Acid Reflux, Treat the Cause, Not the Symptoms

Stomach acid is essential for good digestion and absorption of nutrients from your diet. Suppressing stomach acid only treats the symptoms, it does not treat the cause of the disease. In fact, it can actually make things worse. Taking acid blocking drugs long enough will cause numerous nutrient deficiencies, including vitamin, mineral, and especially vitamin B12 and amino acid deficiencies.

Studies have shown that people who take acid blocking drugs long term, may end up with a variety of illnesses including osteoporosis, hip fracture, IBS, fatigue, nerve damage and eventually dementia. Long term use can also lead to an overgrowth of clostridia in the small intestine that can be life threatening.

Stomach acid, also called hydrochloric acid (HCL) is needed for both, separating vitamin B12 from food to make it absorbable and also for breaking down protein rich food so that the amino acids can be absorbed. Not enough amino acids can lead to depression, insomnia, brain fog, anxiety, trouble building and maintaining muscles and more. Amino acids are precursors for essential neurotransmitters which are needed for proper brain function.

Stomach acid is essential for killing bacteria and other pathogenic organisms that might be ingested while eating or drinking. If the stomach acid is too low, these pathogens can colonize in your intestines and cause many health problems.

When pathogenic organisms take up residence in your digestive tract, they can create gas and bloating while feeding on the food you have eaten. The pressure from the gas and bloating can push up through the stomach and then through the upper stomach valve (esophageal sphincter) causing acid reflux.

A urine test or breath test for small bowel bacterial overgrowth can diagnose the presence of certain strains of bacteria.

Hiatal hernia can also cause acid reflux. This can be diagnosed with an x-ray. Extra fat around the midline can also contribute. Stress is another contributing factor.

Food allergies to gluten and dairy products may also contribute to acid reflux. I suggest completely eliminating these two foods for a month or so and see if it makes a difference. Other food allergies may also be a factor.

Nutritional deficiencies can also lead to acid reflux. If you are on a low sodium diet you might become deficient in the minerals sodium and chloride. Zinc, magnesium, vitamin C and B vitamins are also needed to have a properly functioning stomach.

Helicobacter pylori, is another common cause of acid reflux. However, unless you go to a holistic or functional medicine doctor, you most likely will not get tested for it unless you have an ulcer. H-pylori can be diagnosed with a simple stool test.

Numerous holistic and functional medicine doctors have been testing their clients who have acid reflux and finding that most of them have low stomach acid levels. Not high levels!

The following is an example of how low stomach acid can lead to acid reflux.

When the acid level in the stomach is too low, the upper stomach valve might not stay closed and the acid from the stomach can leak up into the throat. Our body needs to sense enough HCL in the stomach in order for the upper valve to stay closed properly. Note that in this case, acid reflux is caused by low stomach acid and not by high stomach acid. It is very often the case that people identify acid reflux as having too much stomach acid while most of the time it is caused by not enough stomach acid.


Traditional medical doctors are trained to prescribe acid blocking drugs to treat the symptoms and seem to overlook the dangers of using these drugs. Instead they should be testing the person’s stomach acid level, testing for microbial overgrowth or looking for other causes.

The gastric analysis by radio telemetry test is the most accurate way to measure stomach acid. One just needs to swallow a small capsule with a radio transmitter that measures the pH of the stomach. The result of this test provides you with a graph showing your pH levels at regular intervals over time. If the test shows the HCL level to be low, a betaine HCL supplement can be taken with meals to raise the acid which may keep the upper valve closed when food is present.

There are also two other tests. These can be done at home but are not very accurate. The baking soda test is performed by drinking ¼ teaspoon of baking soda mixed into 5 ounces of water first thing in the morning after waking up. Because the baking soda is very alkaline and your stomach should be very acidic, it will produce carbon dioxide gas that causes burping. You need to measure the exact amount of time that passes from the time you drink the solution until the time that the burping starts. The result gives you an idea of the amount of HCL in the stomach. If it takes more than five minutes to start burping, in may mean that you have low stomach acid. Please note that this test is not always accurate because there are many variables that can give false results.

The betaine HCL test for low stomach acid is the most reliable at home test you can perform. The test is done by taking a betaine HCL pill in the middle of a protein rich meal. If there is no burning sensation after the meal, then do the same thing at your next protein rich meal. If you do this several times and there is no burning sensation, most likely you have low stomach acid.

You may then take 2 pills in the middle of your next protein rich meal and wait to see if there is a burning sensation. Again, if there is no sensation, do the same thing at your next protein rich meal. You can raise the amount of pills by one after every few protein rich meals and see how many pills it takes to feel the burning sensation. When you finally get to the point that you feel the burning, you should then take one less pill during the next meal.

Now that you have determined how many pills your body needs, continue to supplement the HCL with protein rich meals. Over time, your body should need less and less of the HCL supplements as your stomach acid levels normalize. Eventually, you should be able to go off the supplement and not have reflux if the reflux was caused by low stomach acid.

If you have acid reflux, no matter what the cause, it is important to avoid overeating. You will also need to avoid acidic food items such as tomato sauce, fried food, soda, coffee, alcoholic beverages, spicy food and citrus. It is also very important to not eat for a few hours before lying down.

I suggest working with a qualified practitioner who can help you find the cause of the reflux and then slowly wean you off acid blocking drugs. Quitting acid blocking drugs can be dangerous if not supervised by an experienced doctor.

And last thing I would like to share is that there are nutritional supplements that can help. Probiotics are essential to colonize the intestines with good bacteria. DGL (deglycerized licorice) can help with the symptoms. Magnesium is an important nutrient for the proper function of the valves at the top and bottom of the stomach. These valves are actually muscles and muscles need magnesium. And a high quality multivitamin and protein supplement will help replenish nutritional deficiencies that were caused by the acid blocking drugs.


The Vitamin Game

My goal in writing this article is to share what you might not know about vitamins in the area of natural vs. synthetic and to touch on the subject of how vitamin supplements are produced. Keeping it short and to the point was no easy task.

Vitamin A

What we call vitamin A is actually a group of compounds. Some called retinoids and others called carotenoids. Carotenoids are known as provitamin A because they can be converted into vitamin A. However, conversion of carotene to retinol varies from person to person and bioavailability of carotene in food also varies. Only the carotenoids alpha-carotene, beta-carotene, gamma-carotene and beta-cryptoxanthin can function as provitamin A.

Because vitamin A is fat soluble, a low fat diet can result in poor absorption of vitamin A. Fats increase the uptake of both carotenoids and retinoids.

A zinc deficiency can impair absorption, transport, and metabolism of vitamin A because zinc is essential for the synthesis of vitamin A transport proteins and as the cofactor in conversion of retinol.

Retinyl palmitate is the synthetically manufactured form of the vitamin.  It can usually be converted to retinol, and ultimately to retinoic acid. However, acetone and other unhealthy chemicals are used in the process of making it.

Taking carotenoid supplements is the preferred form because the body will only convert them to retinoids as needed. However, taking retinoids in excess can be very dangerous because acute retinol toxicity could occur.

Vitamin B1, Thiamine

Vitamin B1 supplements can be made in three different ways:

Making synthetic vitamin B1 looks something like this: Hydrochloric acid is added to coal tar. Then fermentation, heating, cooling, and other steps are completed until the synthetic vitamin is created. It has a similar molecular structure but is not the same as the naturally occurring vitamin. This is currently the least expensive way to make the vitamin.

Food extracted vitamin B1 is made in a logical and natural way. The plant containing the vitamin is harvested, cleaned, and then put into a vat of water. After the vitamin has moved into the water, the fluid is filtered and the fiber is removed. The plant extract will contain the nutrients found in the original plant. This is the most expensive way to obtain the vitamin and also the form that our body uses best.

Another way so called ‘’natural’ vitamins are created is by growing yeast and then feeding the yeast synthetic vitamins. The yeast is then harvested and made into vitamin supplements. The theory is that the yeast will contain the vitamin it has been fed in a whole food complex. However, I tested this theory on myself. Every day for one year I consumed a B-Complex containing yeast that had been fed the synthetic form of vitamin B12, called cyanocobalamin. Then I took a test to see my B12 status. My white blood cells showed a deficiency of Vitamin B12. I am not sold on this method of vitamin production.

Vitamin B2, Riboflavin

Several biotechnological processes have been developed for manufacturing riboflavin. Different microorganisms are used including filamentous fungi (Ashbya gossypii, Candida famata and Candida flaveri) and bacteria (Corynebacteriumammoniagenes and Bacillus subtilis [1])

The bacteria bacillus subtilis has been genetically modified to increase its production of riboflavin and also to make it resistant to the antibiotic ampicillin. This form of manufactured riboflavin made from GMO bacteria treated with an antibiotic is now used for both animal feed and human food fortification.  Natural food extracted B2 is obviously best with this vitamin.

Vitamin B3, Niacin

Nicotinic acid, the synthetic form of niacin, is created using coal tar, ammonia, and formaldehyde. It is less absorbable and has a greater risk of side effects than the natural form of the vitamin. However, nicotinic acid has been used for over 50 years to reduce low density lipoprotein cholesterol (LDL), very low-density lipoprotein cholesterol (VLDL-C), and triglycerides (TG), and to increase high density lipoprotein cholesterol (HDL).[2]  It has also been used to reduce the risk of cardiovascular events. [3]

Niaspan, available only by prescription, is an extended release form of nicotinic acid. It has a film coating that delays the release over a period of 8 – 12 hours. This can reduce the side effect of flushing but it increases the risk of liver toxicity.

Niacinamide, the flush free form of niacin found in food, does not dramatically reduce bad cholesterol or raise the good cholesterol, but can be synthesized in the human body from the amino acid tryptophan. Vitamin B6 is also required for the conversion of tryptophan to niacin, so low vitamin B6 status will impair this conversion. Niacin can also be extracted from plants for making supplements.

Vitamin B5, Pantothenic acid

Synthetic pantothenic acid is made with formaldehyde and isobutyraldehyde to form a calcium or sodium salt. Panthenol is the alcohol analog and acts as a provitamin for B5. I don’t recommend consuming any other form but food extracted B5.

Pantothenic acid derives its name from the Greek word pantothen, meaning “from everywhere”. Small amounts of pantothenic acid are found in almost every kind of food.

Vitamin B6, Pyridoxine

Synthetic Vitamin B6 – Pyridoxine hydrochloride is made from petroleum esters, hydrochloric acid, and formaldehyde. It may actually inhibit the action of natural B6 in the body. It also has side effects not normally found with natural food sources of this vitamin. Food extracted B6 is certainly best.

Pyridoxal-phosphate also known as PLP is the biologically active form of B6.

PLP is needed for almost all amino-acid-metabolism inside of our body, from synthesis to breakdown

Vitamin B7, Biotin

The process for making synthetic biotin was developed in the 1940s and uses fumaric acid as a starting material.[4] Fumaric acid may be toxic with long term use. [5]

In humans, healthy intestinal bacteria produce biotin in excess of the body’s daily requirements. However, healthy intestinal bacteria is becoming rare as antibiotic use is on the rise.

Biotin is available in a wide range of food sources but few are particularly rich sources.

Vitamin B9, Folate

Folate is the naturally occurring form of vitamin B9 found in food. Folic acid is synthetically produced and needs to be converted to a human active form in order to be used. People with the MTHFR-677 genetic mutation have trouble making the conversion and making folic acid useable. If you have this mutation and supplement your diet with folic acid, you may be doing yourself a disservice. Un-metabolized folic acid can depress the immune system and lead to cancer or other kinds of disease that thrive in a body with a weak immune system.

There are also many manufactured forms of folate that are available, some are good and some are not. They are prescribed for raising folate levels in people with the MTHFR-677 mutation.  Methylfolate is one of the better manufactured supplements for people with the MTHFR mutation.

Vitamin B12, Cobalamin

Vitamin B12 refers to a group of compounds called cobalamins that are found in the human body in different forms.

Naturally occurring B12, cobalamin, is a product of bacterial activity. Natural B12 is created by micro-organisms like the bacteria that grow in soil and in the intestines.

Cyanocobalamin is manufactured using the mineral cobalt and the toxin cyanide. They are fermented to make cyanocobalamin. People with the MTHFR mutation, (about 1 out of every 5 people) have great difficulty using this unmethylated form. What’s even worse, overuse can cause cyanide build up and become dangerous.

Hydroxocobalamin is not a form found in the human body, but can be converted in the body to a usable form of B12.  This form is not yet methylated and needs to be in order to be useful.

Methylcobalamin is the type os vitamin B12 found in the human body and can be used to prevent or treat a vitamin B12 deficiency. Methylcobalamin is produced by certain bacteria or manufactured in a laboratory. This is the best human active form to use as a supplement because it is already methylated.

People with low stomach acid may have difficulty absorbing B12 from animal food because it comes bound to protein. Hydrochloric acid is needed in order to be able to remove the B12 from the protein.


Natural Choline can be extracted from sunflower seeds and is found in lecithin. Synthetic choline called choline chloride or choline bitartrate is made using ammonia, ethylene and hydrochloric acid or tartaric acid. I certainly opt for the food extracted form here.

Vitamin C

Natural Vitamin C is found in nature in combination with bioflavonoids and phytonutrients that are important in its absorption and use. Synthetic Vitamin C, called ascorbic acid is isolated from genetically modified corn sugar that has been hydrogenated and processed with acetone. It does not include the bioflavonoids and phytonutrients that help it work.

Good sources for supplemental Vitamin C include camu camu, amla berry and acerola cherry.

Vitamin D

The human body produces vitamin D3 when exposed to the sun. D3 is the most effective form of the vitamin.

Mushrooms produce the inferior form, D2. Synthetic vitamin D2 is made using ergosterol, a type of plant sterol derived from fungal cell membranes. Ergosterol is turned into viosterol by ultraviolet light, and then converted into ergocalciferol.

To make D3, the waxy secretion from sheep skin called lanolin is processed.

If you decide to supplement with vitamin D, I suggest lichen extracted D3. Lichens produce the same D3 that comes from human skin when exposed to the sun.

Vitamin E

Vitamin E is made up of 8 different compounds: Alpha, beta, gamma and delta tocopherol and alpha, beta, gamma and delta tocotrienol. In synthetic vitamin E, they are only reproducing one part. It is called dl-alpha tocopherol. This analog is created using refined oils, trimethylhydroquinone, and isophytol. It is not as easily absorbed, doesn’t stay as long in tissues, and is quickly excreted like an unknown chemical.

Rice bran and annatto are excellent sources of the entire E complex.

Vitamin K

There is K1 and K2. Natural Vitamin K1 is readily available in dark green leafy vegetables. Vitamin K2 is found in fermented food such as sauerkraut.

The synthetic vitamin K known as menadione comes from coal tar derivatives and genetically modified and hydrogenated soybean oil. They use hydrochloric acid and nickel in its production. It may actually damage the immune system among other unwanted side effects. In the United States, menadione supplements have been banned by the FDA because of their potential toxicity.

Once again, food extracted vitamin K is best.

Shockingly, the raw materials used for making synthetic vitamins can range from coal tar to petroleum and a long list of chemicals that one would never think of consuming. Synthetic supplements are made using chemical manipulations that duplicate the structure of isolated vitamins. Even worse, some supplements are produced by genetically altered bacteria because GMO bacteria can be made to produce vitamins. Unfortunately, formulas for these processes are not made available to the public. If they were, I am sure that it would reduce sales of synthetic vitamins and people would switch to food extracted vitamins.

[1] Stahmann KP, Revuelta JL and Seulberger H. Three biotechnical processes using Ashbya gossypii, Candida famata, or Bacillus subtilis compete with chemical riboflavin production. Appl Microbiol Biotechnol. 2000;53(5):509–516. doi:10.1007/s002530051649PMID 10855708

[2] Villines, TC; Kim, AS; Gore, RS; Taylor, AJ (2012). "Niacin: The evidence, clinical use, and future directions".Current atherosclerosis reports 14(1): 49–59. doi:10.1007/s11883-011-0212-1. PMID 22037771

[3] Bruckert, E; Labreuche, J; Amarenco, P (June 2010). "Meta-analysis of the effect of nicotinic acid alone or in combination on cardiovascular events and atherosclerosis". Atherosclerosis210 (2): 353–61.doi:10.1016/j.atherosclerosis.2009.12.023. PMID 20079494

[4] "Biotin" 2014-03-19. Retrieved 2014-03-19.

[8] European Commission: "European Commission Report of the Scientific Committee on Animal Nutrition on the Safety of Fumaric Acid". Retrieved 2014-03-07