The acid that is secreted by the parietal cells in the human stomach play a couple of very important roles.  First off, it helps to break down proteins so that nutrients are more available in the intestines and easily absorbed.  Stomach acid is important for calcium absorption, among other nutrients.

Stomach acid is also an important part of the immune system of the digestive tract.  Acid kills many of the organisms that we are commonly exposed to and helps to prevent infection.

Over the counter and prescription medications used to treat heartburn or GERD focus on reducing stomach acid production.  As I mentioned in the previous post, stomach acid is not the cause of heartburn - it is caused by a loose lower esophageal sphincter.

Consistent with the physiological importance of stomach acid, recent medical research indicates that medications that lower stomach acidity are associated with an increased risk of infection (gastrointestinal and pneumonia!) and osteoporosis.  Another of the known adverse effects of these medications is hair loss - treated naturopathically with specific nutrients.

The natural treatment of GERD involves identification and avoidance of aggravating foods and herbal and nutritional recommendations that soothe and protect the esophagus while improving gastrointestinal function.  Discontinuance of acid lowering medication and WITHOUT GERD symptoms is a real possibility for many patients.

Be Well,

Richard

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Tonight I saw the movie Julie & Julia. Eric, Julie’s husband, explains that he has a hyperacidic stomach while taking some Tums. Zollinger-Ellison Syndrome is a rare but serious medical condition that is caused by a hormone secreting tumor that triggers secretion of damaging amounts of stomach acid . Eric instead probably had recurrent heartburn, or GERD.

GERD is NOT caused by too much stomach acid; it’s caused by a loose valve that seperates the bottom of the esophagus from the stomach. This valve is called the lower esophageal sphincter (LES). Certain foods commonly cause the LES to relax and are triggers for GERD symptoms: fatty foods, alcohol, caffeine, onions, garlic, mint, and tomatoes to name a few.

So, heartburn is not caused by too much stomach acid. It is caused when the contents of an appropriately acidic stomach move into the esophagus.

In an upcoming post, I’ll discuss surprising adverse effect from acid reducing medications.

Be well,
Richard

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The American Gastroenterological Association (AGA) produced clinical guidelines for the management of Gastro-Esophageal Reflux Disease (GERD) in October of 2008 that advise against using endoscopy for the screening of patients with GERD.

The Bottom Line:

If you have GERD and your symptoms are addressed with treatment recommendations, an endoscopy is not helpful in improving health outcomes.  If symptoms persist in spite of treatment, an endoscopy or further testing may be a good idea.  In this case, you should speak to your doctor.  Fortunately, most people’s symptoms are relieved with medical or natural therapies.

If you have been experiencing persistent fatigue or sadness, it may be more complicated than simply shifting your attitude or pulling yourself up by your bootstraps.  Fatigue and depression (and many other problems) may be signs of a physical medical condition: hypothyroidism - a decrease in the function of the thyroid gland that results in lower levels of thyroid hormone throughout the body.  It may even be possible to have low thyroid function while blood test interpretations say that all is normal.

Thyroid hormone is produced by the thyroid gland; a subtle butterfly shaped gland found in the neck below the Adam’s apple and on either side of the trachea.  Thyroid hormone is important to many parts of the body.  It sends a message to cells in the body to increase activity, function, and energy consumption.  The more thyroid hormone that is present, the faster body systems and organs will run.  It is possible to have too much (hyperthyroidism) or too little thyroid hormone (hypothyroidism).

Effects of Low Thyroid Function:

The symptoms of low thyroid function are diverse and vary considerably from person to person.  The manifestations of hypothyroidism can be vague or subtle, slowly getting worse over months or years.  Patients with hypothyroidism often experience some of the following symptoms: fatigue, depression, poor memory, unclear thinking, low body temperature, cold hands and feet, sensitivity to cold, dry skin, constipation, frequent infections, weight gain, premenstrual syndrome, or hoarseness.

Having hypothyroidism is also associated with several medical conditions; low thyroid function can cause or contribute to infertility, menstrual irregularities, elevated cholesterol levels, atherosclerosis, heart disease, anemia, and carpel tunnel syndrome.

Diagnosis and Treatment:

Thyroid function is first assessed by checking a hormone that tells the thyroid gland to make more hormone, thyroid stimulating hormone or TSH.  Elevated TSH levels are a sign of low thyroid function while low TSH levels are indicative of hyperthyroidism.

The predominant medical view is that in the absence of elevated TSH, hypothyroidism cannot be diagnosed.  However, the possibility of hypothyroidism that is not detected by current lab tests and current standards does exist.  The standards for normal thyroid function have changed over the years and some endocrinologists believe that current standards miss many patients suffering from low thyroid function.  

The easiest treatment for hypothyroidism is supplementation with synthetic or animal derived thyroid hormone.  Improvement in symptoms usually takes as little as a few days or as long as six months.  However, excessive thyroid hormone replacement can cause high levels of thyroid in the body - hyperthyroidism - and result in anxiety, insomnia, palpitations, chest tightness, diarrhea, and osteoporosis.  So, thyroid hormone should be used carefully and with medical supervision - appropriate diagnosis and monitoring are important.

Addressing the Cause:

Iodine used to be a common cause of hypothyroidism.  Today, in our society iodine deficiency is rare.  Conversely, very high doses of iodine can cause hypothyroidism in as short as a few weeks and long term high daily intake seems to increase the risk of hypothyroidism over the years.

In today’s medical practice, hypothyroidism is most commonly caused by one of two issues: 1) an auto-immune attack on the thyroid gland; or 2) the thyroid gland puttering out - not functioning as well as is should or used to.  In either case, supplementation with thyroid hormone is helpful.

While the medical literature states that the causes of both types of hypothyroidism are unknown, there are numerous drugs and chemicals that are definitively known to cause auto-immunity or to hamper thyroid function.  Some of these substances include: food coloring; mercury; numerous solvents; and even some prescription drugs.  Some chemicals contribute to low thyroid hormone levels by increasing the liver’s breakdown of thyroid hormone.

Avoidance of these harmful substances and enhancing the body’s ability to get rid of them can be helpful.  Selenium (200 mcg daily); zinc (15 mg daily); iron (18 mg daily in absence of high iron levels); and the amino acid cysteine help the body make thyroid hormone and convert it to its most active form.  Cysteine is also important anti-oxidant that helps the body handle toxic chemicals and heavy metals.

Other supportive natural therapies include the far eastern Indian herbs ashwaganda and bacopa which support thyroid function and the action of thyroid hormone throughout the body.  Some patients benefit from supplementation with food grade thyroid gland products that supplement thyroid hormone levels.

While hypothyroidism can sneak up on people, accurate diagnosis and treatment often helps to relieve the symptoms and provides dramatic improvement quality of life.

Many folks use stimulating laxatives like senna, cascara, rhubarb, aloe leaf and other herbs that contain anthraquinone glycosides to deal with chronic constipation. Anthraquinone glycosides irritate the lining of the gastrointestinal tract to encourage intestinal activity and contractions called peristalsis. Long-term use of these substances causes discoloration of the intestinal mucous membranes and, more importantly, dependence on them for bowel movements.

Aloe

Cascara

Rhubarb

Many herbal supplements and natural healthcare practitioners recommend them. This is a poor or lazy way of addressing constipation.

So what should someone with chronic constipation do? There are many approaches for identifying the cause and treating chronic constipation that are far more gentle and safe for long-term use but just as effective as stimulating laxatives. These include identifying hidden or subtle medical conditions that are causing or contributing to constipation; identifying foods and lifestyle habits that cause or contribute; and careful treatment with nutrients to address symptoms.

To get most of the details, please listen to my recent podcast on constipation.

Be Well,

Richard

While several research studies (1, 2, 3) show that very high-dose supplementation with vitamin K2 can be very helpful for IMPROVING bone mineral density in women with osteoporosis, another recent study exploring the same treatment has found dramatic reduction in liver cancer in patients that are at high risk for liver cancer.  Other studies show improved outcomes in liver cancer patients taking vitamin 

Vitamin K2, unlike other forms of vitamin K, is non-toxic.

The possibility exists that vitamin K recommended daily allowances are adequate for preventing coagulation problems (one of vitamin K’s jobs is to support blood clotting) but not high enough for healthy bones.  I think it is interesting that the daily recommended allowance of vitamin K is only less than 120 micrograms per day while one cup of chopped kale has over 500 micrograms.

Kale, broccoli, swiss chard, and parsley are the best dietary sources of vitamin K and are also rich in calcium!

For more information on Vitamin K and Osteoporosis, please take a look at my articles and podcasts on the subjects.

Be well,

Richard