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Why Is Hypochlorhydria Common In Thyroid Conditions?

Hypochlorhydria involves a decrease in the production of gastric acid (HCL) in the stomach.  This condition is common in people with thyroid and autoimmune thyroid conditions, and while hypothyroidism can cause hypochlorhydria, people with hyperthyroidism and Graves’ Disease can have this condition too.  Either way, the decreased acid will cause problems with digestion, which of course can lead to numerous symptoms and further problems which I will discuss in this article.

So what leads to hypochlorhydria?  There are numerous factors, but here are four of the more common reasons why a person might have problems producing enough gastric acid:

1. Hypothyroidism. The slowing down of the metabolism associated with hypothyroid conditions can in turn lead to a decrease in the production of gastric acid (1) [1].  As a result, some people with hypothyroidism and Hashimoto’s Thyroiditis have hypochlorhydria.  Taking synthetic or natural thyroid hormone might help, although my goal of course is to try restoring the person’s thyroid health back to normal if at all possible.

2. Autoimmunity. The parietal cells are located in the stomach, and they are responsible for the secretion of gastric acid.  They also produce intrinsic factor, which is required for the absorption of vitamin B12.  Many people are familiar with pernicious anemia, which involves autoantibodies being produced against the intrinsic factor, which result in a reduction of vitamin B12 absorption.  But antibodies can be formed which attack the parietal cells, which will lead to the decreased production of gastric acid.

Remember that people with one autoimmune condition are more likely to develop another autoimmune condition.  As a result, someone with Graves’ Disease or Hashimoto’s Thyroiditis is more likely to develop antibodies against the parietal cells, thus resulting in hypochlorhydria.  The reverse can be true as well, as someone can have this condition and then go on to develop an autoimmune thyroid condition.  Either way the goal is to try to suppress the autoimmune component, control the inflammation, and restore the health of compromised areas of the body.

3. H. Pylori. I’ve written about H. Pylori in a separate article [2], as this is an infection in the stomach, which in turn can interfere with the production of hydrochloric acid (2) [3].  This infection is common in people with Graves’ Disease and Hashimoto’s Thyroiditis.  And it can be difficult to eradicate, as the conventional medical treatment consists of using very potent antibiotics.  And sometimes these antibiotics aren’t strong enough to get rid of this organism.

There are natural treatment methods available to eradicate H. Pylori, which I usually recommend to my patients who test positive for this.  The downside is that the natural treatment protocol for H. Pylori takes time to work, and there is no guarantee they will eradicate the H. Pylori, although in most cases they do work well.  Either way, anyone with digestive issues should consider getting tested for H. Pylori, although the lack of digestive symptoms doesn’t rule out the possibility of being infected by this organism.

4. Acid stopping medication. This one is obvious, although I figured I’d bring it up since many people take acid stopping medication.  This medication is taken to intentionally decrease the production of gastric acid.  While some people might need to take this medication, most people don’t need to take this, and most don’t realize the harm it’s causing.  There are reasons why a person experiences symptoms such as heartburn and reflux, and these problems can usually be corrected over time by improving one’s diet.  And so it makes me sick to see these commercials encouraging people to take this medication.  Once again, I’m not suggesting that some people can’t benefit from these medications, but for most people these drugs are causing further problems with their digestive system while just masking the symptoms.

What Are The Consequences of Hypochlorhydria?

Although the overall pH of the body is supposed to be alkaline, the pH of the stomach should be between 2 and 4.  However, a condition such as hypochlorhydria will reduce the gastric pH.  This in turn will cause problems digesting food, can lead to gastro microbial overgrowth, and can therefore lead to a condition such as gastroenteritis, which is inflammation of the gastrointestinal tract.  Over a period of time this can lead to a condition such as leaky gut, which I’ve also discussed in other articles, and in turn will cause an immune system response.

How Does Atrophic Gastritis Factor Into This?

Atrophic gastritis is associated with the chronic inflammation of the stomach.  There are a number of factors which can cause this condition, but the two main factors are 1) infection with H. Pylori, and 2) it can be autoimmune in nature.  We already know how H. Pylori can affect the production of gastric acid.  And autoimmune atrophic gastritis can also damage the parietal cells, which as you know produce HCL.  Studies also show that autoimmune thyroid conditions are more prominent in people with atrophic gastritis (3) [4].

How Does One Correct This Problem?

As for how to treat hypochlorhydria, the goal of course should be to get to the root cause of the problem.  So if this condition is caused by hypothyroidism, then the goal should be to address this condition.  Taking synthetic or natural thyroid hormone may help, but if possible I of course recommend restoring the person’s thyroid health.  This isn’t always possible, and so some people with hypothyroidism and Hashimoto’s Thyroiditis will need to take thyroid hormone.  If H. Pylori is causing the decreased production of gastric acid then this infection needs to be eradicated.

There are cases when someone will need to supplement with betaine hydrochloride on a temporary basis, which can help compensate for the decreased production of HCL by the body.  So for example, if someone has H. Pylori, while trying to eradicate this infection it might be a good idea to take betaine HCL to help digest the food you eat.  If someone has antibodies against the parietal cells they also will probably need to take something to help with digestion, and hopefully at the same time will be working to suppress the autoimmune component of the condition.

In summary, hypochlorhydria is common in thyroid and autoimmune thyroid conditions.  In hypothyroid conditions the decrease in metabolism will make one more susceptible to having a decreased production of gastric acid.  Those people with Graves’ Disease and Hashimoto’s Thyroiditis have an increased chance of developing antibodies against the parietal cells, and are also more likely to contract an infection such as H. Pylori.  And since proper digestion is so important to an optimally functioning immune system, it is important to address the cause of the hypochlorhydria for anyone who is looking to achieve optimal health.