seems really high. You know, I see patients for twenty hours a week, which is a lot less than other practioners, because I want to have time for research and writing and doing this podcast and, you know, continuing to stay current with the scientific literature. But three patients in a week with this genetic disease and that’s kind of an average for me. I am surprised if I go a week where I don’t see it and in the vast majority of cases people don’t know that they have it. And they are often relieved to find out, because they are suffering from a lot of different problems and nobody has been able to figure out why and they feel like they are going crazy. Even though it’s no fun to learn that you have a genetic disease it is at least a treatable one and it gives you somewhere to focus your attention and there is some explanation to make sense of how you have been feeling. So, I will write a lot more about it, but I will just answer this question briefly. The only two ways to get rid of excess iron are bleeding and chelation. So chelation involves taking substances that bind to iron and other minerals and carry them out of the body. So with bleeding you really only have one practical option. I suppose you could do a more low-tech approach but I would not recommend it. You donate blood and if you don’t have a diagnosis of hemochromatosis then you’ll have to just do it through the normal channels like Red Cross. You can only donate blood every 56 days and that’s a precaution to keep people from bloodletting themselves to death or making themselves anemic by doing it too frequently. So most people who don’t have aggressive iron storage condition like hemochromatosis if they donate blood they will lose between 50 and 100 units of ferritin. So if your ferritin is 300 and you are trying to get it down to 50, for example, usually that will take, depending on the person, maybe three blood draws over a period of time. The second route, which is chelation, I don’t really recommend especially not without medical supervision. The drugs that are used for chelation are actually some of the more toxic and risky drugs there are. They are definitely not desirable. There are some natural substances that can be used to chelate iron like lactoferrin and our good friend phytic acid. So here’s another case where something that we talk a lot about minimizing in the diet can actually be helpful in a therapeutic situation. But that needs to be managed too, because if you take things like that without doing it right you run the risk of eliminating several other minerals that are important to your health in addition to iron. But there are a couple other things to be done from a nutritional or dietary perspective, there are some substances that increase the absorption of iron and some things that decrease the absorption of iron. So the things that increase iron absorption are alcohol. Bad news for people with iron overload. Alcohol does it quite significantly. Supplemental Vitamin C. So the amount of Vitamin C in foods is in most cases negligible, so you don’t have to worry too much about that, but taking Vitamin C capsules or pills will increase iron absorption. And HCL, stomach acid, betaine HCL (hydrochloric acid) that pretty dramatically increases iron absorption. So if you have iron overload, you want to avoid those things.

And the things the decrease iron absorption are tannins, so coffee and tea, black tea, particularly the ones, the teas that are higher in tannins. So if you are eating red meat, if you are someone who has a gradual tendency to accumulate iron and you want to mitigate that somewhat you can drink coffee or black tea with meals that contain more iron, like red meat. And then there is phytic acid. Phytic acid is in as many of you know grains and nuts and seeds, but it’s also pretty high in certain greens, leafy greens. So if you don’t want to eat grains, which can cause other problems that are not related to their phytic acid content, you might want to just stick with a supplemental form of phytic acid, but again I recommend doing that with supervision so you avoid other mineral deficiencies that that could cause. So that’s basically it. Yeah, I just want to caution people not to go overboard here, it is probably best to work with someone on this stuff. There are a lot of different considerations. We talked about this last time. Elevated ferritin doesn’t necessarily mean excess iron. It can mean systemic inflammation. You want to make sure not to get your ferritin too low, because then you are running the risk of anemia. So just exercise caution, folks!

Danny Roddy: I have a mini story about this. So, my ferritin was about 150. I had it measured about a year ago. And I went about four times and we won’t talk about how I was able to do it that many times.

Chris Kresser: Please do not!

Danny Roddy: Yeah, do not do that. But now my level is 30. So that means each time I went, it reduced my iron status by 30ng/dl.

Chris Kresser: So what did you notice in that whole process if anything?

Danny Roddy: Absolutely nothing. I can’t say I have seriously noticed anything.

Chris Kresser: Yeah, so that’s a good example. I mean, before everybody runs out and starts going to different Red Cross offices and trying to donate blood. Ferritin at 150 is very borderline, meaning it very well could not be a problem at all. There is no guarantee that getting it down to 30 is going to do anything significant for you, especially if you did not have any symptoms of glucose intolerance or any problems with that before, which I don’t think you did.

Danny Roddy: No.

Chris Kresser: All right, let’s move on.

Any science to food combining?

Danny Roddy: Next question. This one is from another anonymous. “Food combining –any science to it”

Chris Kresser: Well, they weren’t anonymous to begin with, but I forgot who they were, so now they are anonymous.

Food combining –any science to it? In a word, no. Does that mean there is nothing to it at all? I don’t think so. I mean I have some patients who have difficulties eating fruit after meals. They find that, you know, maybe the digestion of protein takes a bit longer than the digestion of fruit. So if they eat fruit on top of a heavy meat meal, they experience some gas and bloating. So as with everything the key is to experiment and see if you notice any difference, but I have looked several times over the years for any evidence that would support the food combining principles that are often talked about and I have never really seen any. Have you?

Danny Roddy: I have never, oddly enough, in the long time I have been doing this gotten into food combining.  I feel like some foods have a natural synergy with other foods, like what we were talking about, like Vitamin C will increase iron absorption. So you will probably not want to eat oysters and fruit together.

Chris Kresser: Big glass of OJ.

Danny Roddy: So stuff like that makes sense to me, but I don’t know in other contexts, I guess. Like meat and fruit. I don’t do that normally.

Chris Kresser: They are talking about, I mean that’s another issue, there are lot of different theories on food combining. Some of the main ones are don’t eat carbohydrates and protein together.

Danny Roddy: Oh ok.

Chris Kresser: So if you are going to have a meal, I guess you would just have protein and fat separately and carbohydrates in a different meal. That sort of thing. I have never seen anything to support that and number two it does not make a lot of sense, because most foods have some combination of fat, carbohydrate and protein in them, right? So why would we lack the capability of digesting those macronutrients together if they are present in nearly all foods? That to me is the most damning argument to that whole theory.

Danny Roddy: And fat increases the absorption of all the other nutrients?

Chris Kresser: Absolutely! All right.

Will I ever get off meds on Paleo?

Danny Roddy: Coolio. This one is from Kathy, this is another Facebook question. “Sometimes I feel like a failure in the Paleo community when I hear about folks getting off meds with rheumatoid arthritis. Even with strict Paleo, good sleep, exercise, low stress, and meds my joints hurt. Is it as easy to get off meds as it appears?”

Chris Kresser: Sometimes and sometimes not. Again, this is a really personal thing. I feel like a broken record often times on these podcasts and I think that’s ok, because obviously this is a messages that really needs to get repeated and to sink in. A disease like rheumatoid arthritis, even though it has a name there is a risk there of saying “Oh, ok I have got rheumatoid arthritis. That means I am in the same exact situation as somebody else is that has rheumatoid arthritis.”The reality is there is a lot of variability from person to person with even the same autoimmune disease name; I mean each person has different genetics, they have different constitution, different life history, different life circumstances. The list goes on and on. There are a lot of key differences and the way that even the same disease will manifest in different people is really different. I mean, Crohn`s disease in some people produces fulminant diarrhea, like fifteen watery, bloody bowel movements a day to the point where these people have to be hospitalized and get a section of their intestine removed. On the other hand, some people with Crohn`s disease have no diarrhea, never have had diarrhea and actually have constipation and their symptoms are very mild. They have never been to a hospital for it, they don’t even take medication and, you know, maybe in those two cases there is not even a real big difference between what they eat. So diseases really are heterogeneous and it differs a lot from person to person. So it’s impossible to compare oneself to somebody else and say, “Yeah, I am doing all this stuff right and I still am struggling while someone else is doing all that and they are able to get off their meds.”It’s not your fault when that’s the case. It just means that you have a more intense or difficult expression of that disease in many cases.
So, some things that Kathy could consider, one would be low dose Naltrexon. We’ve talked about it on the show a lot. It’s amazingly effective for many autoimmune diseases. It promotes T regulatory cell function, which has an immune balancing effect and especially if you have tried all of this other stuff and you are not getting any results, I would seriously consider that. There are a lot of other things you can do to support T-reg cell function nutritionally with supplements and botanical medicine. Probably at this point it’s a good idea to get some help with someone who is experienced with this sort of thing so that you can make some more progress. But it’s definitely not your fault. There are a lot of different ways that these conditions manifest and it’s really not helpful to compare yourself to other people in that regard.

Danny Roddy: This kind of illustrates how I felt sometimes. If Kathy feels like a failure in the Paleo community, I am sure she is strict with her diet, she says she is strict with her diet, I mean just for comparison and I am not saying for anybody with arthritis to go do this, but like Pete loves aspirin or pure aspirin for arthritis conditions.

Chris Kresser: Yeah, I know where you are coming from. I have my own issues with aspirin over the long term, it’s one of the most toxic drugs to the liver, but what you are saying is by sort of carrying the belief that Paleo diet is the end-all be-all that heals everything magically, then maybe she is not considering other options that would be helpful. And I agree and I have tried to stress that before, the Paleo diet can be magic in a lot of cases in the sense that people who go on it, some people experience a seemingly miraculous improvement in a lot of their symptoms. But that does not always happen. I have a practice full of patients that proves that it does not always happen, because the vast majority of people who come see me are already on a Paleo diet. My patients are people who read my blog and listen to my podcast, they are already following a lot of the recommendations that I make in those venues. So it’s not your typical Standard American Diet people coming to me, they are already on a Paleo diet and yet they are still having a lot of problems. So the existence of my practice is proof that the Paleo diet is not a panacea. So the sooner people ditch that idea, the better. Again that doesn’t mean it can’t be magical for some people, but if you find yourself doing it and you are not getting the results that you would expect then it does absolutely make sense to do further investigation.
Is that like the anti-Paleo episode, huh?

Danny Roddy: So we both agree that aspirin is a great thing to take? Just kidding.

Chris Kresser: Gobble it down.

What’s a low-budget alternative to Grass-Fed Beef, Fowl, Fish, and Eggs?

Danny Roddy: Next question is from Monika. “What do you consider a good alternative protein source for people who are on a budget and cannot afford grass-fed meat, fowl, fish and eggs every time? What about quinoa that has been rinsed, soaked and cooked properly?”What do you think Chris?

Chris Kresser: Well the first thing I would say is that although I think grass-fed and pastured meat and animal products are superior to conventionally raised animal products for a number of different reasons, I don’t believe that it’s either grass-fed or pastured or nothing at all. I guess it depends on what you are basing that decision on. Some people for political, economical, social reasons won’t buy conventionally raised animal products and ethical reasons and I can certainly understand that and sympathize with that. But if you are purely basing this on nutritional factors, conventional animal products would be the best alternative to grass-fed animal products and particularly if you know how to cook and prepare cheaper cuts of meat, you can get really nourishing protein and fat sources without spending a lot of money. So for example even grass-fed, pastured organ meats tend to be very cheap. Grass-fed liver around here, even at Whole Paycheck, is four bucks a pound.  That’s Whole Foods by the way for anyone who does not know. Four bucks a pound, which is pretty darn affordable. Then you have oxtail and brisket and some of the cheaper cuts of beef. You can get chicken parts and make broth, you can get beef bones and make broth, you can get fish heads and make fish head soup. Those are all really, really deeply nourishing foods and they are pretty cheap. So with some creativity and learning how to prepare the cheaper cuts of meat, which tend to be tougher and require longer cooking methods, you can still eat animal products without breaking the bank.
Quinoa does have some of the food toxins that we are trying to minimize by not eating grains. It is not technically a grain; it is one of the pseudograins.

Danny Roddy: It’s a superfood, Chris!

Chris Kresser: It’s a superfood, right. I have just noticed that a lot of people, particularly with gut issues, have problems with quinoa. It’s very fibrous and it seems to irritate the gut even when it’s prepared properly. If you do well with quinoa and you have tested it, you have tried doing without it and added it back in and you do really well and you feel good, then go for it!

Danny Roddy: I don’t digest that stuff at all.

Chris Kresser: No, I don’t do well with it either and a lot of my patients don’t. So I would definitely urge you to pay attention to that if you are testing it out and as I said the protein that you get from even conventionally raised animal products will be superior in terms of its digestibility and assimilability and amino acid profile to what you get from quinoa.

Is Adrenal Fatigue Real?

Danny Roddy: Cool. This next question is from Arnbor from Facebook. He asks or she asks “Is adrenal fatigue real?”And I am assuming they are talking about low cortisol.

Chris Kresser: Yeah, so you hear adrenal fatigue, adrenal stress, adrenal insufficiency.

One of the best ways to be the target of scorn is to go into your doctor and tell them that you have adrenal fatigue. They will look at you like you are some crazy whack job and they will try to start leaving the room as soon as possible. The truth is whatever you want to call it, it is real. If you look into the scientific literature, for example, the adrenal stress hormone profile that you can get from Diagnostix and BioHealth and some other labs where you test your cortisol rhythm throughout the day, that is now being used by specialists who treat Alzheimer’s and dementia as a prognostic tool to determine how quickly they expect somebody to degenerate. So the extent to which the cortisol rhythm is off, is predictive of how quickly someone’s hippocampus is going to fall apart and the reason that is, is because the hippocampus is responsible for regulating the circadian rhythm, the cortisol/ melatonin rhythm. This is actually being used by high-level clinicians that are kind of on the forefront of treating Alzheimer’s and dementia.
Cortisol is a really important hormone. Danny’s buddy Ray Peat talks a lot about the importance of this hormone. I have talked a lot about it. I see cortisol dysregulation a lot in my practice. I see people suffering from it and when we take steps to fix that and we fix it, people feel better. That’s enough for me to be convinced that it’s real and like I said there is plenty of research supporting this. I think a lot of doctors just are not aware of this research just like they are not aware of the research that shows that cholesterol alone is not the cause of heart disease. There are a lot of people who self-diagnose with adrenal fatigue and it’s pretty easy to do that because a lot of the symptoms are non-specific and they may have adrenal fatigue but they may have something else. There is a little bit of a gray area, but it’s absolutely real and it’s absolutely something that needs to be treated.f

Danny Roddy: How many of your patients are completely flatlined? Do you see that often, like not just their circadian rhythm is off but if it’s just low across the board?

Chris Kresser: Low? No, I don’t see that that often actually. I way more often see problems with rhythm than I see absolute low or absolute high production of cortisol and I do this test pretty regularly, so I see a lot of them. The rhythm seems to me more important and more sensitive to problems than the adrenal production of cortisol and that’s interesting, because as I said the rhythm is controlled by the brain not by the adrenals themselves. So technically you could say that that is not an adrenal problem, it’s a brain problem. A lot of the conventional approaches to treating adrenal fatigue ignore the brain and the importance of addressing the brain and that may be why they are not as successful as some would like.

Danny Roddy: Do you find that, I heard this on Robb Wolf’s podcast a long time ago and I don’t know why I never thought about it, but even like food allergies can cause major adrenal stress, just because if you are consuming an allergen you are going to secrete a lot of cortisol to face the inflammation.

Chris Kresser: Absolutely, anything that promotes inflammation will cause a decline in adrenal function and the list of those things is very long.  So really kind of anything that throws the body out of homeostasis can affect the adrenals, which means that anybody who has any kind of long-term chronic illness or like you said allergies, food allergies, anything that is throwing the homeostasis off is affecting the adrenals. So I think and in my experience adrenal issues are very, very often secondary to other problems, meaning they are not the underlying cause of those other problems, they came second but once adrenals get involved, then there is a vicious cycle where adrenal fatigue will make all of those other problems worse and then all of those other problems getting worse will worsen the adrenal fatigue.

Danny Roddy: Cyclical.

Chris Kresser:  Yeah.

Danny Roddy: Ok Chris, that’s going to bring us to the end of this week’s episode. Where can we find more of your work on the Internet this week?

Chris Kresser: Oh man. That’s is the end?

Danny Roddy: This is the end of the road.

Chris Kresser: Only the beginning Danny…of your new chapter.

Danny Roddy: …of a better life for you.

Chris Kresser: Yeah, I am hoping it should be ready on actually the day that this podcast goes live or close to it. Sure you guys have heard me talk about it if you have been listening the last few podcasts. It’s called the Personal Paleo Code. It was born out of a lot of the discussion that we have had on the show, Danny, about the fact that there just really is no one size fits all approach when it comes to diet. My work with patients over the last several years, I’ve developed a process for helping people to figure out their own ideal diet instead of just relying on a canned approach, no matter how good that canned approach is, how good a starting place that approach is. So it’s a three-step process. The book or the program is me guiding you through that process in the same way that I do with patients in my clinic. I have also included tons of resources to make it really easy for you to figure this out and implement these changes. I have got over ten guides, special guides, on subjects like bone broths, nuts and seeds, fats and oils, even kitchen equipment that you might need, how to make salad dressings, you know there is a lot of schwaggy ingredients in commercial salad dressings, Paleo friendly sauces and condiments. I have got a progress-tracking app because that’s really important as you move through these various steps. When you move from one step to the next is predicated on how you are progressing. So you use the progress-tracking app, which has a questionnaire that you fill out each week on all kinds of symptoms that you are trying to deal with and it automatically plots your progress on a chart so that you can see it visually, which is really cool. One of the things I am most excited about is the meal plan generator, which is a web app that you get access to as part of your purchase of the Personal Paleo Code; you get a 60-day free trial to this meal plan generator. It’s really cool.
My wife and I have been using it a lot, the beta versions. So you log in and you can decide exactly what foods you are including or excluding. Let’s say that you are trying an autoimmune Paleo diet and you want to exclude nightshades, eggs and dairy. It can be really frustrating and hard to find good recipes for that because, you know, obviously not everyone is doing that. So you have to either know how to modify the recipes yourself or just be always doing a lot of research to find those recipes. So what you can do with this tool is you just check off the foods that you want to exclude and then you hit a button that says generate a meal plan for either a single meal or one day or a week and it will query the database, we have got over 450 recipes in there, all Paleo type recipes and it will bring back only the recipes that don’t include the ingredients that you have chosen to exclude. So you can exclude dairy, you can exclude nightshades, eggs, concentrated sweeteners. There is a ton of different criteria. Then there are these quick plans where if you just want to generate a plan that is commonly followed, like there is one for strict Paleo, there is one for GAPS-friendly, there is one for a 30-day challenge like Whole 30 type of program. Once the meal plan shows up, you can print the meal plan, you can click on the individual recipes and go the recipe page and print them out, you can print a shopping list, you can save the recipes to your favorite section. I am super excited about that, like I said my wife and I have been using it a lot. It’s been really cool, like last night we had some ground beef and we were kind of tired of the ways we have been normally cooking it. So we went in there and we just searched for beef and we got, like nine or ten recipes showed up for ground beef, different ways to prepare it. So we had a little, I forget the name of it, it’s an Indian dish, it’s like ground beef with a particular Indian spice mixture. It was really yummy.

Danny Roddy: Does the product ever glitch out and tell you to drink orange juice with collagen?

Chris Kresser: Yeah, I’ve got the Danny Roddy quick plan in there actually. It says…Breakfast: low-fat ice cream and OJ. Lunch: crushed eggs shells and wait, what else is in there for lunch?

Danny Roddy: Oh, Gummy bears too.

Chris Kresser: You got to help me out with it, because I wasn’t sure.
So anyways, this is going to be ready, you can check it out PersonalPaleoCode.com. We are doing a special deal for podcast listeners and blog readers and people in my very cool inner circle. So make sure to take advantage of that if you like saving money.
I think that’s it, Danny.

Danny Roddy: That’s it? Let me go through my spiel. Keep sending us your questions at ChrisKresser.com using the podcast submission link. If you enjoy listening to the podcast, head over to iTunes and leave us a review.
Chris, it’s been amazing, thank you for everything, thank you to all the listeners. I’ve had so much fun doing this and you’re the man. I appreciate everything. I ‘ll miss you and everybody.

Chris Kresser: Danny, we’ll miss you. You have been a great co-host. I appreciate all the free work you have done on this show and helping us build it up to the audience. Numbers are growing and growing; I think you had a lot to do with that. We are going to miss you for sure, hope you stay in touch with us. Come back and heck less about fructose and orange juice and stay in touch!

Danny Roddy: Thank you, Chris.

Note: this is the fifth article in a series about heartburn and GERD. If you haven’t done so already, you’ll want to read Part I, Part II, Part III, and Part IVa before reading this article.

In the last article, we discussed the first two of four primary consequences of taking acid stopping drugs:

1. Bacterial overgrowth
2. Impaired nutrient absorption

In this article we’ll cover the remaining two consequences:

3. Decreased resistance to infection
4. Increased risk of cancer and other diseases

Our first line of defense

The mouth, esophagus and intestines are home to between 400-1,000 species of bacteria. However, a healthy stomach is normally almost completely sterile. Why? Because stomach acid kills bacteria.

In fact, that’s one of it’s most important roles: to provide a two-way barrier that protects the stomach from pathogenic bacteria. First, stomach acid prevents harmful bacteria that may be present in the food or liquid we consume or the air we breathe from entering the intestine. At the same time, stomach acid also prevents normal bacteria from the intestines to move into the stomach and esophagus, where they could cause problems.

The low pH (high acid) environment of the stomach is one of the major non-specific defense mechanisms of the body. When the pH of the stomach is 3 or lower, the normal between-meal “resting” level, bacteria don’t last more than fifteen minutes. But as the pH rises to 5 or more, many bacterial species can avoid the acid treatment and begin to thrive.

Unfortunately, this is exactly what happens when you take acid stopping drugs. Both Tagamet and Zantac significantly raise the pH of the stomach from about 1 to 2 before treatment to 5.5 to 6.5 after, respectively.

Prilosec and other PPIs are even worse. Just one of these pills is capable of reducing stomach acid secretion by 90 to 95 percent for the better part of a day. Taking higher or more frequent doses of PPIs, as is often recommended, produces a state of achlorydia (virtually no stomach acid). In a study of ten healthy men aged 22 to 55 years, a 20 or 40 mg dose of Prilosec reduced stomach acid levels to near-zero.

A stomach without much acid is in many ways a perfect environment to harbor pathogenic bacteria. It’s dark, warm, moist, and full of nutrients. Most of the time these bacteria won’t kill us – at least not right away. But some of them can. People who have a gastric pH high enough to promote bacterial overgrowth are more vulnerable to serious bacterial infections.

A recent systematic review of gastric acid-suppressive drugs suggested that they do in fact increase susceptibility to infections (PDF). The author found evidence that using acid stopping drugs can increase your chances of contracting the following nasty bugs:

• Salmonella
• Campylobacter
• Cholera
• Listeria
• Giardia
• C. Difficile

Other studies have found that acid stopping drugs also increase the risk for:

• Pneumonia
• Tuberculosis
• Typhoid
• Dysentery

Not only do acid stopping drugs increase our susceptibility to infection, they weaken our immune system’s ability to fight off infections once we have them. In vitro studies have shown that PPIs impair nuetrophil function, decrease adhesion to endothelial cells, reduce bactericidal killing of microbes, and inhibit neutrophil phagocytosis and phagolysosome acidification.

A gateway to other serious diseases

As we discussed in the first article in this series, a decline in acid secretion with age has been well documented. As recently as 1996, a British physician noted that age-related stomach acid decline is due to a loss of the cells that produce the acid. This condition is called atrophic gastritis.

In particular relevance to our discussion here, atrophic gastritis (a condition where stomach acid is very low) is associated with a wide range of serious disorders that go far beyond the stomach and esophagus. These include:

• Stomach cancer
• Allergies
• Bronchial asthma
• Depression, anxiety, mood disorders
• Pernicious anemia
• Skin diseases, including forms of acne, dermatitis, eczema, and urticaria
• Gall bladder disease (gallstones)
• Autoimmune diseases, such as Rheumatoid arthritis and Graves disease
• Irritable bowel syndrome (IBS), Crohn’s disease (CD), Ulcerative colitis (UC)
• Chronic hepatitis
• Osteoporosis
• Type 1 diabetes

And let’s not forget that low stomach acid can cause heartburn and GERD!

In the interest of keeping this article from becoming a book, I’m going to focus on just a few of the disorders on the list above.

Stomach cancer

Atrophic gastritis is a major risk factor for stomach cancer. H. pylori is the leading cause of atrophic gastritis. Acid suppressing drugs worsen H. pylori infections and increase rates of infection.

Therefore, it’s not a huge leap to suspect that acid suppressing drugs increase the risk of stomach cancer in those infected with H. pylori (which, as we saw in Part III, is one in two people).

In a recent editorial, Julie Parsonnet, M.D. of Standford University Medical School writes:

In principle, current [acid suppressing drug] therapies might be advancing the cancer clock by converting relatively benign gastric inflammation into a more destructive, premalignant process.

One way PPIs increase the risk of cancer is by inducing hypergastrinemia, a condition of above-normal secretion of the hormone gastrin. This is a potentially serious condition that has been linked to adenocarcinoma – a form of stomach cancer.

Taking a standard 20 mg daily dose of Prilosec typically results in up to a three-to-fourfold increase in gastrin levels. In people whose heartburn fails to respond to the standard dose, long-term treatment with doses as high as 40 or 60 mg has produced gastrin levels as much as tenfold above normal.

Another theory of what causes stomach cancer involves elevated concentration of nitrites in the gastric fluid. In a healthy stomach, ascorbic acid (vitamin C) removes nitrite from gastric juice by converting it to nitric oxide. However, this process is dependent upon the pH of the stomach being less than 4. As I discussed earlier in this article, most common acid stopping medications have no trouble increasing the pH of the stomach to 6 or even higher.

Therefore, it’s entirely plausible that acid stopping medications increase the risk of stomach cancer by at least two distinct mechanisms.

Gastric and duodenal ulcers

An estimated 90% of duodenal (intestinal) and 65% of gastric ulcers are caused by H. pylori. It is also recognized that the initial H. pylori infection probably only takes place when the acidity of the stomach is decreased. In a human inoculation experiment, infection could not be established unless the pH of the stomach was raised (thus lowering the acidity) by use of histamine antagonists.

By lowering stomach acid and increasing stomach pH, acid suppressing drugs increase the risk of H. pylori infection and subsequent development of duodenal or gastric ulcers.

Irritable bowel syndrome, Crohn’s disease and ulcerative colitis

Adenosine is a key mediator of inflammation in the digestive tract, and high extracellular levels of adenosine suppress and resolve chronic inflammation in both Crohn’s disease and ulcerative colitis. Chronic use of PPIs has been shown to decrease extracellular concentration of adenosine, resulting in an increase in inflammation in the digestive tract. Therefore, it is possible that long-term use of acid stopping medications may predispose people to developing serious inflammatory bowel disorders.

It has become increasingly well established that irritable bowel syndrome (IBS) is caused at least in part by small bowel bacterial overgrowth (SIBO). It is also well known that acid suppressing drugs contribute to bacterial overgrowth, as I explained in Part II and Part III. It makes perfect sense, then, that chronic use of acid suppressing drugs could contribute to the development of IBS in those that didn’t previously have it, and worsen the condition in those already affected.

Depression, anxiety and mood disorders

While there is no specific research (that I am aware of) linking acid suppressing drugs to depression or mood disorders, a basic understanding of the relationship between protein digestion and mental health suggests that there may be a connection.

During the ingestion of food stomach acid secretion triggers the release of pepsin. Pepsin is the enzyme responsible for breaking down protein into its component amino acids and peptides (two or more linked amino acids). Essential amino acids are called “essential” because we cannot manufacture them in our bodies. We must get them from food.

If pepsin is deficient, the proteins we eat won’t be broken down into these essential amino acid and peptide components. Since many of these essential amino acids, such as phenylalanine and tryptophan, play a crucial role in mental and behavioral health, low stomach acid may predispose people towards developing depression, anxiety or mood disorders.

Autoimmune diseases

Low stomach acid and consequent bacterial overgrowth cause the intestine to become permeable, allowing undigested proteins to find their way into the bloodstream. This condition is often referred to as “leaky gut syndrome”. Salzman and colleagues have shown that both transcellular and paracellular intestinal permeability are substantially increased in atrophic gastritis sufferers compared to control patients.

When undigested proteins end up in the bloodstream, they are considered as “foreign” by the immune system. The resulting immune response is similar to what happens when the body mobilizes its defenses (i.e. T cells, B cells and antibodies) to eradicate a viral or bacterial infection.

This type of immune response against proteins we eat contributes to food allergies. A similar mechanism that is not fully understood predisposes people with a leaky gut to develop more serious autoimmune disorders such as lupus, rheumatoid arthritis, type 1 diabetes, Graves disease, and inflammatory bowel disorders like Crohn’s and ulcerative colitis.

The connection between rheumatoid arthritis (RA) and low stomach acid in particular has been well established in the literature. Examining the stomach contents of 45 RA patients, Swedish researchers found that 16 (36 percent) had virtually no stomach acid. Those people who had suffered from RA the longest had the least acid. A group of Italian researchers also found that people with RA have an extremely high rate of atrophic gastritis associated with low stomach acid when compared with normal individuals.

Asthma

In the last ten years, more than four hundred scientific articles concerned with the connection between asthma and gastric acidity have been published. One of the most common features of asthma, in addition to wheezing, is gastroesophageal reflux. It is estimated that between up to 80 percent of people with asthma also have GERD. Compared with healthy people, those with asthma also have significantly more reflux episodes and more acid-induced irritation of their esophageal lining.

When acid gets into the windpipe, there is a tenfold drop in the ability of the lungs to take in and breathe out air. Physicians who are aware of this association have begun prescribing acid stopping drugs to asthma patients suffering from GERD. While these drugs may provide temporary symptomatic relief, they do not address the underlying cause of the LES dysfunction that permitted acid into the esophagus in the first place.

In fact, there is every reason to believe that acid suppressing drugs make the underlying problem (too little stomach acid and overgrowth of bacteria) worse, thus perpetuating and exacerbating the condition.

Conclusion

As we have seen in the previous articles in the series, heartburn and GERD are caused by too little – and not too much – stomach acid. Unfortunately, insufficient stomach acid is also associated with bacterial overgrowth, impaired nutrient absorption, decreased resistance to infection, and increased risk of stomach cancer, ulcers, IBS and other digestive disorders, depression and mood disorders, autoimmune disease, and asthma.

Chronic use of acid stopping medication dramatically reduces stomach acid, thus increasing the risk of all of these conditions. What’s more, acid suppressing medications not only do not address the underlying cause of heartburn and GERD, they make it worse.

Is the temporary symptom relief these drugs provide worth the risk? That’s something only you can decide. I hope the information I’ve provided here can help you make an educated decision.

In the next and final article of the series, I will present a plan for getting rid of heartburn and GERD once and for all without drugs.

Note: this is the fourth article in a series about heartburn and GERD. If you haven’t done so already, you’ll want to read Part I, Part II and Part III before reading this article.

Believe it or not, stomach acid isn’t there just to punish you for eating Indian food. Acid is in the stomach because it’s supposed to be there. It is found in all vertebrates. And while it isn’t necessary for life, it is certainly required for health.

Most people have no idea how many vital roles stomach acid plays in our bodies. Such misunderstanding is perpetuated by drug companies who continue to insist that stomach acid is not essential. Meanwhile, millions of people around the world are taking acid suppressing drugs that not only fail to address the underlying causes of heartburn and GERD, but put them at risk of serious (and even life-threatening) conditions.

There are four primary consequences of acid stopping drugs:

1. Increased bacterial overgrowth
2. Impaired nutrient absorption
3. Decreased resistance to infection
4. Increased risk of cancer and other diseases

I had originally intended to cover all four of these issues in this article, but as I started to write I realized it would be far too long. So I will cover increased bacterial overgrowth and impaired nutrient absorption in this article, and decreased resistance to infection and increased risk of cancer and other diseases in the next article.

A stomach full of germs

We’re not going to spend much time on this here since the connection between low stomach acid and bacterial overgrowth was the focus of Part II and Part III.

To review, low stomach acid causes bacterial overgrowth in the stomach and other parts of the intestine. Bacterial overgrowth causes maldigestion of carbohydrates, which in turn produces gas. This gas increases the pressure in the stomach, causing the lower esophageal sphincter (LES) to malfunction. The malfunction of the LES allows acid from the stomach to enter the esophagus, thus producing the symptoms of heartburn and GERD.

Bacterial overgrowth has a number of other undesirable effects, including reducing nutrient absorption, increasing inflammation, and raising the risk of stomach cancer. Studies have confirmed that proton-pump inhibitors (PPIs) can profoundly alter the gastrointestinal bacterial population by suppressing stomach acid. Researchers in Italy detected small bowel bacterial overgrowth (SIBO) in 50% of patients using PPIs, compared to only 6% of healthy control subjects. The prevalence of SIBO increased after one year of treatment with PPIs.

Well-fed but undernourished

Stomach acid is a prerequisite to healthy digestion. The breakdown and absorption of nutrients occurs at an optimum rate only within a narrow range of acidity in the stomach. If there isn’t enough acid, the normal chemical reactions required to absorb nutrients is impaired. Over time this can lead to diseases such as anemia, osteoporosis, cardiovascular disease, depression, and more.

Macronutrients

Stomach acid plays a key role in the digestion of protein, carbohydrates and fat. When food is eaten, the secretion of stomach acid (HCL) triggers the production of pepsin. Pepsin is the enzyme required to digest protein. If HCL levels are depressed, so are pepsin levels. As a result, proteins don’t get broken down into their component amino acids and peptides. This can lead to a deficiency of essential amino acids, which in turn may lead to chronic depression, anxiety and insomnia.

At the same time, proteins that escape digestion by pepsin may end up in the bloodstream. Since this is not supposed to happen, the body reacts to these proteins as if they were foreign invaders, causing allergic and autoimmune responses. I’ll discuss this more below.

Micronutrients

We can eat the most nutritious diet imaginable, packed with vitamins, minerals and other essential nutrients, but if we aren’t absorbing those nutrients we won’t benefit from them.

As acid declines and the pH of the stomach increases, absorption of nutrients becomes impaired. Decades of research have confirmed that low stomach acid – whether it occurs on its own or as a result of using antacid drugs – reduces absorption of several key nutrients such as iron, B12, folate, calcium and zinc.

IRON

Iron deficiency causes chronic anemia, which means that the body’s tissues are literally starving for oxygen.

In one study, 35 of 40 people (80 percent) with chronic iron-deficiency anemia were found to have below normal acid secretion. Iron-deficiency anemia is a well-known consequence of surgical procedures that remove the regions of the stomach where acid is produced.

Researchers have found that inhibition of acid secretion by Tagamet, a popular acid stopping drug, resulted in a significant reduction of iron. At the same time, studies have shown that adding acid has improved iron absorption in patients with achlorydia (no stomach acid production).

B12

Vitamin B12 (cobalamin) is needed for normal nerve activity and brain function. B12 enters the body bound to animal-derived proteins. In order for use to absorb it, the vitamin molecules must first be separated from these proteins with the help of – you guessed it – stomach acid.

If stomach acid is low, B12 can’t be separated from its carrier proteins and thus won’t be absorbed. In one study of 359 people aged 69-79 years with serious atrophic gastritis, a disease characterized by low stomach acid, more than 50 percent had low vitamin B12 levels.

A number of studies have examined the negative effect of PPI therapy on B12 absorption. In a study on healthy subjects treated with 20 mg and 40 mg of Prilosec per day for two weeks, B12 absorption was reduced by 72% and 88% respectively.

FOLATE

Among other things, folate (folic acid) is vital for keeping the cardiovascular system healthy and for preventing certain birth defects. Low stomach acid levels can interfere with folate absorption by raising the pH in the small intestine. At the same time, when folate is given to achlorydric patients (with no stomach acid) along with an HCL supplement, absorption of the vitamin increases by 54 percent.

Both Tagamet and Zantac reduced folate absorption in another study, though the reduction in the Zantac group was not statistically significant. The overall reduction of folate absorption was sixteen percent. This modest reduction is probably not enough to harm a healthy person consuming adequate levels of folate, but it may cause problems in those with folate deficiency (relatively common) or other health problems.

CALCIUM

Calcium makes our bones and teeth strong and is responsible for hundreds, if not thousands, of other functions in our body. The importance of stomach acid in the absorption of calcium has been known since the 1960s, when one group of researchers noted that some ulcer patients were barely absorbing any calcium at all (just 2 percent). When they investigated they found that these subjects had a high gastric pH (6.5) and very little stomach acid. However, when the researchers gave them HCL supplements, lowering the pH to 1, calcium absorption rose five-fold.

ZINC

Zinc takes part in several metabolic processes related to keeping cell membranes stable, forming new bone, immune defense, night vision, and tissue growth. In one controlled trial, Tagamet treatment reduced zinc absorption by about 50 percent. Another study found that Pepcid, which raises intragastric pH to over 5, had the same effect.

Although there is little systemic research on the absorption of other nutrients, there is good reason to believe that low acid levels may also effect levels of vitamin A, vitamin E, thiamine (vitamin B1), riboflavin (vitamin B2), and niacin (vitamin B3). Theoretically, the absorption of any nutrient that is bound to protein will be inhibited (PDF).

In Part B of this article I will explain how acid stopping drugs decrease our resistance to infection and increase our risk of stomach cancer and other diseases.

In the next few articles, I’ll be writing about the epidemic of gastroesophageal reflux disease (GERD) and its mismanagement by the medical establishment.

In this first article I will present evidence demonstrating that, contrary to popular belief, heartburn and GERD are caused by too little (not too much) stomach acid. In the second article I’ll explain exactly how low stomach acid causes heartburn, GERD and other digestive conditions. In the third article I’ll discuss the important roles stomach acid plays in maintaining health and preventing disease, and the danger long-term use of acid suppressing drugs presents. In the final article, I’ll present simple dietary and lifestyle changes that can eliminate heartburn and GERD once and for all.

Heartburn and GERD are no joke

According to the National Institute of Diabetes and Kidney Digestive Diseases, sixty million people experience heartburn at least once a month and twenty five million experience symptoms daily.

Gastroesophageal Reflux Disease (GERD), a more serious form of acid reflux, is the most common digestive disorder in the United States. Studies show that 10-20% of individuals experience symptoms at least once a week, and prevalence of GERD is increasing steadily.

Drugs for acid reflux and GERD are cash cows for the pharmaceutical companies. More than 60 million prescriptions for GERD were filled in 2004. Americans spent $13 billion on acid stopping medications in 2006. Nexium, the most popular, brought in $5.1 billion alone – making it the second highest selling drug behind Lipitor.

As sobering as those statistics are, it’s likely that the prevalence of GERD is underestimated because of the availability of antacids over-the-counter. This permits patients to self-medicate without reporting their condition to a doctor.

Up until fairly recently heartburn wasn’t taken too seriously. It’s primarily been the butt of bad jokes about Grandma’s cooking. But we now know that heartburn and GERD can have serious and even life-threatening complications, including scarring, constriction, ulceration, and ultimately, cancer of the esophagus.

Recent studies also show that the damage from poor stomach function and GERD not only extends upward to the sensitive esophageal lining, but also downward through the digestive tract, contributing to Irritable Bowel Syndrome (IBS) and other gastrointestinal problems. IBS is now the second-leading cause of missed work, behind only the common cold.

Problems with the conventional theory

If you ask the average Joe on the street what causes heartburn, he’ll tell you “too much stomach acid.” That’s what most of the ads seem to suggest too. I’m sure you’ve seen pictures like the one at the top of this post in ads for acid suppressing drugs on TV and in magazines.

But there’s a big problem with this theory: the incidence of heartburn and GERD increases with age, while stomach acid levels generally decline with age (Fig 1).

Numerous studies have shown that stomach acid secretion declines with age. In one study researchers found that over 30 percent of men and women past the age of 60 suffer from atrophic gastritis, a condition marked by little to no acid secretion. Another study found that 40% of women over the age of 80 produce no stomach acid at all. ¹

Figure 1. Mean stomach acid secretion from the second to the eighth decade. (from Wright, 2001 p.20)

Just as studies show acid secretion declines with age, it is also well established in the scientific literature that the risk of GERD increases with age.

If heartburn were caused by too much stomach acid, we’d have a bunch of teenagers popping Rolaids instead of elderly folks. But of course that’s the opposite of what we see.

In fact, according to Jonathan Wright, MD of the Tahoma Clinic in Washington state, when stomach acid is measured in people suffering from heartburn and GERD it is almost always low, not high. In his book Why Stomach Acid is Good For You, Wright explains:

When we carefully test people over age forty who’re having heartburn, indigestion and gas, over 90 percent of the time we find inadequate acid production by the stomach.

In Wright’s 25 years of conducting these tests, he found very few people with excess stomach acid. Excess stomach acid is only found in a few rare conditions like Zollinger-Ellison syndrome), and GERD is hardly ever associated with too much stomach acid.

What’s more, Wright and other clinicians have found that giving hydrochloric acid supplements to patients with heartburn and GERD often cures their problem:

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 these folks, symptoms have been relieved and digestion improved when they’ve taken supplemental hydrochloric acid and pepsin capsules.

My own clinical experience, although far more limited than Dr. Wright’s, confirms this. So far every patient I’ve had with heartburn or GERD has responded well to hydrochloric acid supplementation. We’d expect just the opposite to be true if these conditions were caused by too much stomach acid.

A symptom is not a cause

When I explain to patients that GERD is caused by not enough stomach acid, rather than too much, they are initially doubtful. “If that’s true”, they say, “then why do my antacid drugs provide relief?”

I’m not denying that the symptoms of heartburn and GERD are caused by stomach acid refluxing into the esophagus. Nor am I arguing that reducing or eliminating stomach acid with drugs doesn’t relieve those symptoms.

What’s crucial to understand is that any amount of acid in the esophagus is going to cause problems. That’s because its delicate lining isn’t protected against acid like the stomach lining is. You don’t have to have excess acid in your stomach to have heartburn.

Also, symptom relief doesn’t imply that the underlying cause of the problem is being addressed. Too often western medicine focuses on suppressing symptoms without paying attention to what is causing the symptom in the first place. The misguidedness of this approach is clearly demonstrated by the use of acid inhibiting drugs to treat heartburn and GERD – problems which are caused by not enough stomach acid!

The consequences of ignoring the cause

As I wrote above, Americans spend more than $13 billion on acid stopping drugs each year. This expense might be justified if antacid drugs were actually curing heartburn and GERD. But just the opposite is true. Not only do these drugs fail to treat GERD, they will make the underlying condition (not enough stomach acid) worse. This virtually necessitates the lifelong use of these medications for anyone who takes them.

While this is a nifty sales strategy for the drug companies, it’s a bitter pill to swallow (yes, pun intended) for those suffering from heartburn and GERD.

Curing a disease means eliminating its cause. When a disease is cured, the symptoms don’t return once the treatment is removed. This of course is not the case with drugs for heartburn and GERD. As soon as the patient stops taking them, the symptoms return. And often they’re worse than they were before the patient started the drug.

Unfortunately, pharmaceutical companies aren’t interested in cures because they aren’t profitable. It’s much more lucrative to sell drugs that people have to take for the rest of their lives than it is to promote dietary or lifestyle changes that would cure the problem.

Therefore, although the drug companies are well aware that GERD isn’t caused by too much stomach acid and that low stomach acid causes serious health problems and complications, they continue to sell billions of dollars worth of antacids to an unsuspecting public. Even worse, these powerful drugs are now available over-the-counter with no warnings about the dangers they present.

In the Part II I explain exactly how low stomach acid causes heartburn, GERD and other digestive conditions. We’ll also look at the primary causes of low stomach acid, and how you can prevent this condition from occurring. Read on!