International Institute of Nutritional Research
Prima Gest

This report shall review some of the scientific and medical findings which indicate that a deficiency of stomach hydrochloric acid is a significant contributing factor to a wide range of health problems. In addition, this report will review information which indicates that supplements of hydrochloric acid and its associated nutrients at meal times has proven beneficial.


When food is swallowed it passes through a tube called the esophagus and ends up in a muscular bag called the stomach. The inner lining of the stomach is dotted with what are known as gastric glands. These glands contain several different types of cells, one of which is known as the parietal cell which produces the hydrochloric acid or HCl for short. The purpose of HCl is four-fold. (1) It starts the digestive breakdown of protein so that it can eventually become amino acids which our body needs to manufacture enzymes, hormones, neurotransmitters, muscle, connective tissue, and other protein structures. (2) It separates the fats and oils from our food. (3) It separates minerals from the food. (4) It helps us obtain many of our vitamins.


Scientific studies have shown that there are many people who do not manufacture enough HCl in their stomach. Several studies have also shown that we produce more HCl in the early part of the day than we do in the evening. Perhaps this is what prompted Benjamin Franklin to coin the phrase that, "in the morning we should eat like a king, at noon like a prince, and at night like a pauper." This is especially true as we grow older, An indication that we do not manufacture enough HCl is difficulty in digesting large evening meals. This is a rather common occurrence among those past the age of forty and increases as we grow older. A study by Drs. D.T. Davies and T.J. James published in the Quarterly Journal of Medicine showed that in a group of 100 normal people over the age of 60, over 50% had what is called hypochlorhydria. This simply means they did not make enough HCl (hydrochloric acid) to adequately digest the food in their stomach. Worse still was the fact that this and other studies reveals this gets progressively worse as we age, and that many people over the age of 65 make no HCl at all. This is a condition called achlorhydria.1 Without adequate HCl as we age, we are unable to obtain the amino acids, the minerals, or the vitamins we need. This is why every study of those over the age of 60 has shown an increasing deficiency of immuno globulins made of amino acids, a sharp decrease in iron and calcium, as well as other minerals, and a decline in vitamin C, B-12, Folate and other key vitamins.2 Without adequate HCl we actively age faster and faster. However, it is not just the aging individual which is deficient in HCl. As we are about to see, studies have revealed that low HCl production is often a major factor in many of the health problems for people of all ages.


While the stomach and the skin may seem quite unrelated to each other, several studies have turned up a close connection. It turns out that many of the nutrients required by the skin are dependent upon an adequate production of HCl to release them from our food.

Acne Rosacea occurs primarily in middle aged and elderly individuals. It consists of enlarged capillaries of the facial skin, which gives a rosy hue to the afflicted areas. They are often tender and accompanied by inflamed papules and pustules. In a study of 30 patients with the condition, Dr. J.R. Allison found 40% produced no HCl, and 47% produced too little HCl. When these HCl deficient patients were given HCl supplements with B complex at their meals, their skin conditions cleared up.3 Another study involving 32 patients with the additional complication of keratitis (inflammation of the cornea) were found by Drs. L. Johnson and R. Echardt to be deficient in riboflavin (Vit. B-2) and low in HCl production. Improvement followed supplementation with riboflavin and HCl.4

Dermatitis Herpetiformis presents large red and painful vesicles on the skin and occasionally on the mucous membranes. This condition is generally associated with a disturbance of the small intestines which allow the absorption of gliadin, the principle protein from the gluten of grains. However a study by Dr. S. Ayers has shown that 75% of these patients have a deficiency in their HCl production. this reduces their ability to digest the protein of grains, and the extent of their HCl deficiency is in direct ratio to the severity of their condition.5

Eczema or Atopic Dermatitis is a condition where there are dry itching and slightly reddened areas of the skin, sometimes accompanied by small vesicles (tiny papules filled with fluid). This is generally associated with a food allergy, such as the gluten containing grains. Dr. Allison found that 25% of 106 cases had no HCl production at all, and an additional 49% had less than the normal amount. In addition, the degree of deficiency correlated with the severity of the condition.3 In another study Dr. Ayers found that 72% of patients presenting this condition produces less than half the normal amount of HCl following a routine Ewald test meal. Marked improvement followed HCl supplementation.5

Lupus Erythematosus presents itself as red patches on the skin, primarily on the face and neck, without irritable symptoms. The area may be in the irregular shape of a butterfly, and in time the skin may atrophy, become hard, dry and scaly, with a plugging of the sebaceous glands. When Dr. Allison examined nine chronic lupus patients he found all had low HCl levels and 2 had none at all. When supplemented with both HCl and B complex, all had improvement in their condition.3

Psoriasis is a condition where bright red inflammatory patches of skin occurs which generally itch and produce heavy scales of a silver-gray color. They may be quite extensive in size and are commonly found on the elbows, arms, knees, and scalp. When Dr. Ayres examined 29 patients with chronic psoriasis using a routine Ewald test meal, 52% were found to have less than half the normal amount of HCl.5 Dr. Allison examined nine such patients and found only one with normal HCl production, three were below normal and 5, or nearly 60% had no HCI production at all. He noted that the severity of the condition matched the level of HCl deficiency. All patients improved when supplemented with HCl and the B complex vitamins.3

Seborrheic Dermatitis consists of patches of skin that are only mildly red and itching, and which produce light, thin scales with a yellowish cast. These areas tend to locate on the scalp and in the folds of the skin. When Dr. Allison examined 68 such patients which had resisted all forms of treatment, he found that 65% produced too little HCl and another 22% produced no HCl. When given HCl and the B complex supplements these patients all improved.3

Chronic Urticaria occurs when areas of the skin develop enlarged reddened masses consisting of localized swelling and edema that itch intensely. These spots may be called hives or wheals. Although they generally come and go rather quickly, in chronic cases they tend to last longer and reoccur frequently. Eliminating those whose condition was due to a drug, food, or chemical reaction, Dr. Allison examined 77 urticaria patients. He found 84% had insufficient HCl production. When given the B complex vitamins and HCl supplements, they obtained "remarkable" recovery.3

Vitiligo is a condition where patches of skin develop a lack of pigmentation. Studies have shown that as many as 97% of individuals with this condition do not produce enough HCl. As many as 35% have no HCl production at all. Excellent results have been obtained with HCl supplements and the B complex vitamins. However, Dr. H.W. Francis found that it often takes up to two years of daily supplementation at each meal to obtain complete pigmentation of the skin for those who make no HCl.6


The greatest cause of anemia is a deficiency of iron. This may be due to a chronic bleeding problem, or it may be due to a low stomach HCl which prevents the iron from being assimilated. Dr. Jonathan V. Wright states that his clinical experience with this condition indicates low HCl is the number-one cause of iron deficiency in men.7 Dr. I.M. Rabinowich conducted a study with 25 well-managed diabetic patients who had low red blood counts. When given iron supplements for a month there was no significant increase in red blood count. However, when HCl supplements were given with each meal for a month, there was a significant rise in the red blood county by one half million.8


Many important studies have shown that a deficiency of magnesium and vitamin B-6, as well as vitamin C and B-12, play a major role in this condition. However, other researchers have found that a deficiency of HCl in the stomach leads to an inability to assimilate vitamin B-6,9 vitamin C,10 magnesium,11 and B-12.12 Therefore it is not surprising that when Dr. G.W. Bray analyzed the stomach secretions of 200 asthmatic children, he found 80% of them to be hypochlorhydria.13 Such low levels of HCl prevented these children from absorbing the nutrients which would allow the bronchial tubes to function normally.


A wide range of B vitamins, along with vitamin C, and several minerals when deficient, have been shown in several studies to play a major role in creating depression by depriving the brain of nutrients essential for the manufacturing of normal brain chemistry.14 It has also been shown that when stomach levels of HCl are low, these essential nutrients cannot be obtained from the food even when the diet is adequate.9-12 One severely depressed female patient with a 17-year history of medically diagnosed B vitamin deficiency which failed to respond to vitamin supplements, had a remarkable recovery in one week when she was given supplements of HCl at each meal along with a B complex supplement.13


In this condition there is a marked elevation of blood glucose levels, often several times that of normal. This frequently results in severe complications of circulation, kidney function, and nerve degeneration. Studies have revealed that there is a wide range of nutrients which may be deficient in association with this condition.14 Dr. I.M. Rabinowich worked with three patients who had severe neuritis as a result of thiamin (vit. B-1) deficiency. Yet they failed to respond to thiamin supplements. However, when he supplemented HCl along with the thiamin at each meal, there was a very rapid improvement. This was then expanded to a larger group of patients with a similar result. When examining 50 diabetic patients under the age of 40, and fifty over 40, Dr. Rabinowich found a very high number of patients with low HCl production in both groups. However, he found that a full 18% of those in the under-40 group and 64% of those in the over-40 group made no hydrochloric acid at all. This led to a marked increase in anemia, neuritis, and other complications in this group.8 Dr. C.T. Richardson found that diabetics had a reduced ability to produce HCl and they had slower stomach-emptying times which tended to match those of individuals whose vagus nerve to the stomach had been surgically severed.15 These results indicate that diabetes may develop due to a loss of nutrients important to the management of blood sugar. It also indicates that at least some of the complications of diabetes may be due to the loss of nutrients, both of which are associated with impaired HCl production common to diabetics.


The liver produces several waste products which it excretes into the upper intestinal tract. With this waste material, is also excreted a substance called bile acids which are important for the digestion of fats in the diet. This bile and the waste material are stored on the under side of the liver in a small pouch called the gall bladder. It is released at the time a meal containing fat is eaten. Since the only avenue for the elimination of excess cholesterol is through the bile, a large amount is often stored in the gall bladder. There it becomes hard, forming gall stones. The release of cholesterol laden bile along with stones has often been found to reflux, that is move upward into the stomach. There, this strong alkaline material has a destructive influence on the parietal cells which produce HCI. Dr. W.M. Capper and associates found that 16 out of 18 patients with gall stones had persistent regurgitation of bile into the stomach. They also found that over 50% of these patients had a marked decrease in their HCl production.16


Few conditions receive more complaints among the over-40 set than the problems associated with indigestion. This is most frequently seen with the evening meal eaten at 6 o’clock and still tossing and turning with the 11 o’clock news five hours later. The primary cause of this with all of its attendant bloating, stomach gas, belching and heartburn is a lack of HCl production. As Dr. J.V. Wright points out, when there is adequate HCl production, the food in the stomach digests quickly and empties promptly and smoothly. When there is not enough stomach acid, the food just seems to lay there for hours while the starches ferment and generate gas. This causes belching and some reflux of the mildly acidic stomach secretions into the esophagus. Since the esophagus is not designed for even mild stomach acid, it burns, and we reach for the antacid. However, it is not too much acid which has produced this long drawn-out digestive problem, it is too little HCl that has created it. What we need is HCl supplements after the meal, not antacids hours later.7 As we have previously pointed out, stomach indigestion means a loss of important amino acids, minerals and vitamins. It is more than just unpleasant, it speeds up the aging process by causing us to run out of nutritional fuel and building blocks long before we should.


One of the benefits of normal HCl production is that the acidity of the stomach is strong enough to kill many bacteria, yeast, fungus, molds and parasites. A study by Dr. R. Giannella and associates found that when HCl production in the stomach declined, there was an increase in infectious organisms in the intestinal tract.17 One indication of a high content of unwanted bacteria and yeast in the digestive tract is a rise in the indican level of the urine. This is indicated by the Obermeyer test. Dr. J.V. Wright has found that high levels of indican correlates well with candida yeast infections and low HCl production in the stomach.7 For such individuals, supplements of HCl tablets at meal times improve digestion and help prevent the fermentation of starches which allows harmful yeast and bacteria to thrive in the intestinal tract. This is often a first step in eliminating candida.


This condition consists of a number of symptoms, which can be boiled down to a nonprofessional statement, "a pain in the guts." There is considerable evidence that in many instances both positive and negative mental and emotional stress leads to intestinal spasms which produce the pain. However, Dr. R.C. Atkins has found that in a large number of these patients a Heidelberg test using a swallowed radio transmitted to measure the HCl level of the stomach, indicated most of them were very low in HCl. In addition, the Obermeyer test revealed a high indican level in the urine. He found that in 70% of the cases where both the HCl was low and the indican was high, supplementation with HCl at meals resulted in an elimination of the IBS symptoms.18


A study of women with osteoarthritis by Drs. E.F. Hartung and Q. Steinbrocker revealed that 25.7% of these women were producing no HCl, while in a control group of the same ages, only 13.7% of the women failed to produce HCl. The doctors examined another group of 36 women, this time with rheumatoid arthritis and found 28.6% of this group without HCl production, compared to a control group of women in which only 8.6% had no HCl production.19 While there are many factors involved with arthritis, it is clear when the incidence of no HCl production is twice as high in arthritis as it is in those without arthritis, that an absence of HCl production may be an important contributing factor.


A condition in which calcium is lost from the bone, literally hollowing the bone and making it weak and brittle. This condition is very predominate among post-menopausal women. A study by Dr. M. Grossman and team found that 40% of post-menopausal women had no secretion of HCl.20 Dr. R.R. Recker conducted a study which disclosed that normal individuals absorbed virtually the same amount of calcium whether from the citrate or carbonate form. However, individuals who were without HCl production obtained twice as much calcium from the citrate form as from the carbonate.21 In another study, Dr. P. Ivanovich and group found they could increase the calcium absorption in individuals without stomach HCl from 2% to 10% by increasing the stomach acidity to that normally associated with healthy HCl production.22 While many factors are no doubt at work in osteoporosis, it is clear from these studies that a lack of stomach acidity drastically reduces the body’s ability to absorb calcium.


One of the problems faced by older people is a loss of bone around the teeth. One study conducted by Drs. J. Brechner and W.D. Armstrong compared the quantity and strength of stomach acid between a group of 42 individuals who had suffered bone loss around the teeth versus 32 people who had not experienced this loss. They found that the group which had retained the bone around their teeth had, on the average twice as much available stomach acid as those which suffered bone loss around the teeth.23


A conclusive amount of scientific evidence has been accumulated which demonstrates that a reduction of stomach hydrochloric acid is a part of the aging process. A process which robs us of many amino acids, vitamins, and minerals—which sets the stage for many other health problems. Not the lease of which is indigestion and fermentation, which creates alkaline conditions that encourage the growth of harmful bacteria and yeast in our intestines. PRIMA-GEST capsules contain 486 milligrams of HCl with pepsin and other synergistic nutrients. Supplementation with these capsules where indicated, 3 to 6 capsules at the end of the meal according to the size of the meal and the time of the day, often brings major improvements in digestion and overall health. Obviously, PRIMA-GEST is contra-indicated where stomach or duodenal ulcers do or have existed in an individual.


Vitality’s Prima-Gest offers a simple way to supplement meals with HCl when the signs of decreased production begin to show themselves.

One Prima-Gest capsule contains the following nutrient values:
Betain HCl ................................................... 162 mg.
Glutamic Acid HCl ..................................... 324 mg.
Pepsin ......................................................... 7.6 mg.
Niacinamide ............................................... 10 mg.
Vitamin B-6 ................................................ 950 mcg.
Papain ........................................................ 8 mg.
Extract of Ox Bile ...................................... 16 mg.
Whole Pancreas ....................................... 16 mg.
Potassium Chloride .................................. 57 mg.


The Institute offers the following suggestion in the use of this product. One or two capsules after the morning meal. Three or four capsules after of the noon meal. Five to six capsules after the evening meal. When traveling in a foreign nation, five or six capsules with food and drink often prevents dysentery and other stomach and intestinal disturbance.

Note: Prima-Gest capsules should not be used by those who have or have had a stomach or duodenal ulcer. Chronic indigestion may be an indication of a more serious problem. If symptoms persist, consult you doctor, or take as directed by your physician.

Vitality Product Code 3004 (100 capsules)

Reprinted by Permission - Product Overview from the Complete Product Overview & Physicians Guide -
Dr. Robert Preston N.D. Copyright 2000 International Institute of Nutritional Research. All right reserved.