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Dear Suzy: In a column on apple cider vinegar, you stated that "heartburn and reflux can sometimes be related to insufficient levels of stomach acid, not high levels as many of you who take acid blockers assume." Really? I've been on Omeprazole for years for heartburn. My doctor says you're nuts and got angry when I questioned him.

-T.B., Fort Lauderdale, Fla.

A: Doctors who thoroughly understand gastrointestinal function know this basic principle of physiology. A simple blood test evaluates stomach acid levels. Most physicians don't test your "gastrin" level, they just hand you a prescription for medication. This bothers me.

Judging from the millions of pills that are dispensed from American pharmacies on a daily basis, the business of convincing you that "stomach acid is bad" is working.

Don't misunderstand: Acid blocking drugs are effective and necessary for certain individuals, but they are way overprescribed. As a nation, we should spend more money educating the public on how to eat healthier, rather than drugging people up each day and advertising double-bacon triple-bypass cheeseburgers.

Anyway, the signs of low acid (termed hypochlorhydria) may be heartburn, irritable bowel syndrome, burping, cramps, food sensitivities and a higher risk for autoimmune disorders, gallbladder disease, pancreatitis and cancer.

Hypochlorhydria is a huge problem in this country, and it's getting more widespread, especially since the advent of acid-blocking meds. Insufficient acid, whether drug-induced or not, can also cause:

* Hashimoto's thyroiditis

* osteoporosis

* elevated homocysteine

* rosacea and acne

* rheumatoid arthritis

* eczema and psoriasis

* yeast infections

* adrenal exhaustion

* vitiligo.

Why does acid help? Many reasons, and one of them is that it keeps the tiny trap door shut between your stomach and esophagus.

This sphincter is pH sensitive, and in a healthy person, it stays shut because of the natural stomach acid. With acid deficiency, the stomach pH increases, and this may cause the trap door to swing open, causing that familiar burn.

Many people swear by the vinegar trick because it provides various acids including "acetic" acid, but gulping vinegar forever is not my preference because it may be too caustic.

Digestive acids are sold at health food stores by names such as "betaine hydrochloride," "betaine with pepsin" or "trimethylglycine." Begin supplementation slowly, and increase your dosage upward based on symptom relief. Take acid supplements at the end of each meal, not the beginning.

Ask a knowledgeable physician if acid supplements are appropriate for you, especially if you take medications of any sort. Acid supplements aren't right for everyone and should be approached with caution.

Betaine supplements work best when you eat healthy foods; you may also need to be gluten- and casein-free. Depending on your condition, you could also greatly benefit from probiotics, digestive enzymes, ginger, cayenne pepper, glutamine, bile salts and/or DGL (deglycyrrhizinated licorice).

Did you know?

A new study concludes that bisphenol-containing plastics (some water bottles) make men four times more likely to have erectile dysfunction.

***

This information is not intended to treat, cure or diagnose your condition.

Suzy Cohen, author of "The 24-Hour Pharmacist," can be reached at www.DearPharmacist.com.

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