Digestive enzymes

[davina70]

Following a gastroscopy in Feb I’m still waiting on NHS advice for managing atrophic gastritis.I have Addisons Thyroid disease and PA.Had anyone taken these do they help with low stomach acid please?

[Nackapan]

Some have used symprove with success on here.Very expensive.

My daughter gets a cheaper version and uses it daily which helps her.

She had no recommendations from gastro or the hospital dietician.

She found the best thing for her was to use fodmap to work out what she could digest .

Took a long time but totally worthwhile.

She only rarely gets reflux now .

Also often mentioned on here lime juice or similar 3/4 or just before finishing g your meal helpful.

Also has blocks at the foot of thr bed so not lying completely flat .

Eats little and often and does not eat within 2- 3 hours of going to bed.

I've had it twice badly which was related to exhaustion.

Just not able to digest .

Vile . So slept dozed sitting up. 😴

Anything worth a trial for bad digestion

[davina70 in reply to Nackapan]

Many thanks for your reply I’m presently I believe suffering from IBS I think that’s causing the low stomach pain and crampsAlso indigestion after anything .,what do I treat first is my quandary I’m trying to work that one out until my recommended meds arrive lol !

[wedgewood]

As you are diagnosed with A Gastritis you have Pernicious Anaemia and should be treated with B12 Injections . You will have Low / No stomach Acid and Intrinsic Factor . (Achlorhydria/hypochlorhydria. ) Pernicious Anaemia cannot be cured , but must be treated with B1/ injections for LIFE You need to have injections regularly enough to prevent return of symptoms . This varies enormously from person to person. Anything from daily to 3 monthly . Best wishes .

[davina70 in reply to wedgewood]

I am on B12 injections every twelve weeks just wondered if I could improve my low acid levels by taking digestive enzymes thank you

[Nackapan in reply to davina70]

Perhaps you might benefit from more frequent b12 injections ? 2 monthly

[davina70 in reply to Nackapan]

I will ask my GP if I can have them at two instead of three months

[Nackapan in reply to davina70]

Good idea to try. The guidelines state 2-3 monthly now

[Littlelodge123 in reply to davina70]

In short no. Digestive enzymes replace those produced by the pancreas to digest fats, carbs and protein. In fact there is an association between low stomach acid and poor digestive enzyme secretion- it is not yet fully understood but explains why some people with PA also have exocrine pancreatic insufficiency (EPI). Stomach reacidification assists with nutrient and vitamin absorption. Examples include iron, folate and B6. Acidity in the stomach also assists with killing pathogens in and on food and keeps the gut flora in balance. I use Betaine HCL to reacidify my stomach to good effect.

[wedgewood]

When i first discovered i had P.A. I took a water based probiotic called Symprove , which worked very well . Once i had established the appropriate treatment ( self injections ) I found that my gut problems resolved them selves . Digestive enzymes would be good to take , and would do no harm Also remember to chew your food very well .There are digestive enzymes in your saliva , and if you masticate thoroughly, those enzymes can start the work of breaking down the food .( saliva is not affected by Intrinsic Factor antibodies ) Also don’t eat big meals . . Smaller meals more often is the way to go .

Some PA patients drink diluted organic cider apple vinegar with a meal and find that helps . Patients who are very low on stomach acid use Betaine Hydrochloric acid capsules with pepsin to improve stomach acidity . Best used with the guidance of a nutritionist ., as it can be tricky Ro get the dosage right .

[Gambit62 Administrator]

the enzymes won't change the fact that you have low stomach acidity but they may help with digestion in other ways.

[davina70 in reply to Gambit62]

I di realise that thank you

[Imaaan]

I have hypothyroidism and struggled with gastritis induced by antibiotics. My doc recommended digestive enzymes, probiotics and ox bile at 250 mg. If your gastritis is active, you may want to wait until the lining of your stomach has improved before taking ox bile. These 3 have been great for digestion and moving things along the tract. Also I take dgl and zinc carnosine and they have been helpful in my journey as well. I drink half a cup of goat kefir at breakfast and sometimes have beet and cabbage sauerkraut with my lunch and they are really beneficial for gut health

[davina70 in reply to Imaaan]

I’ve started the enzymes today can see that they recommend taking the zinc two to three times daily seems excessive should I just take one or more please ?

[Imaaan in reply to davina70]

I take zinc Carnosine from the brand Integrative Therapeutic . It has 16 mg of zinc per pill. I take two pills at lunch and it totals 30mg of zinc a day. I've been taking this amount for a few years. My research findings showed that anything above 40mg should be taken with some copper because its really important to maintain the zinc/copper balance.

The study I read about two years ago had the subjects ingesting more than 30mg but I can't recall exactly how much. Also it was administered for a short period of time, if I recall

Bonus is that zinc is great for thyroid health and helps in the conversion of t4 to t3

Integrative therapeutic brand

[Imaaan in reply to davina70]

A great food source of zinc is oysters. I love canned/tinned oysters. You can refrigerate the oysters and incorporate eating one a day to your meal. It has a crazy amount of copper in it as well.

[davina70 in reply to Imaaan]

Thanks …no to oysters don’t like them but thanks anyway

[Imaaan in reply to davina70]

I quickly perused your profile and noticed that you have never posted on the thyroid forum. I hope your levels are optimal and not just "normal" on the range. I know gut health is very much linked to the thyroid. So I would encourage you to post there if you already haven't and maybe post your latest levels to get some assistance on understanding them.

[davina70 in reply to Imaaan]

Where I live I do not have access to my thyroid blood tests results however my levels have been fluctuating I’m next due a blood test in 4 weeks m.

[Luac]

I have PA and also exocrine pancreatic insufficiency.

If you have pancreatic issues related to malabsorption, I was told by an nhs nutritionist that the pancreas favours an alkaline environment so discouraged me from supplementing with apple cider vinegar tablets. They said that normal acid in diet is fine - slice of lemon with food or vinegar in a salad dressing etc. I was trying 200mg of acv a day and it really improved my absorption.

Subsequent to the nutritionist appointment, I spoke to the gastroenterologist and put to him that taking acv tablets improved absorption - could I please get my acid levels tested to be able to know if I need to supplement or not. He said that acid is the enemy and they dont deal with that anymore except trying to reduce it. He laughed awkwardly when I asked about those that genuinely have low stomach acid?

I am still trying to learn about this. There are some dangers to supplementing, but I am now hoping to trial increasing dietary acid through lemons, limes, vinegar, pickled foods etc.

I have read here that some take half the juice of a lime before a main meal. This might be the best way for those of us that need to take digestive enzymes such as creon - ie not take them together.

[Rexz]

davina, Depending how far your Atrophic Gastritis has progressed, if advanced as mine is you'll have little to no functioning parietal cells remaining thus low to no stomach acid. The digestive system is a very complex dance between chemicals, enzymes, and hormones all working together. The main one is gastric acid or Hydrochloric Acid this acid not only breaks down your food and sterilizes it but also initiates other cells to produce enzymes. Your stomach acid, once it enters the small intestine interacts with the cells on the wall of intestine that release a hormone called CCK this hormone is a messenger to the gallbladder to contract and squeeze the stored bile into the small intestine also your pancreas is sending enzymes. Without stomach acid this whole process is broken and you will not digest food properly. Some people may have a lot of vomiting with no acid...I lost 90 pounds before we figured out what was going on. So, no stomach acid and little to no enzymes can cause a whole cascade of digestive issues that are related to your PA. In my case I was always getting sick (my food was not being sterilized by the acid), I had SIBO, IBS, Leaky Gut, Poor gut microbiome (I virtually had no good bacteria), sludge in my gallbladder (since my bile was not moving), constipation etc. Then I started taking, prescribed by my doctor, Betaine HCL (a plant based hydrochloric acid in capsule form) and digestive enzymes (in pill form) before each meal. My SIBO was treated with antibiotics and now I can eat. I've gained 20 pounds back, I no longer get sick, I have more energy. I asked my doctor if this AMAG will heal and they all say no. So not only do I take SI B12 but also I take my HCL and Digestive Enzymes.

That's a long winded answer to "yes" if you've got digestive problems/symptoms you should take both an HCL capsule and digestive enzymes before each meal.

I use:

Betaine HCL One 1.3 g capsule, by Integrative Therapeutics here in the U.S. It contains both HCL and Pepsin

Panplex 2-Phase Two tablets, by Integrative Therapeutics. This tablet contains 320 mg of HCL, Pepsin, L-Glutamic Acid and pancreatic enzymes Pancreatin, Amylase, Protease, and Lipase.

These have worked wonders for me clearing up most of my digestive issues and for some time I took a pre and probiotics to add back the necessary good bacteria into my gut.

The B12 injections resolve the anemia and most of any DNA neurologic issues but does nothing for your digestion. So you need to take care of both. Assuming your PA is at and advanced state.

That's my own personal story and my own research. Take this to your GP and see what they say.

Rex

[davina70]

Thank you very informative I have started by ordering the Betaine HCL and will see how I get on with those.My GP is clueless she’s on holiday for two weeks at the moment I’m still waiting for a gastrologists report from February NHS wheels grinding very slowly !

[prillyb12]

I've been taking betaine Hcl for decades. A natural healer told me to take it, not an MD. I take a larger dose of it with high protein meals, and lesser with minimal protein. The acid is needed to digest protein. When you get your Hcl, see if you can divide the tablets or caps (recap in gel caps) so you can start with a small dose at first and see how your stomach feels. If you get too much acid and the stomach bloats or is unhappy, some baking soda in water will neutralize the acid. It's a matter of experimenting. We're all different and some meals are a lot higher in protein. This is what I've done with success.

[davina70 in reply to prillyb12]

I seem to have a stomach ache most days anything that improves that would be good right now

[jkiron]

If you definitely have AMAG (tested positive for parietal cell antibodies) then you should take Betaine HCL at each meal as your stomach is not producing any HCL. You may even take two if you have an occasional high protein meal (i.e. steak). You will learn to carry these pills with you everywhere. I ended up with SIBO from not taking HCL with meals when I was first diagnosed with PA & AMAG. If your pancreas is still healthy it will still produce other digestive enzymes. Good luck!

[davina70 in reply to jkiron]

I’m still waiting for the gastrologists report after my gastroscopy that revealed “generalised erythematous mucosa reflux gastritis with a focus on intestinal metaplasia.He definitely talked about pariental cells when we met in January before the procedure have been on steroids for 40 years and have thyroid disease.

[deniseinmilden]

I have idiopathic chronic pancreatitis and so don't naturally produce digestive enzymes. For me they are a life-saver.

I think they are definitely worth a try but will just say that I, and several others who have found that they are brilliant, find that once we've tried them we don't ever want to eat anything without them because if we do we get bad reactions to food that we were reasonably OK with before - ie we seem to get reliant on them. That said, we know we are anyway and it might be partly the case that we find it's so much better with them!

They are not a drug in any way so I can't see it being unsafe to try them and if you do and don't need them you are unlikely to see any benefits so you can look for another source of help. We are all so different, it's hard to say.