I Have PCOS – Should I Try The Keto Diet?
Is the Keto diet right for PCOS?
This is one of the most common questions I get as a Functional Medicine practitioner and person with PCOS myself…
And with good reason! The Keto Diet is often touted as a solution for two of the biggest issues people with PCOS face: blood sugar issues and weight gain.
But as with most things related to PCOS, using the Keto diet for PCOS is not a one-size-fits-all solution.
Today, let’s take a deeper look at this question - and hopefully, provide you with a customized answer.
What Is PCOS?
If you’re reading this, you probably either have been diagnosed with or suspect PCOS: polycystic ovarian syndrome.
But even though it's very common (affecting 1 out of very 10 women), this condition is hugely misunderstood, so I think it’s always good to start with a quick refresher on what exactly it is.
First of all, despite what the name implies, people with PCOS don’t necessarily have cysts on their ovaries. (And equally important - just having cysts on the ovaries doesn’t mean you have PCOS!) Instead, PCOS is about hormone imbalance - specifically, an excess level of androgens.
Androgens are hormones typically thought of as “male”: primarily testosterone and androstenedione, but also DHT, DHEA and DHEA-S. (But just to confuse things even further, some people with PCOS will never show high testosterone or DHEA levels.)
Along with androgen excess, people with PCOS generally have “ovulatory dysfunction” - meaning they don’t ovulate monthly. They may have irregular periods (long, short, heavy, or absent) - but they can also have normal-appearing periods (they might not even know they aren’t ovulating, or they may ovulate sometimes, and not others).
Lots of other symptoms go along with androgen excess and ovulatory dysfunction - but none of these HAVE to be present. Some people with PCOS have them all, and some have none:
- Insulin resistance (even if the person is not overweight)
- Cysts on the ovaries
- Excess hair growth on the body
- Weight gain and weight loss resistance
- Acne
- Thinning hair on the head
- Oily skin or hair
- Infertility
What Is The Keto Diet?
Now that we’ve brushed up on PCOS, let’s do the same for Keto.
Keto is shorthand for the ketogenic diet - this is a pattern of eating where carbs are kept low enough, and fat intake is increased, so that the body shifts from burning glucose (sugar, carbs) for fuel to manufacturing ketones, an alternative source of fuel for your body. The state in which you are using ketones for fuel is called “ketosis.”
It takes a few days of very low carb eating to switch into ketosis - and once you’re there, eating carbs again will bump you back out. That means keto is not a diet you can do halfway or dabble in easily - it's all or nothing.
It varies person to person, but usually carbs need to be kept below 20-50 grams per day to achieve ketosis. That is very low: one banana alone has 27 grams of carbs. This means all starchy foods are out: potatoes, most fruit, oatmeal, rice, bread, etc. Non-starchy foods that are high in sugar - like ice cream - are also out.
But it's not just about cutting carbs - you also have to significantly increase fat intake, with 70% or more of total calories coming from fat - and that’s where this can get a little tricky for some people (more on that to come).
But one REALLY important thing to note before we go any further: keto is not the same as just cutting carbs, and for people with PCOS, it should not involve under-eating. Under-eating calorically can further suppress ovulation, making PCOS symptoms worse.
How Does Keto Help PCOS?
Keto may help PCOS by addressing one of the biggest symptoms: insulin resistance. And for people with PCOS who have weight loss as a concern, the keto diet may help them shed unwanted weight.
Research has shown that in small groups of people with PCOS, a keto diet can:
- Lead to weight loss
- Normalize insulin levels and reverse insulin resistance
- And, most importantly: The LH/FSH ratio, LH total and free testosterone, and DHEAS blood levels were also significantly reduced
That suggests that the Keto diet isn’t just treating the symptoms - it may actually help to balance hormone levels.
It’s not completely understood yet how this happens, but the endocrine system is very complex, and interactions between hormones matter - and don’t forget that insulin is a hormone, too!
I know it sounds great, but before you dive into keto there is a big catch that we need to talk about.
The Keto Diet for PCOS is NOT One-Size-Fits-All
If you are considering trying a keto diet for PCOS - great! I support you 100%. For my own PCOS, reducing carbohydrate intake was one of the best things I did.
But before you go any further…. I want to give you a quick warning:
Depending on your genetics, you might need to do keto a specific way.
Most people with PCOS need to follow a “Mediterranean keto” diet - in fact, it was this specific diet that led to the amazing results in that 2020 research article I mentioned above.
Mediterranean keto focuses on poly and monounsaturated fats from foods like olive oil, avocados, fatty fish, and nuts and seeds.
Traditional keto focuses more on quantity than quality - it's all about lowering carbs and increasing fat in any way possible.
That often means LOTS of cheese and red meat - both of which are very high in saturated fat.
For some people, there is nothing wrong with saturated fat - they are genetically programmed to tolerate high levels of saturated fat well. But for many people - especially those with PCOS - saturated fat is problematic.
3 Things People with PCOS Need to Know Before Starting Keto
There are two gene variants to look for and one general rule to know about before starting keto.
First, for people with either the FTO or APOA2 SNP variant, saturated fat can be problematic. People with the FTO variant usually don’t tolerate simple sugars or saturated fats well. This variant also makes you more likely to burn fat slowly and struggle with feeling full.
The APOA2 gene variant also affects metabolic hormones. Research suggests that people with this variant do best if they eat under 22 grams of saturated fat a day. That’s very hard to do if you’re eating red meat, dairy, and bacon!
Finally, dairy in particular can be a problem for people with PCOS - whether or not they have the FTO or APOA2 variants. Milk (from cows, goats, sheep, and camels) contains the hormone insulin-like growth factor-1 (IGF-1), which mimics insulin in our body. IGF-1 is a growth hormone (which makes sense, as milk is for baby animals!). In most people, a little dairy here and there can be well-tolerated because humans have a binding protein for IGF-1 that inactivates it.
But for people with PCOS or hormonal imbalance, who already are likely to be insulin-resistant or have high insulin, the added burden of IGF-1 can be a problem. This is amplified because women with PCOS have LESS of the binding protein for IGF-1 and higher IGF-a levels than other people do, too. And the ovaries of women with PCOS are more sensitive to IGF-1 (and other growth hormones), too.
IGF-1 can also cause your ovaries to overproduce testosterone (an androgen) - which is something we’re trying to minimize.
That’s why I recommend most people with PCOS try cutting dairy - and if you’re considering Keto, get some basic genetic testing done to reveal how you tolerate saturated fat (I can help with that).
Your Genes Can Reveal So Much
Whatever your health struggles are - I think investing in genetic testing is one of the smartest choices you can make.
Your genes are like your body’s instruction manual. Your genetic variants can give you information about your diet, lifestyle, exercise needs - and even what nutrients you’re likely to struggle getting enough of.
That’s why I’m making genetic counseling a bigger part of my practice: it helps patients create a truly customized health plan, without wasting time on plans that would never work for you genetically.
Want to learn more? Book a free consult with my team today and we can talk through what we offer. We’d love to support you on the journey to better health.
Meet Your Gallbladder: The Essential Detox, Hormone, and Digestive Organ Most People Know Nothing About
More than 600,000 people have their gallbladder removed each year in the U.S.
That’s like if every single person in Las Vegas had their gallbladder removed!
Usually, the gallbladder is removed because of painful gallstones. It’s treated as a totally normal, safe procedure with no side effects.
But that’s just not true...
Your gallbladder is actually a crucial part of your digestive, detox, and hormonal systems.
And even if you haven’t had your gallbladder removed, gallbladder dysfunction is becoming more and more common, and can cause symptoms like:
- Digestive issues (pain, bloating, diarrhea)
- Fatigue
- Skin congestion (acne, rashes, eczema, etc.)
- Weight loss resistance
- Hormone imbalance (PCOS, estrogen dominance, etc)
- Fatty liver disease
- And more
Today, I want to explore the role of the gallbladder, common signs and symptoms of gallbladder dysfunction, and steps you can take to heal and optimize your gallbladder function. Learn about hormone imbalance after gallbladder removal.
What and Where Is The Gallbladder?
Your gallbladder is a small organ that sits underneath your liver. Your liver makes bile (the digestive liquid needed to break down and absorb fat) and the gallbladder stores it, concentrates it, and then releases it to the stomach on demand.
The gallbladder plays key roles not just in digestion, but also in detox and hormone balance, as bile is needed both for clearing toxins from the body and for the healthy production of hormones, as well as hormone removal and balance. For that reason, the gallbladder isn’t just a digestive organ - it’s also a hormone and detox organ.
In Chinese medicine, the gallbladder is also attributed with governing decision making and qualities like inspiration, action, and assertiveness (think of the saying “they have gall!”). A strong gallbladder is associated with a quick return to normal after a physical or emotional shock. On the other hand, a weak gallbladder is associated with timidity or hesitation, and problems making decisions or following through. Finally, the gallbladder is also seen as a pivot, a turning point for new decisions and stages of life.
What Bile Does
Although it’s not sexy, the bile created by the liver and then stored, concentrated, and secreted by the gallbladder is one of the most important secretions in your body. Bile consists of ~95% water, in which are dissolved bile salts, bilirubin phospholipid, and cholesterol, primarily.
Here are just some of the many roles of bile:
- Bile emulsifies fat, increasing fat absorption. Bile is an essential “degreaser” and “emulsifier” of dietary fats. Bile is also essential for the utilization of the fat-soluble vitamins A, D, E and K. Bile deficiency leads to vitamin deficiencies.
- Bile prepares nutrients for assimilation in the small intestine. Bile takes food that has been acidified in the stomach and alkalizes it, allowing it to be broken down and absorbed.
- Bile assists in detoxification. Bile contains the conjugated toxins - carcinogens, xenobiotic chemicals, pharmaceuticals, heavy metals like mercury, aluminium and lead, and deconjugated hormones - from the 2 phases of liver detoxification.
- Bile helps modulate the microbiome. It acts as an antimicrobial, keeping the balance of bacteria in check.
- Bile transports excess cholesterol out. In doing so, it prevents cholesterol levels from rising too high.
- Bile lubricates the intestines and plays a regulatory role in motility, allowing food to go through the digestive tract a lot easier and preventing constipation.
- Bile prevents the formation of gallstones by breaking down fats before crystallization, and also digests and dissolves gallstones, which are composed mostly of cholesterol and particles.
- Bile triggers the release of glutathione, which is considered the “master” antioxidant, and helps eliminate bilirubin.
- Bile breaks down fats, and as such, is essential for weight loss!
- Bile controls the rhythm of the gut - the circadian timing of your gut motility is controlled by the gallbladder. Changes in motility (the time it takes for food to move through the digestive system) can lead to issues like Small Intestine Bacterial Overgrowth (SIBO).
The Gallbladder, Bile, and PCOS
The gallbladder’s role in hormone balance deserves special attention, especially in relation to PCOS (Polycystic Ovarian Syndrome).
Dietary fat and bile (to absorb it) are both necessary for the production of hormones. Even more importantly - bile helps your body excrete excess and used hormones, like estrogen. In addition, estrogen dominance (either as a result of hormone imbalance or due to supplemental estrogen, like birth control pills) are known risk factors for sluggish bile (the precursor to gallstones) and gallstones themselves. This is believed to be because estrogen causes an increase in cholesterol levels in the bile, which can then thicken and form stones.
Interestingly, research has shown that in PCOS, bile acid levels are actually significantly elevated, and that high levels of bile acids correlated with higher levels of testosterone levels, meaning worse PCOS.
The exact mechanism is not yet known, but it is thought to be related to sluggish bile, which is more commonly seen in those with hormone imbalance and PCOS. The sluggish bile raises levels of bile acids in the blood. There, the bile acids act on the Farnesoid X receptor, which has hormonal actions throughout the body, and can lead to elevated testosterone.
In addition to increasing testosterone, high levels of bile acids can also contribute to insulin resistance, another major issue in PCOS.
Bile and Leaky Gut
Bile flow issues or lack of bile can also cause or worsen leaky gut (increased intestinal permeability).
While leaky gut is often attributed to toxins produced in the gut or pathogenic bacteria living there, insufficient bile is another major cause.
One role of bile is to bind with toxins and help them be safely excreted from the body. But if there is inadequate bile to bind with the toxins, they can damage the intestinal barrier, allowing toxins and undigested food into the bloodstream… creating “leaky gut.”
Leaky gut causes widespread, multi-system issues and may even be a major part of triggering autoimmune disease. It is common in IBS (Irritable Bowel Syndrome), ulcerative colitis, Crohn’s disease, Celiac disease, and more.
Signs of Gallbladder Dysfunction
The most common type of gallbladder dysfunction is the result of slow or sluggish bile. This can be a result of not enough water (remember, bile is 95% water!), but can also occur when bile is oversaturated with toxins. The sluggish bile is more like peanut butter than water, and is too thick to flow freely.
In addition, the removal of the gallbladder, as well as other conditions, can lead to reduced levels of bile salts in the bile and weakened bile.
Symptoms of sluggish or weak bile include:
- Abdominal tightness
- Bloating
- Difficulty digesting fats
- Diarrhea
- Constipation (fat can build up in the intestinal wall and cause slow movement in the digestive tract)
- Trapped gas
- Bad-smelling gas
- Stomach cramps
- Gallstones
- Fatigue and malaise
- Fatty stool that floats or is light in color or grayish white
- Increase in allergies, chemical sensitivities, or food intolerances
- worsening PMS/Estrogen dominance…
- Hormone imbalances like PCOS
- Heartburn
- Erratic bowel movements
- Weight loss
- Signs of Vitamin A deficiency: Dry eyes, night blindness, red or white acne-like bumps (on your cheeks, arms, thighs, and buttocks), and dry skin
Why Are So Many Gallbladders Removed?
Typically, the gallbladder is removed due to gallstones. Gallstones are crystallized masses of bile and cholesterol. Around 20% of females over the age of 40 have gallstones.
When gallstones become stuck in the duct of the gallbladder, they can cause pain and inflammation called cholecystitis. The most common treatment for gallstones is simply having the gallbladder removed. The surgeon then ‘“reroutes” the bile to go straight from the liver to the stomach.
Risk factors for gallstones include:
- Alcohol
- Excess reproductive hormones from supplementation or steroids (most commonly estrogen dominance)
- Oral contraceptive pills (birth control pills)
- High Endotoxin load causing sludgy bile
- Hereditary disorders like Gilbert's syndrome
- Thyroid issues or thyroid supplementation with T4
- Hepatitis
- Pregnancy
However, without the gallbladder, bile isn’t concentrated and lacks adequate bile salts - leading to the problems discussed above. That’s why gallbladder removal isn’t something you should just jump into.
Testing For Gallbladder Issues
If you suspect gallbladder issues, various tests can help pinpoint the problem:
- Blood test for cholesterol levels - if a person’s cholesterol production is low, bile production is also likely to be low. I look for cholesterol levels lower than 170.
- Digestive stool analysis - can help identify undigested fat in stool, which is caused by low bile availability.
- Bloodwork - to look for changes in serum bilirubin, alkaline phosphatase, serum glutamic oxaloacetic transaminase (SGOT), lactate dehydrogenase (LDH), aspartate aminotransferase (AST) and alanine transaminase (ALT). In early stages of gallbladder dysfunction, these levels might not change. However, functional medicine practitioners like me also use a more narrow interpretation of what normal is.
- A HIDA scan - this imaging test uses a radioactive material to measure the emptying function of the gallbladder, and can help diagnose:
- Gallbladder inflammation (cholecystitis)
- Gallstones, which can’t be seen, but can contribute to reduced flow or blockage to less bile flow if blocking
- Bile duct obstruction
- Congenital abnormalities in the bile ducts, such as biliary atresia
With my own patients, I use the ION panel by Genova (Organic Acids section) to evaluate the various pathways of liver detox and glutathione/antioxidant capacity. These results often illuminate when the liver or gallbladder are overburdened long before we see markers of pathology like elevated liver enzymes in labs. They also give more detail about exactly how the liver or gallbladder are compromised and can best be supported, in each individual.
Support for a Healthy Gallbladder
If you’re having signs of any gallbladder issues, step one is to get tested and find out exactly what’s going on.
In addition, here are some of the steps I turn to again and again with my patients:
- Switching out hormonal birth control (pill, patch, ring, etc.) for non-hormonal to reduce estrogen levels
- Supplements that support healthy gallbladder function
- Digestive enzymes and bitters
- Dietary changes: avoid excessive fried, fatty and greasy food and increase leafy greens
- Cut out alcohol
- Exercise regularly
In addition, addressing the emotional side of gallbladder health can be important. Try to express your emotion freely (journaling is an easy way to get started), address your past traumas (get help from a professional), and forgive.
And if you’ve already had your gallbladder removed? I can help you with strategies to support your digestion and hormones, even without your GB!
Want to learn more? Book a free 15 minute consult with my team now. It’s a zero-obligation opportunity to get a functional medicine opinion on your gallbladder health (and even if removal is something you should consider!).
P.S. Gallbladder issues are more common in women and those on hormones (like HRT or birth control). But if you catch gallbladder issues early on, you can avoid ever developing painful stones. Book a free 15 minute consult now.
The Surprising Truth About Low Stomach Acid (And How To Solve It Naturally)
Do you burp after meals? How about get so bloated, you want to unbutton your pants? Does food feel like it just sits in your stomach?
These are all tell-tale signs you might be suffering from a really common but not-well-known condition: low stomach acid, also called hypochlorhydria.
Stomach acid has a bad rap - most people are familiar with antacid medication for heartburn or indigestion, and (understandably) assume that stomach acid is bad for you and must be decreased.
But surprise - the complete opposite is actually true. In fact, adequate stomach acid is a crucial part of the healthy digestive process. And, in my clinical experience, far more people have low stomach acid than high!
Today, let’s talk about why stomach acid is so key, what it feels like when yours is low, and how we can treat this common issue easily and naturally.
The Truth About Stomach Acid
Stomach acid - scientific name hydrochloric acid (HCL) - is one of the key steps in the digestive process.
During the gastric phase of digestion, food you chew and swallow travels down the esophagus and into the stomach. There, distention (literally the stretching of the stomach by the addition of food), triggers the production of acetylcholine (ACh), which then triggers parietal cells in the stomach to release stomach acid.
But even before you start eating, just the sight, smell, and thought of food can also jumpstart the secretion of stomach acid via activation of the vagus nerve. This is called the cephalic phase of digestion.
The stomach is specially designed to handle the incoming acid - the stomach is lined with lipoprotein rich membranes that protect it from being burned by the acid. (Other parts of your body don’t have this same protection - which is why when stomach acid gets into the esophagus, it causes a burning sensation.)
Once secreted by the parietal cells, stomach acid performs several key functions:
- It kills any pathogens that may have come in with food (i.e. the kind of bacteria that cause food poisoning) or hitched a ride on the saliva from the mouth, where tons of bacteria live.
- It activates pepsin to start protein digestion
- It stimulates bile production and release by the liver and gallbladder, so fats can be emulsified and digested
- And finally, it triggers the release of pancreatic enzymes in the small intestine, where the partially digested food from the stomach (called chyme), is broken down and absorbed into the bloodstream
What Happens When Stomach Acid Is Low
When stomach acid is low for any reason, it can impact all aspects of digestion.
Low stomach acid can slow and stall out the digestive process - leading to discomforts like burping, bloating, stomach pain, and even (surprisingly) cause heartburn and acid reflux symptoms.
And while these are the symptoms most people notice (and complain about) first, they are actually just the tip of the iceberg.
More troublingly, low stomach acid can have a huge impact on your body’s ability to absorb nutrients from the food you eat. Stomach acid is essential for breaking down protein into digestible amino acids, and for the absorption of certain key nutrients like iron and vitamin B12. Without these key nutrients, the body is unable to repair tissues, produce hormones, and create neurotransmitters - all things necessary to feeling happy and vital!
Finally, low stomach acid also is a common factor in the development of food sensitivities, because it is stomach acid that triggers the release of digestive enzymes in the small intestine. Lack of enzymes is often to blame for food reactions - the one most people are familiar with is lactose intolerance, where a lack of lactase enzymes cause digestive issues like gas, diarrhea, and pain.
If you’re eating a high-quality, nutrient-dense diet but still struggling with symptoms of nutrient deficiency like brittle hair and nails, poor skin quality, cravings, and fatigue - or you have ever-increasing food sensitivity - low stomach acid could be the reason why.
What Causes Low Stomach Acid?
Stomach acid gradually decreases with age, and levels can start to drop as soon as age 40.
In most people, environmental factors are the main cause of low stomach acid. These include:
- Stress - the big one that no one likes to talk about! Stress impacts all phases of digestion, and especially the production of stomach acid and other digestive fluids
- Low protein diet - this is often a “chicken and the egg” situation, since eating less protein is often a result of those with low stomach recognizing protein-rich foods don’t make them feel well, and consciously or subconsciously cutting back. On the other hand, eating low protein can cause the body to naturally downregulate acid production (since less is needed to digest protein).
- Low zinc status - zinc is an essential cofactor for stomach acid production, and the modern diet is fairly low in zinc-rich foods like oysters.
- Eating on the go - like stress, eating in a hurry or while distracted can prevent the body from shifting into the “rest and digest” parasympathetic state needed to complete all the phases of digestion adequately.
- And finally - using over-the-counter or prescription acid-reducing medications.
Are You Using Antacids?
Antacids include over-the-counter and prescription PPIs (proton-pump inhibitors) like Prilosec or Nexium, H2 blockers like Pepcid or Zantac, and antacids like Rolaids or Tums. They work by either blocking the production of stomach acid, or neutralizing acid in the stomach.
These are some of the most commonly used drugs in the world. And, when used the right way, they can be extremely beneficial. But, many people take these drugs daily for years without any idea of the potential side effects.
Research has shown that PPI use can lead to the development of Small Intestine Bacterial Overgrowth (SIBO), which causes bloating, diarrhea, constipation, food intolerances, and stomach pain. In one study, more than half of people on a PPI for 12 weeks developed SIBO. In addition, research has shown PPI use is a risk factor for candida overgrowth, as well. The connection between PPIs and both candida and SIBO is likely due to the reduced ability of the body to kill pathogens that come in on the food you eat or with your saliva.
The irony with antacids is that most people take them to address the symptoms of low stomach acid - bloating, gas, indigestion - without realizing that they are actually just compounding the problem by further reducing acid levels.
How Do I Know If I Have Low Stomach Acid?
Testing for stomach acid levels is possible with a test called the Heidelberg acid test. However, this test is extremely difficult to come by, and most doctors and practitioners don’t have access to it.
Instead, I use an advanced stool panel to look for several key specific bacterial indicators of low stomach acid. Specifically, I look for these bacteria:
- Pseudomonas - this bacteria grows on poorly digested proteins that may be present due to low stomach acid. It also commonly occurs with food sensitivities, as undigested proteins are a main driver for triggering an immune response to foods. If you have high pseudomonas, and especially with food sensitivities, think about raising your stomach acid levels!
- Streptococcus and enterococcus - these gram-positive, aerobic species naturally occur in the oral microbiome, gut microbiome (found in the large intestine), and upper respiratory tract. However, they can overgrow or become infectious. Streptococcus commonly causes strep throat and upper respiratory infection, and if stomach acid is low, can infect the stomach. Enterococcus strains are common in dental infections (and found in up to 90% of infected root canals), and if stomach acid is low, can also infect the stomach.
- C. difficile - I always work on raising stomach acid levels in those with chronic or recurrent infection with this organism. C. difficile infection can be life-threatening in some cases, causing bloody or profuse diarrhea requiring hospitalization, and is commonly seen in medical settings after the use of broad-spectrum antibiotics. But it also often shows up on stool panels with minor or moderate symptoms, not requiring hospitalization. In addition to raising stomach acid levels I use herbs and probiotics to treat this.
- H. Pylori - this common infection thrives in a low-acid environment and even deconjugates stomach acid in order to make its host more hospitable. Ironically, PPIs are often used as part of the treatment for the ulcers and gastritis H. pylori can cause, continuing the cycle. Importantly, however, H. pylori is not always a problem. If levels are high or symptoms like ulcers, gastritis, rosacea, upper GI gas and bloating are also present, it may need treatment. For low or normal amounts of H. pylori, raising stomach acid levels is often all that is needed!
- Klebsiella- this bacteria is common in the oral microbiome, but high levels are associated with inflammatory bowel disease like ulcerative colitis and Crohn's disease. Because klebsiella is common in the mouth, elevated levels are often a sign stomach acid isn’t doing it’s job of killing bacteria in the stomach.
(Interested in a stool test like this? Book a free 15-minute consult here to learn more about stool testing and get started!)
How to Support Healthy Stomach Acid Levels Naturally
Creating a customized plan to support your digestion is what I do best. Every person is unique, and needs a unique protocol for best results. But, in general, these are some of the strategies I turn to again and again:
- Supplemental HCL - supplemental betaine HCL paired with pepsin (a digestive enzyme that specifically helps with protein digestion into amino acids) can be extremely helpful. One 6-week study in 97 people with indigestion found that taking betaine HCL and pepsin significantly reduced symptoms like stomach pain and burning.
One word of caution: supplemental betaine HCL may not be right for those with ulcers or gastritis. If you have these conditions, try one of the other suggestions or book a free consult for one-on-one support.
- Adequate B vitamins - B vitamins have thousands of benefits, one of which may be better stomach acid levels. One study found that increased B vitamin intake lowered risk of acid esophagitis. In addition, low stomach acid levels can hinder B vitamin absorption, increasing your need.
- Apple Cider Vinegar - this is a long-time fix for low stomach acid. Try taking a shot of ACV or dilute it with water to drink with meals. Be sure to rinse your mouth with plain water after drinking ACV.
- Ginger - helps to stimulate the digestive system. Try ginger tea or ginger chews.
- Bitters - bitter flavors stimulate the vagus nerve and tell the body food is coming, promoting the release of HCL and other digestive secretions like enzymes and bile. Try taking a bitter tincture directly on the tongue before eating.
Put Low Stomach Acid in Perspective
If you suspect low stomach acid, taking these simple steps to raise it can help you feel a lot better.
But in my clinical experience, low stomach acid is very rarely the only problem!
It either comes on as a result of other issues - like poor nutrient status and stress - that need to be dealt with, or causes other issues, like SIBO or candida overgrowth that require separate treatment.
If you’re dealing with digestive issues of any sort, I would be honored to support you in healing. Having struggled with health issues myself, I know exactly how debilitating they can be, and what vibrant health feels like (it’s AMAZING!) - and I want that for you, too.
We have a variety of plans and approaches to fit your health needs, schedule, and budget - but Step 1 is always a free, no-obligation chat with my team to learn about you and your concerns.