The pH Paradox
Establishing a Healthy Acid/Alkaline Balance
Illustration © D. Yael Bernhard
When it comes to good digestion, the chain of cause and effect is long, beginning with the source of your food and how it’s prepared, and continuing on to the hormones and enzymes it triggers in your mouth, how it’s broken down in your stomach, absorbed in your small intestines, fermented in your colon, transformed in your liver, carried in your bloodstream, bound by cellular receptors and finally burned as fuel in your mitochondria. From beginning to end, the whole process of digestion is intricately orchestrated, a symphony of biological parts and biochemical reactions. Keeping the whole chain of events in mind, we can forge good habits that keep our digestion functioning smoothly and our bodies well nourished.
Yet in today’s climate of medical specialization, if one link in this complex chain is faulty, only that one link is repaired, without regard for the original cause of the problem or the resulting repercussions. This is especially true of a common condition known as acid reflux, a/k/a heartburn or GERD. Acid reflux occurs when stomach acid backs up into the esophagus, causing a burning sensation in the upper belly or chest. But what is the cause of this burning backwash? Mainstream doctors are not trained to think about that, and simply correct the symptom by prescribing antacid medication. Roughly 25% of Americans suffer from acid reflux, making prescriptions to alleviate the symptoms the seventh most popular drug nationwide.1 Over-the-counter medications are also available, and not knowing what else to do, many people reach for these for relief. Antacid medications are also used to treat gastric and duodenal ulcers, pancreatic insufficiency, certain kidney disorders, and more.2
This stopgap measure may serve well to bring about relief of an acute condition such as a bleeding ulcer, but too often it ends up serving as a long-term substitute for a real solution. This is like patching one link in a chain, only to cause weakening and breakage in the others. The downstream effects of long-term antacid medication are multiple and profound. Only by understanding the whole chain of cause and effect can the underlying problem be resolved. Let’s unpack this progression, see how it works, and explore ways to address the root cause with good nutrition.
Stomach acid is necessary in order to break down and digest food, especially proteins. Hydrochloric acid begins the process by denaturing the bonds of protein molecules. If you repress or neutralize stomach acid, proteins arrive in the small intestines undigested, and the intestines cannot break them down. This causes bloating, discomfort, and not surprisingly, your intestines become irritated and want to get rid of this unmanageable mess as quickly as possible, thus inflaming the bowels and causing diarrhea. This is why insufficient stomach acid is a major driver of irritable bowel syndrome (IBS), and why many individuals who take antacids trade stomach pain for intestinal dysfunction. Short-term measures to reduce stomach acid may increase long-term digestive distress.
Repressing stomach acid also interferes with the absorption of vitamin B12, which is critical for survival, and of calcium, a crucial mineral for maintaining normal blood pressure, bone health, and much more. Your stomach needs acid to break down and assimilate these vital nutrients!
Paradoxically, stomach problems are often caused by too little stomach acid, not too much. Our ability to produce hydrochloric acid diminishes as we age, and we need it for healthy digestion. A tablespoon of apple cider vinegar in half a glass of water twenty minutes before eating a meal helps to stimulate stomach acid, increases the duration of gastric juices in the stomach, and promotes healthy gut bacteria. Put these gastric fluids to work by eating protein first in your meal. Ginger root and foods rich in zinc also help increase your gastric juices, such as nuts and seeds, oysters, grass-fed beef, and yogurt. Probiotic gut bacteria also stimulate stomach acid and balance the pH in your gut. For this reason and many others, it’s a good idea to make fermented foods a regular part of your diet. Your best sources are full-fat yogurt and kefir, kimchi and sauerkraut, tempeh, miso, kombucha, and natto.
Too much stomach acid may be produced in response to eating too much at once, and by drinking alcohol and eating highly acidic foods – mostly (you guessed it) processed foods and sugar. Eliminating this cause is a much better way of coping with acid reflux than repressing the excess stomach acid that’s produced in response to these foods.
Stomach acid may back up into the esophagus and cause heartburn if the sphincter at the bottom of your esophagus does not completely relax when it should, allowing food to fully pass into your stomach, or to close when it needs to keep food down. This may be caused by insufficient magnesium, which governs muscle contractions and relaxation. Foods rich in magnesium, or if necessary a high quality supplement, may eliminate this possible cause. Excess belly fat and lack of exercise may also cause organ prolapse. The more you exercise and the more core strength you have, the better your internal organs will function. Movement also massages your intestines and increases motility.
Black coffee, alcohol, soft drinks, orange juice, and other acidic beverages irritate and degrade the lining of the esophagus. Beware of the acid content, especially on an empty stomach. A high acid diet may also leach calcium out of the bones, which serve as a mineral bank. Calcium is alkaline, and may be drawn out in order to neutralize excess acid. Calcium deficiency may be caused as much by being “spilled” in the urine this way as by inadequate dietary intake.
Antacid medications are not a solution to these problems – they are only a temporary bandaid. Imagine wearing a bandaid for two decades instead of allowing a cut to heal. When antacids were first invented, scientists understood it was dangerous to interfere with the stomach's pH, and doctors were strictly warned never to allow patients to use these drugs for more than a few weeks. But the processed food industry saw great potential for profit by repressing the consequences of eating junk food, and antacid medications soon became a huge money-maker. Doctors are incentivized to push these drugs on their patients, without regard for the consequences. But the truth is that antacids should still never be used on a long-term basis. They are not a solution to the underlying cause of acid reflux, which is inflammatory foods. Processed sugars, refined grains, and unhealthy fats are the main culprits. A diet rich in leafy greens and homemade, minimally-processed foods is the real solution. Rather than reaching for a pill that causes trouble downstream, try getting rid of the carbonated beverages, the cocktail, the coffee, the fried and spicy foods, sugar-sweetened treats, pasta, pizza, crackers, candy, and chips.
All pharmaceutical drugs come with a price, and may have negative long-term side effects. All are harmful to your gut microbiome, which in turn affects your brain, and all put a heavy load on your liver. No medication should be continued indefinitely without careful consideration and periodic re-evaluation. The goal is to enable your body to function well on its own, naturally.
As antacid medication is reduced, there may be a temporary rebound effect. Now that the body’s gastrin, the hormone that triggers the production of hydrochloric acid, is no longer being repressed, there may be a surge of stomach acid. A gradual reduction may be eased with the use of deglycyrrhizinated licorice (DGL) or a baking soda solution to neutralize stomach acid – only as needed. Herbal infusions such as linden, marshmallow, and violet leaf are cooling, soothing, mucilaginous and healing to the lining of the gut. If you have a tendency toward heartburn or IBS, consider making these infusions a part of your daily routine (see my article Infuse Yourself With Liquid Nourishment for more on this subject).
A low-acid diet won’t change your blood pH, which must remain within a tight range in order for you to survive – but it does reduce the load on your kidneys and lungs to keep it there by excreting and exhaling excess acid. Chronic, low-grade metabolic acidosis may contribute to any number of problems, including impaired enzyme activity and degraded bone density.
“As for bones, it’s about balance and, in particular, acid:alkaline balance. Much of the food we eat is acid-forming, and we need to balance it with alkaline-forming vegetables and fruits. Grains, meats, oils, and alcohol slowly rob minerals from our bones over a lifetime. We pay for it in old age, with stiffness, ailing joints, weak bones, and immobility. It’s a growing burden on our healthcare system, and a symptom of an unhealthy, unbalanced diet.”3
It should be added here that not all meats are highly acidic. Once again, quality is what counts. Since grains are acidic, grain-fed animals produce more acidic meat and dairy. Factory-farmed animals also tend to have more systemic inflammation due to their poor nutrition and living conditions, and this acidic state also transfers into their meat and milk.4 Eating meat and dairy in moderation is one way to make quality, pasture-raised products more affordable. More on this subject in a forthcoming article.
Cancer cells may also thrive on acid. Research on this subject continues to develop and is sometimes controversial, but a recent study does show that tumors become more aggressive and more able to metastasize in an acidic environment.5
“Nearly 3,000 genes showed pH-dependent changes in activity, and close to 300 displayed changes in how the genes are assembled, or spliced. Tumor acidosis gives rise to the expression of molecules involved in cell invasion and migration.”6
By contrast, a low-acid diet is more aligned with the kinds of food your digestive tract is designed to process: simple, high-fiber foods in their original form. Basic – that is, alkaline – foods were mostly what was available to our hunter-gatherer ancestors. Alkali-rich fruits and vegetables are the way to go. Alcoholic beverages, fried foods, grain-based foods (cereals, cookies, cakes, breads, crackers, chips, and pasta) and meat and dairy from factory-farmed, grain-fed animals all tend to be acidic. Many lists of acid-forming and alkaline foods are available online. Here’s one of my favorites, published by one of my personal mentors.
The key is balance. Proteins are known to be acidic, but also play numerous important roles in the body, including that of transport cells in the bloodstream that act as buffers to maintain normal pH by taking up excess hydrogen, which is acidic (the term “pH” means “potential of hydrogen”). Hence, it makes more sense to increase your intake of alkaline fruits and vegetables rather than reduce the proteins in your diet. Protein is essential not only for maintaining acid-base balance but also for numerous other functions, especially as we age.
Lemon juice, though acidic, is paradoxically considered an alkaline food due to its alkalinizing effect on the kidneys. To increase stomach acid and/or relieve acid reflux, try a squeeze of fresh lemon juice in a glass of water with potassium-rich Celtic sea salt. Potassium, magnesium, and calcium are all alkaline minerals, and also act as pH-balancing buffers in bodily fluids. It’s important to eat foods rich in potassium and magnesium on a regular basis: fruits and vegetables, whole nuts and seeds, and whole grains. Stick to low-glycemic fruits, and skip the fruit juice. Potassium bicarbonate is an alternative form of baking soda, and constitutes the main ingredient in my homemade tooth powder, which keeps my oral microbiome tilted in the right direction. I also love sweet potatoes, and cooked, chilled purple, yellow, or red potatoes, for both their potassium and their prebiotic fiber.
Be sure to chew your food thoroughly so that your saliva can do its job, and so that your salivary glands may properly signal your pancreas to produce digestive enzymes. Properly chewed food also makes your stomach’s job easier, as more surface area of the food is exposed. Skipping chewing, however – such as by drinking a puréed smoothie instead of eating the whole food – circumvents the critical contribution of your salivary glands, and also reduces the fiber content of the food by partially breaking it down. Your pancreas produces a bicarbonate fluid that neutralizes stomach acid as food enters the small intestines. A healthy pancreas is one that is not overtaxed by a high-carb diet. Don’t make your pancreas work too hard, so it can work for you. Bitter foods such as cruciferous vegetables; sour citrus fruits and olives; and dandelion greens all help the pancreas produce more enzymes.7
Avoid eating after 8:30 at night, or even earlier in the winter. Your stomach and pancreas have a circadian rhythm, and want to go to sleep after dark. If you prod these organs to become active at night, they may become overstimulated and produce too much stomach acid and too much insulin.
Once again, the takeaway here is to eat more fruits and vegetables – especially vegetables, as many fruits are acidic – and healthy protein. Try to fill half your shopping cart in the produce aisle. Cucumbers and celery make great, crunchy, alkaline snacks; and dark leafy greens, as always, are your greatest allies – including alkalinizing dandelion greens. Common sense and whole, natural and organic foods are the shortest path to a healthy pH balance and a happy gut. It’s worth listening to your body, if you want it to keep quiet and serve you well.
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To your good health –
Yael Bernhard
Certified Integrative Health & Nutrition Coach
Have you seen my other Substack, Image of the Week? Check it out here, and learn about my illustrations and fine art paintings, and the stories and creative process behind them.
Yael Bernhard is a writer, illustrator, book designer and fine art painter with a lifelong passion for nutrition and herbal medicine. She was certified by Duke University as an Integrative Health Coach in 2021 and by Cornell University in Nutrition & Healthy Living in 2022. For information about private health coaching or nutrition programs for schools, please respond directly to this newsletter, or email dyaelbernhard@protonmail.com. Visit her online gallery of illustration, fine art, and children’s books here.
Information in this newsletter is provided for educational – and inspirational – purposes only.
https://www.ncbi.nlm.nih.gov/books/NBK526049/
Ibid.
https://thescienceofnutrition.me/2023/11/10/the-bones-on-bone-health/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8728510/
https://news.mit.edu/2019/how-tumors-behave-acid-0320#
Ibid.
Axe, Josh Dr. Eat Dirt: Why Leaky Gut May Be the Root Cause of Your Health Problems, Harper Wave 2016, pg 224.