With low bicarbonate, it makes sense to supplement with sodium bicarbonate. With hypochlorhydria, it makes sense to supplement with Betaine HCL or ACV. What about when someone presents with both? Are the same strategies viable?
High anion gap and hypochlorhydria are two distinct medical conditions that require different treatment approaches after the underlying cause is investigated.
A high anion gap refers to an electrolyte disturbance that occurs when the body produces too many acids or loses too many bases. The ODX range for anion gap is 7 - 12 mEq/L, and a "normal" range is between 6 and 16 mEq/L. Increasing levels suggest a trend toward metabolic acidosis. The most common causes of high anion gap metabolic acidosis include lactic acidosis, diabetic ketoacidosis, and renal dysfunction.
Hypochlorhydria is a condition where the stomach produces insufficient hydrochloric acid (HCl) to digest food properly. This can lead to nutrient deficiencies and increases the risk of infections.
Supplementation with sodium bicarbonate can help correct metabolic acidosis and increase the bicarbonate levels in the blood. On the other hand, supplementation with betaine HCl or apple cider vinegar (ACV) can help improve the digestion of food by increasing the acidity of the stomach.
However, if someone presents with both high anion gap metabolic acidosis and hypochlorhydria, it is essential to identify the underlying cause before considering any supplements. The two conditions have different mechanisms and may have different underlying causes that require different treatment approaches.
For example, if the high anion gap metabolic acidosis is caused by lactic acidosis due to hypoxia, a lack of oxygen in the body, which can lead to the production of lactic acid. Treating the hypoxia is the first priority. Supplementation with sodium bicarbonate may be required to correct the metabolic acidosis temporarily, but it does not address the underlying cause.
Similarly, if hypochlorhydria is caused by Helicobacter pylori infection, treating the infection is essential. Supplementation with betaine HCl or ACV may be helpful, but it does not address the root cause of the hypochlorhydria.
In summary, if someone presents with both high anion gap metabolic acidosis and hypochlorhydria, it is crucial to identify the underlying cause before considering any supplements.