In this solo episode, Dr. Izabella Wentz shares the turning point that shifted her Hashimoto’s recovery: discovering that “acid reflux” can stem from low stomach acid (hypochlorhydria) rather than excess stomach acid, as many believe. She explains how hypochlorhydria drives fatigue, brain fog, pain, nutrient deficiencies, SIBO/H. pylori risk, and why supporting digestion can restore energy and clarity fast. She outlines a practical betaine HCl + pepsin titration, who should avoid it, and simple daily upgrades (like mindful meals, lemon water or diluted ACV, bitters, and thiamine). Real-world response rates and safety notes are included. 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. Dr. Wentz shares 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 Dr. Wentz’s 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.” Be sure to subscribe to the Thyroid Pharmacist Healing Conversations podcast so you don’t miss an episode! Sign up for the Thyroid Pharmacist Weekly Thyroid Solutions Newsletter here: https://thyroidpharmacist.com/gift/  For the full list of resources and products mentioned in this episode, and to get the full episode transcript, see complete show notes here: https://thyroidpharmacist.com/articles/podcast/ Learn more about your ad choices. Visit megaphone.fm/adchoices