Age and Antacids: A Double Whammy Against Your Body's Optimal Health

Anti-aging enthusiasts will all tell you that eating a whole-food, organic diet is a necessary part of staying younger longer-and I agree with them. But such a diet won't do you much good if you're not digesting and assimilating the nutrients from the food you eat. That's why good digestion and assimilation are equally important factors in maintaining optimal health. Yes, you've read this from me before, but I'll repeat it from time to time until every anti-aging physician and enthusiast gets it.

The main causes of poor digestion and assimilation are age-related gastric hypochlorhydria (more commonly referred to as low stomach acid) and age-related gastric achlorhydria (which is no stomach acid at all). Like it or not, the older you get, the more likely you are to develop these problems.

According to research conducted in the early 1900s, approximately 50 percent of people over the age of 60 had significantly low stomach acid due to age. But if stomach acid tests conducted at the Tahoma Clinic are any indication, that number has jumped considerably since the initial research was done. (We use the extremely accurate "gastric analysis by radiotelemetry," also called the "Heidelberg capsule test.")

Unfortunately, doctors rarely recognize the seriousness of this problem and treat the underlying cause. Instead, many doctors today are only making the problem worse by putting people on patent medications specifically designed to suppress stomach acid production.

This could all be changing in the near future, though, as doctors are slowly becoming aware of the fact that low or no stomach acid can literally influence the health of the entire body. Not surprisingly, this "discovery" is coming about in a backward way: by observing the negative effects of patent medications that induce low levels of stomach acid-and even worse, ones that wipe it out altogether.

But whether your low stomach acid is caused by age, by certain acid-suppressing patent medications, or by both, the end result is the same: poor digestion and assimilation of nutrients that are vital for your body's ultimate health and longevity potential. And this isn't just theory: Published research shows that both patent medication induced gastric acid suppression and age-related lack of gastric acidity have the same effect on your body's ability to absorb nutrients.1

The good news is that whatever the underlying cause of low stomach acid is, the condition is easy to treat.

An open invitation for unfriendly intestinal bacteria

Low stomach acid levels lead to alterations in your intestinal microflora. Friendly intestinal microorganisms are dependent on the natural intestinal pH balance that results when all digestive organs are working well. When the major source of intestinal acidity (the stomach) fails or when it's suppressed by patent medications, intestinal contents become too alkaline, allowing unfriendly microorganisms to enter the scene, including Candida albicans (yeast) and many others.

The Journal of the American Medical Association (JAMA) published the results of a study demonstrating that two different types of patent medications known to suppress stomach acid are both associated with a significantly increased risk of overgrowth of a potentially serious intestinal micro-organism called clostridium difficile.2 This antibiotic-resistant bacterium produces a toxin that causes watery diarrhea, which can occasionally lead to hospitalization and sometimes even death.

Low stomach acid linked to hip fractures, pneumonia, macular degeneration, and more

The increased risk of infection that goes along with low gastric acidity isn't limited to the intestinal tract, though. Other studies have shown that when patent medications suppress stomach acid, many seemin-gly unrelated parts of the body are affected. And it makes sense when you think about it since individual nutrients are vital for maintaining all sorts of body functions.

For example, a study published last December in JAMA, which involved 150,000 individuals followed from 1987 to 2003, demonstrated that people who are on proton pump inhibitors (patent medications that totally shut off stomach acid production) have a significantly higher risk of a hip fracture. The researchers reported that the risk of hip fracture steadily increased with the length of time the patent medication was taken, as well as with higher doses.3 They suggested that the hip fractures were caused because of poor calcium absorption caused by the stomach acid suppression.

Having low stomach acid also increases your risk of developing pneumonia. When researchers studied 364,683 individuals-5,551 of whom developed community-acquired pneumonia-they found that those on acid-suppressing meds were four times more likely to develop pneumonia.4

And in 2005 researchers noted once again5 the finding that antacid use significantly increases the risk of age-related macular degeneration.6

Recently, researchers found that the suppression of gastric acidity also interferes with the absorption of vitamin C (although at this point they don't know what causes this to happen). In research involving a commonly prescribed acid-suppressive patent medication, they reached the following conclusion: "We have shown that a short course [only 28 days of the patent medication] will cause a reduction in the plasma vitamin C level of healthy volunteers. This decrease in plasma vitamin C is independent of dietary intake of the vitamin and indicates reduced bioavailability."7

Vitamin C isn't the only nutrient affected by low or absent gastric acidity. Older research demonstrated that iron, calcium, folic acid, vitamin B12, and zinc are all poorly absorbed when your stomach acid is low.8

Step up your anti-aging routine

If you're seriously into health maintenance and anti-aging, you should work with your doctor to monitor your stomach acid. If you do have age-related gastric hypochlorhydria or achlorhydria-and we all develop one or the other sooner or later-the problem is fairly easy to treat. Talk to your doctor about taking hydrochloric acid and pepsin capsules to improve your digestion and balance the pH of your gastrointestinal system.

Although it's not as common, poor digestion and/or absorption can also be caused by low levels of pancreatic enzymes and by hidden gluten/gliadin sensitivity. So your doctor should check those levels as well.

In the meantime, I also recommend reading the book that Lane Lenard, Ph.D., and I wrote about the causes and consequences of low stomach acid levels. Why Stomach Acid Is Good for You is available through compounding pharmacies, natural food stores, and the Tahoma Clinic Dispensary. (See the Resources section.) JVW

Age and antacids: a double whammy against your body's optimal health
1 Reference cited in Wright JV and Lenard L, Why Stomach Acid Is Good for You, Natural Relief From Heartburn, Indigestion, and GERD, Chapter 5.. M. Evans and Company, New York City, 2001
2 Dial S, Delaney JA, Barkun AN, Suissa S. "Use of gastric acid-suppressive agents and the risk of community-acquired Clostridium difficile-associated disease." JAMA 2005 Dec 21;294(23):2989-95.
3 Yang YX, Lewis JD, Epstein S, Metz DC. "Long-term proton pump inhibitor therapy and risk of hip fracture." JAMA 2006 Dec 27;296(24):2947-53.
4 Laheij RJ, et al. "Risk of community-acquired pneumonia and use of gastric acid-suppressive drugs." JAMA 2004 Oct 27;292(16):1955-60.
5 Clemons TE, Milton RC, Klein R, Seddon JM, Ferris FL 3rd; Age-Related Eye Disease Study Research Group. "Risk factors for the incidence of Advanced Age-Related Macular Degeneration in the Age-Related Eye Disease Study (AREDS) AREDS report no. 19." Ophthalmology 2005 Apr;112(4):533-9.
6 Age-related Eye Disease Study Group (AREDS). "Risk factors associated with Age-related macular degeneration," Ophthalmology 2000:107:2224-2232.
7 Henry EB, Carswell A, Wirz A, Fyffe V, McColl KE. "Proton pump inhibitors reduce the bioavailability of dietary vitamin C." Aliment Pharmacol Ther. 2005 Sep 15;22(6):539-45.
8 All references cited in Wright JV and Lenard L, Why Stomach Acid Is Good for You, Natural Relief From Heartburn, Indigestion, and GERD, Chapter 5. M. Evans and Company, New York City, 2001


This article was published in the March, 2007 issue of the Dr. Jonathan V. Wright's Clinical Nutrition & Healing newsletter.