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Benefits of Betaine with Pepsin for Hypothyroidism

Could supplementing with digestive enzymes help hypothyroid patients relieve gastrointestinal symptoms?
Benefits of Betaine with Pepsin for Hypothyroidism
Last updated:
8/21/2024
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The Big Picture

In this article

One of the more common symptomatic areas affected in autoimmune thyroid diseases like Hashimoto’s and hypothyroidism is the gastrointestinal (GI) system, with issues such as bloating, irregular bowel movements, and acid reflux. These GI issues are often seen in people with an autoimmune condition like Hashimoto’s and hypothyroidism because of hypochlorhydria, or low stomach acid, characteristic of an underactive thyroid.

Stomach acid breaks down food into essential nutrients, so a lack of this acid creates imbalances and other health issues, including nutrient deficiencies, food sensitivities, and small intestinal bacterial overgrowth (SIBO).

Ahead, a look at how targeting this issue head-on with supplements may be a solution.

Understanding digestion

It’s important first to understand how digestion occurs, which involves exploring the two ways digestion takes place: mechanically and chemically. We’ll break it down step by step:

1) When food enters the mouth, the mechanical action of chewing mixes food with saliva. Saliva is rich in mucus and salivary enzymes that, combined with chewing, create food you then swallow.

2) The food travels down the esophagus and into the stomach.

3) The stomach begins both a mechanical and chemical digestive process. Mechanically, it begins to squeeze and churn the food.  Chemically, the stomach secretes a mixture of compounds –  including water, mucus, hydrochloric acid, pepsin, and other enzymes – to help break down macronutrients such as protein, fat, and carbohydrates. 

4) Once everything has been processed, it’s on to the digestive tract, where food moves through the three areas of the small intestine – the duodenum, the jejunum, and the ileum. Food is broken down further in the small intestine by bile released by the liver and pancreatic enzymes.

5) Nutrients are absorbed into the bloodstream and transported where they need to go throughout the body.

6) Any undigested foods move into the large intestine (colon), forming stool that is eventually eliminated during bowel movements. 

Now that you better understand how the digestive process works let’s explain the role of betaine and pepsin.

What is betaine?

The combination of choline with another amino acid called glycine creates betaine, a chemical made in the body that helps to break down proteins, specifically homocysteine. Choline is an essential nutrient available in the human body and in many foods. Without choline, the body cannot produce enough betaine. Betaine is also involved in liver function, cellular reproduction, and in making carnitine, an amino acid and protein building block that plays a crucial role in energy production. Choline is found in beef liver, chicken liver, eggs, bacon, soybeans, and pork. Betaine is readily available in broccoli, seafood, spinach, and beets.

When the body cannot break down certain proteins, a buildup of homocysteine in the blood can develop. This inherited condition is known as homocystinuria, and can cause symptoms such as extreme fatigue, abnormal bone structure, weakened bones, blood clots, and weight loss. Betaine supplementation works by reducing the amount of homocysteine in the blood. Aside from the inherited condition, people can still develop high levels of homocysteine, and again, betaine can be useful to help lower those levels.

What is pepsin?

Pepsin is a stomach enzyme that helps with the effective digestion of proteins in foods. Usually, gastric cells secrete pepsin in its initial form, called pepsinogen. Cells within the stomach lining, called parietal cells, secrete hydrochloric acid that helps lower the stomach’s pH, making it easier to begin digesting protein. Pepsin depends on that acidic environment for effective protein digestion. When there’s a lack of pepsin and stomach acid (called hydrochloric acid), several issues can develop, including bloating, constipation, diarrhea, indigestion, and acid reflux. Low stomach acid can also result in inadequate absorption of nutrients.

Betaine and pepsin for people with Hashimoto’s and hypothyroidism

Is supplementing with betaine and pepsin beneficial for those with Hashimoto’s and hypothyroidism? When looking at the benefits of both separately, the answer is yes! 

1) Betaine can help to support heart health

Hypothyroid patients are at higher risk of cardiovascular disease. Betaine can help reduce homocysteine levels, a factor directly related to lowering your risk of heart disease.  Supplementing with betaine could be helpful, and multiple research studies have shown how supplementing with betaine can help lower homocysteine levels.

2) Betaine has anti-inflammatory effects 

As most of us know, chronic inflammation is a common driver of autoimmune diseases such as Hashimoto’s’. Betaine offers protection against inflammatory conditions.

3) Both betaine and pepsin help you normalize stomach acid levels 

Betaine helps promote the body’s ability to create hydrochloric acid. As we’ve discussed, your stomach needs adequate levels of stomach acid to break down food. Pepsin is also required to help digest and absorb nutrients and resolve poor protein digestion. 

4) Pepsin supports digestion

Digestion in thyroid patients is often slow. In one study, patients experiencing gastrointestinal disorders had an improvement in symptoms after six weeks of continuous use of pepsin supplements.

While betaine with pepsin won’t resolve Hashimoto’s or hypothyroidism or heal a damaged thyroid gland, these supplements could help relieve residual GI symptoms in thyroid patients. If you are curious about supplementing with betaine with pepsin, please be sure you speak to a healthcare professional. Overdoing it can cause additional problems if you have other conditions, such as high cholesterol or kidney disease. That’s why checking in with your practitioner before beginning these supplements is smart.

A note from Paloma

The essential step in resolving gastrointestinal issues with Hashimoto’s and hypothyroidism is the optimal treatment of your thyroid condition. Consider scheduling a virtual visit with one of our top Paloma Health practitioners. Our entire Paloma Care Team is ready to support you with cutting-edge hypothyroidism care, from testing, diagnosis, and treatment, to nutritional and lifestyle support for optimal wellness.

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References:

Betaine Information | Mount Sinai - New York. Mount Sinai Health System. Accessed March 7, 2023. https://www.mountsinai.org/health-library/supplement/betaine#:~:text=Betaine%20%2D%2D%20also%20called%20betaine

‌Betaine: MedlinePlus Drug Information. medlineplus.gov. https://medlineplus.gov/druginfo/meds/a608012.html

‌Yago MR, Frymoyer AR, Smelick GS, et al. Gastric Reacidification with Betaine HCl in Healthy Volunteers with Rabeprazole-Induced Hypochlorhydria. Molecular Pharmaceutics. 2013;10(11):4032-4037. doi:https://doi.org/10.1021/mp4003738

Zeisel SH, Mar MH, Howe JC, Holden JM. Concentrations of Choline-Containing Compounds and Betaine in Common Foods. The Journal of Nutrition. 2003;133(5):1302-1307. doi:https://doi.org/10.1093/jn/133.5.1302

National Institute of Diabetes and Digestive and Kidney Diseases. Your Digestive System & How It Works. NIDDK. Published January 13, 2019. https://www.niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-works

McRae MP. Betaine supplementation decreases plasma homocysteine in healthy adult participants: a meta-analysis. Journal of Chiropractic Medicine. 2013;12(1):20-25. doi:https://doi.org/10.1016/j.jcm.2012.11.001

Zhao G, He F, Wu C, et al. Betaine in Inflammation: Mechanistic Aspects and Applications. Frontiers in Immunology. 2018;9. doi:https://doi.org/10.3389/fimmu.2018.01070

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Neeyaz Zolfaghari

Holistic Nutritionist and Nourishment Coach

Neeyaz Zolfaghari is the founder of Unspoken Nutrition, a nutrition and lifestyle brand dedicated to helping others find and create harmony with their daily habits to support their wellbeing and ‘health’. Her journey began over a decade ago, when she was diagnosed with two autoimmune diseases. Knowing what she learned from her upbringing, Neeyaz turned to nutrition as the first pillar of her healing. As her body began to heal on a physical level, she began to learn how our minds, bodies and souls are all innately connected.  

Now as an Integrative Nutritionist and Patient Advocate, Neeyaz offers the people she works with the support, guidance, and tools they need in order to live a fulfilled life. While Neeyaz initially endeavored to make a difference at the individual level, her vision grew to embrace broader community impacts. She is currently pursuing her Masters in Public Health, serving as a testament to her unwavering commitment to instigate change on a grander scale.

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