CFIDS and FMS Support Group of DFW


Written by Carol Sieverling, this information is based on tapes of her October 2000 visit to Dr. Cheney. He gave permission to share this information, but has not reviewed or edited it.

When Dr. Cheney reviewed the results of my CDSA (Comprehensive Digestive Stool Analysis) from Great Smokies Laboratories (, he noted indications of "proteolytic problems" - trouble digesting proteins. First he confirmed I was taking digestive enzymes, which he believes are essential for all CFIDS patients.

Cheney then suggested the supplement betaine. Most CFIDS patients do not have enough stomach acid, and betaine HCL (hydrochloric acid) is stomach acid. (One knowledgeable patient recently theorized that the amount of acid might not be the problem. He believes the pH of our stomach acid is not acidic enough, therefore it can not do the job. Supplementing with betaine would address this.)

Stomach acid is a paradoxical substance: too little can actually make you think you have too much. Many people think they have acid reflux or GERD, and they take Prilosec or other antacids to reduce the amount of stomach acid. In actuality, they may not have enough acid in their stomach to trigger the opening of a valve at its base. When food begins to fill the stomach, acid is released to assist with digestion. When enough acid is detected, the valve opens, releasing the food into the small intestine. If there isn't enough acid, the valve doesn't open. The food, mixed with what little acid is present, is forced back up the esophagus, creating a burning sensation. Paradoxically, the answer to the burning sensation is more acid, not less. Antacids can create a vicious cycle in these cases.

Cheney said stomach acid does at least four important things:

(1) It creates an acid trap to kill bacteria in food. A lack of stomach acid allows bacterial overgrowths to develop, particularly in the small intestine. A UCLA study of 52 FM/CFS patients found bacterial overgrowths in 90%! Antibiotics were given to wipe out all bacteria (good and bad). Pain, fatigue, and cognition improved. Cheney strongly recommends betaine instead of antibiotics.

(2) According to Cheney, betaine "clips proteins", part of the process of digesting proteins. The enzymes (natural or supplemented) that break down protein need acid in order to work. You may take lots of enzymes, but if you donĚt have enough acid, they won't be effective. (Plant-based digestive enzymes are the exception. They don't need acid, though we still need the acid for all the other reasons listed here.)

(3) Betaine helps extract minerals from food. Stomach acid is required for the body to absorb minerals. Without enough stomach acid, mineral depletion results.

(4) When the "acid chyme" (partially digested food mixed with acid) is released from the stomach, it enters the duodenum (first part of the small intestine). If enough acid is present, the pancreas will release pancreatic enzymes and the liver will release bile. These are essential for good digestion and absorption. Without enough acid, these enzymes are not released, compromising digestion and absorption.

Most CFS/FM patients need to be taking supplemental betaine. Cheney recommends "Betaine Plus" made by Douglas Labs. It is available from NEEDS,,1-800-634-1380,1-800-634-1380. Each capsule contains 500 mg of betaine.

Regarding dosage, take as much as you can tolerate. Most patients take one or two caps per meal. A few can tolerate only 1/2 cap. A few take much more, up to 7 caps a meal. As with so many things, the dose is very individualized. If you take too little, you will have that paradoxical burning sensation from the food/acid mixture coming back up the esophagus, because there isn not enough acid to trigger the release of food into the small intestine. If you take more, but still not quite enough, the food/acid mixture will still come back up the esophagus. However, now it will burn even worse because it has more acid in it - just not enough to open the valve at the bottom of the stomach. If you take too much, you will experience "dumping", as Cheney calls it, usually diarrhea or a general "yucky" feeling.

One patient began taking Betaine a couple of months ago and has finally escaped from the horrible pain and discomfort after meals that has plagued her for the past 5 years.

Try taking betaine to improve your digestion, absorption, and kill off bacterial overgrowths!

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Update 01/10/05. For questions or comments concerning this site, please contact Lori or Deborah.

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