September 29

Betaine HCl – The Simplest Solution to Acid Reflux Disease and GERD

How to Dose Betaine HCl For Best Results

  1.  Avoid all of your trigger foods while taking Betaine HCl.
  2. For the first two days take two capsules of Betaine HCl immediately after eating your largest meal of the day. 
  3. On the third and fourth days take three capsules of Betaine HCl immediately after your largest meal of the day.
  4. Continue adding one additional capsule to your dosage every two days until you experience a warm, slight burning sensation in your stomach. This indicates that your stomach is producing more acid on its own. 
  5. The next day reduce your dosage by one capsule. Take this new dosage of Betaine after eating your largest meal.  
  6. Continue at this new dosage until you again feel the slight burning sensation in your stomach. This indicates that your stomach is now produing even more stomach acid on its own.
  7. Each time you experience the slight burning sensation reduce your dosage by one capsule. Continue at this new dosage until you experience the sensation again. Reduce by one more capsule. Keep repeating.   
  8. After a few more weeks (depending on the max dosage you started with) your dosage should be down to just one capsule per day. 
  9. At this point you can further reduce your dosage by taking one capsule every other day with your largest meal.
  10. Do this for a week and if you experience no GERD or acid reflux symptoms during this time you can stop taking Betaine.
  11. You can now start introducing your trigger foods back into your diet. Do this gradually, not all at once. 
  12. If you feel the least bit bloated after eating a meal which included one of your trigger foods take one or two Betaine capsules. This does not have to be immediately after the meal. It could be hours - whenever you feel bloated. Start with one capsule and if that doesn't give relief take one more.  

Introduction

You can often tell a lot about the state of the nation's health from merely watching television commercials. Drug companies spend millions of dollars airing commercials promoting their health care products. One of their most heavily advertised products is digestive aids, and among the many best sellers in this category are those that deal with acid reflux disease and GERD (Gastroesophageal Reflux Disease). This is a multi-billion dollar industry.

These commercials would have you believe that excess stomach acid is an epidemic. It is not. A common misconception is that everyone who suffers from acid reflux disease or GERD have excessive stomach acid. It's the opposite. Low stomach acid is the primary cause of acid reflux and GERD!

In 98% of cases, Acid Reflux Disease and GERD are caused by not having sufficient stomach acid.

In an old 1989 survey of the prevalence of diagnosed hypochlorhydria (clinically low stomach acid), it was determined that at least 37% of healthy people over age 60 do not produce enough stomach acid. That seems low but since very few doctors ever test for hypochlorhydria, an accurate estimate of the occurrence of low stomach acid in the general population over the age of 45 could be as high as 90 percent.

Have you or anyone you know, ever been tested for low stomach acid? No? I have never met anyone that has either. Including myself.

Unfortunately, doctors do not test for low or high stomach acid. Instead, they will prescribe a PPI (proton pump inhibitor) or an H2 Blocker. These medications suppress your symptoms (for a while); but they do not remedy the cause. PPI's completely stop the production of stomach acid. PPI's are meant for treating people with stomach ulcers, giving the ulcers time to heal without being hindered by stomach acid. PPI's are not meant to be taken for longer than eight weeks. 


What is Betaine HCl?

Betaine HCl (Betaine hydrochloric acid) is a dietary supplement made from Betaine and hydrochloric acid. Hydrochloric acid is a strong acid, naturally produced by the stomach. Its production is triggered by the ingestion of food, and is essential for proper digestion and improved immunity. As we age the amount of stomach that is produced is reduced.

Before 1993 Betaine HCl, was used in OTC products for better digestion, but the FDA passed a law in 1993 banning the use of Betaine HCl in OTC products. It was reclassified as a food supplement and stated as "Generally Safe and Effective." Betaine HCl is now only available as a dietary supplement. Personal testimonials and reports suggest it is beneficial for various medical conditions, including acid reflux and GERD.

Note: Do not confuse Betaine HCl with Betaine anhydrous (also called trimethylglycine or TMG). Betaine anhydrous is used to treat high levels of homocysteine in the urine. High levels of homocysteine are a symptom of arterial damage and blood clots. It's a totally different substance.


The Role of Stomach Acid

Stomach acid is required to break down protein and keep the LES (lower esophageal sphincter) tightly closed. Stomach acid is made up of hydrochloric acid (HCl), potassium chloride, and sodium chloride. Hydrochloric acid activates digestive enzymes and plays a significant role in the breakdown of protein into amino acids. The lack of potassium and sodium chloride doesn't seem to be a factor—it's the hydrochloric acid that people tend to have trouble producing. 

First, it's necessary to understand that stomach acid plays a significant role in the digestive process because it helps to break down food, chemically altering it so that the body can extract the required nutrients. The acid initiates the digestion of protein in the stomach and then triggers the pancreas to secrete digestive enzymes and the gallbladder to release bile into the small intestine. The acid is also responsible for killing pathogenic bacteria that enter the body via food.


80 Million Americans Suffer Have Low Stomach Acid

It's estimated that as many as 80 million Americans suffer from low stomach acid problems, including acid reflux disease and GERD. The valve that connects the esophagus to the stomach is called the Lower Esophageal Sphincter (LES). In simplest terms, without sufficient stomach acid, the LES is not triggered to close tightly enough, allowing stomach acid to back up into the esophagus. The result can be inflammation (swelling) and possible damage to the lining of the esophagus.

The pharmaceutical industry has developed many drugs to deal with the symptoms associated with GERD. One category of drugs is called proton pump inhibitors (PPIs), which stop the production of stomach acid produced by the stomach. Side effects of PPIs may include nausea, stomach pain, diarrhea and constipation.


Should you consider a natural alternative to such drugs?

Rather than blocking the production of stomach acid with meds, one way to quickly and effectively deal with GERD symptoms is to support the digestive system with adequate levels of hydrochloric acid (HCl). The over-the-counter (OTC), natural formulation I recommend to do this is called Betaine HCl, which will aid in the digestion of all types of foods.

Betaine HCl improves digestion by increasing stomach acid naturally. In the stomach, the Betaine HCl separates into Betaine and hydrochloric acid. The hydrochloric acid naturally increases the production of stomach acid. Often included in many formulations are Pepsin, which aids protein digestion, and/or gentian root, which stimulates natural acid production by the parietal cells in the stomach.

I recommend taking Betaine HCl without Pepsin. Pepsin added to the Betaine HCl is unnecessary because the hydrochloric acid will trigger your stomach to produce Pepsin. Adding supplemental Pepsin in addition to that produced as a result of the Betaine could result in too much Pepsin in your system. At first this won't matter because of the small dosage of Betaine but when your Betaine dosage is increased so will the Pepsin. Pepsin is a major contributor to LPR. The extra Pepsin is refluxed into the esophagus and the larynx causing LPR.


Causes of Low Stomach Acid (Hypochlorhydria)

It is rare to find anyone over 40 years of age with normal stomach acid levels. Many have hypochlorhydria (clinically low stomach acid) or achlorhydria (almost no stomach acid). Normal stomach acid is measured in pH. Normal stomach acid should be in the range of 1-3 pH. Stomach acid in the range of 4-7 pH is considered too low or too alkiline.

The main causes of Low Stomach Acid is: 

  • Normal Part of Aging - The graph below shows that as people age the amount of stomach acid produced by their stomach is reduced. According to Jonathon Wright, M.D., "When we test people over forty years old who are experiencing hearburn, indigestion, and bloating, over 90% of them have inadequate acid production".



  • Stress - Chronic stress can descrease stomach acid production.

  • Vitamin Deficiency - Zinc deficiency and Vitamin B deficiency can lead to reduced stomach acid production. These deficiencies can be a result of inadequate diet or it could also be because you have insufficent acid to extract the nutrients from the food you eat.

  • Acid Reflux Medications - taking OTC antacids and H2 Blockers will reduce stomach acid.  PPI's will stop stomach acid production completely. 

  • H. Pylori - is an infection that can cause gastric ulcers resulting in reduced stomach acid.

  • Gastic Bypass Surgery - can reduce the production of stomach acid.

Symptoms of Low Stomach Acid

Below is a list of some indicators of low stomach acid:

  • Belching or gas within one hour of a meal
  • Bloating and fullness shortly after eating
  • Loss of appetite for meat
  • Nausea after eating
  • Brittle fingernails
  • Undigested food in stool
  • Foul-smelling stools
  • Stomach pain
  • Bad breath
  • Loss of appetite
  • Estrogen buildup
  • Acne rosacea
  • Depression


What can Betaine HCl do for you?

Taking Betaine HCl is the recommended approach for increasing low stomach acid. I recommend taking the Betaine after you have finished your meal. Ingesting food triggers your stomach to produce stomach acid. By taking the Betaine after your meal you allow your stomach to naturally produce as much stomach acid as it can on its own before introducing the Betaine.

If you take the Betaine prior to or during the meal your stomach will not need to produce stomach acid on its own or at least less than optimal. Over time your stomach will be encouraged to produce more and more stomach acid until it can produce enough on its own without supplementing with Betaine.

Taking Betaine HCl improve the absorption of protein, calcium, B-12 and iron. Using Betaine HCl has the potential of enabling you to eat less but absorb more nutrients from the food you eat.

Supplementing stomach acid levels offers the following benefits:


1. Enhanced Absorption of Vitamins and Minerals

HCl is necessary for absorption and assimilation of vitamins and minerals such as B12, folic acid, vitamin C, beta-carotene and iron, by increasing their bioavailability and effecting their cleaving from food. As pointed out by Dr. Jonathan Wright, MD, Medical Director of the Tahoma Clinic, an extensive number of macro minerals and trace minerals have low absorption rates in cases of low stomach acid, namely calcium, magnesium, zinc, copper, chromium, selenium, manganese, vanadium, molybdenum and cobalt. It has been established that many age-related cognitive disorders are linked to declining levels of stomach acid, which disrupt the absorption of folic acid and B12, two vital nutrients in optimal cognitive function.


2. Better digestion of protein

HCI starts the digestion of protein structures in the stomach by transforming pepsinogen into the proteolytic enzyme, Pepsin. Once it is formed, Pepsin acts to break proteins into smaller, easier to digest amino acids that are easily absorbed by the small intestine. When you don't have enough stomach acid, incompletely digested large protein molecules will be absorbed into the systemic circulation but may set off a host of food intolerances.


3. Protection of the GI Tract from Pathogens

In addition to breaking down your food properly and absorbing a host of nutraceuticals, HCl also plays an important role in maintaining a safe environment in the stomach. HCl reaches that goal by defending against orally-ingested pathogens and creating a defensive barrier to prevent bacterial or fungal overgrowth in the small intestine.

Restored acid levels can also destroy ingested bacteria and microorganisms. Stomach acid is important to prevent the proliferation of H. pylori (Helicobacter pylori), which is the bacteria that thrive in a low acidic environment and can cause peptic ulcers, gastritis and duodenitis and may be associated with gastric cancer.

Low stomach acid and GERD are digestive conditions that affect your quality of life. Fortunately, Betaine HCl may hold the promise of helping you get your life back.

What to be Aware of Before Taking Betaine HCl

1. Do NOT take Betaine HCl if you have a Peptic Ulcer. Betaine HCl might irritate stomach ulcers or stop them from healing. Once the ulcer has healed and you are off all antacid medication, you can start taking Betaine HCl.  

2. I see suggestions on the internet indicating that Betaine HCl should be taken 10 to 20 minutes before a meal. I don't agree with this based on personal experience. Initially, I did this but found that occasionally I would start experiencing heartburn before the meal, and then I wouldn't feel like eating. Taking Betaine HCl before a meal can turn off stomach acid production for the meal. This is especially true if you are just starting to use Betaine HCl and your acid levels are still very low. I suggest taking Betaine HCl either half-way through the meal or at the end of the meal.

3. Do NOT take Betaine HCl if you are using any kind of NSAIDs such as ibuprofen, Tylenol, and aspirin or corticosteroids such as Prednisone, Celestone, etc. These drugs can cause damage to the gastrointestinal lining that Betaine HCl may aggravate, increasing the risk of ulcer or gastric bleeding. If you are taking these medications, a safe alternative to Betaine HCl is Digestive Bitters.

4. I recommend taking Betaine HCl without Pepsin. Most formulations of Betaine contain Pepsin, but they don't promote taking the dosages necessary to normalize your stomach acid and relieve GERD. Small amounts of Pepsin are fine initially, but when you increase your dosage of Betaine (with Pepsin) and as your stomach begins to produce more stomach acid on its own, you may reflux the excess Pepsin into the esophagus and larynx. Excess Pepsin has been shown to cause Laryngopharyngeal Reflux (LPR). 

5. I had the best results taking Betaine once per day with my largest meal. I felt that taking Betaine just once per day made it easier for me to determine my max dosage. With smaller meals, I would have had to take less Betaine and the mixing of dosages would have made it more difficult to determine my maximum safe dosage. The dosage taken at one meal could affect the next meal.  

6. Taking the wrong dosage of Betaine HCl. I've also read on the internet where people suggest finding your tolerance the first day by taking Betaine HCl until you feel a burning sensation in your stomach. I don't agree with this and prefer that the people I advise to increase their dosage gradually over a few weeks. I generally advise taking one capsule, once a day, with your largest high protein meal for the first 2 days. If you have no burning sensation (almost guarantee you won't), add another capsule with your olargest meals for the next two days. Every two days, increase your dosage by an additional capsule until you experience a slight burning sensation in your stomach. This is very mild and is nothing like heartburn. it is more like the warm sensation you would get in your stomach if you drank a hot liquid too fast. The largest dosage I've heard of anyone taking was 8 capsules for one meal. This would be the exception rather than a normal dose. I've never taken more than 4 capsules with one meal (500mg caps).

7. Adding to number 5 above - you don't need the same dosage at every meal. Vary your dosage based on the amount of protein you are digesting. I find I need to take extra (2-3 caps) if I am eating a large piece of beef (10-12 oz), but I only need to take one capsule if I have chicken (6 oz). And as I said above, if you are just eating salad, I wouldn't take any Betaine HCl.

How to Determine How Much Betaine HCl to Take?

This section is summarized at the beginning of this article. 

The proper dosage of Betaine HCl depends on a person's age, health and current level of stomach acid. It's important to find the correct dosage for your situation. Everyone will be different. If you fail to do this gradual dosage increase, you will not get the results you want.

Failing to take the optimal dosage is a very common problem with many people. Remember, the stomach is purposely built to handle extreme acid environments. If your correct dosage is 2400mg and you're only taking 1200mg, you're not really doing your stomach any favors. You must follow the process below to figure out the right dosage to get the maximum benefit.

Follow These Steps to Determine Your Correct Dosage of Betaine HCl

  1. Throughout this whole proces avoid eating your trigger foods. Trigger foods are foods that cause symptoms for you.
     
  2. Only take Betaine once per day with your largest meal. I'm assuming this will be your dinner. I tried taking Betaine with every meal. Different sized meals require different doses of Betaine. This got very complicated very quickly and I found that taking Bataine with breakfast and lunch made it difficut to track my doses and harder to find my optimal dosage. I also found that the Betaine taken earlier in the day affected meals eaten later in the day. Taking it once a day worked very well and was easy to track.

  3. On the first two days, take 2 capsules (500mg to 650mg) of Betaine HCL after you finish your meal.
    Note: If you can find capsules that are less than 500mg you will be more accurate on your dosing but they are extremely hard to find. Never attempt to ingest Betaine powder or Betaine that has been removed from the capsule. This will burn your throat and esophagus when you swallow it. It's very acidic.

  4. An hour or so after your largest meal make note of how you feel - things to look for: burning sensation in the pit of your stomach. It's unlikely this will occur with just two capsules. If it does, you probably don't need to take Betaine HCl. 

  5. On the third and fourth day take 3 capsules after eating your largest meal. Make note of how you feel an hour or two after eating. 

  6. Keep increasing the number of pills taken with each meal until you notice a burning sensation in your stomach. This burning sensation is very mild and is more annoying than it is painful. It is nothing like heartburn. It is more like the warm feeling you get in your stomach after drinking a hot liquid too fast. If this sensation is too much for you, drinking eight ounces of cool water with a 1/2 teaspoon of baking soda will relieve it quickly. Repeat this every 10 minutes as needed.

  7. This mild burning indicates that your stomach is now producing more stomach acid on its own and you need less Betaine to achive the same level of stomach acid. You should be experiencing less or reduced symptoms of acid reflux. Continue to avoid your trigger foods.  

  8. Continue at this new dosage until you feel the burning sensation again. As before, reduce your dosage by one more capsule. Your stomach is now producing more stomach acid.
     
  9. Continue this process until you are only taking one or two capsules wit hyour largest meal. If you are symptom free at this dosage, you may reduce further by taking Betaine every other day. After a week at this dosage, if you are still symptom free, you can stop taking Betaine regularly.

  10. Now you can start reintroducing your trigger foods. Do this gradually starting with foods that caused the least symptoms. Try introcuing one trigger food every few days, making note of how you feel. If you feel like you are bloated or feel like you are getting heartburn, take a capsule of Betaine. This should reduce the bloating and relieve the heartburn. 

    This process worked very well for me. It took me a few weeks to build up the nerve to try Betaine HCl. I wasn't fully convinced that taking something this acidic could help me. It didn't make sense to me. The first day I only took one capsule, and I felt nothing. The next take I took two. Again, I felt nothing. I continued increasing the dosage every other day.  I got the burning sensation after taking 8 capsules. I reduced my dosage by one capsule at my next evening meal. So, my optimal initial dosage was 7 capsules.  It took me seven more weeks to get down to one capsule every other day. I stopped after a few days and have been symptom free for six years.

    I'd be lying if I said I never take Betaine anymore. I do take it occasionaly after a very large meal with lots of my  trigger foods. I'll take one or two capsules and it will go away. This happens to me every six months or so.   

 

Can Betaine HCl Be Harmful?

Excessive amounts of Betaine HCl can burn the stomach lining. This will occur if you take too much at once. The key is to always start with low doses and gradually increase your dosage over time. Start with one capsule with your largest meal of the day.   Increase your dosage gradually until you experience a slight burning sensation in the pit of your stomach. This feels nothing like heartburn and can be relieved by drinking a few glasses of water. Reduce the number of capsules at your next meal. The amount of Betaine that causes this burning sensation is different for everyone. Do not try to guess your dosage. 

Some people need one capsule (very few); others need more as everyone is unique and have different levels of stomach acid. If you get the burning sensation after just one or two capsules you probably don't need to take Betaine. Something other than low stomach acid may be the problem. If you have stomach ulcers you should not take Betaine until they are healed.

Side Effects of Betaine HCl

Betaine hydrochloride does not have many side-effects in most people. Nausea, stomach upset, diarrhea and a body odour all have been reported but only with high doses. If you notice any other effects, check with your doctor. As stated above, do not take Betaine HCl if you have stomach ulcers, or are on NSAIDs or corticosteroids.

Additional Info:

Some brands of Betaine contain Fenugreek. Fenugreek helps soothe the gastrointestinal tract by providing mucilage to calm down inflammation by coating the lining of the stomach and intestines. Betaine HCl with Fenugreek supports normal digestion and helps alleviate many symptoms of digestive insufficiency. But, don't think that taking a lot of Fenugreek is a good idea. It can cause severe diarrhea (disaster pants).

References & Studies

[1] Takumi K, de Jonge R, Havelaar A. Modeling inactivation of Escherichia coli by low pH: application to passage through the stomach of young and elderly people. J. Appl Microbiol 2000 Dec;89(6):935-43. https://pubmed.ncbi.nlm.nih.gov/11123466/

[2] Brummer P, Kasanen A. The effect of hydrochloric acid on the indican metabolism in achlorhydria. Acta Medica Scan 1956;155:11- 14. https://pubmed.ncbi.nlm.nih.gov/13339277/

[3] Morihara M, Aoyagi N, Kaniwa N, Kojima S, Ogata H.Assessment of gastric acidity of Japanese subjects over the last 15 years. Biol Pharm Bull 2001 Mar;24(3):313-5. https://pubmed.ncbi.nlm.nih.gov/11256493/

[4] Young DG. A stain for demonstrating Helicobacter pylori in gastric biopsies. Biotech Histochem 2001 Jan;76(1):31-4. https://pubmed.ncbi.nlm.nih.gov/11440301/

Britton, E., & McLaughlin, J. (2013). Ageing and the gut. Proceedings of the Nutrition Society, 72(1), 173-177. doi:10.1017/S0029665112002807 https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/ageing-and-the-gut/A85D096755F5F7652C262495ABF302A0

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991651/

https://www.ncbi.nlm.nih.gov/books/NBK507793/?fbclid=IwAR1U6-gN5-psr6Er5ffyISazfNdZ0pViq__9mDb4YvoJhFaF-HgnCeiBYmg


DISCLAIMER

The information contained here does not constitute medical advice and is not meant to diagnose, treat, prevent, or cure disease. Please contact your doctor. The information provided is for informational purposes only and are solely the views of the author.

Low Stomach Acid is the Main Cause of Heartburn, Acid Reflux, and GERD

Please Leave a Comment

  • Hi David,

    I’ve been having reflux issues for a year now (I’m 32) and it has gradually got worse especially after taking anti acid medications.

    I met a new colleague recently who has had the same exact symptoms I’m going through currently (feeling of food stuck in throat, anxiety, bloating, difficulty breathing at times, trouble swallowing). He mentioned the exact same things that you mentioned regarding the lack of acid in your stomach being the ultimate cause. He consumed apple cider vinegar to help him and also went on a full meat (carnivore diet). He mentioned that this has helped him tremendously and he feels almost 100% back to his old self.

    I intend to try Betaine HCI now to see if this works. I’m currently just weaning off my medications (Ganaton and Pariet) and should stop by tomorrow.

    I just have a few questions:

    1. How long do you reckon I should wait before I start taking Betaine HCI?
    2. What was your dosage like? I read the number of tablets you took initially for the first few weeks but I’d like to know what your dosage was like as well. So I can try follow a more similar plan.
    3. On a another note, do you drink? And also are you able to drink again now? (I’m not much of a drinker but enjoy a few pints of beer every now and then)

    Looking forward to your response!

    Cheers.

    • Hi Ellan,
      Thanks for your comment. Be careful stopping your medications – do it very gradually or you will experience what is referred to as “Rebound Reflux.” Pariet is Rabeprazole which stops the production of stomach acid and if you stop taking it cold turkey your stomach may produce excess acid for a short while and you could experience worse heartburn than ever before. While reducing your medication and before and during taking Betaine HCl avoid all of your trigger foods.

      1. I would suggest waiting an additional two weeks after you have stopped taking the medications before starting Betaine HCl.
      2. I will tell you my dosage, but keep in mind that it is different for everyone and have to determine this yourself following the instructions in the article. Do this slowly, adding one capsule every other day with your dinner until you get the slight burning sensation in your stomach. It took me three weeks to determine my max dosage. I felt the burning sensation with 8 capsules (500mg), so my max dosage was 7 capsules. Every week or less I again got the burning sensation and reduced it by one capsule each time. When I was down to one capsule I started taking them every other day. After a week of no symptoms, I stopped taking Betaine. This took nine weeks from start to finish. My symptoms stopped once I was taking 6 capsules and never returned. Then I gradually started adding my trigger foods back into my diet and if I felt the least bit bloated, I would take one capsule of Betaine. This only occurred a few times. I have been symptom free now for over six years.
      3. Yes, I drink. I like beer, rye whiskey, and wine. My biggest trigger was drinking rye mixed with coke while eating dry roasted peanuts. If I injested this within a few hours of going to bed I was guaranteed to have severe acid reflux. The powder on the dry roasted peanuts irritated my LES causing it to swell slightly and not to close properly and the alcohol relaxed my LES allowing my stomach contents to be refluxed up into my throat. Now, I can drink and eat anything I want with no problem.

      Here is a trick with beer: Always drink from a glass and pour it like an idiot. By that I mean, leave the glass flat on the table (do not tip it) and pour the beer into the glass from 3-4 inches above the glass. This will produce 4-5 inches of foam. People look at me funny when I do this but I would rather have that head in the glass than in my stomach where it will cause bloating. I still do this because I found that the beer actually tastes better being poured this way.

      Maintain perfect posture, especially after eating: https://theacidrefluxsolution.com/improve-your-posture-to-improve-gerd/

      One other thing to be careful of – it’s best to buy Betaine HCl without Pepsin. This is hard to find, I think there are only three companies that make it without. Stomach acid triggers the production of Pepsin in your stomach. Taking large doses of Betaine will cause your stomach to produce normal amounts of Pepsin, but if there is Pepsin added to the Betaine this may be more than you require. The excess Pepsin will be refluxed into your esophagus – this is LPR or silent reflux. While not as bad as acid reflux it can cause hoarseness, chronic cough, and throat irritation. Three brands of Betaine without Pepsin are Bioclinic Naturals, Natural Factors, and Prairie Naturals. All are available on Amazon. I prefer the Natural Factors brand – it’s cheaper and contains Fenugreek which can help soothe gastritis.
      Cheers

      • Thank you, David.

        I’ve been off my meds now for more than 2 weeks and still feel the silent reflux (The acid blockers taken before this hasn’t helped either). I took the baking soda test recently and didn’t burp until about slightly after 5 minutes; so I’m pretty sure that’s an indication my stomach acid is low.

        I’ve managed to get the Natural Factors’ Betaine HCl so I’m going to give it a go from today onwards. Wish me luck!

        Thank you again for your comments so far.

        Cheers,
        Ellan

        • Hello Ellan,
          Just make sure you start slowly with one or two capsules the first day and increase by one capsule every other day. I recommend only taking them immediately after your largest meal of the day. I also recommend avoiding any of your trigger foods for the next 8 weeks or so – at least until your symptoms have been gone for two weeks. Once you get the warm sensation in your stomach reduce your dosage by one capsule. Remain at this dosage until it happens again and then reduce by once more capsule. Continue this until you are down to one or two capsules. Then take them every other day with your largest meal. If you have no symptoms after a week you can stop taking the Betaine. You may want to take them occasionally if you feel bloated after a meal. Gradually introduce your trigger foods, maybe one or two per week, but not at the same meal. If you experience no symptoms you should be okay to add more trigger foods. I wish you all the best. Please let me know how you make out.
          Best Regards, Dave

  • Hello. Under the heading “Can Betaine HCl Be Harmful?” the end of the first paragraph reads “ADD MORE INFO HERE.” I’m not sure if that should have been removed or there is still information to be added, but I thought I’d mention it.

    • Thanks, Carl, I do all the research and write all these articles myself and I sometimes leave myself notes in the text. I’ll go back and review my notes to see if I did update that section and forgot to remove my note or if, I didn’t update it. I will correct it by tomorrow. Thanks again.

    • Hi Carl, thanks again for your comment. I just updated the entire article. I found a few inconsistencies and corrected them. Thanks again.

      • Hello, David. Thank you for taking the time to consider my comments and even updating the article. (I do the same thing, too, regarding notes to myself when writing.) It’s clear you put a lot of time and effort into your website and also helping the many people who ask numerous questions. I sincerely appreciate your significant contributions and profound generosity that I’m sure doesn’t garner anywhere near the acknowledgement it deserves. To me, there is nothing more noble than being of service to others, even when it doesn’t appear to be appreciated or reciprocated. Thank you very much.

    • Hi Lori,
      I get asked this question all of the time. It really does not matter what brand. Betaine HCl is the same for all. There are two things that are important criteria for selecting a brand: 1. What size are the capsules, and 2. What else is included in the formula.

      1. The capsule size is important because the smaller they are the more precise you can get with determining your correct dosage. In general, most brands have capsules of 400mg, 500mg or 650mg. I did find a brand that has 250mg capsules, but it no longer seems to be available. So, select the brand with the smallest capsule size.

      2. Most brands of Betaine HCl contain Pepsin. I try to avoid brands with Pepsin because I also have LPR (Silent Reflux) which can be caused by too much Pepsin. Stomach acid triggers the stomach lining to release pepsinogen (pepsin) into the stomach. By supplementing with Betaine HCl you will trigger your stomach to release pepsin. Adding additional pepsin with your Betaine HCl may result in you having too much pepsin, possibly resulting in refluxing pepsin. I prefer Betaine HCL by itself (Prairie Naturals Brand – 500mg) or with Fenugreek (Natural Factors Brand – 500mg Betaine & 100mg Fenugreek, Bioclinic Naturals 500mg Betaine HCl & 100mg Fenugreek). Fenugreek reduces inflammation of the stomach (gastritis), can prevent stomach ulcers, and can help with weight loss. All brands listed above are available on Amazon. I am not an Amazon affiliate.

  • Lots of great information. Suffering LPR amongst other things. Big mountain to climb after health knocked severely last September after what seemed to be a viral infection. Legacy was massive weight loss( I wasn’t overweight to start), reflux, LPR, PPIs then gut dysbiosis/SIBO type symptoms. Bit of a maze as to actually know where to start especially during COVID times when lots of people worse off and need more attention from GP.

    Was wondering if I suspect low acid but have say indigestion at night would you take antacids just before bedtime or a bentaine HCL capsule to increase acid and close the LES. Also with reference to the brands of Enzymes is there any specific ones that you can propose that contain the ingredients you previously mentioned in other articles. Last point, lots of enzymes seem to have ox bile. Just wondering if this could cause other issues.

    • Are you completely off the PPIs? Do not take Betaine until you have been off PPIs for a few weeks and then introduce them gradually with your largest meal of the day. Taking Tums if you have indigestion at night is okay in the short term but is not helping the situation of low stomach acid. Avoid eating within 3-4 hours of going to bed. The best advice I have is to determine your optimal Betaine dosage to increase your stomach acid to normal levels. I don’t recommend taking Betaine without food, but having said that, I have occasionally taken Betaine a few hours after a meal that did not seem to be digesting properly and it has helped, but I have only done this three times in the last five years. Ox bile helps with digesting fats, emulsifying them in preparation for digestion, especially for people who have gall bladder problems where insufficient bile is produced. Ox bile may cause diarrhea, constipation, stomach pain, and vomiting. I hope this helps. Thanks for the comment and the questions. Dave

  • I have autoimmune atrophic gastritis. My stomach acid level was 7.5, I started taking betaine hcl with pepsin. Once I start taking that and my pH lowers will I then start making more acid like a “normal” person??

    • Hi Sarah, I’ve not researched autoimmune atrophic gastritis extensively but from what I have read, it destroys the parietal cells in the stomach. These are the cells that make stomach acid. If you take Betaine HCl it should increase your stomach acid over a few weeks. But, where most people can stop taking Betaine after they increase their acid levels, you may not because you have less parietal cells. The only thing I can suggest is to try Betaine HCl and see if there is an improvement. I hope this helps you. Dave

      • Hi Anubhav,
        It’s a bit of a long story. I am 65 now and have suffered from Acid Reflux since my early 20’s. I knew nothing about acid levels and had no idea they were related. I have been into weightlifting/bodybuilding since I was 14 and I signed up for a training course about ten years ago. The author had a website with a ton of videos and one that caught my eye was about protein absorption. I’d read studies where it said in general people over 40 require twice as much protein supplementation (whey) ingestion than younger people because we have low stomach acid and can’t process the protein as well. He recommended taking Betaine HCl with the protein supplements and any large meals containing meat. I’d never heard of Betaine but decided to try it. I don’t know if my protein absorption improved but my acid reflux went away entirely. To me, at the time it was a miracle side effect.

        Sorry, I got off on a big tangent – to answer your question I really had no idea what my stomach acid levels were. Like the majority of people, I thought I had excess stomach acid and that was why I had heartburn and acid reflux. I was taking PPIs, antacid tablets in addition and nothing helped. And of course, these drugs actually made it worse. It wasn’t until after I no longer suffered from acid reflux that I heard about the baking soda test. While the baking soda test is not accurate, it can indicate that you have low or normal acid levels.

        Dave

  • Hi David.
    How does this help with H. Pylori, if guidance per GI Doctors is to take antacids which reduce stomach acid as well as antibiotics – which fights off good bacteria as well? I also heard about Magic Gum – have you ever taken that? Any insight you can provide will be appreciated.

    • Hello Ramatu, DO NOT TAKE Betaine HCl if you have H. Pylori. Do what your doctors tell you. Once that is cleared you can start taking Betaine, but not before. And yes, unfortunately, you do need antibiotics with H. Pylori. Make sure you start taking probiotics after you have finished with the antibiotics to build up your good bacteria. By Magic Gum I believe you are referring to Mastic Gum. I’ve never used this so I can’t comment – here is an article I found that may explain: https://www.healthline.com/health/mastic-gum#:~:text=It%20may%20help%20relieve%20digestive,anti%2Dinflammatory%20compounds%20it%20contains.
      Hope this helps
      Dave

      • Turns out I do have H. Pylori. I guess I am slightly nervous as I was prescribed a quad therapy in that I have to take antibiotics in addition to PPIs, which I am highly against due to their long term side effects. I appreciate your recommendation above, however, do you think I can take probiotics along with the antibiotics, or will that interfere with treatment? In addition, how soon after treatment (the 14 day treatment) should I start taking the Betane/do you presume I will need it? Sorry for all these questions, but there’s too many gray areas and I understand if you’re not able to offer suggestions on all.

        • Hello Ramatu,
          From my research it can be helpful to take probiotics with antibiotics together. This can counteract some of the side effects of antibiotics. Once the antibiotic course has been completed probiotics can help rebuild your biota. You may also want to take some prebiotics as well to feed the good bacteria.

          Once the H. Pylori is under control, increasing your stomach acid with Betaine can actually stop H. Pylori from coming back. But before you start taking Betaine HCl you will have to ween yourself off of the PPIs. It would be pointless to take them at the same time, Betaine would try to increase your stomach acid while the PPIs are stopping its production. Do not stop the PPIs all at once or you will have the worst heartburn you have ever had. Graduallly titrate your PPI dose down and be off them for a few weeks before starting Betaine. This will take a few weeks to get off PPIs depending on how long you have been taking them. If you have only been taking them a short time you should be able to get off of them quickly. Refer back to my article on Betaine to determine what dosage of Betaine HCl will work best for you.
          I hope this helps you
          Dave

  • Hi David;
    I am from Pakistan and Unfortunately,getting betain HCL in Pakistan is really expensive. Some how I managed to get 50 pills I have been suffering from LPR since march 2020 when the pandemic started. Long story short my symptoms go so much worst I started refluxing 24/7 and shortness of breath was unbearable. The day I took the first Capsule it calmed everything down in my stomach. I can breath again. I can eat again, Thank GOD.

    I just want to ask that if there is any other alternative of betain HCL becasue I can not afford poping two capsules after each meal. My current dosage is two capsules. after a meal

    • Hi Ghufram, thanks for your question. Sorry to hear that Betaine is difficult for you to obtain. The only alternatives I know of are apple cider vinegar (ACV) or Swedish Bitters. I never found ACV very helpful for myself but I didn’t like the taste and dreaded taking it. I never tried Swedish Bitters so I can’t comment on its effectiveness. I believe it’s okay to take them together.

      I haven’t research Swedish bitters so you may want to google “Swedish Bitter GERD” to see what is known and the best way to take it. Here is one article I found that may be helpful: https://www.healthline.com/health/food-nutrition/how-to-use-bitters#what-are-they-good-for
      Hope this helps you
      Dave

    • Hi.i am from pakistan.fighting with Gerd n dyspepsia since last 10 years.betaine hcl is very expensive.i hv ordered through amazon spending 25000 pkr for 5 bottles.i am going to try this for d ist time.i hope i will get rid of my discomfort.

      • Hello Mustanser,
        I think 5 bottles may be more than you need. Can you send some back? I was able to cure my GERD in 9 weeks. I can’t remember exactly, but I think that I only required 3 bottles at most.
        Did you purchase Betaine HCl without Pepsin, as I recommend in the article on using Betaine? If your Betaine contains Pepsin, it will be okay initially but once you get to higher doses you will be ingesting too much Pepsin, especially since your stomach will be producing more Pepsin because of the Betaine, and too much Pepsin can cause LPR. Manufacturers expect you to only take 1-2 capsules only, not the higher doses I recommend to cure GERD. Taking the recommended dose of 1-2 capsules will require you to take Betaine for the rest of your life. No one wants to do that.

        My preferred brand is the Natural Factors brand of Betaine Hydrochloride with Fenugreek 500mg. It is also significantly cheaper than the brands containing Pepsin. Let me know if you have any questions once you start taking it.

        I got the best results from taking Betaine only once per day, immediately after my dinner meal (largest meal). Remember to increase your dosage gradually (increase by one capsule every other day) until you get the slight burning sensation in your lower stomach, then reduce your dosage by one capsule – that is your optimal dosage to start with. You may be completely symptom-free by this point, but keep going. Do not try to rush this process by starting at a higher dose or increasing by more than one capsule every other day. Each time you get a slight burning sensation in your stomach reduce your dosage by one capsule. Once your dosage is back down to one capsule, start taking one capsule every other day after your dinner. If, after a few days, you are still symptom-free at this point, you can stop taking Betaine. As I said, this took me 9 weeks and my max dosage was 7 capsules (I got the burning sensation at 8 capsules). It may take you longer or it may take you less time depending on your determined optimal dosage. Everyone is different and must determine their dosage individually. Avoid your trigger foods during this process. Once you are off the Betaine you can gradually add your trigger foods back into your diet. Also, make sure you maintain good posture throughout, but especially after eating. I had very poor posture and this helped me a lot.

        Warnings:
        Do not take Betaine if you have a stomach ulcer.
        Do not take Betaine if you are taking any PPI’s, H2 Blockers, or other antacid medications.
        If you have recently had acid reflux and have any esophageal inflammation wait until this is healed.

        Please let me know how you make out. Wishing you good health.

    • Hi Gwen, I usually buy Betaine HCl without Pepsin and a separate bottle of digestive enzymes. But I don’t take them together. I would suggest taking the Betaine HCl (with or without Pepsin) with meals containing 20 grams of protein or more and then take the digestive enzymes just with meals that contain less than 20 grams of protein.
      Once the Betaine HCl has increased your stomach acid to normal levels your stomach will produce its own enzymes and you won’t need the digestive enzymes (or the Pepsin). Just be aware that if you also have LPR (Silent Reflux), Pepsin can make it worse. I will be publishing an article on LPR soon. If you sign up for my email list you will receive a notification when it is published. I never send SPAM. Thanks for your question. Dave

  • Hi, thank you for this. I have two questions: does the Pepsin come with the Betane HCI Pepsin? You rarely mentioned when to take the Pepsin above. Also, is the pill something one would take for life or can we repair our stomach lining/acid to ween off the Betane?

    • Hi Aisha, thank you for your question.
      Sorry for any confusion. You can get Betaine HCl with or without Pepsin. After a few weeks the Betaine HCl will gradually increase your stomach acid and help your stomach to produce more of its own HCl.

      Once you have sufficient stomach acid, your stomach will be triggered to produce its own Pepsin. Because of this I prefer to get Betaine without Pepsin because if you also have LPR (Silent Reflux) like I do, the Pepsin can make this worse. If you choose to take Pepsin you should take it at the same time as the Betaine( after the meal), always with high protein meals (greater than 20 grams of protein). Having the Betaine and Pepsin separate gives you the option of not taking the Pepsin.

      In my experience, I was able to reduce the amount of Betaine I take to almost nothing. About every 4-6 months I feel like my food is not digesting as quickly as it should and I start feeling bloated. When this happens I will take 1-2 capsules of Betaine after the meal (sometimes as long as two hours later) and the bloated feeling goes away. Just to be sure I will also take Betaine with my largest meal the next day. If it seems to digest quickly then I will stop taking Betaine until I get the bloated feeling again. Just to give you an idea, a bottle of Betaine will last me over a year because I only take it occasionally.

      I also recommend taking Betaine HCl (with or without Pepsin) after you finish your meal. From what I have read, taking it before a meal will stop your stomach from producing its own stomach acid. It makes sense to me to allow the stomach to produce as much stomah acid as it can and then supplement it after the meal. I hope this clarifies your question.
      Thanks
      Dave

      • Thank you so much. I have a much better understanding. Furthermore, I just got my aloe vera juice in the mail – do you think it’ll affect the Betaine HCL if I attempt to take them together?

        • Hi Aisha, I’m assuming by take them together you don’t mean at the same time. Take the Betaine immediately after your meal (that contains protein) and take the Aloe in between meals as needed. The main purpose of taking the Aloe is to reduce inflamation and pain in your throat and esophagus caused by acid reflux, you wouldn’t take it with your meal. And once the Betaine has removed your symptoms you won’t need the Aloe Vera anymore. I hope this answers your question. Thanks, Dave

  • I’m confused with part of this article. You say most people will not exceed 8 capsules in1 day. But when you explain how to find your proper dose at a meal you suggest it could be as high as 5 capsules at a high protein meal. If that turned out to be true for someone and they ate 3 high protein meals a day that would mean they would be taking 15 capsules a day. 15 capsules a day is almost double the original daily max of8 you suggested earlier in this article. Can you clarify this?

    • Sorry Nate, that a typo. I should have said, “Most people will not exceed 8 capsules at one meal.” I will update that right now. Thanks for your comment.

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