by Carol Sieverling
November 7, 2001
Editor’s Note: The following information is based on tapes of Carol Sieverling’s October 2000 visit with Dr. Cheney. He gave her permission to share this information, but has not reviewed or edited it.
When Dr. Cheney reviewed the results of my CDSA (Comprehensive Digestive Stool Analysis) from Great Smokies Laboratories (now Genova Diagnostics), he noted indications of "proteolytic problems" - trouble digesting proteins. First, he confirmed I was taking digestive enzymes, which he believes are essential for all CFIDS patients.
Dr. Cheney then suggested the supplement betaine. Most CFIDS patients don’t have enough stomach acid, and betaine HCL (hydrochloric acid) is stomach acid.
Stomach acid is a paradoxical substance: too little can actually make you think you have too much. Many people think they have acid reflux or GERD, and they take Prilosec or other antacids to reduce the amount of stomach acid. In actuality, they may not have enough acid in their stomach to trigger the opening of a valve at its base. When food begins to fill the stomach, acid is released to assist with digestion. When enough acid is detected, the valve opens, releasing the food into the small intestine. If there isn’t enough acid, the valve doesn’t open. The food, mixed with what little acid is present, is forced back up the esophagus, creating a burning sensation. Paradoxically, the answer to the burning sensation is more acid, not less. Antacids can create a vicious cycle in these cases.
Dr. Cheney said stomach acid does at least four important things:
(1) It creates an acid trap to kill bacteria in food. A lack of stomach acid allows bacterial overgrowths to develop, particularly in the small intestine. A UCLA study of 52 FM/CFS patients found bacterial overgrowths in 90% of the patients. Antibiotics were given to wipe out all bacteria (good and bad). Pain, fatigue, and cognition improved. Dr. Cheney strongly recommends betaine supplementation instead of antibiotics.
(2) According to Dr. Cheney, betaine "clips proteins," part of the process of digesting proteins. The enzymes (natural or supplemented) that break down protein need acid in order to work. You may take lots of enzymes, but if you don’t have enough acid, they won’t be effective. Plant-based digestive enzymes are the exception. They don’t need acid, though we still need the acid for all the other reasons listed here.
(3) Betaine helps extract minerals from food. Stomach acid is required for the body to absorb minerals. Without enough stomach acid, mineral depletion results.
(4) When the "acid chyme" (partially digested food mixed with acid) is released from the stomach, it enters the duodenum (first part of the small intestine). If enough acid is present, the pancreas will release pancreatic enzymes, and the liver will release bile. These are essential for good digestion and absorption. Without enough acid, these enzymes are not released, compromising digestion and absorption.
Most CFS/FM patients need to be taking supplemental betaine. Regarding dosage, take as much as you can tolerate. Most patients take one or two caps per meal. A few can tolerate only 1/2 cap. A few take much more – up to 7 caps a meal. As with so many things, the dose is very individualized. If you take too little, you’ll have that paradoxical burning sensation from the food/acid mixture coming back up the esophagus, because there isn’t enough acid to trigger the release of food into the small intestine. If you take more, but still not quite enough, the food/acid mixture will still come back up the esophagus. However, now it will burn even worse because it has more acid in it - just not enough to open the valve at the bottom of the stomach. If you take too much, you will experience "dumping", as Dr. Cheney calls it – usually diarrhea or a general "yucky" feeling.
One patient began taking betaine a couple of months ago and has finally escaped from the horrible pain and discomfort after meals that has plagued her for the past five years. Try taking betaine to improve your digestion, absorption, and kill off bacterial overgrowths. [As with any new treatment, discuss betaine supplementation with your physician first.]
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Note: This information has not been evaluated by the FDA. It is generic and is not meant to prevent, diagnose, treat, or cure eany disease. It is very important that you make no change in your healthcare plan or health support regiment without researching and discussing it in collaboration with your professional healthcare team.
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