Low Stomach Acid and Vitiligo – What You Need to Know

There’s something that those of us with non-segmental vitiligo have in common:

Low Stomach Acid

Why Is This a Problem?

Well, simply put, low stomach acid means increased food allergies and lower absorption of amino acids, vitamins, and minerals – which for us translates into deficiencies in B-12, folate, zinc, etc. Those with vitiligo are shown to be deficient in B-12 and folate (among others).

Additionally, low stomach acid increases intestinal permeability (A.K.A. leaky gut), inflammation, and infection. (source)

Leaky gut is the microscopic loss of the integrity of your intestinal lining. In other words, it’s teeny tiny holes in the lining of your intestine.

Here’s how it happens:

Adequate stomach acid is required to completely break down and assimilate the nutrients contained in the foods we eat, especially proteins and starches. But when stomach acid is low, the food we eat doesn’t get digested properly.

When this undigested food passes into the small intestine, it becomes breeding ground for pathogenic bacteria and candida, which causes the friendly gut flora to become depleted and overrun by bad bacteria.

Once this happens, the lining of the gut becomes inflamed and weakened, ultimately resulting in a leaky gut.

Once your gut is permeable, or leaky, microscopic food particles can enter the blood stream…and that’s when things get ugly.

On his site, Dr. Ben Kim (who also suffers from vitiligo) describes what happens when food particles enter the bloodstream as a result of leaky gut:

Once the lining of your digestive tract begins to break down, if your genetic programming allows for it, you will begin to experience the antigen-antibody complex formation that occurs whenever incompletely digested protein leaks through your damaged digestive tract into your blood…

Whenever any unnecessary, harmful, or unidentifiable substances enter your bloodstream, they get noticed by your immune system. In an effort to preserve your health, your immune system produces antibodies that seek out and attach themselves to these unwanted substances; these substances are generally referred to as antigens.

Once your antibodies attach themselves to antigens, antigen-antibody complexes are formed. Your immune system will work to eliminate these antigen-antibody complexes from your body so that the foreign antigens cannot harm your cells. But if enough of these complexes are formed, your immune system may not be able to eliminate them as quickly as they are formed. This can lead to some of these complexes getting deposited into different tissues, where they can cause inflammation and damage. Typically, the sites at which these complexes get deposited are determined by your genetic predisposition. (read original article here)

Autoimmune disorders, including vitiligo, have all been linked to low stomach acid and leaky gut. In his book, Why Stomach Acid Is Good for You, Dr. Jonathan Wright actually says that he is surprised when a patient with autoimmune disease does not have low stomach acid. The image below is a chart from his book.

What Causes Low Stomach Acid?

A number of things can contribute to low stomach acid, which is why so many of us have it.

Some of them are:

1. Aging
2. Low thyroid or thyroid dysfunction
3. Adrenal fatigue/insufficiency
4. H. Pylori infection
5. Medications
6. Poor diet
7. Stress

How Do You Know if You Have Leaky Gut?

Sometimes there are no symptoms. However, most people have some sort of clue. Personally, I have allergic skin issues and fibromyalgia – leaky gut is thought to be a causative factor in fibromyalgia.

Generally, you can assume your digestive tract is in trouble if you have multiple food sensitivities or allergies, chronic diarrhea and/or constipation, hives or skin eruptions, discomfort in your abdomen during and/or after you eat, excessive fatigue, brain fog, and nutritional deficiency, just to name a few.

How Your Gut Affects Your Skin

There’s something called the “gut-skin-axis”, which Chris Kresser describes very well in this article on his site. Under the subheading Associations Between Gut Disorders and Skin Conditions, he says this:

Epidemiological evidence shows a clear association between gut problems and skin disorders. A recent report indicated that small intestine bacterial overgrowth (SIBO), a condition involving inappropriate growth of bacteria in the small intestine, is 10 times more prevalent in people with acne rosacea than in healthy controls, and that correction of SIBO in these individuals led to marked clinical improvement. 14% of patients with ulcerative colitis and 24% of patients with Crohn’s disease have skin manifestations….Celiac disease also has cutaneous manifestations, such as dermatitis herpetiformis, which occurs in 1/4 of celiac sufferers. Celiacs also have increased frequency of oral mucosal lesions, alopecia and vitiligo.

Now you may be thinking, “Well, that’s nice but I don’t have celiac disease.”

And I say, “How do you know you don’t?” 🙂

There is such a thing as a “silent celiac”, meaning you have NO symptoms at all.

The only way to really tell if you have celiac disease is through an endoscopy. A blood test will only show autoantibodies in individuals that have suffered significant damage to the intestinal wall. Most of us have not yet reached that point, so blood tests are worthless. I tested negative for celiac disease, but I am not fully convinced I don’t have it.

Many people unknowingly carry genes associated with both celiac and vitiligo – NLRP1 and LPP:

We know from federally-funded genetics research that the gene NLRP1 (formerly known as NALP1), has been confirmed as being associated with vitiligo, as well as with celiac disease, Addison’s disease, systemic sclerosis, and lupus, and with type 1 diabetes in two out of three studies. We recently learned from a newly released study about another common gene, LPP, which is associated with vitiligo, celiac disease and rheumatoid arthritis. Perhaps these genes may be involved in mediating vitiligo and CD. (source)

This means that if you have vitiligo, you would do well to completely avoid gluten.

What to Do About Low Stomach Acid and Leaky Gut

As you have seen, low stomach acid and leaky gut typically go hand in hand.

One of the most important things you can do is avoid gut irritating foods that cause irritation and inflammation. You may also want to limit animal proteins, as they are difficult to digest and can lead to the formation of antigen-antibody complexes, as mentioned above. It’s a good idea to always take a digestive enzyme, especially when you eat animal protein.

Here are some other ways to treat low stomach acid:

1. HCL supplementation – You can read more about that here.
2. Digestive enzymes – To help you fully digest your food and extract necessary amino acids and nutrients
3. Digestive bitters
4. Apple Cider Vinegar

Repairing a leaky gut requires patience, as it can often take up to a year or more to fully heal. You can read more about how to heal a leaky gut in this article on Chris Kresser’s site. Otherwise, here are a few suggestions:

1. Eat a diet high in cooked vegetables – provides fiber, helps restore good bacteria, and promotes gut healing
2. Restrict or eliminate gut irritating foods, such as sugar and grains (especially gluten)
3.  Zinc supplementation 
4. L-Glutamine supplementation
5. Aloe vera
6. Probiotics – to restore healthy bacteria to the gut