SALT LAKE CITY—When it comes to nutrition, you are what you absorb. A great diet and all the right supplements won't make much difference if intestinal absorption is compromised, said S. A. Decker Weiss, NMD, at the annual meeting of the American Association of Naturopathic Physicians.
Good absorption is dependent on good digestion, and this depends on the inter-relationship between stomach acid production, enzyme activity, and pH regulation throughout the GI tract.
Ideally, the empty stomach has a pH of between 2–3 (very acidic), the full stomach is slightly less acidic at 4–5, and the intestines are highly alkaline at 8–9. Having the right pH in the right place at the right time is critical for proper enzyme function, and consequently, proper digestion.
The simplest way to get a sense of what is happening pH-wise in the digestive tract is to measure urine pH, said Dr. Weiss. "The first morning urine is ideal. Have the patient urinate out the first part of the stream, then fill a cup and dipstick test it." In a subject with healthy digestion, urine pH should be between 6.5 and 7. Anything consistently higher or lower signals trouble.
Unfortunately, many patients have highly dysfunctional digestive systems. It begins in the stomach, with low acid production. This results in poor breakdown of food, and sets the stage for downstream digestive dysregulation.
Acid n' Zimes Save Nine
If a patient is chronically reaching for antacids, get them to stop. The indigestion they seek to control may not actually be due to over-production of acid, and in the long run antacid overuse only exacerbates poor digestion.
Do not be afraid of HCl supplementation, said Dr. Weiss. There are a number of good products on the market, and 1–2 capsules taken with meals can greatly aid digestion. They have additional benefits in reducing Candida in the digestive tract. They also help to reset natural pH levels throughout the gut, thus reducing risk of both intestinal overgrowth with unfriendly bacteria and urinary tract infections. The only major contraindications to HCl supplementation are peptic ulcers and hiatal hernias.
HCl supplements work best when combined with pancreatic enzymes or ox bile, to aid digestion of lipids. Pancreatic enzymes are generally from animal sources, and should be taken with meals. The formula should be buffered with bicarbonate, to avoid inactivation by stomach acid.
There are several plant-based multi-enzyme supplements on the market, and they can markedly improve nutrient absorption. "Plant enzymes are typically active in a wide range of pH levels, and so are able to aid digestion throughout the GI tract." The best formulas contain a variety of enzymes capable of digesting all of the major nutrient groups at different pH levels.
Dr. Weiss stressed that patients who take a lot of supplements need to take enzymes as well. "You get very gassy if you take multiple supplements without enzymes."