Dear Dr. Roach: I started taking betaine hydrochloride for my digestive health. I have had some ongoing issues, and my sister, the wellness guru, has been sharing some things she has learned and suggested this to me. In the first week I have noticed a difference. My wonderful partner, who is always skeptical, is wondering if there is true value with this supplement, so we are turning to you for some insight. — J.Y.
Answer: Betaine hydrochloride has several purported uses. One is to improve athletic performance; however, the data are mixed about whether it is effective at improving muscle strength and endurance.
It also is used to relieve symptoms of gastroesophageal reflux disease and “functional dyspepsia,” a nonspecific term encompassing several types of stomach upset.
Betaine temporarily increases acid levels in the stomach (that’s the same thing as a lower pH). This effect lasts a few hours, at least in one study of volunteers taking acid-suppressing drugs. Because of this, betaine hydrochloride has been used to help absorption of some medications.
However, there is no convincing evidence that this helps with symptoms. I am always concerned that an individual person’s response could be due to the placebo effect, meaning that the difference you noted could be due to expecting to find some benefit from taking the supplement.
Betaine hydrochloride does not have many side effects in most people. Nausea, stomach upset, diarrhea and a body odor all have been reported.
I don’t recommend betaine hydrochloride, but if it is helping and is not causing side effects, it is not likely to harm you.
Dear Dr. Roach: I have a question about your recent column on colloidal silver. Are you saying you do not advocate using OTC antimicrobial silver (55 PPM) for topical wound care? Is that what the Food and Drug Administration says is neither safe nor effective for any condition?
When I had shingles 15 years ago, I was told to get some silver salve to use. Can’t really say if it did anything or not. — E.C.
Answer: Topical silver is an effective antimicrobial, and even at small doses can improve the effectiveness of other antibiotics. Prescription-strength silver ointments usually are 0.5 to 1 percent, which is 50,000-100,000 parts per million concentration. The effectiveness of 55 ppm silver is doubtful: For a difficult bug like Staphylococcus aureus, the minimum concentration of silver needed to effectively kill bacteria is about 500 to 1,000 ppm. I’m not sure why you would have been recommended it for shingles, which is a reactivation of the chickenpox virus. The only thought I had was that perhaps your rash got secondarily infected by bacteria, but that should have been treated by a more effective method. An OTC antibiotic like triple antibiotic (neomycin, polymyxin and bacitracin) is a reasonable first-line treatment for superficial wounds with mild infection.
While topical silver (in the correct dose) is effective for treatment of infected wounds, colloidal silver, which is taken internally, is neither safe nor effective.
Dear Dr. Roach: I heard that taking L-lysine when you have shingles helps to relieve the symptoms. What is your opinion regarding this treatment? I take it for three or four days whenever I get fever blisters, and it does help to clear my lips. — J.B.
Answer: L-lysine, an amino acid, has some effectiveness at reducing recurrences and speeding healing in herpes simplex infection of the mouth or genitals. However, even though varicella-zoster virus is related to herpes simplex, L-lysine has not been effective for treatment or prevention of shingles. The vaccine is the best protection, but early treatment with antivirals, such as valacyclovir, also is helpful.