Betaine HCl is a dietary supplement that is used as a digestive aid. It is a delivery form of hydrochloric acid, the substance that creates the acid environment in the stomach. Betaine HCl is made up of betaine, a substance from beet sugar, bound to hydrochloric acid. By binding the HCl to betaine, the substance becomes stable and can be swallowed without damaging the esophagus. Once in the stomach, betaine HCl is cleaved (separated). The HCl creates a more acid environment, while the betaine moves on to be absorbed in the small intestine.
A 5% solution of Betaine HCl has a pH of 1. A low pH, or acidic environment is needed in the stomach to begin the digestive process. The low pH or acidic environment is also necessary to have the proper digestive enzymes in the small intestine, and for proper nutrient absorption in the colon.
HCl serves three purposes in the digestive system. Its first, and most important action, is to assist in the digestion of proteins. HCl converts pepsinogen to pepsin. HCl, along with pepsin, is responsible for the initial step in protein digestion. It is able to cleave complex proteins into amino acid chains that can then be further broken down in the small intestine and absorbed as single or short chain amino acids. Without proper levels of HCl in the stomach, protein does not get digested or absorbed. This can cause serious health conditions.
The second action of HCl is protection. HCl contributes to the protective barrier in the stomach in two ways. The first line of defense in the stomach is its acidic environment. Most microorganisms cannot survive in such an acid environment, and actually prefer the opposite, a basic environment. HCl protects us from the common germs found in all foods; from bacteria that cause food poisoning in some people, and from the single celled organisms like giardia and cryptosporidium that can cause diarrhea and vomiting.
It also protects the small intestine from bacterial overgrowth. The acid environment in the stomach also causes a reflex production of mucus by specialized cells in the lining of the stomach. The mucous provides another barrier against microorganisms, and also protects the lining of the stomach from the other digestive enzymes, as well as HCl itself. Without this mucus barrier the lining of the stomach becomes more susceptible to damage and conditions such as gastritis, H.pylori, peptic ulcer disease, and stomach cancer.
The third purpose of HCl is providing a buffer from acid/base homeostasis throughout the body. Because every cell in our bodies uses water, carbon, and hydrogen, there needs to be a system to recycle those elements as well as compensate for intake and output. That is the acid/base system. It coordinates the movement of all the important ions in our bodies, including sodium, calcium, potassium, magnesium, chloride, hydrogen, carbon dioxide, and oxygen. If the acid/base system gets too basic or too acidic it can use the reservoir of hydrogen ions created by HCl to correct the system.
Additionally, it is also believed that HCl allows for the proper absorption of trace minerals and vitamins. But this is not a specific function of HCl, and is more beneficial for proper digestive function. Low HCl is also associated with increased absorption of drugs that are normally broken down by HCl, and decrease dosage of medications that need such an acid environment to activate them.
The only use for Betaine HCl is as a digestive aid when the stomach acid is known or suspected to be low. The proper medical term for low stomach acid is hypo-chlorhydria or achlorhydria. Currently, it is believed that as many as 30% of adults , and 50% of adults over 50 have low stomach acid.
There are no published research trials that test the efficacy and safety of Betaine HCl or any HCl. However, its use as a supplement is well accepted in the medical community when the stomach acid is suspected to be low.
The symptoms of low stomach acid are very similar to those of excess stomach acid, and may include reflux, burning or warmth in the stomach with meals, dyspepsia, and indigestion. One can have the levels of stomach acid tested by their physician, or they can do an HCl challenge as documented in the dosage section.
The usual dosage amount is 600 - 650 mg before a large meal. Because Betaine HCl is very acidic there are strict directions for its administration and timing of a given dose. It is advised that individuals do an HCl challenge prior to supplementing with Betaine HCl. This allows for the proper dose to be ascertained with the least chance of side effects.
Betaine HCl must be taken at the beginning of a large meal. It can be taken before all the large meals of the day. It is important to only take it at the beginning or after the first few bites to avoid damaging the stomach with excess acid. If you forget to take the HCl until after you have started your meal, it is important to wait until the next meal. Also, it is recommended not to take the HCl until you are ready to eat. If it is taken without ingesting food, you can severely damage your stomach and severe pain may result.
To perform the challenge, begin with one capsule before each large meal of the day. After day one, if no warming sensation was felt with the administration of the HCl, then take two capsules before each meal of the second day. Increase the number of capsules by one, each day until a warming or slight burning sensation is felt in the stomach. Then subtract one from the total number of capsules taken before that meal and this will be your usual dose.
Again, this dose can be taken before any large meal to assist in digestion. If warmth or burning is sensed, decrease dosage or evaluate for proper timing of dosages.
Betaine HCL Contraindications
Individuals who have a known hypersensitivity or allergy to Betaine or HCl should not use betaine HCl.
Individuals with GERD (gastro-esophageal reflux disease) and PUD (peptic ulcer disease) should not use Betaine HCl, as it can make the condition worse.
Also, individuals who use aspirin or NSAIDs (non-steroidal anti-inflammatory) should not use Betaine HCl due to the increased risk of damaging the innter lining of the stomach. Popular NSAIDs include; Advil, Aleve, celebrex, and vioxx.
Betaine HCL Toxicities
Side effects include nausea, vomiting, and diarrhea. Immediate symptoms of an excessive dosage include burning pain and warmth in the epigastric region.