Poliquins Low HCL Stomach Acid Views..... A different thought!

I had the pleasure of meeting a new client yesterday. Came to see me with cervical spine issues and a fractured right fibula. But anyway, the really interesting bit is this....

He is a specialist Gastroenterologist who runs his own business, lectures, deals with intern's all day and has been doing this for 30 years! Now i'm a huge believer that when you meet someone like this, you should try and rinse them for every single bit of info they can tell you. Nothing rude or anything, but opportunities like this don't come along every day. So i started to question him about what i've read from Poliquin's website and articles. Please bear in mind hear that i think Poliquin is brilliant. Full stop! .... But, you can't just take everything people say as for definite & some of what he says doesn't make complete sense to me.

To summarise, what he honestly said to me was that he very rarely see's anyone with an issue of low HCL, if he does they are of old age, and when i showed him Polquin's articles he said they weren't correct and dangerous for him to be in this position of such educational power and putting out this kind of info.

Now i've got to say hear again (and i mean this), i'm not for a second slating Poliquin. Considering his track record with athlete's, the medal's they've won, the courses he runs, the info he gives for FREE & that he's massively improved this industry, i don't think you can slate him. Poliquin is a world class coach. All i want from this article is to give you all the idea, that you must think for yourselves. Just because someone says something, that doesn't mean its 100% accurate for everyone. Do your own research and come to your own conclusions, based on what you read, hear and think.

Here is an old excerpt that i read about 2 years ago, on exactly this, when i read it for the first time and did a bit of research for myself. Thanks for reading.

A Rebuttal to Charles Poliquin's Article on Stomach Acid.
Dr. Ralph Giarnella MD practices Gastroenterology in Southington, Connecticut.

T-Nation: Besides zinc and magnesium, what other deficiencies do those of us seeking muscle and performance need to worry about?

Poliquin wrote: The most common one, which actually causes zinc and magnesium deficiency, is hydrochloric acid (HCl) deficiency. Back when I was an undergrad many moons ago, they used to tell us that you lose about 1% stomach acid per year after the age of 40. Well, that's not true anymore because our high stress levels these days decrease HCl.

We did a study at our Chicago facility where we gave 160 clients an HCL test. Only two people passed it with a medium score; 158 had a horrendous score.

Giarnella MD: What kind of test did he perform? Hydrochloric acid is only present in the stomach when stimulated by the ingestion of meals (gastric phase) or in anticipation of eating (cephalic phase of stimulation).

Did they put a nasogastric tube into the clients stomach, stimulate them in such a way that the stomach would secrete acid and then suction the contents of the stomach to measure the amount of acidity present? When I was a Gastrenterology Fellow in training, we would measure gastric acid secretion by doing such a test. We used intravenous calcium infusion to stimulate the stomach to produce acid. We would then suction the entire contents of the stomach by way of a nasogastric tube and measure both the amount of fluid produced as well as the acidity. The last time I did that test was in 1976 one year before Tegamet was introduced.

Poliquin wrote: If there's insufficient hydrochloric acid, proteins will pass into the intestine and putrefy instead of being digested.

Giarnella MD: This statement is blatantly false. The vast majority of protein digestion takes place in the small intestine by way of enzymes secreted by the pancreas and these enzymes require an alkaline solution to function.
If the statement made by Poliquin were true the best diet pill in the world would be Nexium because it totally shuts down the stomach's ability to produce acid.

Poliquin wrote: Carbohydrates will also be left to ferment without adequate digestive enzymes from the pancreas.

Giarnella MD: Another false statement. Carbohydrates are primarily digested by enzymes contained in the brush border of the intestines. These enzymes not only do not need HCL but they work best in an alkaline solution.

Poliquin wrote: Fat digestion is also dependent on the acid's influence on the pancreas to secrete lipase and the gall bladder to secrete bile.

Giarnella MD: Another false statement. Neither lipase nor bile are stimulated by the presence of acid. The only substance produced by the pancreas that is stimulated by acid is Bicarbonate. Lipase and bile are stimulated by the presence of fat in the duodenum by way of a cholecystikinin.

If we were to believe Poliquin's statement that protein, carbs and fat cannot be digested without acid then the ideal weight loss pill should be Nexium. Nexium shuts down the stomachs ability to produce acid, therefore taking Nexium you should be able eat all the food that you want without fear of gaining weight, after all it will all end up in your colon and eventually down the toilet.

Poliquin wrote: Poor digestion of these macronutrients means poor absorption of our basic energy sources. Over the last four years, I've been amazed how a correction in HCL deficiency has led to not only dramatic improvements in physique and strength, but also improvements in a variety of health parameters. Interestingly enough, in strength-trained individuals those improvements are often associated with gains of 15 to 18 pounds of lean body mass within two months!

Why? They are now absorbing proteins and minerals.

Giarnella MD: I would be interested in testing how much HCL acid is really in the capsules Poliquin is giving his athletes. HCL is one of the most caustic acids. Only Sulfuric (battery) acid and Flouric acid are more caustic. Just a small amount of undiluted HCL in the esophagus can cause significant ulceration.

Poliquin wrote: Here are a few of the symptoms of low stomach acid:

belching or gas within one hour of a meal
bloating shortly after eating
bad breath
loss of taste for meat
nausea after taking supplements
brittle fingernails
undigested food in stool
foul-smelling stools
stomach pain
desire to skip meals
estrogen buildup
acne rosacea
depression

Giarnella MD: All false and unfounded statements.

Poliquin wrote: In the US, many experts estimate the deficiency to be in the range of 40 to 50%. Some gastroenterologists are now advancing that it is today�?�¢??s most under-diagnosed ailment.

Giarnella MD: I would like to know who these gastroenterologists are. I have attended national Gastrointestinal conventions, I read GI journals every day and I have never heard anyone state that HCL deficiency is a major problem. Amongst the most sought after and prescribed medications in the world are the Proton Pump inhibitors and H2 blockers better known as Nexium, Tegament and Zanctac. If HCL deficiency were a problem there would be no need for any of these medications

Poliquin wrote: There are a variety of medical tests you can get,

Giarnella MD: I would like to know what these tests are.

Poliquin wrote: but here's a simple test you can do at home (but I suggest you talk to a physician qualified in nutritional medicine before you try it). It requires a bottle of Betaine HCl, at 200 mg potency per capsule.

Giarnella MD: Betaine HCL is a methyl group donor that functions in the normal metabolic cycle of methionine and reduces homocystinuria in patients with inborn errors of methionine metabolism.

Uses

Homocystinuria

BetaineHCL is used in the management of homocystinuria, including forms of the disorder caused by cystathionine synthase (CBS) deficiency, 5,10-methylenetetrahydrofolate reductase (MTHFR) deficiency, or cobalamin cofactor metabolism (cbl) defect, and has been designated an orphan drug by the US Food and Drug Administration (FDA) for the management of this condition. Although betaine can correct biochemical abnormalities (e.g., reduce elevated plasma homocysteine concentrations) in these patients, the drug does not correct the underlying basic genetic disorder.

SIDE EFFECTS:
Nausea, stomach upset, or diarrhea may occur

Cost:
Approx. Price: $185 per 180Grams (source Medscape Drug search)

Poliquin wrote: Here's how it's performed:

Step 1: Have a high-protein solid meal (no shakes). Let's say for illustration purposes a 12-ounce steak and vegetables.

Step 2: Eat half the protein, roughly 6 ounces of the steak.

Step 3: Swallow a 200mg capsule of HCl.

Step 4: Eat the other half of the steak and the vegetables.

Step 5: Wait 15 minutes.

Step 6: If your stomach acid is normal, you'll feel like you just drank a hot cup of tea or feel a burn. If you feel nothing, you need HCl as a supplement.

So what do you do next? At every meal repeat steps 1 to 6, upping the dose one capsule per meal until you feel the burning sensation. So if it takes five meals to get a burning sensation, you need on average four capsules per meal. If you get to seven capsules and you have no burning, stop the test you're achloridic, meaning you have almost no stomach acid!

At our Phoenix center alone we've been doing over 250 tests a year for the last four years, and in that time I've never seen one person not need at least one capsule; the average person tested could feel it after five capsules. You're getting better when you start feeling a burn at your initial determined dosage. For example, if you found that five capsules was your initial need, you may find that three days later it starts to burn, so then you'd cut back to four capsules with a typical high-protein solid meal, and so on.

Giarnella MD: If the capsules noted in the above citation in fact do contain Hydrochloric acid then this is a very dangerous and possibly life threatening practice.

I have had patients who developed severe esophageal ulcerations caused by pills which remained in the esophagus too long. Just two weeks ago one of my patients had to be hospitalized and transfused several units of blood because he often would take his medications without drinking fluids. The pills in question did not contain Hydrochloric acid.

On another note, normal acidity of the stomach does not cause a burning sensation. I would be very concerned if anything you eat or drink causes a burning sensation. If there is in fact some HCL in those pills the patients may be developing gastritis (small erosions or ulcerations of the gastric mucosa).

I would love to perform and Esophogastro Duodenoscopy on these clients after they have ingested 5-6 HCL pills and felt a burn. Pass the Maalox please.

Poliquin wrote: Most people achieve normal levels within eight weeks even when they start at seven capsules, but some individuals take as much as 18 months. I have two clients who need two caps a day permanently. Why? Because neither one will ever escape their stress levels (one of them is a real estate mogul and the other is a highly accomplished author). Make sure that your HCL product also contains the probiotic pepsin and the digestive enzymes papain and pancreatin, as they have a synergistic effect with HCL therapy.

Giarnella MD: How would taking HCL pills restore the stomach ability to produce acid in 8 weeks or even 18 months?

Furthermore there is no evidence that stress causes achlorhydria. On the contrary under certain circumstances, which I will not elaborate here, extreme stress can cause stress ulcerations. Patients in the Intensive Care Units are often given acid suppressant drugs to prevent these stress ulcers.

Unless you suffer from chronic pancreatitis or small bowel disease such as Chron�?�¢??s disease there is not need for digestive enzymes. Just another useless supplement.

Poliquin wrote: In addition to the above HCL protocols, here are a few other suggestions to normalize your stomach acid levels. First, avoid carbonated drinks.

Second, avoid all-you-can-eat buffets, as they're America's leading source of food-borne pathogens. Finally, there are numerous herbs that can contribute to raising HCL, such as gentian, peppermint, and ginger, but
be aware that very few controlled studies exist on this topic.

I believe this is so important that my clients aren't given a supplement program until they get an HCL test. Remember, not only are you what you eat, you are what you assimilate!

Giarnella MD: Gastric acid and Pepsin are not critical to the digestion or absorption of foods.

Fibromyalgia! ..... (BIG word!)

Got a new client with Fibromyalgia today. It's a serious issue, causing Chronic Fatigue, disturbed sleep, adrenal fatigue, severe pain in most joints, large inflammatory response throughout the body, chemical imbalances, gut and immune system dysfunction....... Not good! It's estimated that 2.7 million people suffer with this (ref Publications.Parliment 2009).

I want you to read this and see how complicated some clients issue's are. I've been fortunate enough to have worked with a lot of clients in my career and so many people nowdays have serious health issue's. What i thought i'd do for you all is just show you the initial stages of my thoughts, my advice to the specific client, why i'm giving that advice and anything i feel you need to know. Hopefully it gives you a chance to see there's so much more to gym training than biceps curls and bench press. Plus, it gives me a chance to show off and use big words!

This particular clients is suffering with:
1. Chronic Fatigue
2. Very bad sleep
3. Depression
4. Severe pain throughout most joints
5. Worn away right knee cartilage
6. IBS...!!!
7. Bad stomach pains
8. Large amounts of stomach bodyfat (the client feels they have fat too much weight here)
9. Back pain on left side of lower back

(On a personal note, i really feel for the suffering they have and the client was in tears during the consultation)

Physical Static Assessment showed:

1. Stiff right calcanius
2. Right foot arch lower
3. Right hip rotation
4. Left shoulder hip hike
5. Rotoscoliosis (right side higher)
6. Shoulder Protraction
7. Gut distension
8. Forward head posture
9. Atlas subluxation

The client has been advised by the GP and Nutritionist to:

• Do no exercise
• Avoid dairy
• Eat a lot of Vegetables
• Use Soy milk and Soy protein
• Take a Vit D supplement
• Lastly, that the issue couldn't be cured.

Clients Goals:

1. Obviously to reach homeostasis and be Fibromyalgia free
2. Lose weight, reduce stomach bodyfat and tone up.

Now, i can't be bothered to sit here and slam the advice given. Rather focus on trying to be a touch more positive. I have also been provided with current eating plan.

I will not be detailing the exercise program here as it's all individualised to each specific client, and of course i want to protect my clients anonymity. It doesn't matter what the clients issue is, they could have a leg falling off and be walking round in circles! All they want is to lose weight and tone up &, quite honestly, this is something i find very sad about modern society. Very few people put their health first!

So here are my initial thoughts and advice to this client;

• Everything begins with nutritional work. Everything!
• I believe Fibromyalgia to originate in the Gut. Studies show a large overlap between Irritable Bowel Syndrome (IBS) and Fibromyalgia. A major finding is a connection involving overgrowth of bacteria in the small intestine producing gases like hydrogen and methane. These gasses cause intestinal bloating and widespread pain in the body by lowering the pain threshold.
• Bin the Soy and slap whoever told you to consume it. Soy promotes estrogen, which blocks T4-T3 conversion therefore lowering metabolism, which leads to hypothyroidism, which leads to weight gain, and gives off the same "tired" symptoms as Fibromyalgia.
• According to Michael Gershon in the book The Second Brain, “70-80% of the bodies immune system is in the GALT system of the gut!”, and problems with the gut are thought to be the first initial causes of a lot of modern diseases such as cancer. So you REALLY want to take care of your gut
• Begin with the 4R gut healing protocol (Remove, Replace, Reinnoculate, Repair). This is in Paul Chek's book " How to Eat, Move and Be Healthy". I'll write about this in more detail in another blog.
• Start on an HCL deficiency protocol to boost Hydrochloric Acid in the stomach which will help ability to absorb nutrients. My client was asked to take Vit D, well what i'm asking is WHY are they deficient in Vit D. Could be because they are not breaking down and absorbing what they are eating. See this links for more here http://www.charlespoliquin.com/ArticlesMultimedia/Articles/Article/27/Maximize_Your_Progress_with_Hydrochloric_Acid.aspx

• For the nutritional work i will be following an entirely natural eating plan. Mostly following the advice given in the book ..... http://www.gutandpsychologysyndrome.com/ .... which goes into detail about how many issue's (such as ADHD, IBS etc) are caused by gut issue's from eating the worng foods for your body. I have also instructed my client to start reading it.
• On this note, immediately stay away from any Gluten or Lactose food groups, and only organic Meat, Vege, Fruit for the next month. A definite no, are sugars and starches as small intestinal bacteria ferment carbohydrates into gas which as i explained above, cause widespread pain.
• A food intolerence test ..... http://www.yorktest.com/en/our-tests/product-information/FoodScan113Programme.html?ProductID=2 
• They have also agreed to run a Adrenal and Hormone profile. Being estrogen dominant inhibits T3-T4 conversion and slows down the metabolism so i want to check whether this is the case. But Cortisol also blocks the conversion of T4 - T3 and running on Cortisol from being chronically stressed can cause some of these symptoms to. Also want to check for any stage of adrenal fatigue because this can also cause Chronic Fatigue.
• Raise Serotonin! This is a biggy! Serotonin can help to stimulate the endorphins which work with sedative receptors that are known to relieve common pain. What you don't do here is take a Serotonin supplement or anti-depressant. You just start with the  pre-cursors to the chemical/neurotransmitter you need. So in this case we are talking L-Tryptophan! Our bodies make Serotonin from 5-HTP, which is made from L-Tryptophan. You can find L-Tryptophan in chicken, turkey, cheese, eggs. Our bodies cannot make enough Serotonin and 5-HTP and most people do not get enough L-Tryptophan as they consume to little meat/protein and too many carbs.

Longer term, we will be looking at reducing stress and helping my client to take more time to themselves as being in a constant Sympathetic Nervous System state places continuous demands on eevry system in the body which will eventually break down

Thanks for getting to the end. I know this topic won't apply to many of you but i appreciate you reading it. Hopefully you can see from here that i do know a thing or 2 about the body but what i want you to see most of all...... is how complicated some clients are and how much thought goes into it. If this client trained with someone who didn't know about this and was then made to do drop sets on Squats, bad-ass Tabata training and basically smashed them in the gym, they'd be made MUCH worse!

The gym is a very small part of looking great, feeling great and being great!

Thanks!
B

Quick thanks :-)

My page had loads more hits on it today... so thank you Jade!

Had a couple of responses on the Coconut Oil question, and i've had this repeated over the last few years with clients. It seems ingrained in people that saturated fat kills, cholesterol kills and you will get Calcium from drinking the milk you buy in supermarkets. Wrong on all counts!

Look i 100% agree that the saturated fat you find in some meats, which are fed GRAINS, is a crappy form of saturated fat that could clog your arteries but there's so much current research done on the benefits of saturated fat/Coconut Oil, that i think this is becoming harder to miss.

As with the Ray Peat work i posted on my L-tryptophan blog (go and read it). Ray isn't keen on ANY polyunstaurated fats for consumption and he has unbelievable science knowledge and experience to back him up! I mean this is quite a hardline to take but i personally feel the guy is way ahead of his time and gradually you'll start to see a lot more of this info come out in the public domain.

But the main point i want to make here, apart from thanks for reading, is don't take my word for it. I promise I research what i write here, it's come through my continued education, the hours i've spent reading, studying, learning and my love for the human body..... but, i want all of you to educate yourselves as well. Check these topics, read about them and get back to me.

If you choose not to, to ignore it or just say i'm talking rubbish or it's wrong, then you will lose out on the chance to take control of things, look, feel & perform better. But i know you don't want that......

Thank you!

The ATLAS Bone

Ladies & Gentleman, take a look at this bad boy of a bone. The Atlas Bone!

Always sounds to me like some Greek porn film, but this bone(r) is very important to you and that wonderful body of yours.

Have a look at the pic I stole from Wiki just for all of you. Actually a great little pic this and I think it can help you understand how any issue’s with the Atlas can effect your body. Now you’re looking at the back of the neck/cervical spine, right below the base of the skull. As you can see the Atlas is quite a wide bone and in a lot of clients I see (nearly all) the Atlas has been shifted out of place on them. The technical, or Chiropractic, term for this is a subluxation. Now the Atlas can shift sideways, flex up and down, rotate, do all 3, just one, etc. Point is it can move around into various positions.

Now just think about the positioning of this bone. Considering it’s location at the top of the neck/just below the Occipital bone. All the nerves that activate the muscles of the body have to run down through here to do their job. There are also ligaments, tendons and muscles that attached onto the Atlas itself, such as the subocciptal muscle, rectus minor muscle, inferior oblique muscle, plus also the Vertebral Artery.
So where I’m going with all this science info…..

So if the Atlas gets Subluxed out of position, it can literally block the nerves down one side of your body from working properly and also change all the muscles lengths down both sides of the body, like a bad domino effect. I’ve seen personally with clients who have very poor grip strength that an Atlas adjustment, instantly improves their grip by a huge amount. The body is connected, so you change one thing, you change the whole thing.

What I’ve also had with clients is that they’ve come to see me when they’ve been in pain for years and their Atlas has been overlooked as the root cause of the problem. It makes sense to me to start looking here if there are problems (particularly with the upper section of the body) as a change here, even small, can have much larger implications on your body.

I’ll be writing more about this topic soon, so make sure you check here soon. Just realise the Atlas can literally change the alignment of your entire body. Bottom line, if you've had headache's neck pain, eyesight issue’s, arm pain, shoulder pain, lower back pain… it could be coming from your Atlas!

B

P.S. Just in case you ask….. this is the guy I use with clients to re-align the Atlas. He is fantastic!  http://www.sportscareuk.com/chiropractic-london.html

Coconut Oil

Organic, extra virgin oils are great for your health, you already know this. Now Extra Virgin Olive Oil is good, but easily the best is Extra Virgin Coconut Oil!
Here are some PubMed links to research done (mainly for justification so you don't just have to take my word for it)

http://www.ncbi.nlm.nih.gov/pubmed/22164340

http://www.ncbi.nlm.nih.gov/pubmed/20645831

Now i'm waayyy behind with this news, in fact i've been using Coconut Oil for about 4 years after reading the fantastic book "The Coconut Oil Miracle". The bottom line with what i'm going to write is.... You should be using Coconut Oil everyday!

Now, because i'm so nice, i'll summarise what i tell my clients with regards to beneficial info so you don't have to read through 50 paragraphs & can finish reading all the other blog's i'm sure you follow.

Ben loves Coconut Oil because.....

1. Its reduces Inflammation in the body by raising HDL cholesterol.
2. Its the only oil you should cook with, as the Hydrogen bonds in it don't de-nature at high heat. ALL other oils (olive oil, vegeatble oil) do de-nature. So you end up consuming rancid oils which can break down the wall of the gut lining and cause gut issues and inflammation. Bad times!
3.A study in the Cook Islands, showed the people their got 50% of their daily calories from saturated fat, mainlty Coconut Oil, and they had a big decrease in heart problems and lived longer than expected. Are you seeing the recurring theme here Sherlock.....
4. Yes Coconut Oil is made up almost entirely of saturated fat, but no thats not a bad thing! This is because of the Medium-chain triglycerides (MCTs). These quite wonderful fatty acids have been shown to stimulate the metabolism, improve Thyroid function, improve digestion, strengthen the immune system, and protect against bacterial, viral, and fungal infections, as well as protect the heart and arteries from the conditions that cause heart disease. Boom!
5. Coconut oil has also been used to enhance utilization and retention of calcium and magnesium.
6. Osteoporosis (which in my opinion occurs mostly though Hormonal problems, Cortisol production and sugar) can be helped then as both the above are massively benefical for this disease. As the Coconut Oil improves mineral absorption.#
7. People suffering from B vitamin deficiencies have been helped simply by giving them coconut oil as it enhances the absorption of the vitamins already in the food.
8. Struggling to make it 10........ :-) It is used medicinally in special food preparations for those who suffer digestive disorders and have difficulty digesting fats. For this reason, it is also used for the treatment of malnutrition.
9. Coconut Oil is not stored as fat by the body (as most healthy fat is not) and is instead used for fast energy by the body.
10. It is a fantastic moisturiser...... but don't tell anyone i use it for that!!
11. Well happy i made it to 10.

UPDATE: My laptop and phone are currently dead. As in, completely! So please stick with me, once they're up and running i'll be heading hardcore into exercises, the best, the worst, how to do them, best combinations, best rep range's, new ones, old ones, etc. Contact me with any questions. See you very soon!

B