Is Stomach Acid The Missing Link?
Saturday, January 16, 2010 at 5:03PM 
Is there anyone reading that has not experienced the pure dread of waking up in the middle of the night with a knot in your leg that feels like the size of a basketball?
My experience is as follows:
Cramps weren't around during the day time, but loved showing up at 3-4am. Waking up - gasping for air - I would grab whatever leg was spasming and immediately leap out of bed to my feet. I would describe the pain as having felt like someone jabbed a knife in my calf and began to twist.
My nightly routine to counter these attacks was to hobble around for 10 minutes until they were gone. Once the cramp finally did go away, it was a toss up if I would wake up again from another cramp. It sucked.
Until now I thought this phenomenon was just part of the acclimation period to a very low carbohydrate diet (VLC) or carnivorous diet. My goal for this post is to garner some thought on the idea that cramps are related to a much bigger problem, a lack of hydrochloric acid (stomach acid).
Hydrochloric acid (HCL) is secreted in response to the food we eat, specifically protein. HCL in large is responsible for the energy intensive task of breaking down protein as well as promoting the absorption of many key vitamins and minerals. HCLs other duties include maintaining the acidic pH of the stomach and warding off bacteria, fungi and pathogens.
When we're low in stomach acid we're opened up to bacterial overgrowth, lowered resistance to infection, and high probability of nutrient malabsorption. If that wasn't bad enough, when the stomach lacks acidity, food will not be emptied into the duodenum for further digestion. Half digested food is now sitting in the stomach, fermenting, causing inflammation, stress and potentially causing acid reflux symptoms.
We've touched on nutrient malabsorption, but let's go over a few that are interesting.
- Zinc - Although it's important for women, zinc is the man mineral. Zinc has a hand in libido, fatty acid utilization, b-vitamin utilization, sperm production, hair growth, and just about every important bodily function you can think of. Oddly enough zinc is also crucial for the production of stomach acid.
- Magnesium - Think of magnesium as the relaxation mineral. It wouldn't be surprising if most Americans were deficient considering high blood glucose and insulin resistance cause rapid evacuation of this important mineral. Engaging in physical and mental stress induces chronic over stimulation of your adrenal glands - essentially milking your bodies stores of magnesium. Magnesium along with potassium and calcium (the "um" minerals) are all integral in promoting relaxation - especially in the muscles.
- Vitamin B12 - Reduced acidity in the stomach delays the release of "intrinsic factor" which is needed to absorb vitamin B12 later on in the small intestine. Muscle weakness, extreme fatigue and neurological problems are all the calling cards of a vitamin B12 deficiency.
- Histidine - Low stomach acid will hinder protein digestion crippling the 50,000 bodily functions that require amino acids. While it's not the most glamorous amino acid, men and women with libido trouble may want to pay close attention to histidine. Histidine is converted into histamine, which has a strong role in promoting the ease of achieving an orgasm. Furthermore, histamine increases vasodilation which may promote blood flow to sexual organs.
What was this post about again?
Cramps. Carnivorous ones.
Okay, so minerals aren't absorbed so well when stomach acid is low. This naturally leads us to our next question:
Why is stomach acid low?
Here are a couple common conditions associated with low stomach acid:
- Hypothyroidism - The suppression of gastrin, the hormone responsible for the release of HCL, is compromised in thyroid hypofunction.
- Chronic Mental & Physical Stress - Digestion is a parasympathetic nervous system dominant process, which means we need to be in a relaxed state to properly secrete HCL and digestive enzymes. Along with relaxing at meals, one can make sure to avoid stressful situations whenever possible. Stress causes excretion of important vitamins (b-vitamins especially) and minerals including zinc - which as I mentioned is needed to produce HCL.
- H. Pylori Infection - I'll let Dr. Stephan from Whole Health Source field this one.
There are a few different ways to reduce your stomach's acidity level. The most straightforward is to take an antacid, or any number of drugs that lower stomach acidity (as in the mouse study above). But can we do it naturally? Sure, all it takes is a little Helicobacter pylori infection! Luckily, most people already have one.
H. pylori is a bacterium that's the main proximal cause of stomach ulcers. Antibiotics are now the standard treatment for ulcers, and they're effective. Treating an asymptomatic H. pylori infection with antibiotics increases stomach acidity, suggesting that H. pylori is capable of suppressing the secretion of stomach acid. In another study, eradicating H. pylori with antibiotics improved nearly all patients suffering from hypochlorhydria (insufficient stomach acid).
Like any organism, H. pylori likes to stay well-fed. Its favorite food is hydrogen gas (H2), and the more it gets, the more it grows. It's not the only bacterium to like H2. Salmonella, of food poisoning fame, requires H2 to become pathogenic. Clostridium bacteria are also associated with elevated H2. H2 is produced by the fermentation of food by bacteria in the digestive tract. It's very small so it diffuses around the body, reaching the stomach lining where it's eagerly gobbled up by H. pylori. It may be equally good food for a number of other parasites around the body.
- High Sugar/Starch Diet - High carbohydrate diets, combined with vegetarian sensibilities (high fiber), hamper the body from producing adequate amounts of stomach acid. Plant foods containing "phytates" actively bind to zinc, magnesium, calcium and iron escorting them out of the body. Perhaps a lack of stomach acid is why vegetarians and vegans claim that red meat just "sits in their stomach". I would be willing to bet most of them are achloridic for sure...
- High Protein Diet - HCLs main duty is to break down dietary protein into peptides. Nora Gedgaudas, author of the phenomenal book Primal Body, Primal Mind, points out that protein intake above that which the body needs is extremely taxing on digestive system. If one has HCL issues, perhaps less protein would be the way to go avoiding the potential stress related to poor digestion.
My over simplistic conclusion is that there's a possible correlation between hydrochloric acid deficiency and a lack of the "um" minerals; magnesium, potassium, and calcium. These minerals are crucial in regards to avoiding cramps and spasms.
If Dr. Jonathan Wright, author of Why Stomach Acid Is Good For You, is to be believed, 90% of Americans are deficient in HCL. That's a huge number, but I wouldn't be surprised if it were true. Correcting any possible issue with digestion, whether it be consuming pemmican, eating less protein (and more fat), eating less meals a day, or supplementation with hydrochloric acid (betaine HCL); will assure the absorption and proper utilization of the bodies most important nutrients. Perhaps the replenishment of stomach acid will make the cramp induced misery that some experience when adventuring into VLC/ZC land more tolerable or better yet, nonexistent.
Please share your thoughts and experiences below.
Digestive Enzymes, Stomach Acid, Stress 
Reader Comments (42)
Very timely post. I am almost decided to go and try some ZMA supplement. Does anyone have any experience with this?
Danny,
I had asked you about leg cramps before because it was the one thing that really stood out about my breif experimentation with Atkins several years ago (you don't forget those cramps easily). You advised me that more dietary fat might help and let me tell you it HAS helped! When I thought about the days of Atkins, my focus was on low carb, high protein. That is in line with what you were just saying here in your post about HCl and high protein diets. My diet these days is decidedly Zero Carb, High FAT and my struggles with leg cramps have been minimal. I'll awake stretching, feeling the start of a cramp in my calf, take some deep breaths and relax my legs and it goes away. That may only happen once a week if that often. For me, I'm sure it's the ratio of fat:lean that keeps me in bed resting. Thanks for that most helpful hint!
Danny,
Sorry - hate to clog your blog, but I've got a question for you as it relates to HCl acid. I saw a clip on motion sickness on tv (and surely if it's on tv it has to be true - NOT) that was discussing the relation of HCl acid production in the gut in relation to motion sickness. Did you see anything like that in your reading? All I know about this is that all through childhood and in all my adult years prior to ZC, I've suffered horribly from motion sickness. And last weekend I was co-pilot on a road trip using my phone's nav system and was reading to my husband from entertaining websites and didn't even have a hint of sickness. I'm so sorry to get off topic, but if there's a connection WOW wouldn't that be wonderful!
When I reduced my carbs to 20-15 g/day, I started experiencing nocturnal leg cramps. They resolved when I started taking supplemental calcium, magnesium, and potassium.
I wouldn't say the cramps were dreadful, but I'm glad they're gone.
I don't really care much about the acid situation in my stomach. Rather than trying to alter that, I'll just take my supplements.
-Steve
Thanks for commenting Radek,
Sorry Radek, I have no experience with ZMA.
Thanks for reading Karen,
Your post is what inspired me to give this issue more thought. I was trying to figure out why a higher fat and lower protein intake would combat cramps.
The one other thing I've noticed about a protocol like this is that I drink less water. Is that a good or bad thing? I have no idea, just something I've noticed. Perhaps the fat is hydrating?
The motion sickness connection sounds interesting. There could be a gut connection there, similar to "butterflies in the stomach", but I'm not sure.
Thanks for commenting Dr. Parker,
Really? Hydrochloric acid has many more functions than just absorption of minerals.
Danny, interesting post. I've noticed increased cramping since going ZC, but not in typical areas like calves. I get cramps in larger muscles like my back (lats), thighs, neck, and abs, which I've never had before. Quite painful, especially the abs, but nice in another way (feeling in-tune with body)! Not sure what the cause may be so still experimenting. WP
Thanks for commenting Winalot,
You're not alone, I used to experience cramps in my abs as well. They are painful and funny at the same time. Well, at least for anyone near you that watches you stretch it out.
Hey Danny,
You didn't mention yeast as a cause of low stomach acid. I really think it is a major cause, especially in those with heavy metals poisoning. I just found out I've had a yeast infection the whole time I've been on ZC. ZC alone is not enough to kill yeast, at least for me.
My yeast flared up so much after a chelation round that I had trouble breathing and swallowing for several days and had to go to the emergency room. I can usually manage to take 15 capsules of HCl with a meal without burning. I think one of the reasons people do so well on ZC and are so sensitive to minute amounts of carbs is because ZC usually keeps yeast in control(but many times doesn't kill it completely), but one apple will cause a huge flareup and yeast causes carb cravings. If I eat carbs(like a piece of fruit) I get a reaction that I suspect is more severe than just blood sugar and insulin. I get strongly emotionally effected and go crazy.
I believe there is a link between people who choose ZC and heavy metals poisoning/yeast, (known or unknown) That would explain the extreme sensitivity/aversion to small amounts of carbs.
Thanks for commenting Rich,
It's hard to find good resources regarding candida yeast infections. I'm weary of throwing info out there that I've read, due to the high probability that it's total bunk. I'm sure we can agree that the internt harbors and overwhelming amount of garbage about candida.
Perhaps candida is similar to H. Pylori in damaging parietal cells in the stomach thereby reducing stomach acid production.
How did you find out that you have a yeast infection? Same question with metals?
I too can handle A LOT of betaine HCL. If I lower my protein intake I don't have to take as many.
Definitely an interesting theory for why people are drawn to ZC.
Does a ZC diet chelate metals? I'm not sure.
Also, what do you get rid of first? Yeast or metals? I've read that yeast absorbs metals and of course it weakens the immune system. If you get rid of the infection, and bolster the immune system with good nutrition, can the body rid itself of the offending metals?
For individuals that have amalgam fillings and no symptoms, what is their secret? Do they have really robust immune systems and no problems with yeast?
Unfortunately I don't even know where to look for answers to these questions.
I've battled leg cramps that happen along with heart palplitations off and on since going low carb/zero carb for the last six months. In my n1 stragedies, I've discovered that mg supplements coupled with dairy restriction knocks both out together. Once I ran out of mg citrate and ran and grabbed a cal/mag blend. The ratio of high calcium to magnesium allowed my symptoms to return. This leads me to think, that in my case at least, it takes very little calcium in my diet to counter act the mg and bring back both leg cramps and heart palpitations. Mg saves the day.
Thanks for commenting Rachel,
The question is not whether or not magnesium is good for cramps, but rather why aren't you absorbing the magnesium in your diet? Red meat is an excellent source of bioavailable magnesium.
Another reason to avoid Proton-Pump Inhibitors. C. Diff susceptibility increases immensely while on PPI's, for example.
Many people have mentioned supplementing with Magnesium and Potassium. Low-carb diets are usually deficient in these two. I take magnesium citrate as a supplement to reach the RDA and use Half and Half salt to fill up on the potassium.
Great Blog!
And regarding the question of Magnesium absorption:
Let's take grass-fed ground beef for example.
If you eat 1kg of grass-fed ground beef you only get 190mg of Magnesium and 2.89g of potassium.
The RDA for Magnesium is 400mg and the RDA for potassium is 4.7mg
btw, calcium is also very low, you only get 120 mg while you require 1g.
In regard to supplements, specifically magnesium and calcium, aren't the RDA values established to supplement SAD? And, because of its nature, the SAD is deplete or leeched of those minerals and without the carb in the diet, an all-meat, high fat diet provides enough bioavailable minerals in the proper proportions? That is not to say that for some reason one person or another may not be able to absorb what's there, but what we need is there to begin with.
Heres a thought. Maybe because our bodies are so damaged by the SAD that maybe we still need the SAD values for certain nutrients and minerals?
That is, until we are healed.
I'll tinker with some hydrochloric acid supplementation and keep you guys posted. *fingers crossed* :)
Good to see you here Epistemocrat,
I can't believe I forgot to add this in the post, but yes, another reason to avoid them. Thanks for reminding me Brent.
Thanks for commenting Hans,
I disagree, meat is very high in potassium, and has sufficient in bioavailable magnesium. Like Karen said below, the RDA is for those eating SAD.
Concentrating on bioavailable sources of nutrients (meat), kicking fiber and carbohydrates to the curb, and restoring stomach acid should do wonders for nutrient status.
Hey Karen,
Well said.
Thanks for commenting Bill,
This could be a very real possibility, but I'm not sure micromanaging nutrient status in any regard works out in the field. I know I've never had any success with it.
Hey Rachel,
Keep us updated.
Danny,
I imagine you're familiar with the heavy metal/yeast theory? Dr. Klinghardt published this in Europe and claims to yet be disproven. He's idea is that the the yeast is a protective mechanism by the body in response to heavy metals. He goes on to say what is thought to be die-off is actually a storm of heavy metal release. After battling candida/yeast issues for years I think there is some truth to this theory...it explains why my persistent dysbiosis temporally responds to probiotics but soon returns upon stopping them probably because of underlying heavy metals.
It seems the body 'ecology' cannot be restored if the heavy metals are present. My next step is probably to give modified citrus pectin a try. Have you looked into this? I know you have problems with lead and there was a positive study on lead removal in humans using modified citrus pectin.
http://www.ncbi.nlm.nih.gov/pubmed/18616067
Quite impressive results..
http://www.iherb.com/Now-Foods-Modified-Citrus-Pectin-100-Pure-Powder-1-lb-454-g/14339?at=0
Hey Jim,
I'm familiar with Andy Cutler's protocol, but not Dr. Klinghardt's.
Dr. BG sent me an awesome PDF that outlined Hg and candida, it was pretty interesting.
While I dig most of the stuff on Klinghardt's website, he has some religious ideas mixed in with chelation that throw me for a loop. I'm sure I can learn a lot from him though.
One of my biggest fears is doing this for x number of years, only to find out that I haven't gotten anywhere because I haven't chelated.
Andy Cutler believed that citrus pectin would only chelate money out of your wallet. He was a strong supporter of DMSA and alpha lipoic-acid in small doses every 3 hours. Check his stuff out and tell me what you think. I have his book, and it's the best stuff I've ever read on chelation.
It is really frustrating because heavy metal toxicity, candida and leaky gut share so many symptoms. I am quite sure I have a candida/leaky gut problem, how am I to tell if I have heavy metal poisoning? I never had fillings in my teeth, only had a big fish eating burst for about a year, and then pretty much stuck to salmon... how did you get your metal poisoning Danny?
I have anti candida and leaky gut healing products lined up to order and now I read this about heavy metals needing to be chelated before trying to beat candida? And chelating takes a year they say...
As I said I dont have metal fillings, I wasn't really a huge fish eater most of my life and almost never had tuna. I know your not an expert but is it worth all the money or should I just go for the healing of the leaky gut and the candida? I eat VLC, Panu as well.
Danny,
I am no Klinghardt devotee he is to me a flawed genius...lately i've been avoiding he's work as it's pessimistic to me. Not exactly the kind of thing I want to read on the path to healing, though I do think the heavy metal/yeast theory is sound.
I haven't looked into Andy Cutler's work but will look into it! DMSA + Lipoic Acid intrigues me.I share you're frustration Danny we both have similar medical history and have seemed to have hit a glass celling when it comes to our health. Like you I'm no success story even though the carnivores diet has done wonders there is still other pieces I need.