The Digestive Theory of Aging
Last Updated on Monday, 09 May 2016 20:05
by Dr. Jonathan V. Wright
Medical Director of Tahoma Clinic in Renton, Washington
No matter how much "antiaging" therapy we do, we may only be able to slow aging down, not stop it. After all, we need to get on to our next lifetimes someday, so that future regression therapists can tell us where we've been, don't we? But as long as we're here in this lifetime, why not take full advantage of it, stay healthy, "age gracefully," and perhaps outlive Victor Herbert, David Kessler, and all the other folks who know everything there is to know about staying well with drugs, chemotherapy, and radiation?
"Digestive Failure" Theory
The proliferation of over-the-counter and even vending-machine versions of Zantac,® Pepcid,® and other patent-expired "acid-blockers" has prompted this brief note to remind us all of yet another theory of aging, the "digestive failure" theory.
It's long been noted that grandpas and grandmas have considerably more indigestion than younger folks, but their indigestion generally has been ascribed to "being older." Not much thought has been given to the possibility that the "being older" could (at least in part) be due to the indigestion!
Let's give it a little thought. If we have bodies made up of some 60 or so essential nutrients (essential being defined as nutrients without which we sooner or later would drop dead), then how healthy are we going to be if even one of those essential nutrients isn't getting through very well? Like engines running on a lean fuel mixture, our cells are going to misfire, sputter, and ultimately choke. And what if a dozen or more nutrients are in short supply? How are our bodies, particularly older bodies, going to keep themselves in good repair? Like older houses, older bodies require more parts and maintenance, not less. It just makes sense that, if we're not digesting and assimilating properly, not supplying all the cells of our bodies with a full complement of essential nutrients, we're going to age and fall apart more rapidly.
A recent article in the Journal of the American Medical Association tells us that "only" 10% of "healthy" older folks have inadequate levels of stomach acid production. (Apparently, that doesn't include all those older folks gulping down over-the-counter and vending machine Zantacs and Pepcids, persuaded of their virtues by the barrage of newly-unleashed-by-FDA direct-to-the-public TV, radio, and print advertising.) Back in the 1930s, studies by the Mayo Clinic and Johns Hopkins on several thousand older folks told us that by age 60 nearly half of us had functionally low stomach acid. After some 27 years of nutritionally oriented medical practice, I'm more inclined to agree with the researchers at Mayo and Hopkins, especially since I'm working mostly with folks who don't consider themselves healthy. Moreover, this problem is not limited to older people.
Inadequate Stomach Acid Production
Hydrochloric acid (HCl) supplements with and without pepsin were widely prescribed in the 1800s and the first half of this century. Using medical judgment and common sense, physicians reasoned that replacement of such a powerful digestive secretion was the only logical thing to do if the function of the stomach could not be revived on its own, as is often the case with increasing age. HCl and pepsin replacement therapy for "failed stomachs" is exactly parallel to hormone replacement therapy for "failed ovaries." Unfortunately, poorly designed and widely misinterpreted research starting in the 1950s has convinced most medical practitioners of today that HCl and pepsin replacement therapy is not necessary. Encouraged by the legal drug industry, medical students are not taught that hypochlorhydria (inadequate stomach acid production) is treatable only with unpatentable natural replacement therapies. Instead, their education concentrates on hyperchlorhydria (excess stomach acid production) and its treatment with patentable "acid blocker" drugs and highly profitable over-the-counter antacids.
Although research in this area is entirely inadequate, it's been my clinical observation that calcium, magnesium, iron, zinc, copper, chromium, selenium, manganese, vanadium, molybdenum, cobalt, and many other "micro-trace" elements are not nearly as well-absorbed in those with poor stomach acid as it is in those whose acid levels are normal. When we test plasma amino acid levels for those with poor stomach function, we frequently find lower than usual levels of one or more of the eight essential amino acids: isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. Often there are functional insufficiencies of folic acid and/or vitamin B12.
Count the number of essential nutrients named above: 21! Although no one with a poorly functioning stomach is deficient in all of them, and no two people have the exact pattern of insufficiencies, even if "only" 10% of "healthy" older adults have this problem, that's a large number of folks who aren't nourishing their cells very well. Of course they're going to age prematurely!
And having "low stomach acid" or falling for those Zantac and Pepcid commercials isn't the only way to impair our digestive processes. A lot of us don't have sufficient pancreatic digestive enzymes. The pancreatic enzymes trypsin and chymotrypsin complete the digestion of protein started by the stomach's enzyme pepsin. As its name implies, lipase digests fats and aids in the assimilation of fat-soluble vitamins A, D, E, K, and the essential fatty acids. Pancreatic amylase is necessary for carbohydrate digestion. And remember all those important "anti-aging" phytonutrients, flavonoids, carotenoids, mucopolysaccharides, and so on? They don't just leap out of our food into our bloodstreams, they must be digested out.
Many of us have inadequate bile flow (that's the real bile, not the mental thing) due to impaired liver function or having our gallbladders carved out because the surgeon didn't tell us that avoiding allergies will do the job just as well. Bile is another important digestive secretion, necessary to "emulsify" fats, oils, fat-soluble vitamins and other dietary components before they can be assimilated.
Then there's allergy-induced malabsorption, lectin incompatibility, and that favorite medical category "idiopathic," which means, "it's happening (or not happening), but we don't know why."
And in a related matter: What about those germs so delicately termed "intestinal microflora?" These "normal" or "friendly" bacteria are responsible for some of the digestive processes, and play a vital role in production of a major proportion of the essential nutrients, vitamin K, folic acid, biotin and vitamin B12 that our bodies depend on. Since the early 1940s, the entire population of the United States (not to mention most of the rest of the world) has been so thoroughly dosed with antibiotics that our intestinal microflora in many cases isn't even close to normal.
Detecting and Correcting
So while we're slowing the aging process by swallowing our vitamins, minerals, and botanicals (oops, I meant antioxidants), and taking our replacement hormones (the natural or identical-to-natural versions, of course), let's not forget to detect and correct any failures in our digestive and absorptive processes, or the digestive failure theory of aging may catch up with us while we're preoccupied elsewhere and send us on to that next lifetime before we are really ready to be there!
When organs get older, they usually don't work as well as they did when they were younger. We don't run as fast at age 47 as we did at 27; our vision and hearing are usually less acute in our 70s than in our 30s. Our skin is less elastic at 53 than at 23. Why should our stomachs be any different? Why should stomachs become more active with age, rather than less? As Mr. Spock would say, "That's illogical!"
What do stomachs do? While digesting breakfast, lunch, dinner and snacks, the stomach makes an extremely powerful acid, hydrochloric acid. The stomach also makes pepsin, a protein-digesting enzyme, and a factor (originally termed "intrinsic factor") that combines with vitamin B12 and is necessary for B12 absorption. The hydrochloric acid that healthy stomachs make is one million times stronger than the mild acidity of blood or saliva. A tough, stringy piece of meat becomes meat soup after digestion in the stomach. That's normal!
After 30, 40 or more years of digesting or attempting to digest everything we put in our stomachs - not just food, which the stomach is designed to handle, but also refined sugar, caffeine, distilled alcohol, grease and oxidized oils, fluoride and chlorine from water, chemical flavorings and colorings, pesticides, herbicides - you get the idea, no? - why would anyone except an antacid salesman or the average gastroenterologist imagine that our stomachs would make more acid, more pepsin, and digest things more efficiently as we get older? Common sense says that after 30 or 40 years, the stomach slows down, just like the rest of us, and makes less acid, less pepsin, and digests things less efficiently.
We'll pause here to point out that the "overacidity" theory of peptic ulcers has been rather thoroughly debunked. Thanks to Dr. Barry Marshall, we now know that "the helicobacter(s) (i.e., Helicobacter pylori bacteria) did it." Let's also note here that there is an extremely rare syndrome named after Drs. Zollinger and Ellison, which indeed features abundant hyperacidity at any age, but again, it's extremely rare.
So when you get past 35, 40, 45, and start to develop indigestion, it's highly likely that the indigestion is due to a weaker stomach, not a stronger one, a stomach making less acid, less pepsin. The very word "indigestion" implies lack of digestion, not overdigestion. Why in the world would we want to take "antacids" or "acid blockers," when our stomachs are weak and not digesting adequately already?
The answer's in two words: symptom relief. We know that if we have "heartburn," unthinkingly attributed to "overacidity," taking an "antacid" or "acid blocker" relieves symptoms. So why isn't that the right thing to do?
Let's try an analogy. If we get a headache, we take an aspirin. The headache disappears. Does that mean the headache was due to a lack of aspirin? Of course not! In the tradition of Western allopathic medicine, we've taken away only the symptoms. We've just covered up the problem; we haven't discovered what the cause actually is.
Think for a moment: if you've ever seen a doctor about "heartburn" and indigestion (or know someone who has), did you actually have a test to determine that your stomach was making too much acid? Ninety-nine percent of the time, the answer is "no." Perhaps an X-ray or even gastroscopy to check for an ulcer, but a test for over- or underacidity is rare.
Since 1976, I've checked literally thousands of individuals complaining of "heartburn" and indigestion for stomach acid production using a commercially available, extremely precise, research-verified procedure. Overacidity is almost never found, especially in those over age 35. The usual findings are underacidity (from "just a little under" to no acid at all) or normal acidity, in which case the indigestion symptoms are caused by something else. The majority have underacidity (as might be expected in a no-longer-young stomach) and I advise them to take capsules containing hydrochloric acid and pepsin with each meal. The supplemental hydrochloric acid and pepsin not only relieve the symptoms but actually improve digestion. (A good parallel is hormone replacement when our hormone levels drop, another common happening when we're somewhat older.)
So why do we have a burning sensation, sometimes severe, along with indigestion, if our stomach acid is low? And why should underacidity symptoms be relieved by "antacids" or "acid blockers," which presumably would worsen a condition of underacidity?
Would you believe that in 1997 there's no research being done to answer this question? (If anyone out there has research grant funds available, I would be happy to determine the answer!) The most recent research I've been able to locate was done in 1887 or 1898. That's right, 100 years ago. At that time a doctor trying to answer the same question put a tube into the stomachs of heartburn sufferers, sucked out the contents, and found very little or no hydrochloric acid, acetic acid, butyric acid. He pointed out that these small amounts of acid don't digest anything, but, he guessed, they could cause pain. Of course, antacids would neutralize them.
This might explain why antacids relieve symptoms, but it still doesn't explain why acid blockers, like Tagamet, Zantac, Pepcid, Prilosec, and their clones, which can prevent hydrochloric acid secretion entirely, would do the same thing. I'll admit that I don't have a clue either (although that research grant would help).
I can say that in 24 years of nutritionally oriented practice, I've worked with thousands of individuals who've found the cause of their "heartburn" and indigestion to be low stomach acidity. In nearly all of these folks, symptoms have been relieved and digestion improved when they've taken supplemental hydrochloric acid and pepsin capsules, available in every natural food store. (Certainly it would be preferable that our stomach production of hydrochloric acid and pepsin be restored on its own, but a reliable way to do this hasn't been found.)
And that takes us to the above-noted acid-blocking drugs on the market. By remarkable coincidence, shortly after their patents expired, they must have become much safer, since the requirement for a prescription disappeared. Multimillion dollar promotions to the public were launched to drive home the point that "heartburn" and indigestion are caused by too much acid, which can be "blocked" (with these products, of course) at minimal risk. (Oddly enough, the FDA has never required the companies advertising these products to document their claims that indigestion and "heartburn" are actually caused by overacidity.)
In case you missed last month's column, let's briefly review: without adequate hydrochloric acid to activate pepsin, protein can't digest properly, and any of up to eight essential amino acids may become deficient. It's been my clinical observation that calcium, magnesium, iron, zinc, copper, chromium, selenium, manganese, vanadium, molybdenum, cobalt, and many other "micro-trace" elements are not nearly as well absorbed by individuals taking "acid-blocking" drugs. A small amount of research shows that vitamin B12 absorption is decreased by Tagamet, and there's every reason to expect the other "acid blockers" do the same. Folic acid doesn't absorb well when stomach acid is low. When any one or any combination of these nutrients is reduced, enzyme systems, cells, tissues, and organs can't repair themselves. In other words, the more we take Zantac, Pepcid, Tagamet, or even Tums or Rolaids, the more we accelerate our aging!
So, if you develop indigestion or "heartburn," don't be fooled by the myth of "acid indigestion." Find out what the problem really is, and correct it. You'll be helping to slow, not accelerate, the aging process.
How to Test Yourself for Low Stomach Acid
Is your heartburn caused by low stomach acid? Just because you don’t have heartburn, reflux or GERD doesn’t mean you’re free from having low stomach acid.
There are three tests for low stomach acid; two you can do at home and one, the most accurate one, is done by a doctor.
The Heidelberg test works by the patient swallowing a small capsule with a radio transmitter that records the pH of their stomach as they drink a solution of Sodium Bicarbonate. The result of the test is a graph showing the pH levels at regular intervals of time. This is the best test but is usually not covered by insurance and can be expensive.
The Baking Soda test is the easiest but least accurate. It’s a good way to start, however. Here are the steps:
Mix 1/4 teaspoon of baking soda in 4-6 ounces of cold water first thing in the morning before eating or drinking anything.
Drink the baking soda solution. Try not to gulp down a lot of air as you drink.
Time how long it takes you to belch. Time up to five minutes.
If you have not belched within five minutes stop timing. If your stomach is producing enough stomach acid you’ll likely belch within two to three minutes. Belching quickly and continually may be due to excessive stomach acid. Any belching after 3 minutes indicates a low acid level.
The Digestive Theory of Aging http://www.ei-resource.org/articles/general-environmental-health-articles/the-digestive-theory-of-aging/