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Doctor Says Stomach Acid Levels Normal But Reflux Symptoms

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running wild
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Posts : 1371
Posted 2/9/2021 12:13 PM (GMT -7)
Is it possible to have reflux symptoms if your acid levels are in normal range? I'm not convinced they are as the gastro just did a blood test (I had never heard of it and will see what it is named tonight).

Have had endoscopy (mild gastritis like always) but nothing else. Yet after I eat my stomach feels worse, I'm constantly clearing my throat, and it feels like it's impacting my sinuses. Going to a ENT next week but am wondering if you can even have normal level of stomach acid yet have reflux.

My stomach hurts most of the time (not as bad as when I was on heavy herbs a few years ago), and there is no doubt things get worse after eating, exercise or lying down. Can Lyme cause this but have the normal levels of acid/ And I do not burp at all when I do the baking powder test, for what that's worth.
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Blakeleysmom
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Joined : May 2019
Posts : 218
Posted 2/9/2021 12:27 PM (GMT -7)
Have you tried taking apple
Cider vinegar after eating? That has helped blakeleys reflux tremendously, as has the supplement ortho digestzyme. Not sure about stomach acid levels but we had been assuming Blakeley had too much since she had reflux. When we changed ideas and started looking into how low stomach acid affects people, she began to heal with the above.
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WalkingbyFaith
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Posted 2/9/2021 3:43 PM (GMT -7)
I had many symptoms of “silent reflux.” The PA at the pulmonologist office suspected reflux and referred me to a gastroenterologist. I had an endoscopy with a camera inserted and 48 hour acid monitoring. Said no acid and no signs of GERD. This was just prior to the sudden onset of unrelenting constipation, too.

All tests were normal - CT scan, hida scan, colonoscopy.

I took Nexium and Zantac for 6 months. It definitely relieved symptoms. It also had the very unexpected effect of knocking out the redness, heat, and burning I had had in my face off and on (more on than off) from the onset of Lyme symptoms up to that point. I never figured out the connection, though.

I used apple cider vinegar for a few weeks to wean myself off the drugs. Those drugs definitely will cause backlash reflux. It’s understandable why people stay on them.

Post Edited (WalkingbyFaith) : 2/9/2021 3:46:15 PM (GMT-7)

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astroman
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Posted 2/9/2021 3:53 PM (GMT -7)
"acid levels" - PH?

Yes 100% possible for gerd with normal acid.

All it takes is one bad episode from to much gas, excessive bloating, bad food whatever to "burn" the LES valve. Its job is to seal the stomach contents from the esophagus, in any position.

Then it wont shut right allowing acid to keep getting by. Then you get stuck in a cycle. Need to break this cycle and let help LES heal.

This is why one should not eat food that is spicy or bloating to you individually before laying down. We've all done that, but it can rigger a gerd episode. And then it can repeat.And repeat and repeat.....

Ive mentioned how I corrected my nasty gerd now and then here without RX med. Rx made it worse (8 different ones). Granted Rx helps sometimes but it doesn't get to the root of the problem and we need acid to digest.

Its more bio-physics than bio-chemistry sometimes.

Post Edited (astroman) : 2/9/2021 9:24:26 PM (GMT-7)

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The Dude Abides
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Posted 2/9/2021 9:12 PM (GMT -7)
There is a test to directly measure stomach acid production:

https://www.phcapsule.com

Here's a site that offers some good explanations:

https://www.gsmcweb.com/heidelberg-gastric-analysis
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Garzie
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Posted 2/10/2021 4:29 AM (GMT -7)
to flesh out what others have intimated above - the functional medicine practitioners community believe that GERD/acid reflux is caused by too little stomach acid - rather than too little.

their explanation is along the lines that good stomach acid is needed to suppress bacteria in the stomach and small intestine and for proper digestion. without it, excess bacterial growth and fermentation in the small intestine is likely to occur - causing gasses to be produced that can produce sufficient pressure to encourage gastric juices to be forced out of the stomach into the esophagus - causing discomfort and potential damage long term - hence GERD - as well as a chain of inflammatory changes and hyperpermeability in the gut leading to systemic symptoms.

lower levels of stomach acid are associated with many chronic diseases - pretty much anything that runs the system down - including auto-immune diseases and low thyroid function in particular ( present in a high number of chronic Lyme patients) lowers stomach acid production dramatically.

low stomach acid is also highly associated with infections such as H-Pylori and Bartonella ( ref Dr Burrascano - and his guidelines). both of these infections have been shown to reduce stomach acid in their hosts - presumably to improve their survival in the stomach. low stomach acid is also linked to insufficient pancreatic function causing insufficient digestive enzyme production and a potentially vicious cycle with nutrient malabsorption leading to poorer health of the host and lower stomach acid as a result.

functional medicine treatments are typical to get off proton-pump inhibitors ( antacid meds) - take digestive supplements - like Betaine HCL and pepsin and make dietary interventions to improve nutrition, reduce fermentation and treat SIBO if needed

I have gastritis via gastroscopy, Lyme with suspected Bart. betaine HCL with pepsin helped me reduce overall symptoms of Lyme as well as SIBO by about 30-40% and then considerably more when combined with a ketogenic diet ( v low fermentable content)
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dcd2103
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Posted 2/10/2021 4:51 AM (GMT -7)
Garzie, this is a great explanation. I long worried about low stomach acid myself since i have sibo and have never had heart burn/gerd, but when i took betaine i actually got heart burn pretty bad. I assumed that this was becuase i already had enough acid, do you think that makes sense? Or should i have kept up w/ it to see if it normalized?
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Garzie
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Posted 2/10/2021 5:24 AM (GMT -7)
its a tricky one Dcd -

i guess is depends on what exactly is going on down there

my partner and i both had bad gut issues - she would bloat till she looked more than 6month pregnant after eating some things - literally as i watched - no gas - just inflammation of some sort. it was freaky!

we both found some immediate improvement with betaine HCL - and after a year on keto she found she was feeling 80% better all round and actually starting to get a mild burning after taking them which we took to mean her natural acid production was back now ( functional medicine people wrote about this happening) and so she was able to stop without issue.

my recovery has been much slower and more gradual - i have been able to reduce from 3-4 650mg HCL with each meal down to 1 per meal without ill effects - but still feel i need help with digestion.

if the valve at the top of the stomach is damaged - i guess more acid could aggravate it more initially - perhaps it would be necessary to help protect the esophagus from acid damage while you try to address the downstream stuff and allow it to heal
some say licorice or DGL helps with this - others use over the counter things like Gavisgone
astroman has written quite a bit on here about GERD type stuff too

i wondered if my own abdominal pain could be GERD of some type - and even wondered about trialing something like Omeprazole ( the most common PPI) for a month to see if it reduced it -

having been through the whole functional medicine gut health cycle I am a bit wary of using PPI's - in your case possibly a short course like that could be used to help the valve heal and then gradually build back up again?

as an anecdote - my sister has odd auto-immune diseases - inflammation- fatigue, weight gain, mild neurological issues, and sky high NK cell counts - and had an episode of unrelenting sore throat, loss of voice and face swelling recently( i have often wondered if she has a similar infection to me ...... perhaps even from childhood - as we grew up in remote rural setting) - GP diagnosed silent reflux and prescribed omeprazole and Gaviscon ultra for one month - it cleared and she was able to stop the meds

i heard recently that although omeprazole is primarily designed as an antacid ( PPI) it is of the same group as tinidazole and metronidazole and has antibacterial properties - so was she in fact suffering an infection that omeprazole knocked back ....?

so many questions....

probably a case of experimentation ...
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astroman
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Posted 2/10/2021 8:02 AM (GMT -7)
Been thru all of this along with my other gut stuff of the past.

Ive had major reflux in the past. Drs gave up on me and the only thing left was the nissen LES rubber band operation.............I said NO.

Acid would would my teeth at night.

Acid would flow up several min after being horizontal.

Slept in a recliner a few weeks vs a bed.

I fixed it on my own.

What made it happen:
- Major stomach upset event that started the cycle

What else was going on:
-lyme
-low T3
-Candida, prob sibo to
-leaky gut


What I did that helped ,most first"

-cut off all RX acid reducing meds
-D-limonine, coats the gut and LES valve with protective citrus oil then heals it, take b4 bed, you will burp 2-5 min
-upped T3 hormone
-took digestive enzymes, and DLG licorice
-blocked head of bed legs 6" to make angle, (the gerd angle pillows actually make it worse)
-continued low acid diet i was already on

got better in several days tapered off D-L in a couple months

that was 10-12 years ago

I take a couple DL tabs a few times a year at most. And I take stomach acid with meat meals.
-

Post Edited (astroman) : 2/10/2021 8:53:02 AM (GMT-7)

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saraeli
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Posted 2/10/2021 8:27 AM (GMT -7)
People can have esophageal irritation for a number of reasons that don't involve high or low stomach acid. Valve issues, nerve issues, tissue being worn away by past reflux, lying down or reclining after eating, food allergies or MCAS reactions to food (especially with the congestion), and probably other things. Do you know what causes your history of gastritis?
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running wild
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Posts : 1371
Posted 2/10/2021 10:15 AM (GMT -7)
So many good points and information. All are appreciated. Seems Lyme messes so much with gut. Anyone more emotional when gut issues are worse?

The test I took was "serum gastrin," which the doctor said was normal. My score was 74 with norms from 15-110. But I have asked for the heidelberg test, but all doctors want to do is throw pills at it. Doctor said I shouldn't be having stomach issues with normal gastric test. When I said "The problem is I do have bad stomach issues," she just had no answer.

With kidney issues I deal with, betanine is not allowed. Not sure if it was coincidence, but when I did start taking betanine HCL, my GFR (filtration rate for kidneys) went down lower than ever. Stopped it and D limonene and it went back up. Could be more to it than that, but I'm never sure and kidneys frustrate me to no end. It doesn't allow for a lot of treatments.

Frustration level is really high as suggested therapies you have all put out three are good ones, but I'm so limited in treatment. Saraeli - you asked about gastritis. Over the last-7 years, I have had three endoscopies and all three indicate "mild gastritis." The doctors have said it shouldn't be causing the symptoms as bad as I'm having. Just don't know anyone.
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saraeli
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Posted 2/10/2021 10:39 AM (GMT -7)
Definitely more anxious and depressed when my gut is not in good shape! 90% of serotonin and other neurotransmitters are made in the gut, so it makes sense, but it's so tough to handle.

I'm sorry you are not getting more help from GI docs. So disappointing. sad
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astroman
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Posted 2/10/2021 11:14 AM (GMT -7)
Thats right your kidney issues are another thing to deal with.

Based on experience, candida and sibo also tend to get gerd symptoms going. I dont remember if you tried diets for these(?)
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running wild
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Posted 2/10/2021 11:56 AM (GMT -7)
saareli - We've all experienced doctors who do not help. Some just chalk it up to "it's in your head,' while others simply don't know what to do, fail to answer questions for lack of an answer. Then, there are some good ones, too.

astroman - It's a catch 22 on diet. With all the fat/elasticity loss, weight is an issue. So trying to find a diet that provides enough calories without making symptoms/kidneys worse is a challenge. You had success and are a good example of fortitude and how it can be done.
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Tu Wang
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Joined : Jul 2015
Posts : 223
Posted 2/10/2021 5:33 PM (GMT -7)
Hi,

I also have Gut issues since 2015. Got better and wean from PPI and antacids. Last year due to big pills I was taking and some NSAIDS, it made my stomach so sensitive. Did all test, cat scan, blood test and h-pylori. Praise God it is normal. So I started the SCD diet. It got better been on it for 5 weeks. But now my thyroid issue kicked in Hyperthyroidism. Then anxiety, palpitations just calmed down. Then, now heartburns again. I am losing weight due to limited food I can eat. It seems I am scared to eat any other food as this creates bad heartburns. Sometimes too much water does this too. Alkaline was ok for a while. Warm then it got bad again so I tried room temperature. My gastro doctor told me after my endoscopy that it is a very mild gastritis nothing to worry about. My regular doctor just keep saying nothing to worry. But why I am feeling this bad?

Post Edited (Tu Wang) : 2/10/2021 5:36:24 PM (GMT-7)

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Garzie
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Posted 2/11/2021 5:42 AM (GMT -7)
running wild - can you tolerate natural high-quality fats for calories

stabilized my weight using these as additions to my diet when on long term restrictive diets due to gut issues
extra virgin coconut oil ( little or no digestion required - directly absorbable calories)
extra virgin olive oil
grass-fed beef dripping
grass fed butter ( OK if you tolerate dairy ) and can use clarified if you have dairy issues
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saraeli
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Posts : 2425
Posted 2/11/2021 7:03 AM (GMT -7)
Maybe this is an unhelpful question, but why is chronic gastritis nothing to worry about?
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acarined
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Joined : Jul 2015
Posts : 422
Posted 2/11/2021 8:50 PM (GMT -7)

WalkingbyFaith said...
I took Nexium and Zantac for 6 months. It definitely relieved symptoms. It also had the very unexpected effect of knocking out the redness, heat, and burning I had had in my face off and on (more on than off) from the onset of Lyme symptoms up to that point. I never figured out the connection, though.

I used apple cider vinegar for a few weeks to wean myself off the drugs. Those drugs definitely will cause backlash reflux. It’s understandable why people stay on them.


Nexium and Zantac are mast cell stabilizers.
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running wild
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Posts : 1371
Posted 2/12/2021 7:42 AM (GMT -7)
Tu Wang - My doctor aid the same ting. Each time I have endoscopy, it has shown "mild gastritis," and it is ignored. Which leads to saraeli's question, which is a good one and no doctor has answered. It is a good question.

Garzie - Your point about high quality fats is good. I do take a tablespoon of olive oil each morning. Avacados are not allowed, which have been suggested by others, because of potassium content (which has to be limited for kidney problems). What are grass-fed beef drippings?

Are there others who have problems with depression or anxiety when their stomach is acting up?
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Garzie
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Posted 2/12/2021 12:15 PM (GMT -7)
rw - yep my partner has a massive flare in emotional upset when her gut is bloated/swollen and vice versa

you could ramp up the healthy fats consumption as a trial

eg i was losing weight with gut issues etc - and doing keto ( low carb - medium protien - high fat and fiber diet )
so added around
-1oz of grass-fed butter with breakfast ( i seem to tolerate a bit of Dairy ok )
-1oz of coconut oil at lunch
-1oz of olive oil at dinner

together this was just about enough additional calories to counter the weight loss
you can typically eat more than this as natural fats are generally gentle on the digestive tract

grass-fed beef dripping is just beef fat from pasture-raised beef.
( in many countries, beef is raised in small pens with only factory produced pelleted food shoveled in, and many regard the meat they produce and the fats it contains to be of lower quality - hence the distinction )

Post Edited (Garzie) : 2/13/2021 1:12:00 PM (GMT-7)

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Tu Wang
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Posts : 223
Posted 2/13/2021 10:30 AM (GMT -7)

Garzie said...
running wild - can you tolerate natural high-quality fats for calories

stabilized my weight using these as additions to my diet when on long term restrictive diets due to gut issues
extra virgin coconut oil ( little or no digestion required - directly absorbable calories)
extra virgin olive oil
grass-fed beef dripping
grass fed butter ( OK if you tolerate dairy ) and can use clarified if you have dairy issues

Hi Garzie,

I tried the Olive oil for now. It seems to help on my weight even for few days. Thank you. Coconut oil for some reasons gives me bad effect. Beef is still being introduced as we speak. I am being Hopeful. I am doing the SCD diet and it gives me a little relief but good enough for now. Few hours feeling good after eating is counted as a blessing for me.

Saraeli and Running Wild, I was diagnosed with Mild gastritis and so confused why the situation is so tough on me. Once my gut acts up, It gives me bad heartburns and Anxiety kicks in. Running Wild, I can't figure it out. I am doing breathing exercise but this gives me dry mouth. Even drinking water sometimes is a pain. Been praying an I know God will always answer.

Thank you all for the support. Appreciate it.
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astroman
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Posted 2/13/2021 2:59 PM (GMT -7)
"What are grass-fed beef drippings?"

At first I read this wrong and was thinking of buffalo chips. (a natural sun dried "fuel")
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running wild
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Posted 2/13/2021 3:49 PM (GMT -7)
Tu Wang - I also get dry mouth, especially while sleeping. I think it may be from reflux that comes up at night. I cannot elevate my pillow much as mentioned by astroman because of disc problem in neck. And I also had trouble with coconut oil. I'm wondering if it stirs up bacteria? The depression or anxiety really gets bad. I had a month until last week where it was better with gut and no migraines. Not sure why, but gut started feeling worse, migraines came back, along with depression.

astroman - Your thoughts are always appreciated as you seem to be most experienced on this site with gut issues.

Garzie - thanks for the grass-fed beef drippings idea. I am looking into it. The gut can really do some crazy things, and doctors seem to have no answers except a pill. And it could even be the wrong pill. We can guess as well as they can.
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astroman
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Posted 2/13/2021 4:29 PM (GMT -7)
Elevate the bed frame at the 2 bed feet on one end with wood blocks. Then the whole bed frame is at an angle.

not your pillow - which makes gerd worse.

Post Edited (astroman) : 2/13/2021 4:33:44 PM (GMT-7)

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Alxander
Regular Member
Joined : Jun 2018
Posts : 293
Posted 2/13/2021 8:01 PM (GMT -7)
Hi Astroman,
I’ve been trying to use pillows not only to elevate my head but also my upper body.
That isn’t as good as putting the bed to an angle?
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