Digestive output — acid, enzymes & bile
One of 5 mechanistic pathways to 🦠 Gut health & digestion · 11 options
Bloating an hour after eating, undigested food, and feeling heavy after fat are output problems, not microbiome problems. Stomach acid falls with age and with PPI use; bile flow drives fat digestion and the excretion of everything the liver conjugates.
Low stomach acid impairs iron and B12 absorption specifically, since both need acid to be freed from food. Low fat-soluble vitamins with normal intake points at bile or lipase instead.
FerritinVitamin B12Comprehensive Metabolic Panel (CMP)AmylaseLipaseVitamin A🌱 Gut Health & Absorption covers these in one panel →
What engages this pathway
Ordered by how directly each one acts on the mechanism above — never by how much trial evidence exists. Each links to its full breakdown with dosing, half-life and vendor.
🧬 Betaine HCl
Supplemental acid where hypochlorhydria is the issue. Contraindicated with active ulcer or ongoing NSAID use, and the self-titration protocols circulating online deserve more caution than they get.
🧬 Digestive Enzymes
Broad-spectrum enzyme support. Genuinely necessary in pancreatic insufficiency; more variable in ordinary bloating.
🧬 Pancreatic Enzymes
Higher-potency lipase, protease and amylase — the clinical-grade version.
🧬 Ox Bile
Essential after gallbladder removal, where bile delivery is no longer concentrated or timed to meals. Also relevant in fat malabsorption and pale stools.
🧬 Artichoke Leaf Extract
Choleretic — increases bile production. Trial evidence for functional dyspepsia and for cholesterol.
🧬 Dandelion Root
A traditional choleretic — proposed to increase bile flow, which is both a digestive aid and the physical exit route for everything the liver conjugates.
🧬 TUDCA
A hydrophilic bile acid that protects hepatocytes from the toxicity of hydrophobic bile acids, and reduces ER stress. Used in cholestasis with real clinical rationale.
🧬 Bromelain
Proteolytic; with food it aids protein digestion, away from food it acts systemically. Two different uses of one supplement.
🧬 Ginger
Accelerates gastric emptying and has strong meta-analysis support for nausea. The best-evidenced botanical for functional dyspepsia.
🧬 Fennel
Carminative — reduces gas and spasm. Component of the gripe-water tradition with modern trial support in infant colic.
🧬 Betaine Anhydrous (TMG)
TMG, distinct from betaine HCl — a methyl donor rather than an acid source. The names cause endless confusion.
The other 4 routes to gut health & digestion
Pick the pathway that matches where you are actually stuck. An appetite drug does nothing for someone who already undereats.
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Frequently asked questions
Bloating an hour after eating, undigested food, and feeling heavy after fat are output problems, not microbiome problems. Stomach acid falls with age and with PPI use; bile flow drives fat digestion and the excretion of everything the liver conjugates.
11 options are mapped to this pathway in the Vault, including Betaine HCl, Digestive Enzymes, Pancreatic Enzymes, Ox Bile. They are grouped by the mechanism they act through rather than ranked by how much trial evidence exists — 8 carry clinical validation and 3 are mechanistic predictions.
Low stomach acid impairs iron and B12 absorption specifically, since both need acid to be freed from food. Low fat-soluble vitamins with normal intake points at bile or lipase instead. The markers worth checking are Ferritin, Vitamin B12, Comprehensive Metabolic Panel (CMP), Amylase.
Unproven is not the same as ineffective. Of the 11 options on this pathway, 8 have clinical validation and 3 are graded theoretical — meaning the mechanism is sound but the specific human trial has not been run, which is true of a great deal of what works in this space. Nothing on this page is ordered by evidence tier, because sorting by trial count would bury the compounds you came looking for.