In order to confirm whether hydrochloric acid (HCl) is needed, the HCL trial is used to assess stomach digestive function by evaluating the integrity of the stomach lining and its mucous barrier. There is a correlation between a strong barrier and a strong digestive function (i.e. acid and enzyme production).
HCL capsules are taken in increasing doses with substantial meals until symptoms of excess manifest. A typical program would be:
Capsules should be swallowed whole, not emptied into food or water.
When and if irritation (heartburn, stomach ache, heaviness, nausea) occurs, you may take an antacid (i.e. Tums, Alka-seltzer Gold, or baking soda and water at 1/2 tsp. per cup) to neutralize the excess acidity if you desire. Resume taking the acid capsules at a dose of 1-2 capsules less per meal than the number that caused symptoms. You may take even less with smaller or lighter meals. If symptoms of poor digestion are reduced or disappear during the trial it indicates the need for HCL supplementation.
Individuals with very moderate HCL deficiency generally show rapid improvement in symptoms and early signs of intolerance to the acid. This typically indicates a return to normal acid production. Supplementation levels are reduced accordingly, even to the point of no longer requiring the supplement. If maldigestion symptoms return, supplementation can be restarted. Individuals with low HCL/Pepsin may not respond as well to botanicals and supplements, so to maximize benefits, it is important to continue HCL supplementation.
In the 1940s it was discovered that the large majority of people with vitiligo also have stomach malfunction, with partial or complete lack of hydrochloric acid and pepsin production. At that time, hydrochloric acid and pepsin supplementation was recommended in some cases and repigmentation was achieved in 2 to 3 years with this alone. In the 1990s, hydrochloric acid and pepsin supplements are still recommended for those who need them, and still are part of overall vitiligo treatment.
Some people with low stomach acid have no symptoms that are obviously related, and are led to believe they are digesting properly, when they are not. An HCl trial is a safe, worthwhile, and relatively accurate way to discover if an insufficiency exists. Since the long-term administration of supplemental HCl may result in reduced stomach output of acid, administration is advised for diagnostic purposes and short-term use only. Short-term use may result in a return of normal acid production.
Upper digestive symptoms are often due to hydrochloric acid (HCl) or pancreatic insufficiency and it can be difficult to distinguish between the two. The easiest way to find out is to do both an HCl and digestive enzyme trial, one at a time. Often a doctor's assistance is helpful in conducting these trials.
Once the stomach lining has been healed by the use of other agents, a hydrochloric acid (HCl) trial is often useful since it may have been an HCl deficiency that contributed to bacterial overgrowth and subsequent inflammation in the first place. Do not take HCl until the stomach lining has fully recovered, which usually takes at least a month.
If improvement isn't clear when using zinc or essential fatty acids, consider HCl and pancreatic enzymes. The pancreas manufactures picolinate, which is used in zinc absorption. A Dr. Bray, MD, as well as linking asthma to a high rate of HCl deficiency, found that in severe eczema 50% of subjects were hypochlorhydric. Most cases are not this severe, but the possibility of HCl deficiency should be checked.
Lack of hydrochloric acid (HCl) secretion by the stomach has been linked to chronic hives probably as a result of increasing the likelihood of developing food allergies. In one study of 77 patients with chronic hives, 24 (31%) were diagnosed as having achlorhydria, and 41 (53%) were shown to be hypochlorhydric. [Rev Gastroenterol 1951;18: pp.267-71]
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