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Acid Stomach – or Not Enough Stomach Acid? The Symptoms Are Similar, but For CFS and FMS Patients It’s Often the Latter

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Betaine hydrochloride, derived from beets, is near the top of the list of dietary supplement and health aid recommendations that CFS specialist Paul Cheney, MD, PhD developed for Chronic Fatigue Syndrome patients.1 Why? “Because most CFS patients don’t have enough stomach acid, and Betaine (hydrochloric acid) is stomach acid,” according to the article “Dr. Paul Cheney on Betaine for Chronic Fatigue Syndrome and Fibromyalgia Patients,” by Carol Sieverling. 2

Importantly, Dr. Cheney points out:

n Hydrochloric acid is responsible for converting another stomach secretion – pepsinogen – to pepsin, an enzyme largely responsible for breaking proteins down into substances that the body can absorb more easily.

n This is considered “the first step” in digestion, and is ultimately a necessity for cellular growth and repair.

n Hydrochloric acid also works in the stomach to fight infection of the digestive system by microorganisms such as bacteria that are ingested in food and water – since most of these are destroyed by an adequately acidic environment. Dr. Cheney notes that “a UCLA study of 52 FM/CFS patients found [small intestine bacterial overgrowths (SIBO)]in 90 percent of the patients.” Low levels of stomach acid may create a Ph in the small intestine that facilitates the overgrowth of bacteria. This may cause inflammation and even leaky gut syndrome.

n Further,it is thought that many people suffer recurrent yeast infections because low levels of stomach acid allow them to be reinfected continually by yeast consumed with their food.

Overall, a reduction in the stomach’s natural production of hydrochloric acid – often associated with the aging process and referred to as “hypochlorhydria” – can interfere with the stomach’s digestive and infection-fighting functions. A Betaine hydrochloride supplement with pepsin, taken with food, is especially useful to enhance digestion in individuals with hypochlorhydria because it raises the levels of both hydrochloric acid and pepsin in the stomach. For individuals with low hydrochloric acid production, Betaine hydrochloride has been described as a “stomach tonic.”

But to confuse matters, the symptoms of hyperchlorhydria are similar to the symptoms of too much stomach acid which are so frequently described in over-the-counter and prescription antacid drug advertising.

n An excess of digestive acid may cause acid reflux, which is a burning backflow of stomach acid into the esophagus or “swallowing tube,” sometimes referred to as gastroesophageal reflux disease (GERD).

n By contrast, if there isn’t enough digestive acid in the stomach after food is ingested (with hyperchlorhydria), the valve at the stomach’s base that releases food into the small intestine may not open as it normally would, Dr. Cheney has explained. Then, the food/stomach acid mixture may be forced back up toward the esophagus, creating a burning sensation similar to the one associated with acid reflux. And the mistaken addition of antacid remedies to the mix is likely to create a “vicious cycle.” 2

One test for hypochlorhydria is to determine the extent of undigested protein in the stool. There is also a definitive test of stomach acidity, called the Heidelberg test. It involves swallowing a “telemetry” device the size of a large vitamin capsule, and tracking the acidity-level signals it broadcasts from the stomach as doses of acid-neutralizing sodium bicarbonate (baking soda) are ingested. If the acid level doesn’t return after a few doses, hypochlorhydria is a likely diagnosis. A simple preliminary test is to drink a small amount of baking soda in water first thing in the morning. If you have not belched within a few minutes, you may not be producing enough stomach acid, since hydrochloric acid reacts with baking soda to produce carbon dioxide gas.3

Conversely, if an individual takes a dose of a Betain hydrochloride supplement (this should always be at the start of a meal) and experiences the warmth/burning or indigestion associated with excess acid, further B-CHl supplementation is not advisable, and a neutralizing teaspoon of sodium bicarbonate in water should provide relief.

Individuals who believe they have symptoms of either excess or insufficient hydrochloric acid in the stomach should consult with their doctor, and should never change their health management regime without doing so. Additionally, supplement manufacturers commonly advise that:

1. People using non-steroidal anti-inflammatory drugs such as ibuprofen (NSIADs), cortisone-like drugs, or other medications with the potential to cause a peptic ulcer (a break or sore in the tissue lining the upper digestive tract) should avoid supplementation with Betaine hydrochloride.

2. Pregnant or nursing women, children, and people with kidney or liver disease should avoid Betaine hydrochloride supplementation, because its safety for these populations has not been established.

If you are in doubt about what over-the-counter or prescription drugs, dietary supplements, or combinations of these may irritate the digestive tract or affect the production of digestive juices, consult a pharmacist.


1. “Dr. Paul R. Cheney’s Basic Protocol Supplement/Health Aid Recommendations, (2003),” CFIDS & FMS Support Group of Dallas-Fort Worth, http://www.dfwcfids.org/medical/basc2003.html
2. “Dr. Paul Cheney on Betaine for Chronic Fatigue Syndrome and Fibromyalgia Patients,” by Carol Sieverling, November 7, 2001, http://www.immunesupport.com/library/showarticle.cfm/ID/3171/e/1/T/CFIDS_FM/
3. “Stomach Acid Assessment,” by Dr. Joseph A. Debé, at http://www.drdebe.com/stomachacidtest.html

Note: This information has not been evaluated by the FDA. It is generic and is not meant to prevent, diagnose, treat, mitigate, or cure eany condition, illness, or 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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2 thoughts on “Acid Stomach – or Not Enough Stomach Acid? The Symptoms Are Similar, but For CFS and FMS Patients It’s Often the Latter”

  1. DrRobDAquila says:

    Great article! I see hypo-chlorhydria as being much more prevlent in my patients than hyper-chlorhydia. I also believe GERD is extremely over/mis-diagnosed. Lastly, there should be as many Heidlberg tests administered as there are GERD diagnoses when acid-stopping medication prescriptions are dispensed.

  2. elinormartin says:

    when 75 years old, i could keep nothing down. lost 30 pounds in one month. had every test known to god and man… nothing showed up. my doctor did not know what to do. am trying to make this short as [possible. i found a naturopath. saved my life. she informed me my whole system had crashed.. i could have told her that myself. family looking at me like i was already dead.. she put me on many vitamins, minerals, and predigested protein. and HCL . i wanted to kill myself when i looked at all those pills. she informed me to decide right now whether i wanted to live or not.. it is that critical for you.. so i kept it up. i had to drink raw juices to be able to hold anything down.. after three or four weeks she started me on the HCL. i could actually eat an egg. two months later, i knew i was going to live. what a joy to take the HCI caps. after three months i ate mexican food and swallowed six 650 mg caps during the meal. my proton pumps had died because of all the antacids. yep ! the purple pill plus many others. today i am 83 years old. eat anything i want to. my proton pumps must have repaired themselves because they are working perfectly now.
    i never told my doctor about the naturopath. just told him about the HCL.. he agreed the betaine might have had something to do with it. but would not agree about the acid. i now am 83 years old. my blood pressure is 112/75 . and i am on no meds.. i go in for my check up and as i am going out the door he says, AMAZING, JUST AMAZING..I AM VERY GRATEFUL SOMEONE KNEW WHAT TO DO TO HELP ME. AND I THANK GOD FOR IT EVERY SINGLE DAY OF MY LIFE. I AM ALSO RAISING KIDS. I HAVE A 12 AND 16 YEAR OLD BOYS. HAVE A BLAST BEING GRANNIE TO THEM.. THE HCL IS ABSOLUTELY A LIFE SAVING PRODUCT. MY GASTRO DR REFUSED TO TEST MY STOMACH ACID AND LAUGHED AT ME FOR SUGGESTING IT TO HIM.. SO AM BLESSED BECAUSE I WOULD NOT BE HERE NOW IF NOT FOR THE HCL… GOOD LUCK AND GOD BLESS ALL THAT ARE LOOKING FOR A NATURAL WAY TO SAY ON THE PLANET.

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