Hypochlorhydria and vitiligo

Last Updated on 31st October 2023 by Caroline Haye

How checking for low stomach acid could save your skin

I used to be slightly sceptical about vitiligo being an autoimmune disease. Mainly because no doctor had ever mentioned this to me (and still hasn’t to this day!).  When I was first diagnosed, as a child, it was the 1960s. The idea that antibodies could attack a person’s own cells was still a relatively new theory. And it had definitely not reached the average family doctor’s surgery. The question of whether or not I had sufficient stomach acid to absorb nutrients form my food was never raised.  In fact, low stomach acid (hypochlorhydria) and vitiligo were simply never mentioned in the same sentence by any medical professional.

Even after I had heard about autoimmunity, I still didn’t feel that my vitiligo necessarily fitted the autoimmune model.  I eventually managed to rid myself of nearly all my white patches simply by taking nutritional supplements (and some sunshine). I believed that that the progressive pigment loss I had suffered throughout my life must be due to some unidentified deficiency. Maybe I lacked the nutrients that my body needed to make melanin.  Since I had always suffered from symptoms of poor digestion and fatigue I thought I might not be absorbing enough nutrition from my diet.  I am still certain that this was the key part of the picture.  However, it was a simplistic explanation for what is obviously a much more complex condition.

Poor digestion leading to autoimmunity

Once I started to read up on vitiligo research, I realised that the evidence for an autoimmune connection was overwhelming.  But what wasn’t at all clear was if and how this aspect of the disorder fitted in with the nutritional side of things. Was the autoimmunity a genetic defect, which then led (in my particular case) to digestive problems?  Or did the cumulative effect of improperly digested food lead to an autoimmune response? A response in which the vitiligo gene allowed my immune system to mistakenly attack my pigment-producing cells.  Researchers in this field still don’t have all the answers (hence the absence of a cure). But the prevailing view appears to support the second scenario.  In other words, there was a domino effect:

1. I was born with a genetic predisposition to pigment loss;
2. A digestive defect (also genetic?) did not allow me to absorb sufficient nutrition from my diet;
3. The cumulative effect of this “malnutrition” triggered an autoimmune response, in which my melanocytes became the target, due to their genetic fragility

It would help if doctors discussed digestion with vitiligo patients

My digestive symptoms were stomach aches, cramps and general discomfort, constipation and heartburn. A succession of doctors labelled these in a variety of ways over the years. Spastic colon, indigestion, “lazy bowel” and, eventually, IBS were all mentioned. But no one could ever give me any idea of the cause. And no one ever made me aware of any link with vitiligo … until I read about the high incidence of hypochlorhydria (low stomach acid) in vitiligo patients.  This prompted me to get tested. Sure enough, the results indicated that I do indeed produce insufficient stomach acid for normal digestion to occur. A fact which could well explain both the nutritional deficiencies and possible autoimmunity.

Digestive problems may be one of the more common triggers for vitiligo

I’m not saying that there is necessarily a digestive dimension to all cases of vitiligo. There are most likely various triggers, as I discussed in a previous post.  However, a lot of the people I correspond with about their vitiligo tell me they have chronic digestive symptoms. So I get the impression it is one of the more common triggers. Certainly, vitiligo (and other autoimmune diseases) are frequently associated with hypochlorhydria. And, given that it is possible to have low stomach acid and not experience noticeable symptoms, I think it is a pity that doctors do not routinely test for it whenever they see a new patient with vitiligo. Especially as hypochlorhydria is relatively easy to treat with betaine HCL.

I have read that it is statistically more likely that an individual who experiences symptoms of indigestion will have too little stomach acid, not too much. And that the risk of deficiency only increases with age.  It is also statistcally more likely that individuals with vitiligo or other autoimmune conditions will have hypochlorhydria.  So I do think that doctors should make all vitiligo patients aware of the fact. 

Insufficient stomach acid means that the body is unable to absorb iron, calcium and magnesium, essential antioxidant vitamins like C, A and E, and vitamin B12. These are all quite common deficiencies in vitiligo. It also means that you are not able to break down proteins and digest them properly.  When left untreated, numerous chronic diseases, food allergies, leaky gut syndrome, and autoimmune conditions including vitiligo may resultb 

Antacids make hypochlorhydria worse

What can often make matters even worse is that most people who suffer from poor digestion reach for the antacids. This is because the symptoms of too little stomach acid are, confusingly, identical to those of hyperchlorhdria (too much acid). So they mistakenly reduce acid levels in the stomach even further.

Anyone with low stomach acid should avoid indigestion remedies (antacids) like the plague. Instead they should look at measures to increase acid levels at meal times. Drinking some apple cider vinegar or lemon juice before eating is enough to help some people if their hypochlorhydria is not severe.  But the usual treatment is to take an appropriate amount of Betaine HCL in tablet or capsule form with meals (especially those meals that contain protein).  This provides the stomach with the right levels of hydrochloric acid to be able to digest food properly. You are then able to absorb nutrients needed for the maintenance of good health and empty the stomach effectively (thus avoiding acid reflux or heartburn). This also creates the right environment to sterilise the stomach and kill bacteria and yeast that may be ingested, reducing the risk of candida and other forms of bacterial overgrowth.

Choosing a betaine  product containing pepsin is a good idea if you are not already taking a separate digestive enzyme supplement.

This is a big topic – one I will probably revisit in future posts. But the main points that stick in my mind are these… Hardly any doctors talk to their patients about hypochlorhydria as a possible trigger for vitiligo. And yet low stomach acid is quite common and can causes the body to mount autoimmune attacks against itself.

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