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Hello,

Several wrote to ask me for more info on taking digestive enzymes versus
antacids, so I am sending along some info taken directly from a book by
Dr. Jonathan Wright (Dr. Wright's Book of Nutritional Therapy - Rodale
Press) that might be helpful.  I have read very similar info in books by
other doctors; this is just the quickest one I can put my hands on. I
recommend the assistance of a nutritional-oriented doctor for
determining the need for hydrochloric acid; however, the digestive
enzymes I am taking now (Nature's Sunshine) are very safe and can be
tried without supervision.
Susan
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>The textbook' type of malabsorption syndrome is not the same as the
common forms of nutrient malabsorption described below.  These are much
more common, milder versions with chronic, insidious effects and many
fewer symptoms.  In some cases, there are no specific symptoms at all.
Because of this, many digestive-absorptive problems are not recognized
by those who have them.  So they can continue for years, with possibly
serious results which are never related to the unrecognized absorptive
problem.

If you are on a good diet, taking what appear to be the right
supplements for you, and you're still not doing well, absorption may be
the problem.

Chronic, excessive intestinal gas is probably the most frequent symptom
of absorptive problems.  Many are troubled with chronic constipation;
fewer have a low-grade diarrhea.  If you don't feel like it's digesting
when you eat quantities of meat, you probably have a problem.  The
frequent appearance of a variety of undigested foods in bowel movements
is of course an excellent clue.  Many persons  bloat' after meals.

As we all get older, the chance of poor digestion-absorption increases.
Particularly after age 60, it's extremely common.  Some estimates have
gone as high as 40 to 50 percent of all those past that age.

I should note, though, that youth is no guarantee of good digestion and
absorption.  I have records of over 50 children under the age of 3 who
definitely have problems with nutrient absorption.  As mentioned, some
people have no symptoms of absorptive difficulties, particular in the
early stages.  How can these be found?

One way is with mineral analysis of a specimen of hair.  Hair analyses
are available without seeing a doctor (even though for proper
interpretation, this isn't always a good idea).

Most mineral analysis companies include roughly the same group of
minerals, including the following: calcium, magnesium, iron, copper,
manganese, zinc, chromium, and selenium.  If five of this group are low,
I suspect poor nutrient absorption.  If six or more are low, then it's
highly probable.

By far the most frequent cause of poor absorption is a lack of
sufficient stomach acid production.  A total lack of stomach acid
(achlorhydria) is very rare, but an insufficient quantity -- a relative
lack -- of stomach acid (hypochlorhydria) is quite common. Apparently,
having enough stomach acid is important to the absorption of all
minerals except sodium, potassium, and lithium.  For example, I've seen
any number of older persons show no improvement or only marginal
improvement of hair tests for calcium, iron, or magnesium despite taking
relatively large quantities, until it was discovered they suffered from
hypochlorhydria.  Upon correction of this problem, the minerals were
much better absorbed.  The same applies to other minerals.

The most useful tool for accurate diagnosis of hypochlorhydria at
present appears to be radiotelemetry.  This test uses a small
plastic-enclosed, battery-operated, pH-sensitive radio transmitter,
which is swallowed. Once in the stomach, it radios out to a recorder the
pH (degree of acidity or alkalinity) of the surrounding fluids.  Using a
variety of challenge and stimulation tests, it is possible to diagnose
hypochlorhydria with a much higher degree of accuracy.

Another frequent cause of poor nutrient absorption is a lack of
pancreatic digestive enzymes.  If you have less than optimal digestion,
it's easy to guess if this is the cause. There are many digestive enzyme
preparations sold without prescription.   As there are no known hazards
in taking them, except allergy, they can safely be tried.  If the
symptoms are corrected, this is quite likely the problem.  However,
deficiency of pancreatic enzymes often is related to lack of stomach
acid. So taking enzymes and correctly interpreting what happens is not
always as simple as it first appears.

Pancreatic enzymes are concerned with the digestion of carbohydrates,
fats, and proteins, as well as fat-soluble vitamins A, D, E, and K.
With this wide range of digestive functions, it's once again impossible
to say exactly what will go wrong if the enzyme deficiency persists.

It is not known how safely and reliably to induce a stomach to produce
more acid on its own.  The solution to this problem at present is taking
hydrochloric acid supplements.  If you have a symptom such as excess gas
or indigestion that is correctable with acid supplementation, it is
usually safe to take enough to correct the symptom, and no more.

I usually recommend taking betaine hydrochloride or glutamic acid
hydrochloride tablets, available from most health food stores.  On three
consecutive mornings take 1, then 2, then 3 on an empty stomach.  If you
have no bad reactions, then take 1 or 2 before each meal for a week, and
see how your digestion feels.  If it's better, we can safely assume that
your stomach hasn't been producing enough acid for proper digestion.

A bad reaction is anything that feels bad.  Heartburn, worse gas, pain
in the stomach - anything.  If it hurts, don't take any more. Neutralize
the reaction with milk or baking soda in water.  Remember too, that
aspirin or aspirin-containing compounds, or  anti-inflammatory' drugs
such as Indocin, Butazolidin, or cortisone should never be taken when
hydrochloric acid is being taken (or vice versa).  The risk of ulcer
becomes much greater.<