We do not yet know the true cause of hypochlorhydria. When we find it out, we may be unable to cure it, but at least we can now treat the condition and return the patient to normal functioning.
Once the diagnosis is certain, one of two items can be used: betaine hydrochloride or glutamic acid hydrochloride. These “carrier molecules” make it possible to introduce the HCL as a powder in a capsule and thus avoid damage to your teeth, which occurs with the liquid form of HCL. These preparations should always contain pepsin for best results.
The solid tablet form of HCL is to be avoided because it is not as effective as the powdered form. When you put the HCL into your stomach with a meal you want it to work then, not later when the tablet has finally dissolved.
The amount of HCL needed can vary from 30 to 100 grains. The largest capsules are ten grains, so this means three to ten caps with each meal. The number per meal can vary based on the quantity and type of food you are eating, but no exact guidelines can be stated. You should start with one cap with a meal, and if this is tolerated, build up with each successive normal meal (whatever is “normal” for you) until you experience a burning sensation. One cap less than that dose which produces a burning sensation is your proper dose for a normal meal. The dosages for smaller or larger meals are adjusted accordingly.
These may seem like large doses; however, they represent considerably less acid than a normally functioning stomach can make. I recommend no more than this, because this amount seems to work. I believe in using the lowest dose of anything which works.
The lab tests which will reveal the benefit of HCL supplementation are: (1) stool analysis to demonstrate complete protein digestion, (2) a blood count to demonstrate correction of pernicious anemia or a previously iron-resistant form of anemia (due to poor iron absorption) and (3) x-rays to demonstrate recalcification of certain types of osteoporosis caused by poor calcium absorption in turn due to low stomach acid.
In addition, a few weeks of supplementary vitamin B12 intramuscular injections twice each week usually produces marked improvement in well-being and a clearing of several symptoms. The B12 is given in combination with folate, so that folate deficiency is not masked and left untreated by the injections. B12 and folate together usually result in more sound sleep, more energy and less anxiety.
As you might suspect, B12 injections are out of vogue with the medical establishment because of the fact that a seven year supply of B12 can be stored in the liver. The fact that it can be stored does not mean that it is stored in this quantity in every individual, however. Even if B12 is stored in these quantities, this does not guarantee availability when needed in larger-than-usual quantities.
While it certainly is an inconvenience to supplement stomach acid with each meal for a lifetime it may be less inconvenient than the alternatives. It is well-known that hypochlorhydria is associated with increased risk of stomach cancer, and this may be due to the conversion of nitrites into cancer-inducing nitrosamines in an abnormally alkaline stomach. Also, intestinal overgrowth of bacteria and the incidence of parasitic infections is increased when stomach acid is low. Risk of cancer, risk of parasites, expected bacterial overgrowth and remember the always-present yeast organism, ever ready to become a problem — all adds up to a lot more inconvenience than popping a few betaine HCL caps with each meal.