LISTEN TO THE PODCAST – Also available on Spotify and Apple Podcasts
I used to think my “acid reflux” meant I had too much stomach acid. But uncovering the real issue – low stomach acid – was the turning point in my Hashimoto’s journey. Within days of the right support, I went from sleeping from 11 to 12 hours to waking refreshed after seven hours, with my brain fog lifting, memory returning, and even my sense of humor back on board!
In this solo episode, I explain why low stomach acid (hypochlorhydria) is common in hypothyroidism, how it drives fatigue, pain, mood changes, GERD-like symptoms, SIBO, H. pylori, and nutrient deficiencies – and exactly how I tested and addressed it. If you’ve felt exhausted after meals, heavy after protein, or stuck despite “clean eating,” this could be your missing piece.
I walk you through the practical steps: a safe, structured betaine HCl + pepsin titration, how to support digestion with mindful eating, lemon water, diluted apple cider vinegar, digestive bitters, and thiamine – plus when to loop in your clinician, and when not to use it.
What you’ll learn in this episode:
- Why “acid reflux” can actually mean low stomach acid. In hypothyroidism, stomach acid often runs low, which impairs protein breakdown, fuels overgrowths, increases ammonia (hello brain fog), and leaves you tired after meals. Understanding this flips the usual reflux narrative and opens a path to real relief.
- How low acid drives fatigue, pain, and mood changes. Poor protein digestion means fewer amino acids for neurotransmitters and repair; when you add in nutrient gaps (B12, iron/ferritin) and inflammatory byproducts, you’ve got a perfect storm for low energy, aches, and low mood.
- A step-by-step guide to finding your ideal betaine HCl + pepsin dose at meals. I share how to determine how many capsules would be most suitable for you, and how to use it safely for best results.
- When to pause or avoid HCl. It’s not for everyone: if you have active or past peptic ulcers, confirmed H. pylori, current acid overproduction, ingredient sensitivities, or chronic NSAID/steroid use, if you use ongoing PPIs (or you’re weaning), or if you are pregnant/breastfeeding, talk to your clinician first.
- Simple daily upgrades to raise digestive fire. Eating in a calm state, chewing well, trying diluted lemon water or apple cider vinegar with meals, considering digestive bitters, and assessing thiamine can be surprising helpers for stomach acid and thyroid fatigue.
- Real-world outcomes and what to expect. In my experience, ~60% of people feel better on HCl, ~33% don’t tolerate it, and ~7% feel no change. Wins often include more energy, less pain/bloating, better mood, smoother bowels, and easier weight balance when digestion finally “clicks.”
IBS: Finding and Treating the Root Cause of Irritable Bowel Syndrome by Dr. Izabella Wentz. Many people with Hashimoto’s have irritable bowel syndrome, which can be both a root cause and symptom of autoimmunity. This comprehensive guide reveals how irritable bowel syndrome is often a catch-all diagnosis that overlooks treatable root causes. It offers a step-by-step approach to help readers understand what’s really driving gut symptoms, and how to create a personalized plan to restore gut health and overall wellness. The book is available for preorder now and will be released on March 17, 2026!
Supplements We Discussed
- Betaine HCl + Pepsin: Temporarily boosts stomach acid to support protein breakdown, nutrient absorption (B12/iron), and downstream digestive function; use a careful titration and observe precautions. Consider Rootcology Betaine with Pepsin. Use code PODCAST for 20% off Rootcology; there’s no risk, as there is a 30-day money-back guarantee.
- Thiamine (Benfotiamine): Can upregulate stomach acid production and rapidly improve thyroid-related fatigue for some (common dosing discussed: ~600 mg/day for 3-5 days, then reassess). Consider Rootcology Benfotiamine.
- Digestive Bitters: Gentle priming of gastric juices and bile flow to aid digestion before meals; helpful for those who don’t tolerate HCl or as a maintenance option. Consider Quicksilver Scientific Dr. Shades Digestive Bitters (use code DRWENTZ15 for 15% off your first order) or Wellena Liver & Digestive Bitters Kit.
- Lemon Water / Diluted Apple Cider Vinegar: Non-supplement options that can nudge digestive acidity and support mealtime digestion when properly diluted.
Other Tools and Resources
- Mindful eating routine (sit, breathe, chew thoroughly)
- How to safely stop taking proton pump inhibitors (PPI) – download the PPI tapering protocol here.
- H. pylori testing/treatment guidance if reflux or ulcers persist – consider the GI-MAP test from Diagnostic Solutions, available via Rupa Health.
- Iron (ferritin) and B12 testing for fatigue workups
- SIBO evaluation if bloating and post-meal heaviness continue – consider the SIBO 3-Hour test from Genova Diagnostics, available via Rupa Health.
Books and Articles About Thyroid & Digestion
- IBS: Finding and Treating the Root Cause of Irritable Bowel Syndrome by Dr. Izabella Wentz. Many people with Hashimoto’s have irritable bowel syndrome, which can be both a root cause and symptom of autoimmunity. This comprehensive guide reveals how irritable bowel syndrome is often a catch-all diagnosis that overlooks treatable root causes. It offers a step-by-step approach to help readers understand what’s really driving gut symptoms, and how to create a personalized plan to restore gut health and overall wellness. The book is available for preorder now and will be released on March 17, 2026!
- How Betaine with Pepsin Can Help with Hashimoto’s
- The Missing Link to Thyroid Fatigue
- Got Acid Reflux? And Hashimoto’s?
Get the Full Episode Transcript
Let’s Connect!
- Follow me on Instagram:@izabellawentzpharmd
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Got questions? Drop them in the comments! 🙂
About Our Host
Dr. Izabella Wentz
Dr. Izabella Wentz is a compassionate, innovative, solution-focused integrative pharmacist dedicated to finding the root causes of chronic health conditions. Her passion stems from her own diagnosis of Hashimoto’s thyroiditis in 2009, following a decade of debilitating symptoms.
Dr. Izabella Wentz has written several best-selling books, including the New York Times bestseller Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause, the protocol-based #1 New York Times bestseller Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back, the Wall Street Journal bestseller Hashimoto’s Food Pharmacology: Nutrition Protocols and Healing Recipes to Take Charge of Your Thyroid Health, and Adrenal Transformation Protocol. Her latest book, IBS: Finding and Treating the Root Cause of Irritable Bowel Syndrome, will be released March 17, 2026 and is available for pre-order here.
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