Hypochlorhydria: A Review, parts 1 & 2
Townsend Letter for Doctors and Patients. Oct., Nov, 2001
I am grateful you published my letter "Optimum Digestion and a Vital Diet Necessary for Treating Porphyria" (in the July, 2000 issue) because it draws attention to what is often a 'blind spot,' hypochlorhydria.
Because hypochlorhydria (low stomach acid) is so common and yet leads to terrible degenerative diseases such as cancer, congestive heart failure, osteoporosis and even Alzheimer's, patients as well as doctors need to become aware of its causes and symptoms and how to respond to them. I believe by working together in community we can apply healing helpful principles to ourselves, to others and the land. Your journal encourages us to do just that.
When my doctor told me to take antacids 21 years ago, he diagnosed hypoglycemia and hypothyroidism. Since writing the aforementioned letter, I've learned that these are caused by hypochlorhydria; let me explain why. We need a healthy level of hydrochloric acid (HCI) to stimulate digestive action in the small intestine, to break down fiber, to provide enzyme activity for nutrient absorption, and to assimilate minerals. Herein lies the electrical and manufacturing potential of our entire body. Non-absorbable, cooked or heated minerals become absorbable liquid crystalloid electrolytes, and organic minerals from raw foods are made more available and their electrical quality is maintained via healthy gastric activity. The body needs most of its minerals to be 'ionic' (electrically charged) and in solution. With low stomach acid there are fewer and fewer electrolytes in the body, and even these can lose their ionic quality and go out of solution-to form troublesome deposits. Liquid crystalloid electrolytes give us the correct alkali and acid balance (pH) needed before almost any chemical activity can occur. When the pH of the stomach is chronically 'off' (from low gastric activity -- hypochlorhydria), the pH won't be correct anywhere else in the body.
Not one enzyme, can be produced without the assistance of liquid. crystalloid electrolytes. All hormones, vitamins, proteins, amino acids, carbohydrates, fats, sugars, oils, etc. require electrolytes and enzymes to be properly metabolized. Even a slight deficiency of electrolyte minerals has a progressive effect (in hypochlorhydria) on our assimilation of all nutrients and every bodily process suffers. [1, 2]
Hypoglycemia: We cannot digest the protein needed for a stable blood sugar. Over 50% of digested protein is converted to glucose,  and there are deficiencies of magnesium, copper, chromium and zinc. These minerals are needed to maintain proper levels of blood sugar. The symptoms of hypoglycemia are tremulousness, palpitation, faintness and hunger. Because glucose is one of the main fuels for the brain, there may also be confusion, headache, dizziness and even coma. 
One of the most deleterious results of hypochlorhydria is our inability to assimilate B complex vitamins. (Vitamins serve as coenzymes. A deficiency of vitamins, especially B vitamins, means that many enzymes cannot and will not work. Enzymes are required for every bodily function necessary to keep us alive. )
Hypothyroidism: To function properly the thyroid needs sufficient B vitamins especially B2, B3 and B6, and minerals -- especially iodine, zinc, selenium, magnesium, copper and molybdenum, essential fatty acids and the amino acid Tyrosine.  Because my diet and supplements contain all that's needed to maintain a healthy blood sugar and thyroid (after a year on betaine 1101 with pepsin and enterically coated pancreatic enzymes), I no longer feel hypoglycemic and I no longer need thyroid medication.
There are other reasons for hypoglycemia and hypothyroidism, e.g. low adrenal output,  poor liver function  and aluminum toxicity,  and we will address them in the following list of symptoms, conditions and. diseases associated with hypochlorhydria.
Additional hormonal conditions are: Thyroiditis,  Parathyroidism, Hyperthyroidism, Thyrotoxicosis, Graves disease  and weakening adrenal gland function leading to adrenal exhaustion and nervous breakdown. 
There are myriad manifestations of hypochlorhydria because it affects every cell in the body. (When minerals are 'ionic' it means they have magnetic. attraction to other electrically charged substances and can form complex molecules. The body uses liquid crystalloid electrolytes to feed, oxygenate, detoxify and energize each cell. ) Here are some visible examples of hypochlorhydria's deficiencies.
Deteriorating Nails: I learned my nails definitely indicated hypochlorhydria. At first they developed longitudinal ridges, then horizontal dents, then they split chronically, deep into the nail bed and their edges peeled.  They are much- thicker and stronger now, quite smooth and have a healthy sheen.
Geographic Tongue: Lines traverse the tongue forming a road map effect. At the beginning lines are usually only small and in the center. of the tongue.  Eventually they multiply to cover the top surface of the tongue: some become deep furrows. This shows a B complex deficiency and possibly intestinal permeability (leaky gut syndrome). After the porphyria attack that caused the most intestinal damage, the lines on my tongue increased dramatically in depth and number. A healthy intestinal lining regenerates completely every three to five days  and to do so needs a large supply of B vitamins and liquid crystalloid electrolytes. 
Cracks develop at the corners of the mouth from a B2 deficiency. 
There are recurrent canker sores (aphthous stomatitis and ulcerative stomatitis) from B12, folic acid, B6, B1 and iron deficiencies.  I no longer have them since using the correct amount of betaine hydrochloride to restore my stomach's acidity. during main meals.
EYES: (The health of the eyes, ears, skin and hair depends on an adequate supply of B vitamins, which depends on sufficient zinc, selenium, sulphur, manganese and, magnesium -- in their soluble electrolyte form, to cover the individual's needs.)
Blepharitis: A bacterial eye infection caused by vitamin A, B complex, C and zinc deficiencies  Absorption of vitamin A and the B complex depends on zinc. 
Cataracts: Caused by calcium deposits and zinc, magnesium, manganese, copper, sulfur and selenium deficiencies which cause antioxidant and B vitamin deficiencies.  Those with hypochlorhydria are low in vitamin C. An adequate supply of calcium and magnesium (missing with low stomach acid), is needed, for the utilization of vitamin C.  of the first indications of low gastric activity may be the need to switch from ascorbic acid to a buffered o because of digestive problems. Eventually the buffered C causes digestive difficulties too. 
The following conditions are also the result of a lack of assimilation from low stomach acid:
Macular degeneration: From zinc, selenium, vitamin E and taurine deficiencies. 
Chronic open angle glaucoma: caused by elevated Nitric Oxide levels - one of the many consequences of hypochlorhydria's iron and oxygen deficiencies. [17b]
Night Blindness: from zinc and vitamin A deficiencies.
Recurrent ear infection: From zinc, vitamin C and A deficiencies. 
Age related hearing loss: In a recent study, 55 women with age related hearing loss were discovered to have B12 and folic acid deficiencies. 
Migraine headaches: from magnesium and B6 deficiencies. 
Anemia: Its symptoms are: shortness of breath, with loss of energy and appetite, incapacity for work and loss of concentration. This condition can be caused by hypochlorhydria's iron, calcium, copper, protein, vitamin C and electrolyte deficiencies. These nutrients are needed to make hemoglobin, (the blood compound that carries oxygen), and the red blood cells. (B12 and folic acid are also needed for the maturation of the red blood cells.)
As these deficiencies progress with low stomach acid, extreme fatigue deepens and secondary symptoms appear: apathy, brittle nails, depression, dizziness, fainting, hair loss, headaches, irritability, weakened immune response, impaired memory, poor circulation, (especially in the legs) and pale lips and skin. 
B12 deficiency: When we do not produce sufficient HCl from the parietal cells in the stomach, we cannot secrete enough intrinsic factor from the same cells to bind with B12. Intrinsic factor is essential for the absorption of B12 in the ileum of the small intestine. B12 is required for proper digestion. It aids in cell formation and longevity. It is linked to the production of acetylcholine, a neurotransmitter that assists memory and learning.
Symptoms are: abnormal gait, chronic fatigue, constipation, depression, digestive disorders, hallucinations, headaches, inflammation of the tongue, irritability, labored breathing, memory loss, moodiness, nervousness, neurological damage, palpitations, pernicious anemia,  ringing in the ears with or without hearing loss from noise, spinal cord degeneration and sleep-wake rhythm disorders. (B12 influences melatonin secretion.) It takes five to six years for the body to use up its stores of B12 and for symptoms to appear.  For these reasons it is very important for those with hypochlorhydria to ensure that adequate amounts of B12 are in the diet and are being taken in sublingual supplements or injections. However, injections of B12 are not a sufficient treatment for hypochlorhydria, achlorhydria or pernicious anemia, when so many other processes are affected by the lack of HCl.
There may be dilated blood vessels  in the cheeks and nose (in non-alcoholics) due to B6, selenium and magnesium deficiencies and consequent platelet aggregation.  Magnesium and selenium keep blood platelets from clumping together.
High blood pressure and stroke: At least 28 independent studies show that patients with high blood pressure have a magnesium deficiency, which increases the risk of stroke.  Research reveals that selenium also offers protection against heart disease and strokes. Both selenium and magnesium levels are low with hypochlorhydria, so the protection is missing. Selenium increases the ratio of HDL to LDL cholesterol. (Supplementation of selenium over time can cause psychological problems, nausea and vomiting, a garlic odor of the breath and sweat, and even loss of hair and fingernails. This is rare from dietary sources. ) With low stomach acid, a zinc deficiency causes cadmium toxicity, which also results in high blood pressure and stroke. 
As long as we are deficient in liquid crystalloid electrolytes, we are vulnerable to accumulating all kinds of toxic metal deposits in our bloodstream, cells and tissues. With hypochlorhydria we are unable to digest and absorb iron, zinc and calcium properly. This causes lead, cadmium and aluminum levels to rise in the body. [1,8,12,122] Non-absorbable iron and calcium become deposited in the arteries and joints leading to arteriosclerosis, heart disease and arthritis. Without electrolytes inorganic iron is loose like a free radical in the bloodstream.  In hypochlorhydria, aluminum, antigens and xenobiotics enter the bloodstream where they inflame and irritate the arteries, causing the buildup of plaque. Aluminum severely reduces the elasticity of blood vessels by its production of cross linkages wherever it lodges  (caused by a deficiency of absorbable calcium. See bone metabolism.) Low stomach acid leads to B6 and copper deficiencies, which could contribute to the development of aortic aneurysms due to impaired lysyl oxidase activity. 
Heart: "The nutrition most needed by your heart is the very nutrition that requires adequate stomach acid for digestion."  Hypochlorhydria causes the following conditions:
Elevated homocysteine levels: A contributory factor in the development of atherosclerosis due to folic acid and B6 deficiencies. 
There may be heart arrhythmias due to B complex, mineral (especially magnesium) and omega 3 fatty acid deficiencies, food allergies or hyperthyroidism.  Magnesium deficiency causes an oxygen deficiency resulting in coronary artery spasms and angina. Low magnesium levels result in low HDL levels (the good cholesterol) and an increase in the amount of oxidized LDL (the bad cholesterol) so increasing arterial damage. A magnesium deficiency can create potassium and calcium deficiencies. Potassium and magnesium are needed for the production of HCl, which in turn, is needed for the absorption of calcium and magnesium. HCl generates alkalizing and oxygenating electrolytes. Deficiencies of these electrolytes are the seedbed of most, if not all, degenerative diseases. The heart medication digitalis can be toxic if you have a magnesium or potassium deficiency. 
B4 Deficiency: This little known portion of the vitamin B complex, discovered in pigeon studies decades ago, is essential for a healthy rhythmic heart. B4 is not found in synthetic B vitamins. It is especially found in liver, yeast and wheat germ. The following lead to congestive heart failure: deficiencies of the B vitamins (linked together in food by phytochemicals), deficiencies of organic absorbable minerals and omega 3 fatty acids, plus hypochlorhydria's hypothyroidism and adrenal failure. 
Hypochlorhydria begins imperceptibly and progresses gradually (unless one takes acid stoppers or antacids), so it is difficult to know if one has it. A pH test with pH paper is the easiest and quickest way to know if one's stomach acid is low. Test your saliva first thing in the morning and then again about half an hour after eating. The numbers should rise after eating, e.g. seven before and nine after. If they go down (seven to five or six), and especially if the first pH is around five and stays the same or goes down to 4.5, you need more stomach acid. 
Dental Problems: Your mouth is acid, from a lack of alkalizing, oxygenating electrolytes. Your dental health reflects your nutritional deficiencies,  and looking back you may see the history of your hypochlorhydria reflected in the number of fillings and root canals that needed to be done.  On antacids or acid stoppers and with dental metal toxicity,  your mouth becomes even more acid. As we saw, selenium levels are low with hypochlorhydria, which result in depressed immune function. Heavy metals bind with selenium causing its further depletion.  The gums can become inflamed from a vitamin C deficiency and bacterial infections. 
Increased Bacterial Adherence in the Mouth and Bowel: The bacteria that cause dental decay and intestinal infection find a receptive environment and a route of entry in a mouth that lacks a neutral pH of around 6.5 to 6.8. 
When something goes wrong in the production of stomach acid, there are repercussions all the way down the digestive tract and throughout the body and brain. The effort it takes to produce sufficient hydrochloric acid in the parietal cells of the stomach's lining is immense. Dr. Michael Gershon, the neurobiologist, writes in his book The Second Brain that it's "not unlike going up Niagara Falls in a barrel."  The body goes to a tremendous effort expending an enormous amount of liquid crystalloid electrolytes and B vitamins in order to make hydrochloric acid (HC1) and protect the stomach and duodenal lining from the acid, because HC1 with a healthy pH of 0 is not only the gate to the entire body's nutrition, but also the gate to the intestine's immune system, shutting microbes out. It effectively sterilizes the stomach and, via its effect on the gallbladder's secretion of bile, the small intestine too. [1,2] In contrast, low stomach acidity with its unhealthy pH levels (from nutritional deficiencies of their essential components), allows bacterial activity and adherence, and there is a progressive loss of even more nutrients throughout the bowel, causing repair and immune systems to fail and toxins and oxidative stress to increase. 
Deficiencies of B12, B6, niacin, C, E, iron and zinc, all present in those with low stomach acid, damage our DNA by causing single and double strand breaks, oxidative lesions or both. DNA damage leads to cancer.  The demand for nutrients and antioxidants grows progressively higher, but their supply progressively declines.
Dysbiosis:  Low levels of hydrochloric acid in the stomach encourage the overgrowth and imbalance of bacteria all the way from the colon to the stomach. Dysbiosis weakens our ability to protect ourselves from food poisoning and from disease-causing microbes. Low virulence microbes are insidious: if left unrecognized and untreated they become deepseated, eg. rheumatoid arthritis has been linked to a prevalence of a bacteria called Proteus. This bacteria may also be involved in the initiation of myasthenia gravis and is associated with ankylosing spondylitis.  What originates as a local infection becomes an autoimmune illness. There is often a long transit time with hypochlorhydria; the longer bacteria sit inside us, the more they proliferate. In 24 hours one E. coli bacteria produces nearly 5,000 identical bacteria. Perforations in the digestive tract form in a matter of days. Bacterial enzymes recreate estrogen levels and estrogen-dependent breast cancer. When there are abnormal levels of microflora t here's a malabsorption of vitamin K needed for blood clotting and there is an increased susceptibility to bruising. 
Published research has listed Dysbiosis as the cause of arthritis, autoimmune illness, chronic fatigue, cystic acne, the early stages of colon and breast cancer, eczema, food allergy/sensitivity, inflammatory bowel disease, irritable bowel syndrome, psoriasis and steatorrhea. All bacterial, fungal and parasitic infections found with hypochlorhydria are linked to Dysbiosis. Liver detoxification is further compromised by the growing load of toxic byproducts from these infections.  Because the body is extremely depleted with long term hypochlorhydria, there is a very low immune response (e.g. a significant number of the immune system's enzymes work best in the presence of zinc, iron and B 6.)  Antibody blood tests with negative findings may mislead doctors and patients while infections rage on unchecked. A rectal swab test (for parasites) may be helpful. Probiotic supplementation is essential. 
General Symptoms of Hypochlorhydria are: halitosis (bad breath), a loss of taste for meat, epigastric pain, distress, fullness, distension, nausea, gas, diarrhea and constipation, vomiting and even severe heartburn. 
The emptying time of the stomach is slowed and the food ferments, producing irritating acids and gasses. [2,10] Undigested food alone can damage the lining of the esophagus, stomach and intestine.  Under normal conditions, the stomach is protected by a thick alkaline mucous coating, and by prostaglandins, the underlying cell messengers which signal a cell to move over and take the place of a damaged cell. However, this protection is often missing under conditions causing or caused by hypochlorhydria, Under psychological stress, mucous secretion decreases and with the use of aspirin or anti-inflammatories for pain etc. the biosynthesis of prostaglandins is inhibited.  But far more damage results from the deficiencies caused by low stomach acid.
The synthesis of linoleic acid into gammo-linolenic acid (GLA), as well as GLA into the prostaglandin PGI, are dependent on zinc, B6 and magnesium. Prostaglandins of 3 series are dependent on zinc, niacin and vitamin C. (Manganese and chromium are also needed for the synthesis of fatty acids.)20 Series I and 3 (PG1 and PG3) are the anti-inflammatory prostaglandins. They work with antioxidants such as C and E (both low or missing with hypochlorhydria) to quench or modulate the inflammatory process. Through the inflammatory process, damaged cells are removed, toxins are eliminated, invading microorganisms are overcome, and the repair process begins.  With hypochlorhydria's deficiencies, this process goes seriously awry. The necessary nutrients for a healthy digestion, digestive tract and body are the same ones we have more and more difficulty digesting.  Vitamins A, E and especially C offer significant protection against virtually all forms of cancer, including cancers of the oral cavity, esophagus, col on; pancreas, breast and cervix;  their essential cofactors cannot be adequately supplied with low stomach acid.  Hypochlorhydria is self-perpetuating and has growing complex ramifications.
In the Stomach: nausea after taking supplements,  gastroesophageal reflux,  helicobacter pylori infection causing erosion of the lining, gastric ulcers and using up 75% of the ascorbic acid in the gastric juice. This infection can lead to achlorhydria, pernicious anemia and stomach cancer. [1,31] (Gastric ulcers can also be caused by hypochlorhydria's nutritional deficiencies and trauma to the stomach's lining.) Aluminum toxicity that occurs with low stomach acid, (see bone metabolism), inflames and undermines the bowel's lining. [8,23]
In the Small Intestine: Irritable bowel syndrome (IBS),  chronic candida albicans infection  and parasites,  leaky gut syndrome (intestinal permeability) causing diverse bacterial infections, multiple food allergies and autoimmune disorders, Celiac disease,  peptic and duodenal ulcers (Helicobacter pylori can infect both the stomach and small intestine, with low stomach acid, ulcers can also be caused by deficiencies and stress.)  and intestinal obstruction.  (Intestinal obstructions form when fiber is not broken down by sufficient stomach acid.)
In the Large Intestine: Ulcerative Colitis,  Crohn's disease and colon cancer. 
In the Rectum: Pruritus ani (or itching), undigested food is found in the stools. 
In the Liver: Problems with detoxification, greater sensitivity to drugs (e.g. brain and nervous system dysfunction and damage from Benzodiazepines, valium, prozac, halcion, etc.),  chronic hepatitis.  Hypochlorhydria's growing deficiencies of liquid crystalloid electrolytes, vitamins and amino acids weaken liver function, thereby increasing the liver's burden.  For example, manganese and zinc deficiencies cause a choline deficiency. Choline is essential for the health of the liver. 
In the Bladder: Recurrent bladder infections.  Bladder cancer from the liver's problems with detoxifiction. 
In the Prostate: Prostatisis, enlarged prostate (Benign Prostatic Hyperplasia) and prostate cancer have been linked to a zinc deficiency and the consequent problems of hypochlorhydria. [12,38] Zinc is essential for the production of hydrochloric acid and is critical to many aspects of male hormone metabolism. One of zinc's actions is to inhibit the activity of the 5-alpha-reductase, the enzyme that converts testosterone to dihydrotestosterone, which is toxic to the prostate. 
In the Gall Bladder: gallstones. With low stomach acid there is an incomplete emptying of the common bile duct because the pyiorus or opening to the small intestine is in a state of spasm. Gallstones form in a stagnant gallbladder.  Especially in the absence of choline.  Hypochlorhydria causes an iron deficiency and consequently the production of higher amounts of transferrin (an iron transporting protein). Transferrin causes cholesterol crystals to form more rapidly. Gallstones develop when deposits of either cholesterol or non-absorbable calcium combine with bile. Gallstones may form in the cystic duct, hepatic duct, common bile duct or gallbladder for all of these reasons in those with low gastric activity. 
Inadequate bile production: Hypochlorhydria's protein deficiency prevents adequate bile production. Undigested fats coat food inhibiting digestion even further.  It takes a great deal of enzyme assistance (pepsin in the acid medium of the stomach and pancreatic enzymes in the alkaline medium of the small intestine) to break down protein into amino acids. [4,10] The correct pH for these enzymes to be able to work is provided by liquid crystalloid electrolytes produced by the extremely acid pH of 1 of healthy stomach acid. [1,2,30]
In the Pancreas: Without sufficient HCl and bile, an extra load is placed on the pancreas, the head of the pancreas becomes enlarged, there is incomplete emptying of the pancreatic duct and the electrolytes needed to activate and produce pancreatic enzymes are absent or in very short supply. This results in chronic pancreatitis. The pancreas becomes hard and sore to touch. Diabetes can also occur from stagnation of the pancreas and many nutritional deficiencies,  e.g. the pancreas of a diabetic contains about half as much zinc and manganese as a healthy pancreas. Zinc prolongs the effect of insulin on blood sugar,  and manganese is an important cofactor in the key enzymes of glucose metabolism.  The active liquid crystalloid electrolyte for a substance called glucose tolerance factor (GTF) is chromium; niacin and amino acids complete the formula.  All of these ingredients are deficient with low stomach acid. Vanadium sulphate mimics insulin and improves cell sensitivity to insulin. Julian Whi taker, MD calls vanadium the single most effective and intriguing factor for helping diabetes. 
In the Kidneys: Low back and abdominal pain, fever, chills, fatigue, edema, nausea, vomiting, loss of appetite, a frequent urge to urinate, blood or albumin in the urine. These are all symptoms of nephritis caused in hypochlorhydria by diverse and chronic bacterial infections, protein, choline and vitamin E deficiencies.  Extra vitamin E is needed because of toxic byproducts including aluminum and mercury toxicity that accompanies low stomach acid production.  Because of the body's consequent digestive problems with low HCl, fat soluble vitamins, such as E, and protein and choline are less available. 
Kidney Stones: Minerals go out of solution in the body forming deposits which can lead to the formation of stones. Aluminum and other toxic metals such as Cadmium disturb the pH, producing an overacid serum state which leads to aberrant calcium accumulation in cells.  (See Bone Metabolism Cadmium and Aluminum Toxicity)
In the Skin: Sun sores, itching skin, greater susceptibility to burn in the sun, skin cancer. "Perhaps the most powerful preventive for sun damage in humans is the amount of calcium in skin cells."  Omega 3 fats (as in flax oil and fish oil) are necessary to remove calcium out of the blood and into the cells.  One cannot metabolize sufficient fats without adequate stomach acid production, nor can one keep calcium and copper soluble, in their liquid crystalloid electrolyte form, without healthy gastric activity.  Copper is needed for the conversion of the amino acid tyrosine into melanin (the dark pigment that colors hair and skin).  Melanin absorbs ultraviolet light and protects us from sun damage.  When the kidneys and liver are overloaded, as with hypochlorhydria, the skin will take over in eliminating toxins from the body.  The following are implicated with low HCl deficiencies and toxicity: Septicemia (electrolytes are needed to heal wounds ), boils, abscesses, adult acne, infl ammatory skin disease, rosacea, psoriasis, chronic hives, eczema, lupus erythematosis, dermatitis herpetiformes  and vitiligo.  (See Dysbiosis)
In the Bone Metabolism: Too many minerals in the wrong form and ratios can be as damaging as a mineral deficiency. With hypochlorhydria there are too many inorganic minerals and not enough liquid crystalloid electrolytes. This can cause alkalosis.
Bone spurs: Non-ionized calcium goes out of solution in the body and forms deposits.  (See alkalosis)
Osteoporosis and Osteomalacia: Healthy bones need all of the minerals, especially calcium, magnesium, boron, manganese, copper, silica and zinc.  For example, the electrical properties of copper hold the apatite crystals and collagen fibers in bone together.  Vitamins K, E and D are also essential. Amino acids and vitamin C form the protein fibers of the bone matrix.  Elevated homocysteine levels from deficiencies of B6 and folic acid, as found with low stomach acid lead to a defective bone matrix.  Liquid crystalloid electrolytes are needed for the absorption of all of these nutrients. No electrolytes are formed without sufficient HCl.  "A deficient intake of an element can allow toxic accumulation of another element."  In hypochlorhydria impaired mineralization of bones and stored aluminum  and cadmium makes us prone to osteoporosis and osteomalacia.  The earliest symptoms of these conditions are muscle and leg cramps and low back pain leading to spasms, loss of twisting and b ending strength and spontaneous fractures. 
Poor hormonal balance and production: Omega 3 fatty acid and trace mineral absorption and metabolism is inadequate to maintain the healthy balance and production of hormones needed for strong bones.  A healthy magnesium level (missing with hypochlorhydria) suppresses the parathyroid hormone, which draws calcium out of the bones. Magnesium also stimulates calcitonin, the hormone which increases and maintains the level of calcium in the bones, allowing us to use our body's calcium supply more efficiently. 
Incorrect pH: As the body fights for its essential pH balance with a declining supply of alkalizing minerals, it decalcifies the bones. 
Cadmium and Aluminum toxicity is found in those with low stomach acid. Because of zinc and calcium deficiencies, the body absorbs cadmium and aluminum, [12,22,23] The impairment of calcium metabolism that occurs with cadmium toxicity contributes to bone disorders. Aluminum is a cross-linking agent for collagen, particularly when phosphate groups are present. This leads to malnourishment of the cells and further demineralization of the bone.  Daily use of calcium and magaesium is recommended to reduce the body burdens of aluminum which accumulate in liver, lungs, bones, brain and thyroid.  Cadmium accumulates in the kidneys, arteries and liver, brain, fat deposits and joints. Additional supplementation of copper, iron, zinc and selenium can lessen cadmium toxicity.  We need a good balance and supply of liquid crystalloid electrolytes, otherwise excessive levels of toxic minerals accumulate in cells and tissues. 
Further symptoms of low gastric activity are:
In the muscle tissues: All muscles, including the crucial heart muscle and those of the intestine, require a healthy supply of B vitamins. This supply is missing in hypochlorhydria causing muscular weakness. 
Muscular wasting. Amino acids are not properly assimilated because of progressively poor digestion of protein. As a result we lose nitrogen which is essential for the production of strong lean muscles.  Cramps and spasms are caused by deficiencies of calcium, magnesium, iron, essential fatty acids, hypothyroidism and electrolyte imbalances, all these can be caused by low gastric activity. [1,3]
Slow healing of injuries and surgeries. Copper works in balance with zinc and vitamin C to form elastin, an important component of all muscle fibers. Zinc, copper and vitamin C are needed for healing, but all three are low or missing with low stomach acid. [12,15]
Paralysis or convulsions are caused by hypochlorhydria's electrolyte and hormone deficiencies and imbalances. Muscle and nerve tissues (in fact all cells) must be bathed in fluids which contain regulated amounts of electrolytes. (Calcium ions stimulate muscles and nerves, whereas potassium, magnesium and sodium relax them.) Hormones are critical in governing this process. 
Myasthenia Gravis.  Recovery from this disease has occurred many times when the diet and digestion are adequate. An adequate supply of B vitamins, vitamin E, amino acids and the electrolytes manganese and potassium (missing in hypochlorhydria) are needed.  (See Dysbiosis and Infections)
Chronic muscle pain from cellular deficiencies and imbalances  and from leaky gut syndrome/intestinal permeability.  (See Bowel)
In the Connective Tissue: The plasma that nourishes our cells is progressively lacking in oxygenating alkalizing electrolytes.  Metabolic acidic wastes accumulate and are stored in the collagen or connective tissue, resulting in severe inflammation and even cell death.  The connective tissue's repair system is slowed by poor circulation and impaired by a poor supply of the necessary nutrients, for example, the amino sugars (glycoproteins and glycosaminoglycans) L Proline, L Lysine and vitamin C. Copper is necessary to produce SOD, the innate antioxidant for joint health. (SOD removes free radicals three to ten times faster than vitamin C.)  The synthesis of collagen requires copper,  and copper, like the aforementioned nutrients, is not absorbed without sufficient HCl. The following symptoms and diseases show the long-term effects of mineral imbalances and unrestrained free radical damage.  Bursitis,  Tendinitis, Bunions (from calcium deposits),  Lupus erythematosis, Sjogren's syndro me, arthritis and rheumatoid arthritis.  Intestinal permeability (leaky gut syndrome) and a deficiency of the essential amino acid histidine are implicated in rheumatoid arthritis. (See Small Intestine and Dysbiosis)
Histidine deficiency: a low supply of HCl doesn't provide the enzyme activity needed to break down protein into amino acids [1,2] nor the coenzymes B3 and B6 needed to transform histidine into histamine, an important immune system chemical. The secretion of histamine by the mast cells of the stomach's connective tissue drives or stimulates the production of stomach acid. In addition histidine, the amino acid, is significant for the growth and repair of tissue, in the maintenance of the myelin sheaths that protect nerve cells, for the production of red and white blood cells, for protection from radiation and for heavy metal detoxification.  With hypochlorhydria, the demand for histidine increases as its supply progressively declines. Histidine levels that are too high lead to anxiety and psychological disorders. It is best not to take supplemental histidine unless a deficiency has been identified. Individual amino acids should not be taken for long periods of time. It is wise also, to take a full amino aci d complex, at a different time of day. 
In the Lungs: Infections. With nutrient deficiencies and toxicity caused by hypochlorhydria, the mucous membranes deteriorate. Repair and immune systems fail and invading organisms break in and multiply.  "As we become deficient in trace minerals, cell walls weaken and become irregular and their pH is upset." This enables infection to take hold... "and this is the beginning of disease whether it is a cold or cancer." The body's pH and cell health in addition to the immune system's strength are all dependent on sufficient stomach acid. 
Asthma. Hypochlorhydria causes leaky gut syndrome (See Small Intestine) resulting in allergies and food sensitivities from xenobiotics (foreign chemicals) and antigens entering the bloodstream. White cells in the bronchi secrete histamine resulting in bronchial contraction.  Lack of essential nutrients from impaired digestion and metabolism causes chronic inflammation and also a deficiency of secretory IgA. IgA is an important defense for our mucous membranes from bacteria, food residue, fungus, parasites and virus.  University of Virginia researchers discovered that people experiencing an acute asthma attack have substantially more acidic breath than healthy people. Acidity in the lungs causes bronchospasm and damages the lining of the airways.  Johns Hopkins Medical Center found that when asthmatics take a deep breath while exercising or because of allergens or airborne irritants, their lungs contract instead of relaxing, (possibly indicating a magnesium deficiency . In 1931 Dr. G.W Bray disc overed 80% of the 200 asthmatic children he analyzed had below normal gastric acid metabolism. 
In the Nervous System: Because the brain is the most metabolically active organ in the body and is particularly vulnerable to toxins, oxidative damage and circulatory problems, it is deeply affected by hypochlorhydria. The brain uses 20% of all inhaled oxygen and 50% of the total supply of glucose. These vital brain fuels are decreasingly available with the anemia and hypoglycemia found in those with low stomach acid. 
Mineral deficiencies. The brain must have the electrolytes magnesium and chromium to burn blood glucose properly. A healthy supply and correct balance of liquid crystalloid electrolytes is needed to conduct essential electrical impulses along each nerve. Nerve-cell function involves rapid changes in this 'electrical soup'.  Alarmingly low levels of electrolytes, as in those with low stomach acid, cause severe mental confusion. Hypochlorhydria's deficiencies of calcium, iron and magnesium, and the single deficiencies of copper, vanadium, molybdenum and zinc have been linked to depression.  Low gastric activity severely affects manganese levels which aid in the utilization of choline. Choline is essential for the health of the nerve's myelin sheaths. Manganese activates the necessary enzymes for the utilization of biotin, thiamin (B1) and ascorbic acid. This trace mineral is a catalyst in the synthesis of fatty acids and cholesterol and it helps to nourish the nerves and brain. 
A zinc deficiency causes the eating disorders anorexia  and bulimia.  Zinc (in its liquid crystalloid electrolyte form) is essential for the production of stomach acid. All of the B vitamins depend on zinc for their assimilation and effectiveness. 
B vitamins and amino acid deficiencies. B1, B2, B3, biotin and pantothenic acid are needed to burn blood glucose, the brain's fuel. The entire nervous system needs a good supply of B vitamins, amino acids and trace minerals for the formation and functioning of many neurotransmitters. [2,55,56] The digestion of protein and B vitamins is severely impaired by a low supply of stomach acid and hence, pancreatic enzymes. (Pancreatic enzymes cannot be produced or activated without liquid crystalloid electrolytes.) 
Antioxidant deficiencies. Vitamin C has been found to be 100 times more concentrated in the brain than in the surrounding blood, providing much needed antioxidant protection.  In those with hypochlorhydria the supply of vitamin C is low  and the need for it is higher, especially in the brain. At the core of the vitamin C complex, as it occurs in nature, is Tyrosinase (an enzyme needed to produce melatonin) which is dependent upon copper for its production.  Absorption of copper is also deeply affected by hypochlorhydria.  Because low stomach acid production causes endotoxicity,  hypothyroidism  and a deteriorating ability to detoxify drugs and environmental chemicals,  it demands a much higher antioxidant defense, e.g. vitamins C, E, selenium, the carotenoids and flavonoids. Vitamin E directly protects the nerves from oxidative damage,  and yet absorption of the fat soluble vitamins is affected by low HC1. [1,31] Mercury, aluminum and lead -- all found in the brain and nervous sy stem with low stomach acid, are neurotoxins. Hypochlorhydria's iron deficiency causes an increase in transferrin.  (See Gallbladder) Iron and aluminum are carried to the brain's oligodendrocyte's cells by transferrin. Aluminum increases the brain's lipid peroxidative damage possibly by interacting with iron. 
Low gastric activity is associated with the following symptoms, diseases and conditions: Headache, lethargy, drowsiness, irritability, hyperactivity, confusion, depression and difficulty concentrating caused by multiple food allergies (See Bowel and Small Intestine/Leaky Gut Syndrome) and Celiac disease [2,10] (when psychosis is present caused by a chronic allergy to all gluten foods), insomnia, anxiety, fearfulness, exhaustion, noise sensitivity; hostility; dizziness, mental fatigue, persistent worry, strain and dementia. 
Autism: stomach acid sends a signal to the duodenal lining to release secretin. This hormone stimulates pancreatic secretion,  and so improves digestion and the prognosis of those with autism. (This disease is also linked with intestinal permeability/leaky gut syndrome  and heavy metal toxicity.)  Epilepsy, caused by a sugary and starchy diet lacking in trace minerals and coenzymes. [58b] HIV (positive), Schizophrenia, Lupus erythema tosis  (linked with intestinal permeability), Multiple Sclerosis,  Alzheimers disease (aluminum, cadmium, iron and mercury toxicity are implicated. See Bone Metabolism, Bloodstream and Dental Problems.) In his triumphant autobiographical account, Beating Alzheimer's, one of the first steps Tom Warren made to overcome Alzheimer's was correcting his stomach acid which he'd discovered was as neutral as water. 
Acquired (i.e. Secondary) and Acute porphyria should be added to this category. Because damage to the mitochondria of the stomach's parietal cells causes hypochlorhydria [2,3] and achlorhydria,  defects and diseases of the mitochondria in general (as in Acute porphyria), make one susceptible to having trouble with stomach acid production. This trouble often applies to patients with the photoporphyrinogen oxidase defect in Acute Variegate Porphyria (VP).  Studies have suggested that the mitochondria are the principal subcellular target for protoporphyrininduced damage. This proposal is supported by chemical and ultrasound evidence.  Protoporphyrin -- induced damage in the skin when exposed to light is caused by the oxidation of histidine residues of membrane proteins. The oxidized histidine reacts with side chains on other proteins to produce cross-linking of proteins.  Histidine is needed in sufficient amounts to make histamine which stimulates the production of stomach acid.  (Multiple Sc lerosis is also associated with a histamine deficiency. )
Acute episodes of porphyria, during which there is an overproduction and excretion in the urine of the porphyrin enzyme ALA synthesase, deplete B6 (its coenzyme ) and zinc, selenium and manganese (porphyrins bind with metals making metal toxicity more probable  and zinc, selenium and manganese less bioavailable.) A selenium deficiency leads to a B3 deficiency  and a manganese deficiency leads to a B1 deficiency. B1, B3, B6 and zinc are essential for the production of hydrochloric acid. [12,15] At the same time, zinc, manganese and selenium are porphyrinogenic, i.e. excess amounts would exacerbate or cause a porphyria attack. 
In addition, the free radical damage caused by excess porphyrins depletes antioxidants and the coenzymes and electrolytes needed to produce HC1. For example, glutathione requires B1, B2 and selenium for the synthesis of its active forms, glutathione peroxidase and glutathione reductase. In very high doses glutathione can cause homocystinuria, involving the further loss of B6,  as well as folic acid,  (the coenzyme which stimulates the production of stomach acid. )
Because hypochlorhydria has a progressive effect on the health and production of enymes and red blood cells,  it is associated with:
1. Metal toxicity,  for example:
a. Lead - from a deficiency of zinc 
b. Mercury - from a progressive decline in dental health 
c. Aluminum - from a calcium deficiency 
d. Cadmium - from a zinc deficiency 
2. Chronic infections (especially hepatitis) 
3. A burdened liver that has greater difficulty detoxifying drugs and chemicals.  Low stomach acid could cause Acquired and Secondary porphyria  and the hypochlorhydria caused or worsened during acute episodes of porphyria, would lead to chronic attacks, accumulated damage, causing achlorhydria in some patients. [62,65]
Metabolically-induced hypochlorhydria could occur as a result of many diseases, mineral imbalances or sources of oxidation, because of the deficiencies they cause. For example, Schizophrenic patients can become zinc and B6 deficient by excreting kryptopyrole in their urine, which binds B6 and zinc.  (Because B6 is essential for the conversion of tryptophan to B3, a deficiency of B6 would lead to a deficiency of B3. ) Further examples: the HIV virus, human herpes virus and the coxsackie virus B3, deplete B3. 
A diet that is high in raw, unsprouted legumes, whole grains, nuts, seeds and even wheat germ, could lower gastric activity because these foods contain enzyme inhibitors that cause severe indigestion,  resulting in the loss of the nutrients needed to make stomach acid. Phytic acid is present in the bran or hulls of all seeds. Calcium, magnesium, iron, copper and especially zinc, bind with this fiber compound to form insoluble phytate complexes. [20,75] Healthy levels of these minerals in their liquid crystalloid electrolyte form are needed for the production of HCl. The aforementioned foods are rich in copper and so this may cause higher copper levels, which would result in even lower zinc levels. [15,20]
Elevated by estrogens, serum levels of copper rise progressively during pregnancy. After delivery it takes two to three months before the copper level normalizes. High copper levels cause low zinc levels (and subsequent hypochlorhydria). [2,15] Copper levels increase with the use of birth control pills. Synthetic estrogens are found not only in medication, but also can be easily absorbed from food or liquid sold in plastic wraps or bottles, from the pesticides in our food, air and water (Jobling),  and even from the plastic sealants on our teeth.  High levels of (non-ionized) copper may be a factor in paranoid and hallucinatory schizophrenia, hypertension, stuttering, autism, childhood hyperactivity, toxemia of pregnancy, premenstrual tension, depression, insomnia, sterility and functional hypogylcemia. 
When the electrical properties of different minerals were tested, only copper revealed an electron resonance of its own. Copper was shown to have a number of free electrons  that would be very effective in maintaining the healthy flow of electrons and ions over our body's biologically closed electrical circuits.  (Highest concentrations of copper are in the liver, kidneys, heart and especially the brain. [15,56]) But an excess of copper's electrical activity would have a negative effect, including the loss of zinc and the lowering of gastric activity. [2,20] Copper needs a healthy level of stomach acid  to remain or become 'ionic' - electrically charged and in solution.  With low stomach acid, insoluble non-ionized copper deposits become a useless toxic burden. This form of hypochlorhydria could occur easily with the habitual use of copper water pipes or cooking pots. High non-ionized levels of copper are found in smokers.  Free radicals may be implicated.
Any significant and/or chronic toxic exposure risks causing low gastric activity by depleting amino acids, coenzymes and electrolytes. [1,15,18] For example, mercury, the heavy metal most people are exposed to, depletes reduced glutathione and cysteine  causing the depletion of the coenzymes B1, B2, B3, [66.73] B6, E and the electrolytes selenium and zinc. [12,18,68] Heavy metals, such as mercury, bind selenium, reducing its availability even more. Levels of potassium, mitochondrial and central nervous system function are also negatively affected by mercury.  The production of HCl depends on the central nervous system  as well as healthy mitochondrial function [2,3,60] and also an adequate supply of coenzymes and electrolytes. 
This diminishing capacity to produce stomach acid, progressively worsens the patient's condition because low stomach acidity alone causes autointoxification from the toxic byproducts of its accompanying imbalances, infections and improperly digested food (especially proteins ). Thus, hypochlorhydria prevents the assimilation of the nutrients needed for detoxification and repair. The natural detoxification pathways (intestines, liver, kidneys, skin, lungs, and lymphatic system) are polluted, congested, overburdened and even damaged.  Moreover, the slightest additional chemical exposure creates an allergic reaction which depletes the deficient (and also overburdened) immune system of even more nutrients. 
In addition, low stomach acidity causes a greater permeability of the blood-brain barrier because of high histamine and low iron and oxygen levels, which result in excess Nitric Oxide (NO) in the bloodstream. (NO is a powerful free radical capable of destroying neurons. [17b])
The following conditions show the effects of the autotoxemia caused by low gastric activity plus additional chemical exposures: Multiple chemical sensitivities (MCS), environmental illness (EI), fibromyalgia, myofacial pain syndromes  and Gulf War Syndrome. 
Chronic stress is one of the most frequent causes of hypochlorhydria.  Emotional or physical stress depletes B vitamins and minerals. The high-copper-low-zinc imbalance that causes low gastric activity could result from stress. In research on stress and minerals it has been demonstrated that despite a diet containing more than the RDA of minerals, after a five day period of physical and psychological duress, zinc decreased by 33% and copper by only 12%, iron decreased by 44% and selenium by 9% (all of these minerals' levels affect the level of gastric acidity.) It took an average of seven days for the subjects to register their former mineral levels.  High (non-ionized) copper levels are found in patients who have heart attacks or high blood pressure. 
During the Persian Gulf War there was a three-fold increase in the frequency of central nervous system symptoms following pyridostigmine ingestion by 213 soldiers.  Would the military be better protected from that kind of incident (and consequent chronic problems such as Gulf War Syndrome) by the careful diagnosis of and supplementation for hypochlorhydria, before and during stressful conditions of training and warfare? (Even athletes would fall under this category.) 
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