Friday, March 9, 2018

Folate and Homocysteine: Is There Diminishing Returns?

By now it is common knowledge that B-vitamins, particularly folate, B6, and B12, are extremely important to metabolize the amino acid, homocysteine, which is an intermediate in the metabolism of methionine and cysteine, and has been implicated in vascular disease.

Recently I had the opportunity to review a nutritional product that was touted as a supreme homocysteine support product.  It looked good, actually, but something stood out to me that is apparently not common knowledge among practitioners and supplement manufacturers.

The more-is-better idea is a common mindset among holistic pill poppers and those recommending them.  However, the idea that more is better does not apply to many things, and folate's role in homocysteine metabolism is one of them.

The supplement I reviewed has over 2,000 mcg of folate, which impresses many casual observers.  However, it must be noted that according to a study on homocysteine and folate published in The American Journal of Clinical Nutrition, even very low dose folate supplementation of 200 mcg lowers homocysteine significantly, and most notably, there was no difference in high dose folate supplementation and moderate dose supplementation in lowering homocysteine levels. (See chart below.)  Moderate dosing of 800 mcg lowers homocysteine by 23%, but pushing the dose up to 2,000 mcg did not show any additional benefit.  Even very high dosing at 5,000 mcg showed only minimal additional benefit of a mere two percentage points.  

What might make more sense in achieving the perfect formula for homocysteine metabolism is to keep the folate levels moderate in order to keep the cost down and make room for other important nutrients that aid in the methylation cycle and renal clearance of homocysteine -- nutrients such as molybdenum, N-acetylcysteine (NAC), manganese, betaine, etc.

NAC, in particular, is an important antioxidant that serves many roles in the body.  For example, it is an amazingly powerful antioxidant that supports liver detoxification and glutathione levels in the body, but it is also important for renal clearance of homocysteine.  Therefore, significant amounts of NAC (500 mg or more) should be considered to support those with elevated homocysteine or who have had a history of issues along these lines.

Consider supplementation that supports all four levels of homocysteine clearance (see below).

Saturday, February 3, 2018

Colostrum vs. 2'FL: What you Need to Know

Colostrum is being touted by some sources as the "best" thing for gut health.  But there are some things to be aware of.

First of all, colostrum products are not derived from human sources, but bovine.  Cows, of course, have radically different GI function compared to humans, and bovine colostrum is different in its composition compared to human colostrum.  While there is some evidence that bovine colostrum can have some benefit in humans, it also must be pointed out that commercially available colostrum products also typically contain milk proteins, which would rule them out for people with milk allergies.  

There is also an ethical consideration to "true" colostrum pertaining to mother's "first milk." Some feel an ethical consideration whereby that "first milk" be saved for the feeding calf and not harvested for commercial use. This is an animal rights issue, as well as ultimately a human health issue, since beef raised without the benefit of colostrum can be less healthy.

Therefore, some companies have chosen to avoid this kind of product and go instead with products that are colostrum-like or contain ingredients that provide some of the same healing properties, but without the milk proteins and without the ethical concerns.

Biopure ProteinTM, for example, is not colostrum, but colostrum-like in that there is higher immunoglobulin content and special processing to preserve these immunoglobulins. These milk-derived immune proteins are as high in concentration as colostrum, and, in some cases, can be even higher, because the immunoglobulins can vary with the seasons.

Another choice is the human milk oligosaccaride (HMO), 2' fucosyllacstose, or 2'FL.  This new and novel ingredient is considered an HMO because it is an oligosaccaride bioidentical to the ones found in HUMAN breast milk.  

Colostrum is the first secretion of milk produced by the mammary glands in late pregnancy and a few days after giving birth, used as ‘first feeding’ of the infant.  2’FL is found in human colostrum as it is a naturally occurring component of human breast milk (one of the most abundant HMOs). It is an important prebiotic and anti-adhesion compound. (Human colostrum, by the way, is not available as a dietary supplement.  At least we hope not!)

The researh on 2'FL is piling up, showing that it has potent antimicrobial properties, as well as providing fuel for the growth and proliferation of probiotic bacteria, thus helping to establish a healthy microbiota.  

A 6-week study on the functional food product, UltraGI Replenish, studied on patients with a history of IBS and IBD (but not acute during the time of the study) showed that 7 of 8 pathogenic bacteria were no longer detectable at the end of the six weeks, and bifidobacteria went wild, increasing 19-fold!  SCFAs also increased significantly, in addition to the improvements of several other gut biomarkers.  Symptoms and quality of life scores also improved dramatically.1 

There is no shortage of players in nature's pharmacy for gut health, and 2'FL appears to be one of the most promising ingredients on the market to emerge in a long time.   

1. A Medical Food (UGIR) Reduces Gastrointestinal Symptoms and Beneficially Alters Gut Microbiota in Adults with IBS and IBD
A Multi-Clinic, Open-Label Study, MET2151 070516 © 2016 Metagenics, Inc. All Rights Reserved.

Tuesday, January 30, 2018

VITAMIN C: Still a Superstar and Growing in Fame Even More

Since the 1970s, Vitamin C has enjoyed superstar status, partly due to Dr. Linus Pauling's Nobel Prize winning work.  But for the past several years, good ole' ascorbic acid has been making a rebound in the research, as this "old news" vitamin has been showing great promise for a number of health applications other than just immunity.  
For example, research has shown that vitamin C protects against endothelial dysfunction, high blood pressure, and the blood vessel changes that precede heart disease.1-3 Additional research is discovering that vitamin C can be helpful in preventing asthma,4 protecting against cancer,5 and supporting healthy blood sugar levels in diabetics.6
While often taken for granted, vitamin C is a critical supplement in improving cardiac health and avoid degenerative diseases.  

British researchers, for example, studied the effects of vitamin C supplementation (250 mg/day) on atherosclerosis in 40 healthy adults.7 Before the study, subjects with low pre-supplementation levels of vitamin C had 30% greater monocyte adhesion than normal, putting them at higher risk for atherosclerosis. Impressively, after six weeks of supplementation, the rate of this dangerous monocyte adhesion actually fell by 37%!  

  • Ascorbic acid, or vitamin C, is a potent antioxidant with increasingly diverse uses in health promotion and disease prevention. 
  • Every step in the progression of atherosclerosis can benefit from the antioxidant power of vitamin C, from preventing endothelial dysfunction and altering lipid profiles and coagulation factors to preventing blood vessel changes that can lead to strokes and other vascular catastrophes. 
  • Vitamin C supplements reduce cellular DNA damage that is the vital first step in cancer initiation and also reduce the inflammatory changes that allow a malignant cell to grow into a dangerous tumor.  Additionally, vitamin C has been shown to be chemoprotective, showing protection from both the toxic effects of chemotherapy drugs, but also increasing the anti-tumor activity of chemotherapy, while perhaps reducing the risk of getting cancer in the first place.  8,9,10,11,12,13,14
  • Vitamin C supplements enhance the health-promoting effects of exercise and reduce exercise-induced oxidative damage. 15
  • Vitamin C supplements also dramatically combat the oxidative damage caused by smoking and exposure to tobacco smoke. 16
  • In respiratory conditions, vitamin C supplements help avert or shorten the duration of common colds and may mitigate the risk of serious respiratory conditions like asthma.17, 18,19
  • Vitamin C supplements can speed the clearance of the stomach disease-causing bacterium Helicobacter pylori and cut the risk of gastric cancer it causes.  20,21

While all the above benefits can be obtained by taking basic ascorbic acid, the effects may be enhanced by either adding other antioxidants to the mix, or providing a buffered and better absorbed forms.  Vojdani et al at Drew Medical College showed in 1993 that an admixture of vitamin C metabolites, presursors, and asorbates, along with a more bioavailable form of vitamin C, ascorbyl palmitate, was able to not only provide better uptake into the white blood cell, but the effect on leukocyte activity and overall immunity was profoundly better than ascorbic acid alone.22  This exact formula used in the Drew Medical College study is patented and available commercially in only one place.  Ascorbic acid products are typically not patented and are bountiful on the market.  

Still another study showed that a buffered admixture vitamin C supplement increased the natural killer (NK) cell activity 10-FOLD in 78% of patients who had decreased NK, T and B cell function due to chemical exposure!  T and B cells also returned to normal.23  

Yes, while vitamin C is sort of yesterday's news in a market of trendy supplements now too long to list, it remains one of the most powerful and effective vitamins in the world for overall health. 

1. Rossig L, Hoffmann J, Hugel B, et al. Vitamin C inhibits endothelial cell apoptosis in congestive heart failure. Circulation. 2001 Oct 30;104(18):2182-7.
2. Fotherby MD, Williams JC, Forster LA, Craner P, Ferns GA. Effect of vitamin C on ambulatory blood pressure and plasma lipids in older persons. J Hypertens. 2000 Apr;18(4):411-5.
3. Salonen RM, Nyyssonen K, Kaikkonen J, et al. Six-year effect of combined vitamin C and E supplementation on atherosclerotic progression: the Antioxidant Supplementation in Atherosclerosis Prevention (ASAP) Study. Circulation. 2003 Feb 25;107(7):947-53.
4. Romieu I, Sienra-Monge JJ, Ramirez-Aguilar M, et al. Antioxidant supplementation and lung functions among children with asthma exposed to high levels of air pollutants. Am J Respir Crit Care Med. 2002 Sep 1;166(5):703-9.
5. Guz J, Dziaman T, Szpila A. Do antioxidant vitamins influence carcinogenesis?. Postepy Hig Med Dosw.(Online.). 2007;61:185-98.
6. Afkhami-Ardekani M, Shojaoddiny-Ardekani A. Effect of vitamin C on blood glucose, serum lipids & serum insulin in type 2 diabetes patients. Indian J Med Res. 2007 Nov;126(5):471-4. 
7. Woollard KJ, Loryman CJ, Meredith E, et al. Effects of oral vitamin C on monocyte: endothelial cell adhesion in healthy subjects. Biochem Biophys Res Commun. 2002 Jun 28;294(5):1161-8.
8. Bast A, Haenen GR, Bruynzeel AM, Van d, V. Protection by flavonoids against anthracycline cardiotoxicity: from chemistry to clinical trials. Cardiovasc Toxicol. 2007;7(2):154-9.
9. bdel-Latif MM, Raouf AA, Sabra K, Kelleher D, Reynolds JV. Vitamin C enhances chemosensitization of esophageal cancer cells in vitro. J Chemother. 2005 Oct;17(5):539-49.
10. Chen J, Kang J, Da W, Ou Y. Combination with water-soluble antioxidants increases the anticancer activity of quercetin in human leukemia cells. Pharmazie. 2004 Nov;59(11):859-63.
11. Chen J, Wanming D, Zhang D, Liu Q, Kang J. Water-soluble antioxidants improve the antioxidant and anticancer activity of low concentrations of curcumin in human leukemia cells. Pharmazie. 2005 Jan;60(1):57-61.
12. Correa P, Fontham ET, Bravo JC, et al. Chemoprevention of gastric dysplasia: randomized trial of antioxidant supplements and anti-helicobacter pylori therapy. J Natl Cancer Inst. 2000 Dec 6;92(23):1881-8.
13. Maramag C, Menon M, Balaji KC, Reddy PG, Laxmanan S. Effect of vitamin C on prostate cancer cells in vitro: effect on cell number, viability, and DNA synthesis. Prostate. 1997 Aug 1;32(3):188-95.
14. Wei DZ, Yang JY, Liu JW, Tong WY. Inhibition of liver cancer cell proliferation and migration by a combination of (-)-epigallocatechin-3-gallate and ascorbic acid. J Chemother. 2003 Dec;15(6):591-5.
15. Thompson D, Williams C, McGregor SJ, et al. Prolonged vitamin C supplementation and recovery from demanding exercise. Int J Sport Nutr Exerc Metab. 2001 Dec;11(4):466-81.
16. Block G, Jensen C, Dietrich M, et al. Plasma C-reactive protein concentrations in active and passive smokers: influence of antioxidant supplementation. J Am Coll Nutr. 2004 Apr;23(2):141-7.
17. Romieu I, Trenga C. Diet and obstructive lung diseases. Epidemiol Rev. 2001;23(2):268-87.
18. Trenga CA, Koenig JQ, Williams PV. Dietary antioxidants and ozone-induced bronchial hyperresponsiveness in adults with asthma. Arch Environ Health. 2001 May;56(3):242-9.
19. Tecklenburg SL, Mickleborough TD, Fly AD, Bai Y, Stager JM. Ascorbic acid supplementation attenuates exercise-induced bronchoconstriction in patients with asthma. Respir Med. 2007 Aug;101(8):1770-8.
20. Correa P, Fontham ET, Bravo JC, et al. Chemoprevention of gastric dysplasia: randomized trial of antioxidant supplements and anti-helicobacter pylori therapy. J Natl Cancer Inst. 2000 Dec 6;92(23):1881-8.
21. Chuang CH, Sheu BS, Kao AW, et al. Adjuvant effect of vitamin C on omeprazole-amoxicillin-clarithromycin triple therapy for Helicobacter pylori eradication. Hepatogastroenterology. 2007 Jan;54(73):320-4.

22.  Vajdoni, A, et al.  In Vivo Effect of Ascrobic Acid on Enhancement of Human Natural Killer Cell Activity.  Drew University of Medicine and Science, Published in Nutritiona Research, Vol. 13, pp. 753-764, 1993.

23. Enhancement of natural killer cell activity and T and B cell function by buffered vitamin C in patients exposed to toxic chemicals: Immunopharmacol Immunotoxicol. 1997 Aug;19(3):291-312 

Thursday, December 28, 2017

How Detoxification Can Change Lives (Kenny and Julia Loggins)

Singer/songwriter, Kenny Loggins, who has become known as the king of movie hits, has sold over 40 million records over a span of more than 30 years and won two Grammys.  If you are my age, some of you might know him for hits like, I'm Alright, Meet Me Halfway, and numerous others.  

Several years ago, Julie Katke, the daughter of Metagenics founder, Jeffrey Katke, was walking on a southern California beach, when who did she bump into?  You guessed it.  Kenny Loggins and his wife Julia were walking on the same beach, and Julie decided to introduce herself.  It turned out that the Loggins' were very nice and approachable people, and they stopped to talk with Julie for a few minutes.  They asked her what she did for a living, and she mentioned her career with Metagenics.  When she said the word, "Metagenics," suddenly the eyes of the couple got wide. Kenny said, "You've got to be kidding!"  And he turned to his wife and unzipped her backpack and pulled out a container of Ultra Clear.  He excitedly informed Julie that the product had saved his wife's life.

They went on to tell the story of Julia's long and extended illness for which they could find no help, and the Ultra Clear was the only thing that had helped her, and had ultimately helped to restore her health.  

I have seen stories like this over and over for the last 24 years of my career, and one of those stories is my own, which I will share in a different post.

If you have not yet experienced the life-changing benefits of nutrient-tailored metabolic detoxification, look into the Metagenics detox products such as the Ultra Clear line, or the Clear Change Detox Kits.  

Thursday, October 26, 2017

Magnesium L-Threonate: New Weapon for Brain Protection

It has been lately discovered that magnesium is vital in the activation of nerve channels that are involved in synaptic plasticity, meaning that magnesium is a critical player for the physiological events that are fundamental to the processes of learning and memory.
One form of magnesium in particular, magnesium L-threonate, has the unique ability to permeate the brain and enhance the receptors that are involved in this process. Many forms of magnesium do not effectively cross the blood brain barrier. The magnesium threonate is a chelated magnesium (similar to magnesium Glycinate) which binds the magnesium with a carrier molecule, in this case the amino acid, L-threonate. This chelation provides a form or magnesium that effectively crosses the blood brain barrier and positively impacts synapses. 
As reported in the Journal, Neuron, researchers demonstrated in laboratory animals actual enhancement in the learning abilities, working memory, as well as short and long-term memory, and even quality of sleep when given magnesium magnesium threonate.
One of the most aggressively studied forms of magnesium L-threonate is a patented version by the trade name, Magteinä, developed by researchers at MIT, including a Nobel Prize winner. Their research has  demonstrated actual restoration of function in aging neurons in laboratory animals. Further, it appears that Magteinä may, in fact, be the only form of magnesium that significantly increases the levels of magnesium within the brain.
Anecdotal reports in humans are showing benefits for PTSD, anxiety, and depression as well.  
Magnesium is involved in over 300 biochemical processes in the body, including binding to neurotransmitter receptors and as a co-factor for neuronal enzymes.  The Magnesium L-Threonate appears to be a form preferable for cognitive decline and neuron protection.  

Tuesday, September 12, 2017

Breaking Down the Evaluation Criteria (or lack thereof) of a Popular Online Guide for Multivitamins

Recently it was brought to my attention that a self-proclaimed resource for evaluating multivitamins, a source I will leave nameless in print but that the reader is free to ask me about, gave a not-so-good evaluation of some products that I passionately believe in, but glowing recommendations for products that might be considered questionable.  So I wanted to respond by evaluating the "evaluators."

Perhaps I should start by showing the faulty evaluation method in the multivitamin that they ranked at the top of their list, which I will leave nameless for this post.  Most doctors by now know that if a form of a certain nutrient isn't listed, it's probably the cheap, junky stuff.  The reader should take note of several important micronutrients listed in their #1 ranking that do not have the forms listed: iron, magnesium, vitamin E, B6, B12, calcium, etc.  Nearly 100% of the time, when a product line does not list the forms, it is most likely the cheapest and least-effective forms on the planet.  In evaluating any vitamin supplement, it is vital to consider the forms of the ingredients -- ones that are clinically-proven to be effective. (BTW: listing a source, such as algae, is not the same as listing the FORM.)  It is equally important to look at the company's commitment to full disclosure on the labels.  

Secondly, the product in question lists an enzyme blend on their label.  Those who are in-the-know understand that enzymes mixed into a multivitamin is a dead ringer that the product line doesn't know what they're doing.  You cannot add enzymes in with a laundry list of other ingredients like this and have any enzymes left by the time the product is brought to market.  Enzymes gobble things up.  That's what enzymes do.  The enzymes thus denature themselves when they start that process so that in no time there's nothing left.  In doing so they also diminish the levels of many other ingredients in the product.  If a third-party laboratory assay was performed to measure the amount of live enzymes this product, I would be willing to bet that they aren't there. Most likely the company in question does not perform third-party or even in-house assays since the FDA does not require them, and since doing so would most likely show that the product in question has no live enzymes as the label claims.  

In this same product there is also CoQ10 listed on the label.  The consumer should be aware that CoQ10 is very unstable and denatures very easily when combined with several other ingredients.  Even if it was stable, the fact that it's in a powder/capsule form diminishes its effectiveness, since research shows that oil-based CoQ10 is 3-FOLD more bioavailable than dry forms.  

And THIS is the product that this self-proclaimed evaluator of quality multivitamins ranks number one???  

Additionally, here's some very inaccurate statements made about Cyanocobalamin (B12) on the site, and my short response:

  • "Most manufacturers go with the synthetic cyanocobalamin form because it is cheaper to make and has a longer shelf life."  
    • WRONG - Cyanocobalamin is used because it is the most clinically validated, with reams of data involving MILLIONS of patients. 
  • "Unfortunately, it cannot be readily absorbed by the body."
    • WRONG AGAIN.  The research shows the exact opposite.
  • "It also contains trace amounts of cyanide..."
    • "INFINITELY WRONG.  Who is writing this stuff, anyway?  B12 in any form does not contain cyanide.  The "cyano" part of cyanocobalamin has nothing to do with cyanide.   
  • "...making it slightly toxic [wrong] if taken over a long period of time [wrong]...."
When writing content on health-related topics, it really helps to consult the research first.  

(By the way, our multi/phytonutrient blend contains the methylcobalamin form of B12, but not because it's better than cyano.  This was only in response to doctor requests who didn't want to continue answering questions having to do with this unfortunate misunderstanding of this topic.  Having this form of B12 in the product makes these questions go away.  Both forms are very good, but the idea that cyano is an inferior form is categorically false. Feel free to ask me for references.)  

In looking closely at the quality assessment criteria of the site in question
, it becomes obvious 
that it is based on the number 
of nutrients 
and the amounts, 
which is 
a subjective label review
, not objective.
Can one define and determine quality based on a label review of ingredients?
​ ​
Absolutely not!  
It is a qualitative opinion of the individuals and not one of particular value to a practitioner or consumer in trying to determine which supplement to purchase. 

Does the author include an understanding of herb manufacture as a measure of quality? 
 they provide a quality assessment of the listed actives in the standardized herb proving they survive manufacture so that they can provide clinical value to the consumer
Do they reference any bioactive profiles to prove the herbs are alive, effective, and that the active constituents are maintained at high levels?  Nope.  

And what about 
clinical proof
 Did the 
author include published clinical validation as part of their quality analysis? No.  And why not?  Here's an article showing the importance of this kind of evaluation:

I'm not certain, but the site in question might be related in some way to the book, Comparative Guide to Nutritional Supplements.  The criteria looks very similar.  That book has been around for many years. The author is a former board member for a multilevel supplement company. While everyone has to read for themselves and draw their own opinions, close scrutiny of the book -- as well as the website in question -- suggests the authors (along with a small committee) decided for themselves what nutrients and at what levels should be found in what a 'quality' supplement is, in THEIR OPINION. Then, in essence, they said, "Let’s compare and see who gets closest." One has to decide if this is really a marker of quality. Or, for our phytonutrient/multivitamin blend as an example, is quality ORACfn a much better measurement of phytonutrient 'freshness' and activity? Is COMET assaying a measure of quality? Is peer-journal publication a mark of multivitamin quality

I have not even gotten to GMP, third-party gluten-free certification, GMO status, and on-and-on. Everyone just has to answer for themselves what true quality is, I guess. Is it, "We think quality is specific ingredients at these specific levels," or the kind of standards found in the published research?  


"On what, if any, standards are these scoring systems based?"  

The patient won't be able to tell you, of course, because the site itself can't tell you.  As far as I can tell, again, it's someone's opinion, because they certainly didn't consult the research.  Everybody has an opinion...and a belly-button. "I devised a scoring system..." is not based on fact or objectivity.  Remember that old Wendy's commercial where the old lady demanded, "Where's the beef!?"  That's the same question people should be asking when it comes to research.  Anyone can SAY anything!  I can SAY that our multi grows hair on the heads of 8 out of 10 bald men, and you know what -- if I put that on a website, a lot of people would believe it and buy the product on the basis of that statement.  But where's the beef?  Where's the research to validate my claims?  Without that, the claims on the product are not worth the paper they're printed on.  

Now, if you want research and an objective way to evaluate a multi, it may interest you to know that a study published in 
GLOBAL ADVANCES IN HEALTH AND MEDICINE showed that our phytonutrient/multivitamin blend effected improvements in several health parameters, including cardio markers MPO, LDL, CRP, and PAI-1, as well as the Comet Assay, and an antioxidant level evaluation in the PERSON after taking the product, not just the product itself.  

How come the "evaluators" of this site (and I use that term very loosely) didn't use this kind of criteria?  Good question, Sherlock.

Okay, if I go any further I'm gonna start getting really snarky or start preaching like a Pentecostal evangelist at a tent revival.  So I better quit. 

But here's another very short tidbit I will leave you with:  The site in question denigrates folic acid, yet their #2 recommendation for multis uses straight folic acid. How is it possible that they gave that product the number two ranking, then?  They aren't even consistent with their own standards.  Someone is greasing someone's hand here.  OR, they aren't even really paying attention to what they are saying versus the products they are recommending.  One or the other.  In either case, even a cursory analysis of this site shows they are totally unreliable as a scientific source. 

Friday, July 28, 2017


The topic of proton pump inhibiting drugs, or PPIs, otherwise known as acid blockers, has been a topic near and dear to my heart recently because my father, who is very medically indoctrinated, has been on a PPI for YEARS, and is now very sick with some of the side effects, such as extreme fatigue, stomach distension, and small intestine bacterial overgrowth, or SIBO.  He was also diagnosed with bladder cancer, and a 2011 study showed that PPIs are linked to cancer, although the form of cancer analyzed in that study was esophageal cancer. 

So in researching this topic for the benefit of my father, I discovered that PPI’s were never intended to be used long term anyway, even by the standards of the drug companies who make them.  Yet my Dad and countless other PPI users have been on them for years. 

If you know even basic physiology, it’s not really rocket science to know that suppressing the stomach acid at all, especially for stretches of years, is a really, really bad idea.  Stomach acid is the first line of defense against pathogenic bacteria, it stimulates peristalsis, it initiates bile secretion, and of course it helps to assimilate important nutrients like B-vitamins, minerals, and protein, just to name a few.

Let’s just consider SIBO for a moment.  If stomach acid is suppressed, it allows some pathogens to survive in the stomach that would otherwise be eliminated, leading to infections of the stomach like H. Pylori.  But then that pathogenic bacteria gets transported into the small intestine, and later the bowel, and can also go systemic, leading to all different kinds of potential maladies related to that circulating bacteria. 

Likewise, suppressing the stomach acid can lead to putrefaction of food in the stomach, leading to halitosis, distension, and more problems with indigestion.

And actually, this is where the whole maddening thing about using acid blockers in the first place needs to be addressed, because the whole idea about acid reflux being a manifestation of too much acid represents a lack of understanding, in some cases, of stomach physiology. 

Think about it.  Our stomachs have these cool little muscles at the top called the esophageal sphincter, which pinches off and blocks the acid from reaching the esophagus.  That muscle is activated by, guess what?  Stomach acid!  If a patient has hypchlorhydria, or low stomach acid, that muscle’s action can be inhibited, and it might not activate like normal, resulting in what little stomach is there reaching the esophagus.  Now, even a little acid in the esophagus is very irritating, and the medical interpretation is, “Oh! You have too much stomach acid.  Let’s block it.”  No, that patient probably has too LITTLE stomach acid, but the manifestation is burning in the chest and throat.

Here’s an example that I think will be helpful and applicable.  One Thanksgiving my older sister was at our house sharing the Thanksgiving meal with us, and afterward she sat down on my couch holding her stomach and moaning.  When I asked what was wrong, she said she had been struggling with indigestion and acid reflux for a long time, and she was having another episode.  So I gave her three tablets of a product containing betaine HCl and pepsin, or stomach acid.  In about 20 minutes she felt so much better that she had to ask me what it was that I gave her.   Sometimes if the problem is mild you can accomplish the same thing with apple cider vinegar.  I have had some success with that approach as well.

Now, having a patient go off a PPI can be tricky, because the parietal cells in the stomach have been suppressed for so long that sometimes it can trigger a strong rebound effect.  So to fight that, I would recommend having a combination powder containing DGL, aloe, and glutamine.  That combination is great in helping to soothe the discomfort associated with acid reflux while the patient is weaning off the drug. 

I also had a practitioner just this past week tell me that she gives magnesium to patients coming off long term PPIs because it helps get peristalsis going again, so I thought that was good insight. 

Feel free to reach out me if you need some product guidance.