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January is Thyroid Awareness Month

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Low Stomach Acid and Hashimotos

Discover the link between low stomach acid and your Hashimoto’s.
Low Stomach Acid and Hashimotos
Last updated:
1/13/2023
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Of the various symptoms of hypothyroidism and the autoimmune disease Hashimoto's, digestive issues are one of the most prevalent. Most commonly, those with thyroid disorders experience constipation and unwanted weight gain due to water retention. Understanding that the thyroid and stomach are closely linked helps to further understand why some digestive issues occur in hypothyroidism and Hashimoto's patients versus those without.

Physiology of the stomach

The stomach is a hollow organ that is part of the gastrointestinal system. Food is transported to the stomach from the esophagus and goes through various enzymatic reactions to prepare it for the next phase of the digestion process. It’s important to understand that one of the stomach’s physiological functions is to create an environment where the ingested food can be safely acted on by enzymes and an acidic environment. The stomach organ comprises four regions, with the wall of the stomach consisting of four different tissue layers. The surface cells are mucosal cells (mucus-producing) that help to create a barrier from its acidic environment.

Deeper in the stomach organ is the specialized cells, including the parietal cells. These cells are responsible for secreting gastric acid (HCL or hydrochloric acid) into the lumen of the stomach. Hydrochloric acid, in its simplest form, helps to create an acidic environment that further helps to break down and process the absorption of nutrients, specifically proteins, in the small intestine. In an average person, 3 to 4 liters of gastric juice are produced every day. Aside from being used to break down food, it is also used to kill off any unwanted bacteria. The secretion of this acid is regulated by the vagus nerve, which is why stress can often cause uncomfortable digestive issues (cue: butterflies in the stomach!)

What it means to have low stomach acid

Low or lack of stomach acid, also known as hypochlorhydria, simply means when the stomach is not producing enough hydrochloric acid. When the stomach is not able to properly absorb these nutrients, it can lead to nutritional deficiencies such as vitamin B12, iron, calcium, and magnesium. These and other common nutrients are some that those with hypothyroidism or Hashimotos tend to be deficient in - making the connection between the stomach and the thyroid more prevalent.

In addition to nutritional deficiencies, hypochlorhydria can cause:

  • Constipation
  • Bloating
  • Burping
  • Passing gas
  • Fatigue
  • Weakness
  • Memory loss
  • Heartburn
  • Intestinal infections
  • Nausea when taking supplements
  • Undigested food in stool

These symptoms are also common symptoms of hypothyroidism.

Low stomach acid and Hashimotos

Hashimotos and gastric disorders, such as low stomach acid, are associated with one another. Hashimotos is linked with gastric disorders in 10-40% of patients, and 40% of patients with gastritis also present Hashimotos. But which comes first, or which causes the other?

Since thyroid hormones act on nearly every organ in the body, the stomach is not spared. When there are disturbances or imbalances in thyroid function, it can have numerous effects on the gastrointestinal system as well. The condition of low stomach acid and thyroid hormones play a crucial role in hydrochloric acid secretion; thus, hypothyroidism can lead to Hypochlorhydria or achlorhydria.

How to improve low stomach acid

Conventionally, the use of proton pump inhibitors (PPI) has been the mainstay in treating stomach-related symptoms such as GERD and gastritis, which affect over a third of adults in the United States. While they do offer relief of some symptoms, long term, these therapies are not effective. PPIs, specifically when used long term, can lead to poor absorption of vitamin B12, and deficiency of this vitamin is a common symptom of both hypothyroidism and Hashimotos.

More functional approaches include looking to see what the underlying cause might be, such as nutrient deficiencies or an overgrowth of unwanted bacteria in the gastrointestinal tract. Some find that taking hydrochloric acid with meals helps to digest food and gradually increases your stomach’s inventory of the acid.

If you are someone who suffers from acid reflux or heartburn, here are some natural remedies that can help ease existing symptoms:

  • Eat in a relaxed state: take a few deep belly breaths before you begin eating, as this will help to calm the nervous system and support the vagus nerve
  • Chew your food thoroughly, before swallowing: we are so quick to take our food down as fast as possible to move onto the next thing or distract ourselves with other activities while eating. What would happen if you treated eating as an activity in itself? See it as a meditation and eat slowly, and thoughtfully and notice how much better you feel when doing so
  • Eat more ginger: Ginger is known for its anti-inflammatory properties, is supportive of reducing inflammation from low stomach acid. Seep it in a tea or incorporate it in your cooking in stews, soups or stir fry
  • Eat more foods with zinc: The stomach uses zinc to help produce HCL, making it essential for those with low stomach acid. Foods such as oysters, beef, beans, nuts, and seeds all provide a well-rounded degree of zinc
  • Drink marshmallow root tea: Marshmallow helps to soothe the digestive tract and relieve symptoms of acid reflux and/or heartburn. Another helpful ingredients are aloe vera, which you can add to smoothies or drink on its own

A note from Paloma

It can be overwhelming knowing that thyroid symptoms can also be a singular issue all on their own. Symptoms such as acid reflux and heartburn, as a result of low stomach acid, is uncomfortable and can disrupt someone’s day to day. If you are experiencing symptoms like the ones listed above, work with a healthcare provider who can help address the issue from the root of it.

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References:

Hypothyroidism: Symptoms, Causes, Treatment & Medication. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/12120-hypothyroidism#symptoms-and-causes

‌Hsu M, Forshing Lui. Physiology, Stomach. Nih.gov. Published December 17, 2018.
https://www.ncbi.nlm.nih.gov/books/NBK535425/

Information NC for B, Pike USNL of M 8600 R, MD B, Usa 20894. How Does the Stomach Work? Institute for Quality and Efficiency in Health Care (IQWiG); 2016. https://www.ncbi.nlm.nih.gov/books/NBK279304/#:~:text=The%20hydrochloric%20acid%20in%20the

‌Hypochlorhydria (Low Stomach Acid): Symptoms, Tests, Treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/23392-hypochlorhydria

Acid Reflux Affects Nearly a Third of U.S. Adults Weekly. Acid Reflux Affects Nearly a Third of U.S. Adults Weekly. https://www.cedars-sinai.org/newsroom/acid-reflux-affects-nearly-a-third-of-us-adults-weekly/

‌Cellini M, Santaguida MG, Virili C, et al. Hashimoto’s Thyroiditis and Autoimmune Gastritis. Frontiers in Endocrinology. 2017;8. doi:10.3389/fendo.2017.00092

‌Daher R, Yazbeck T, Jaoude JB, Abboud B. Consequences of dysthyroidism on the digestive tract and viscera. World Journal of Gastroenterology. 2009;15(23):2834. doi:10.3748/wjg.15.2834

‌Fatima R, Aziz M. Achlorhydria. PubMed. Published 2020.
https://www.ncbi.nlm.nih.gov/books/NBK507793/

‌Hu ML, Rayner CK, Wu KL, et al. Effect of ginger on gastric motility and symptoms of functional dyspepsia. World Journal of Gastroenterology. 2011;17(1):105-110. doi:10.3748/wjg.v17.i1.105

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Neeyaz Zolfaghari

Holistic Nutritionist and Nourishment Coach

Neeyaz is a Holistic Nutritionist and Nourishment Coach. Her philosophy is built around nurturing your inner home, to transform your outer home. After learning how to heal from an autoimmune thyroid disease, Neeyaz was inspired and moved by her own journey and chose to take this self love into a business built around supporting others throughout their healing journey. Find her online at www.unspokennutrition.com.

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