Dr. Wald's response to a question posted on the expert health website: AEAllExpert.com
Your question was:
"Hi... I've been taking tmg / betaine as prescribed by my nutritionist for years. I'm currently 11 weeks pregnant ... An still taking... She told me it was safe . I've been reading conflicting things. Can you share any knowledge on the topic ? Thank you"
Dr. Wald's response:
Without having you as my patient I cannot tell you definitively that you should take or not take betaine supplements. Betaine, along with HCL (hydrochloric acid), is a readily available digestive aid available in most health food stores. Store-bought Betaine/HCL usually come together in a single supplement, but you should know that supplements available in health food stores are often of inferior quality compared to those available from trained health care providers. Whether you are pregnant or not there are a few important things that you and everyone should know about taking Betaine/HCL supplementation:
- They should be taken with foods when properly prescribed.
- Different people require individualized dosages. I employ what I call a "stomach acid loading test" to determine individual dosages and I test several important lab tests to help me further evaluate the use and benefits and optimal dosages of Betaine/HCL. The tests include, but are not limited to, total protein, uric acid, serum chloride, serum globulin, A/G ratio, BUN, ionized calcium and others.
- Stomach acid for protein absorption, to kill parasites, bacteria and fungi that are in our food supply. Those with low stomach acid (hypochlorhydria) or no stomach acid (achlorhydria) are more susceptible to infectious agents in our foods making their way into our bodies causing all sorts of health issues - often missed by traditionally trained doctors including gastroenterologists. Strangely, GI doctors have no training in the use of Betaine/HCL.
- Without proper stomach acid levels, which decline by the way because of many reasons (i.e., aging, medications, stress, autoimmune diseases, excessive alcohol consumption, etc.) one can fall victim to accelerated aging, sickness and disease.
- Betaine/HCL is required to activate (ionize) calcium otherwise it is not utilized properly (no matter how much calcium one consumes), remove B12 from proteins in our foods, digest proteins, balance healthy bacteria in our intestinal tract, zinc, iron and copper absorption and to reduce the absorption of heavy metals such as aluminum and mercury in the body.
- Betaine/HCL is needed for an important and fundamental healing process in the body known as methylation along with activated forms of B6 (pyridoxine HCL), methylfolic acid and methylated B12.
Anyone who is deficient in stomach acid (betaine/HCL) should take the properly determined daily dose of stomach acid. If a person requires stomach acid they almost certainly are deficient in many of the nutrients that I have mentioned above and potentially others - even if blood levels of these nutrients appear normal! In other words, there are many ways to determine a need for various nutrients other than measuring their blood levels. Blood levels of most nutrients only reflect intake of that supplement over the last 1-3 days or so.
A nutritional interpretation of blood work (using my Blood Detective technology (www.blooddetective.com) helps determine if one absorbs nutrients, needs stomach acid and unmasks other health issues - especially along with a careful medical and health history, consultation and other functional tests (more my longevity program at: www.intmedny.com).
The only stomach acid supplement that I recommend is the one that I have designed found here called Betaine HCL:http://www.blooddetective.com/betaine-hydrochloride
As with any supplement digestive aid one must only take what is needed. In the case of betaine/HCL it should never be taking by someone with esophagitis, gastritis or ulcers. There are other contraindications as well depending upon the individual.
There are many possible problems that could arise from hypochlorhydria:
- Failure to digest foods properly. This will result in a general malabsorption of proteins. Indeed, hypochlorhydria as induced by antacids and H2 blockers and protein pump inhibitors substantially increases one's risk of osteoporosis because the body simply does not have the raw material to replace bone. Many degenerative conditions will be associated, therefore, with hypochlorhydria.
- Failure to absorb trace elements. Trace elements are essential for normal body functioning. If these are not present then the biochemistry of the body will go slow, organs will go slow and this will accelerate the ageing process. Therefore, one would expect to see people getting diseases, such as cancer, heart disease and neuro-degenerative conditions, before their time.
- Failure to sterilise the stomach contents. This will make individuals more susceptible to gut infections such as gastro-enteritis and possibly enteroviruses such as Epstein-Barr virus, Coxsackie virus, Echovirus and so on. Gastric acid is an essential part of normal defences against disease. Gastric acid is also essential for getting rid of undesirable bacteria and yeast that appear in the diet. Particularly virulent strains, of course, may cause simple food poisoning. However, if there is an overgrowth of bacteria and yeast in the stomach, then foods will get fermented instead of being digested. This produces wind and gas resulting in bloating and alcohols, which may or may not be useful to the body.
- Allergy to gut microbes. The idea here is that gut microbes are miniscule compared with human cells and all too easily spill over into the bloodstream with the potential to cause allergic or inflammatory reactions at distal sites. Irritable bladder or interstitial cystitis is an obvious case. But I suspect many other pathologies such as arthritis, venous ulcers, rosacea, "intrinsic" asthma, mesenteric adenitis, rheumatic fever, polymyalgia rheumatica and other such can be explained by this mechanism.
- Fermenting brain. Nishihara has shown that fermenting gut may result in fermenting brain - low levels of microbes in the brain may ferment neurotransmitters into LSD and amphetamine like substances (to cause hyperactivity, psychosis and other such) or ferment out serotonin, acetylcholine, GABA to cause low mood and depression. If this is correct then this explains a whole range of psychiatric conditions and establishes the mechanism of the widely observed food-mood connection. See Nishihara's work at []
- Increased risk of stomach cancer. Having the wrong bacteria and yeast in the stomach will irritate the lining of the stomach and increase one's risk of stomach cancer.
- Malabsorption of vitamin B12. It is well known that the stomach must be acid in order to absorb B12. Indeed, using a proton pump inhibitor such as Omeprazole, will reduce absorption of vitamin B12 to less than 1% of expected. Many people already suffer from borderline B12 deficiency - this is a difficult vitamin for the body to assimilate, but essential for normal biochemistry.
- Risk factor for cancer. I suspect many bowel tumours are driven by microbes in the upper fermenting gut. Indeed we know that helicobacter pylori infection is a risk factor for stomach cancer. In Japan where hypochlorrhydria is very common stomach cancer is a major killer.
Symptoms of hypochlorhydria
When any of the above problems go wrong, it can result in symptoms.
- Accelerated ageing because of malabsorption.
- Wind, gas and bloating as foods are fermented instead of being digested, i.e. irritable bowel syndrome.
- A tendency to allergies - the reason for this is that if foods are poorly digested, then large antigenically interesting molecules get into the lower gut, where if the immune system reacts against them, that can switch on allergy.
- Gastro-oesophageal reflux disease
- Iron deficiency anemia
- B12 deficiency
- A tendency to candida dysbiosis or bacterial dysbiosis.
I hope that this information was useful for you Linda.
Good luck and the best of health during and after your pregnancy.
Dr. Michael Wald, DC, MD, MS
Integrated Medicine of Mount Kisco
495 E. Main Street
Mount Kisco, NY 1549