By Dr. Sally Daughtry
Please read all this before starting. It is easy but specific. People call us frequently with questions that are answered IN THIS HANDOUT! This handout is for use by patients who have been evaluated and are under the care of Dr. Sally Daughtrey and have been instructed to do this at home test, for their reference. Do not attempt this program without direct medical supervision.
(Super busy? Overwhelmed? Just want the basic instructions? Read the BOLD stuff only. Too hard? Try doing the test phase of the program for just your biggest meal of the day.)
Intro: “Why do we need to test for and treat stomach acid levels?”
Stomach acid and other enzymes produced by the stomach are crucial for digesting food (especially protein) and making those great alkaline minerals and vitamin B12 available to the body. This strong acidic enzyme also acts as a barrier, controlling infectious agents such as parasites, RAT LUNG WORM, Candida, and bacteria that enter the body through the mouth. Optimal production of stomach acid has far reaching effects on health. For example, it ‘primes’ or triggers the rest of the digestive system to make enzymes crucial for nutrient absorption. Without stomach acid mixed with food entering the small intestine, the rest of the digestive system, including the liver, does not work properly either.
This test is VERY IMPORTANT for long term future health. If you don’t absorb your nutrients then you are just making ‘expensive compost’! We do it this way -even though it is pretty involved -because by healing and retraining the stomach this plan is your BEST chance of healing the stomach rather than taking digestive enzymes or antacids for life. Even if you have no stomach symptoms or obvious digestive problems, you could have low levels of digestive enzymes that are contributing to other problems due to malabsorption. Ironically, one can digest sugars and starches pretty well while having low stomach acid. This contributes to sugar cravings and obesity. A person with low HCL output can be quite ‘fluffy’ while being severely malnourished for vitamins, minerals, protein and fat.
“I thought most stomach problems were from TOO MUCH stomach acid! Why would my stomach acid levels be too LOW?”
Stress (Fight or Flight reactions) or ‘natural aging’ can cause us to make low amounts of acid, setting us up for many nutritional deficiencies and opening us to risk of parasitic infestation, Candida or bacterial infections. Low salt diets and deficiencies in zinc or B vitamins are also causative factors. Stomach acid production is challenging for the body. It takes much effort and high nutritional input to make such a strong acid (pH2) and then to produce the mucus lining on the stomach wall that keeps it from being digested like a steak! Once production has decreased, you are not going to be getting as much nutrition from your food, either. So, once production has decreased it can be very difficult for the body to resume production on its own, as the same nutrients you need to make it are not being absorbed due to low nutrient absorption.
Ironically, symptoms of low acid can be very similar to symptoms of excessive acid! Food rotting in the stomach gets mixed with the small amount of acid you are making. This putrefactions/fermentation makes a sulfurous gas that rises and irritates the esophagus, this feels like ‘GERD’.
In addition, release of this alkaline, rotting mess of undigested food into the small intestine can cause a delayed flood of release of the hormone called GASTRIN. This hormone tells the stomach make a desperate surge of acid but TOO LATE, after the food has mostly LEFT the stomach! ARRGH! This often causes a burning or acid feeling several hours after eating, or after going to bed. Ironically ‘the purple pill’ proton pump inhibitors, do stop THIS problem -but at great cost to your overall health due to lack of absorption of nutrients over time.
Low stomach acid (HCL) can also have no ‘direct’ symptoms at all, sometimes for years at a time…meanwhile absorption of food (and your expensive supplements) remains poor. That is why we do the ‘Stomach Acid Challenge Test’. This test is ‘diagnostic’ and ‘therapeutic’ at the same time. The test will help us see if you are digesting properly. If you are not, it will treat you for the deficiency at the same time. Cool!
“But I thought it was good to be ‘alkaline’! Why do I want to be more acid?”
This is a common misconception in the ‘natural health’ world. The truth is that you NEED an acidic medium in the stomach to digest all those lovely alkaline minerals in your vegetables. They can then make the BLOOD the proper pH, which is indeed slightly alkaline.
Yes this is confusing!
Simple stuff you need:
_____Plain water: Use regular filtered, bottled or tap water for this program. Do NOT drink ‘Alkaline water’ during the stomach acid test!
_____Baking soda (or ‘TUMS’)
_____Digestive Bitters, optional
_____ Zypan (or Betaine HCL, use this form if you are vegan, see below***)
Zypan is a special healing digestive formula which contains a small carefully measured (100mg) amount of stomach acid (HCL). Get one small bottle and one large bottle. Use the small bottle first. If you don’t need the large one, you can simply return it for a refund. Do not use other kinds of HCL for this test unless specifically instructed to do so. They are too strong.
Instructions:
To begin, do the ‘Test Day’
On your ‘Test day’ take one HALF of a Zypan tablet with each of your two biggest meals, with 2-4 oz of water. (Take it in the middle of the meal, or after a few bites of food.) If you feel nothing from taking the Zypan, (most people don’t) then go ahead with Day 1 below. If you get tummy symptoms like warmth, heartburn, nausea, bloating, anything at all, then take the ANTIDOTE (Tums) (see below), STOP the protocol and call the office to report it. Do not continue program until you see Dr. Sally. Most people who ‘fail’ the test day just get some warmth, bloating or heartburn from the half tablet that goes away as soon as they take baking soda or TUMS.
Occasionally needed antidote: read this before taking Zypan or HCL:
Here is your ‘just in case’ ANTIDOTE: If you take ZYPAN or HCL, even one half or one, and get ANY reaction that is negative (such as warmth, burning, bloating, nausea, indigestion, etc). then simply take this “ANTIDOTE:” Mix 1 tsp baking soda in 1 oz water or aloe vera juice. Drink! (TUMS is also effective, and easier.) If the symptom is caused by the Zypan (rather than the stomach flu, for example), then the alkaline baking soda will neutralize the acidic Zypan and RAPIDLY stop the symptom. So easy! You can repeat the baking soda drink if desired. If any sensitivity or reaction happens with ½ to 2 Zypan pills, call the office and do NOT proceed with this test, because you may have an ulcer that needs treatment…
(The fine print: very rarely, a person will have a serious but undetected ulcer or other gastric condition. If you do have one, then even a half tablet can cause significant discomfort. Rarely, an ulcer can cause significant symptoms like stomach pain, throat pain, diarrhea, vomiting, or heartburn when even a little bit of stomach acid is taken. Severe symptoms like these are very RARE on the Stomach Acid Challenge, and if they occur they get much better but may not go all the way away from taking TUMS, baking soda or aloe vera juice right away. If they do occur and linger then they indicate that you have a significant hidden medical problem, such as a big ulcer or stomach condition that needs treatment. Although this is briefly uncomfortable, it is MUCH better to know you have the condition so you can treat it! This is why we do the ‘Test day’!)
If you ‘pass’ the test day, with no symptoms from it, then proceed to the rest of the protocol:
1. Day 1: Take one Zypan with or right after each meal with 2-4 oz of water. (This means one with breakfast, one with lunch, one with dinner.) Do not take the pills with snacks, just with full meals. A MEAL is defined as your cupped hands full of food, at minimum, with at least 3 oz of high protein food such as meat, eggs or beans. If you do not normally eat three meals a day you do not have to. Make a note of how you feel after each meal throughout the test, especially if you feel any discomfort such as bloating, fullness, burning, nausea, burping, etc. If this occurs, stop taking the Zypan and contact your physician with the results. If you miss taking it with a meal, just pick up at the next meal where you left off.
2. Day 2: If you did not feel anything on day 1, then increase the number of tablets per meal to 2. Again, note any discomfort and if you feel anything amiss, even a ‘warmth’ in your stomach, go to step 4 below.
3. Day 3: and beyond. If you have not experienced any warmth or discomfort, increase the dose by one tablet per meal PER DAY. (3 tablets on day 3, 4 tablets on day 4, etc) until you do experience some warmth or a mild discomfort in your stomach. (Do not persist until there is a strong ‘burning’ sensation or any other discomfort). Once you do have any symptoms, go to step 4. You can immediately take the ANTIDOTE to stop any discomfort whenever this occurs. (Experienced SAC testers can speed this process up by increasing their dose by 2 pills per day instead of 1.)
After you reach your ‘Max’ what do you do next? PHASE 2!
PHASE 2 ‘After the MAX is reached’
WEANING OFF THE ZYPAN (LEARNING TO MAKE YOU OWN ENZYMES)
Once you have experienced warmth or discomfort of any kind after taking the Zypan, stop taking the pills for the remainder of the day and begin the next day with one less tablet than the day before. (Also call and leave a voice mail or email for your physician when you have reached this stage. This is your ‘therapeutic maximum’ and it tells the Doctor if and how much deficiency you have been dealing with. We record this in your chart and use it to help treat you later.) For example, if you were uncomfortable with 11 pills you would begin the next day with 10 per meal. Continue on 10 per meal HOWEVER LONG IT TAKES until that number of pills causes discomfort, and then reduce the number by one again. When weaning down, DO NOT decrease by one pill every day, this is a common mistake. STAY on the slightly smaller dose as long as it takes until it now causes symptoms. Then decrease by JUST ONE again.
Example: 9 pills cause warmth in the stomach on day 9. The next day, you would take 8 pills per meal. Continue on 8 pills per meal HOWEVER LONG IT TAKES until THAT causes warmth in the stomach. Let’s say that takes a week. At that point, then go to 7 per meal. Let’s say that after 5 days the 7 pills begin to cause warmth in the stomach, then you would go down to 6 per meal. ETC.
NOTE at 2 per meal it is NORMAL not to have burning, so when you get to 2 per meal, just do that for a few days then STOP the program, you have graduated! YAAAY!
IF you get ‘stuck’ for more than 2 weeks at a certain number and never get warmth from it, then call for HELP in making your own enzymes. You have another issue or are missing something in your diet that is needed to make them. It can normally days to weeks to fully wean off the HCL. If it is taking you more than a month, come in to find out why!
6. It is recommended that you start taking a ‘Bitters’ herb blend before each meal if you end up taking a lot of Zypan (9 per meal in the above example). Bitters helps teach your stomach to make its own enzymes and so it speeds up this ’weaning’ part of the Stomach Acid test. Bitters are available at the office, take 1/2 tsp or 1 tablet before each meal with your Zypan. (We are now ‘training’ the stomach to make its own enzymes while supplying it with the enzymes from the outside. This allows you to absorb the nutrients needed to make the enzymes yourself over time. Neat, huh?) The gradual ‘step by step’ reduction of the Zypan allows you to ‘relearn’ to make your own enzyme. (Zypan is unique in that it also contains substances that heal the stomach and pancreas while supplying the digestive enzymes.) Eventually you will probably not need any supplementation OR bitters with this method.
NOTE: IF you get over 6 ZYPAN per meal, it gets BULKY. You can safely SUBSTITUTE Zypan with Betaine HCL at a 2:1 ratio. (IE: our Betaine HCL is TWICE as strong as Zypan.) So, 6 Zypan would be 3 of our Standard Process HCL. You can continue to INCREASE using the HCL, and you will max out twice as fast. Someone who maxed out on 20 Zypan will max on 10 HCL. You can mix and match between the two products as desired. Try to use at least some Zypan ongoing if can because it has additional nutrients that heal the stomach.
A note on getting/having enough ZYPAN: It is a product that often is out of stock because it is a frequently used product. So do not let yourself run out of this! If getting even a little low call us ASAP to re-order, it may take a week to get this formula in stock. ***And in an emergency if you run out of Zypan you can use ‘Betaine HCL’ at any health food store, see the note at the end of this handout if you are going to do this. ) If you do run out, just start the program at 2 less than where you left off when you get more Zypan.
Contact the office and stop taking Zypan or HCL in the following cases:
1. One half or one Zypan makes you uncomfortable in any way. In this relatively rare case your therapeutic plan will need to be modified to treat the underlying problem, such as a severe gastric ulcer. Stop taking the HCL and take several TUMS as needed or mix 1 tsp of baking soda in 4 oz water or aloe vera juice and drink. Have this baking soda on hand BEFORE you do the trial. Repeat if needed. In the extremely rare case wherein the stomach continues to be irritated then drink aloe vera juice (from the health food store) ½ cup every half hour to hour until fine. (See ‘Antidote’, above.) If you are unsure if this is happening simply stop the test until you discuss with the Doctor.
2. Stop increasing when you reach your ‘therapeutic maximum’ level of enzyme (see 4 above) or 30 ZYPAN (or 15 Standard Process 200mg per tablet Betaine HCL)
3. If you run out of HCL or Zypan, then get some more asap. Just restart the challenge at 2 less than your maximum. Example: Joey ran out at 12 per meal. He got more a week later. He started at 10 per meal and continued to work up by one per meal per day to his maximum of 16 (where stomach symptoms began).
* There is some math required if you plan to switch to Betaine HCL from a regular store. Zypan has about 100mg HCL per pill, so you have to figure out how much HCL is in your grocery store version and add it up. For example, if you are taking 12 Zypan you would need 2 Betaine HCL instead if they are 600mg per pill. OUR Standard Process brand Betaine HCL (in brown bottles) has 200mg per pill, so use 1 of them for every 2 Zypan.
Q:“I am not sure I have gone up as high as I should. How can I be sure?”
A:We are trying to figure out EXACTLY HOW DEFICIENT you are in digestive enzymes with this process so that we can fully support your digestive ability. In order to do this we have to fully replace your deficient enzyme and also go SLIGHTLY above this amount. Otherwise you will never fully replace your digestive capacity and some food will still ROT in your stomach. SO, keep going UP until you feel some warmth or mild discomfort, knowing that we can ANTIDOTE that right away with good old baking soda or TUMS. If you are not sure if the ZYPAN dose caused a warmth or symptom, just take Tums/baking soda, and see if it goes away within a half hour! IF it goes away with TUMS then the Zypan was probably the cause of the warmth/symptom and you are slightly over your max replacement dose. If you are not sure if a symptom is caused by Zypan, just try again at the same dose of Zypan the next day, and even one more day. IF it is the amount of ZYPAN causing the symptom, you will get warmth, heartburn, burping or whatever the symptom is pretty reliably each time you take it (and not when you