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Low stomach acid theory debunked???
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Anderson Offline
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Low stomach acid theory debunked???
Here's a doctor's arguments who doesn't agree with the low stomach acid theory:

http://castironknowledge.blogspot.se/201...unked.html
09-22-2013 01:11 PM
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James Offline
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RE: Low stomach acid theory debunked???
(09-22-2013 01:11 PM)Anderson Wrote:  Here's a doctor's arguments who doesn't agree with the low stomach acid theory:

http://castironknowledge.blogspot.se/201...unked.html

I agree with some of what Giarnella is claiming, but there is also a lot he does not really understand. And he has no clue how to properly spell Tagamet or Zantac. They are not spelled "Tegament" and "Zanctac" as Giarnella spells them.

Here are some facts that Giarnellla does not seem to realize about the digestive system:


Giarnella MD: This statement is blatantly false. The vast majority of protein digestion takes place in the small intestine by way of enzymes secreted by the pancreas and these enzymes require an alkaline solution to function.

Giarnella apparently never heard of the protein digestive enzyme pepsin. Pepsin is released in to the stomach where most protein digestion really occurs.

And pepsin requires sufficient stomach acid to function and is inhibited by an alkaline environment.

Pepsin breaks down proteins in to peptides, which are then reacted on by peptidases in the small intestine to form amino acids.

Trypsin is the pancreatic enzyme that helps break down peptides, not proteins, in the intestine. Trypsin breaks down peptides in to smaller peptides that are then converted in to amino acids.

Therefore, as we can see protein digestion occurs in the stomach, not the intestines as Giarnella claims. Provided there is proper stomach acid and pepsin present in the stomach most ingested proteins will no longer be proteins, but rather will be peptides by the time the gastric content empties.

An exception would be elastin, which is broken down in the intestines by elastase. But elastin is not a major protein source in the diet, and thus most protein digestion still occurs in the stomach.


Giarnella MD: Another false statement. Carbohydrates are primarily digested by enzymes contained in the brush border of the intestines. These enzymes not only do not need HCL but they work best in an alkaline solution.

This is generally true. Giarnella is overlooking salivary amylase, which is the first enzyme starches are exposed to and thus starts their digestion. More complex carbohydrates such as cellulose and hemicellulose are acted on by the enzymes cellulase and hemicellulase secreted by acid forming beneficial intestinal bacteria. The digestion of some sugars is completed in the intestines though.

Giarnella MD: Just a small amount of undiluted HCL in the esophagus can cause significant ulceration.

If that is the case then why does it take so long for people with chronic heartburn to develop significant esophageal erosions?

Although, his argument does provide evidence to that natural decline in stomach acid as people age. Chronic heartburn is generally associated with aging. If even tiny amounts of HCl caused significant erosion as Giarnella claims then acid reflux with normal or even high amounts of stomach acid would cause such severe esophageal burns that the person's esophagus would swell shut or ulcerate right through. Therefore, a person with chronic acid reflux would have to have extremely small amounts of HCl present. A fact that is well known these days.


Giarnella MD: I would like to know who these gastroenterologists are. I have attended national Gastrointestinal conventions, I read GI journals every day and I have never heard anyone state that HCL deficiency is a major problem.

Maybe Giarnella should read some medical studies on the topic. I learned a long time ago from medical journals that hyperchlorhydria (excess stomach acid) is so rare that is almost unheard of and that stomach acid levels do indeed decline with age, which is a major reason for nutritional deficiencies in the elderly. It is also the reason that supplements containing calcium carbonate are better absorbed by younger individuals. The more stomach acid they have the more the carbonate gets converted in to the more absorbable calcium chloride.

Giarnella MD: If HCL deficiency were a problem there would be no need for any of these medications

So why do these moronic doctors prescribe these drugs for H. pylori infections considering the fact that H. pylori secretes highly alkaline ammonia to neutralize stomach acid? And also directly inhibits stomach acid secretion:

http://medcapsules.com/forum/showthread.php?tid=5243

Using his same false premise there would be no basis for the use of these drugs in the case of H. pylori infection without the presence of an ulcer.

And again using his earlier statement, if there was so much stomach acid present during acid reflux and HCl was as corrosive as he claims then why aren't people with acid reflux developing deadly esophageal swelling or esophageal erosions even with a single episode of acid reflux? He is contradicting his own claim.


Giarnella MD: (in reference to betaine HCl) Approx. Price: $185 per 180Grams (source Medscape Drug search)

You can buy this stuff at a tiny fraction of this cost in health food stores.

Giarnella MD: How would taking HCL pills restore the stomach ability to produce acid in 8 weeks or even 18 months?

This one really surprised me since Giarnella did make reference to methylation earlier. Therefore, I would have expected him to already know this simple answer.

The answer is the production of stomach acid is dependent on methylation. The body's natural methylator, SAMe, requires B6, B12 and folate that all require sufficient stomach acid for absorption. Therefore, increasing stomach acid promotes the methylation process and more stomach acid formation while a lack of stomach acid inhibits both.


Giarnella MD: Furthermore there is no evidence that stress causes achlorhydria.

No evidence? How about

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312726/

Giarnella MD: Gastric acid and Pepsin are not critical to the digestion or absorption of foods.

They're not? As shown previously pepsin, not pancreatic enzymes is required to digest proteins. And pepsin requires sufficient stomach acid to do this job.

Giarnella MD: This poor old man probably suffers from severe osteoporosis or severe degenerative joint disease neither of which is associated with the presence or absence of acid in the stomach.

Actually yes they do. In order to obtain the amino acids needed for collagen production that is low in both osteoporosis and DJD again we need pepsin and sufficient stomach acid to activate it. This way the proteins can be broken down in to peptides to the pancreatic enzymes can break the peptides down further finally leading to the formation of the amino acids required.

Giarnella MD: The stomach produces a substance called Intrinsic factor. Intrinsic factor is not related to acid production. Intrinsic factor is needed for the proper absorption of B12

But B12 cannot be released from food without sufficient stomach acid.

Giarnella MD: However there is a condition often seen in the elderly called atrophic gastritis which causes a decrease in all the substances produced by the stomach including Intrinsic factor.

So now he is contradicting himself again and now claiming that a lack of stomach acid output is common in the elderly. So again, why is there a need for drugs like Nexium and Zantac in the elderly? Yet this is the primary group these drugs are prescribed to.

http://www.MountainMistBotanicals.com
10-02-2013 03:14 AM
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Anderson Offline
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RE: Low stomach acid theory debunked???
I'm still not sure if I agree with you on the protein digestion part.

I have a Swedish book about physiology and a book by Michael D. Gershon called The Second Brain which is about the digestive system and both state the same thing: only 10 to 15% of the protein is broken down into peptides in the stomach, most of the protein digestion happens in the small intestine and is done by enzymes from the pancreas. Gershon even states that even if you remove the stomach complete protein digestion will still occur.
(This post was last modified: 10-02-2013 11:54 AM by Anderson.)
10-02-2013 11:52 AM
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James Offline
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RE: Low stomach acid theory debunked???
(10-02-2013 11:52 AM)Anderson Wrote:  I'm still not sure if I agree with you on the protein digestion part.

I have a Swedish book about physiology and a book by Michael D. Gershon called The Second Brain which is about the digestive system and both state the same thing: only 10 to 15% of the protein is broken down into peptides in the stomach, most of the protein digestion happens in the small intestine and is done by enzymes from the pancreas. Gershon even states that even if you remove the stomach complete protein digestion will still occur.

The point I was making is that what are being broken down in the intestines by the enzymes are the peptides, which are not the original proteins. Just like there is an enzyme called urease that breaks down uric acid, which can also be formed by protein breakdown. Just because the urease enzyme is breaking down a byproduct of protein digestion does not mean the enzyme is digesting protein. Once the proteins are digested in the stomach forming peptides they are no longer proteins.

Therefore, the claim of proteins being digested primarily in the intestines is misleading and incorrect. If the digestive system is working properly intact proteins are not leaving the stomach as again as I mentioned the proteins are being digested in the stomach forming peptides. These peptides, not proteins, then enter the intestine where they are acted on by the pancreatic enzymes to form smaller peptides then finally amino acids.

http://www.MountainMistBotanicals.com
10-03-2013 05:20 PM
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