816 hypochlorhydria

While most doctors prescribe antacids to lower stomach acid for heart burn and acid reflux, the real culprit may be that your stomach acid is already too low. This is called hypochlorhydria and it plays a role in autoimmune diseases such as Hashimoto’s hypothyroidism.

Sufficient stomach acid, or hydrochloric acid (HCl), is necessary to:

Protect the body from pathogens. When we consume food, bacteria and other microorganisms come along with it. Stomach acid helps neutralize the ones we don’t want in our bodies. HCl also acts as a barrier against bacterial and fungal overgrowth of the small intestine. This is important to preventing inflammatory compounds into the bloodstream where they can trigger Hashimoto’s hypothyroidism.

Activate pepsin. HCl triggers the production of pepsin, which helps break down proteins to be absorbed in the small intestine. When proteins are not adequately digested, they can escape into the bloodstream where they trigger inflammation food sensitivities.

Digest proteins. If you have ever made ceviche or marinated meat in vinegar or lemon, you can see how acid breaks it down. Our stomach acid works much more quickly and efficiently than this.

Activate intrinsic factor. Stomach acid helps activate intrinsic factor, a glycoprotein made in the stomach that is necessary for absorption of vitamin B12.

Stimulate delivery of bile and enzymes. Adequate stomach acid stimulates release of bile from the liver and gall bladder and digestive enzymes from the pancreas. This also supports digestion of carbs, fats, and vitamins A and E.

Close the esophageal sphincter. Located between the stomach and the esophagus, the esophageal sphincter protects the delicate tissue of the esophagus from the strong acids of the stomach.

Open the pyloric sphincter. Stomach acid helps open this gateway between the stomach and the small intestine.

Absorb vitamins and minerals. Absorption of folic acid, ascorbic acid, beta carotene and iron are made more bioavailable by HCl in the digestive tract. Low stomach acid can cause poor absorption of calcium, magnesium, copper, chromium, manganese, selenium, vanadium, zinc, molybdenum and cobalt.

The gut is the seat of the immune system and all of these functions are vital for healthy gut function that can help you manage your Hashimoto’s hypothyroidism and prevent inflammation and flare ups.

Hypochlorhydria is under diagnosed

An estimated 90 percent of the population suffers from hypochlorhydria (low stomach acid), yet most of us have never heard of it.

When stomach acid is too low your body cannot digest food thoroughly. The food in the stomach begins to rot and putrefy, the small intestine attempts to reject it, and the rotten food moves back up into the esophagus. While the food is not acidic enough for the small intestine, it is far too acidic for the esophagus.

In addition, low stomach acid leads to bacterial overgrowth, gut inflammation, increased food sensitivities, and higher risk for inflammatory disorders such as Hashimoto’s hypothyroidism.

Key hypochlorhydria signs and symptoms include:

  • Burping, bloating, gas after meals
  • Upset stomach after eating
  • Nausea when taking vitamins and supplements
  • Indigestion, heartburn, acid reflux
  • Diarrhea
  • Desire to eat when not hungry
  • Undigested food in stool
  • Fatigue
  • Gut infections
  • SIBO (small intestine bacterial overgrowth)
  • Iron deficiency anemia
  • Deficiencies of vitamin B-12, calcium, and magnesium

Taking supplemental HCl can help support your own production and help you better digest your food. Take just enough so it doesn’t cause burning. If taking even a little bit causes burning, you may have ulcers and an H. Pylori infection, which are not uncommon with hypochlorhydria.

Ask my office for more advice on improving your digestion, relieving your heartburn symptoms, and managing your Hashimoto’s hypothyroidism.

 

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815 avoid afternoon thyroid test

If you’re getting your TSH levels checked to monitor your thyroid health, it’s best to get that done in the morning. Otherwise your results may come back normal even though you have hypothyroidism.

All the body’s hormones follow a daily rhythm, including thyroid hormone. This means there are times of the day when it naturally higher or lower. Researchers tested the blood of hypothyroid subjects both before 8 a.m. and again between 2 and 4 p.m.

In hypothyroid patients both untreated and on thyroid medication, TSH dropped was substantially lower during the afternoon test. This means an estimated 50 percent of people with hypothyroidism are not being diagnosed.

In the untreated group, TSH was 5.83 in the morning and 3.79 in the afternoon. In the treated group, TSH was 3.27 in the morning and 2.18 in the afternoon.

2004 study also showed late morning, non-fasting TSH was 26 percent lower compared to early morning, fasting TSH. This means even a late morning blood draw could result in a failure to diagnose.

TSH blood test timing and functional medicine ranges

The timing of your blood draw plays an important role in reading a thyroid panel. However, there is more to it.

Even with an early morning blood draw, many doctors will still fail to diagnose hypothyroidism because they use lab ranges that are too wide and that do not reflect genuine thyroid health.

Many doctors still use a hypothyroidism TSH range of 0.5 to 5.0 e

ven though the American Association of Clinical Endocrinologists recommends 0.3 to 3.0.

In functional medicine we use an even narrower range of 1.8 to 3.0. We also know that only looking at TSH can miss hypothyroidism.

For example, TSH may be normal but other thyroid markers are off. That’s why it’s important to order a thyroid panel that includes total and free T4 and T3, reverse T3, free thyroxine index (FTI), T3 uptake, and thyroid binding globulins. Many conditions can cause poor thyroid function, including inflammation, hormonal imbalances, and chronic stress. Ordering these other thyroid markers provides more insight into such imbalances.

Always include a test for autoimmune Hashimoto’s hypothyroidism

In addition to these markers, anyone with symptoms of hypothyroidism should also test for Hashimoto’s, an autoimmune disease that attacks and destroys the thyroid gland.

Why? About 90 percent of hypothyroidism cases in the US are caused by Hashimoto’s. To screen for Hashimoto’s, order TPO and TGB antibodies.

Thyroid medications may be necessary to support thyroid function, but they do not address the autoimmunity attacking the thyroid gland. Failing to manage Hashimoto’s increases the risk of developing other autoimmune diseases such as pernicious anemia, rheumatoid arthritis, vitiligo, and Type I diabetes. It will also make it more difficult to manage your symptoms.

Ask my office how to properly test and manage your thyroid function.

 

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