What You Will Learn in this Article:
- How Stomach Acid Affects The Body
- Symptoms of Low Stomach Acid
- Benefits of Increasing Stomach Acid
- The Problem with Antacids and PPIs
- How to Test Your Stomach Acid Levels
- How to Increase Low Stomach Acid
Having a low (not high) stomach acid level is a very common issue. It might come as a surprise to you that acid reflux is the result of too little stomach acid and not too much. Think about it: Older adults tend to suffer from acid reflux the most. They also tend to under-produce stomach acid and are more likely to suffer from acid reflux than young adults.
Sufficient stomach acid is part of a healthy digestive system which we now know is vital to keeping your hormones in check – I wrote about it here.
How Stomach Acid Affects The Body
Stomach acid, or Hydrochloric acid (HCl), is secreted by the stomach to help digest and absorb proteins and other nutrients that we consume in our diet. HCl also serves to protect us by killing various pathogenic microorganisms (parasites, yeast, bacteria) that might otherwise cause infection in the digestive tract.
Sufficiently digested food is key for giving the body the nutrients it needs to function well, including producing hormones.
Symptoms of Low Hydrochloric Acid (Stomach Acid)
People with low HCl (hypochlorhydria) or absent HCl (achlorhydria) may have no symptoms at all, or may have symptoms of poor digestion such as gas and bloating (especially meals high in meat and protein).
Here is the list of potential symptoms:
- Bloating or belching immediately following a meal
- An excessive sense of fullness after eating
- Feeling like food sits in the stomach forever
- Gas after food
- Iron and B12 deficiency, chronic anemia
- Chronic constipation
- Undigested food in the stool
- Weak, peeling, or cracked fingernails
- Parasites (especially parasites that come back even after treatments)
- Chronic intestinal infections
- History of multiple food allergies and intolerances
Benefits of Increasing Stomach Acid
By increasing your stomach acid, you can mitigate, reduce or completely eliminate the above symptoms. It might come as a surprise how many other health improvements might come with it.
Problems with Antacids and PPIs
Antacids are medications that neutralize stomach acidity. Similarly, PPIs (Proton Pump Inhibitors) actually block the enzyme that produces stomach acid. If your doctor has put you on antacids and/or PPIs, look back on your symptoms (other than acid reflux) since then and reflect on how your health changed since then. You might notice that many new symptoms appeared (such as feeling tired, losing hair, developing allergies, etc). This is very common and this is what you need to know about antacids and PPIs.
- Slow down digestion, especially protein. As explained above, stomach acid is key in breaking down the food and extracting nutrients from it. No acid, no extraction and processing. Undigested proteins can lead to developing food intolerances and not having enough building blocks for your hormones (which are also made from proteins).
- Food intolerances. Undigested proteins can lead to gut inflammation which can then result in full blown “leaky gut” or IBS.
- Depletion in B12, zinc, folate, calcium and magnesium Sufficient stomach acid is needed for these minerals and vitamins to get absorbed from food and supplements. People on PPIs are chronically low on these which can lead to an array of symptoms from fatigue, autoimmunity, fertility problems, osteoporosis, hair loss, to estrogen dominance.
- Constipation, gas, stomach aches. When the stomach acid is low, you can’t digest the food properly. This can manifest in the form of gas, indigestion, tummy aches, and feeling full for a long time.
- Vulnerability to pathogens such as SIBO, parasites. Sufficient stomach acid is the first line of defense from bacteria, viruses and parasites. The pH 2.0 (how acidic the stomach should be) is there for a reason – to kill the pathogens before they travel further down the GI tract.
- Autoimmune conditions. Low stomach acid can be a big contributor to autoimmunity through GI inflammation and zinc deficiency that is often caused by low stomach acid.
So, how do you maintain good levels of stomach acid to live well and thrive?
How to Test Your Stomach Acid Levels
Method 1: Baking soda test
You can very easily do this test at home.
- Mix 1/4 teaspoon of baking soda in 4-6 ounces of cold or room-temperature water first thing in the morning before eating or drinking anything.
- Drink the baking soda solution.
- Time how long it takes you to belch.
- If you do not belch within 3 minutes, stop timing.
If you do not belch, you have too little stomach acid. If you belch, you are fine.
This is not the most effective test and it often produces false negatives (meaning, it makes you think you have sufficient stomach acid). I, therefore, recommend Method 2 below.
Method 2: The HCl pill test
The idea here is to dose the HCl pills until you feel a slight discomfort in your stomach. When I was low on stomach acid (due to the bacteria h.pylori), I had to take as many as seven pills to feel the warmth.
Step 1
On Day 1, start with one capsule (usually 500 to 750mg) of HCl, at the beginning of each meal. Note: This means a full meal, not a snack.
Step 2
Watch for any feelings of warmth, discomfort, pain or burning in the throat or stomach.
-
- If you experience any of these symptoms after just one capsule, do not take any more pills.
- If these symptoms are NOT present, go to Step 3.
Step 3
On Day 2, increase your dose by one capsule (this would be two capsules for a total of 1,000 to 1,500 mg for Day Two) of HCl at the beginning of each full meal.
-
- If you feel any of the symptoms mentioned above (warmth, discomfort, pain or burning in your throat or stomach) decrease your dose to the level at which you had no symptoms and maintain this dose.
- If you do not feel these symptoms go to Step 4.
Step 4
On Day 3, increase your dose as described in Step 3. Each day increase the dose until you feel a warming sensation or until you reach a dose of seven capsules per meal. Do not take more than eight (8) capsules with a meal.
Looking for a trusted HCl supplement? We recommend HCl Guard+ from Healthy Gut.
How to Increase Low Stomach Acid
For many people, taking HCl Betaine and/or starting the day with 2 tablespoons of apple cider vinegar or lemon juice for 2 to 4 weeks will kick the body back into gear and you might be able to produce your own stomach acid from that point on. If that does not happen, I recommend to work with a functional practitioner to test for h.pylori – a bacterial infection that inhibits stomach acid production. From my experience, h.pylori is hard to diagnose and blood tests often show false negative. My physician ordered GI Map (a name of a lab, stool test) and it finally confirmed the h.pylori infection. Another condition worth ruling out is pernicious anemia – an autoimmune condition when the immune system attacks the stomach lining cells that produce the stomach acid, by testing for antibodies.
Hi,
I’ve been using douglas ultrazyme and 4-6 pills per meal of thorne betaine HCl 1000mg and pepsin 47mg. It seems to help with bloating especially. I felt a bit of heartburn with higher doses, but I still see undigested food in my stool (mushrooms, nuts, green leafy’s, tomato skins and pepper skins.) I’ve tested negative for h. pylori.
Is it safe to use these supplements long-term?
What can I do to increase my own stomach acid?
I react negatively to ACV, and bitters did not seem to be effective.
Thanks for any recommendations.
Betaine HCL with Pepsin causes a burning sensation when I pee. How can I get around this?
We would suggest discontinuing use, and discussing it with a Functional Medicine practitioner. HB Support
great article ! congrats!
Does anyone else get extremely ill from Betaine HCL? After 1 pill I get so dizzy that I fell down half a flight of stairs. I also get a debilitating headache that lasts for hours. My doctor has NO explanation for my adverse reactions to Betaine.
Yes me to just took one tablet for the first time not long after felt dizzy and queezy
We haven’t heard of this Suzanne, you might try connecting with a Functional Medicine Doctor to explore why that might be happening. HB Support
Try a different form of HCL
Glutamic instead of betaine
Hi, I’ve been doing the Betain HCL protocol for the last 4 days. I have IBS-D and have suspected low stomach acid due to noticing digestion problems. I have never had GERD or anything like that, the issue for me is excess gas. I did the bicarbonate test over 3 days and had no reaction whatsoever, so I then moved onto HCL.
I started off really low on 1 tablet (324 mg) then increased to 2 tablets (668mg) and then increased to 3 tablets taking me up to 1000. I felt discomfort at 1000 in terms of bloating and a headache but not burning/heartburn. I didn’t sleep very well that evening. So the next day I reduced it back down to 2 tablets and that seemed to have gone well. The next morning my bowel movements were good and I had a lot less gas (which is my main issue).. But one symptom I seemed to have developed is an acrid taste in my mouth – is this normal? Does that signify too much acid? Also my throat feels more closed up and I’ve been burping a little (don’t normally burp much) . I don’t seem to be having any symptoms that are mentioned on any website, so I don’t know whether they mean I need to take more or less HCL. Any advice would be much appreciated!
That could mean to much acid. I’d back down and see what changes. If it continues stop all together and see if that symptom disappears.
Hi! thank you for this article. I am wondering if you have any recommendations for treating h. pylori. ‘thanks!
Mastic gum,
Found in supplements formulas for H-pylori,
Colloidal silver plus aloe Vera juice can also be effective
Can you still do the test with betaine if it has PEPSIN in it?
Like when increasing the betaine, is it ok to be increasing pepsin as well?
I would like to test for low stomach acid. I am taking prescription Prilosec every morning. To test, using Betaine, do I have to stop taking Prilosec or can I continue taking it while I test with the Betaine?
I suffer from GERD. Would the pills be ok for me to take? About acv or the lemon juice? I just don’t want to aggravate my condition because the pain can be unbearable. Thank you
Amanda, in case you’re still waiting to hear about the prudence of taking ACV or lemon juice while having GERD….I can tell you that my husband has GERD and one day finally got up the nerve to try ACV. He said it did not burn, and did make him feel better. He began taking it daily, and for quite awhile slept better at night, with almost no snoring. He’s back to snoring now, but I think he needs to try something else–possibly the Betaine HCl w/Pepsin. He would NOT recommend lemon juice–that still burns; a little is tolerated now and then, but not continuous amounts.
Hi HB
I suffer from terrible IBS and am on a very limited diet. I don’t typically get burping etc it’s always the other end (diarrhea etc).
I always thought my stomach acid was too high as I cannot tolerate anything acidic. Even a couple of drops of lemon juice in warm water gives me stomach cramps. How would one test for high stomach acid?
Hi Sasha, have you tried the baking soda test in this article?
Here is another article on digestion you might find helpful: https://hormonesbalance.com/articles/digestion-impacts-hormone-imbalance-weight-gain/ ~ Jeanne HB Team
I take synthroid in the morning can I still take the ACV in the morning and if so should I take it before or after my meds?
How would a medical doctor check if a patient produces enough stomach acid? I need 2 to 3 capsules of betain hcl from pure encapsulattion. At the moment I am not sure how to explain my doctor that my findings shows that I am low in stomach acid.
Thanks
Hi Boo, It would be good if you found a trusted practitioner to discuss that concern with. Many clients have had success with a functional medicine doctor. If you need help locating one in your area, here is a good tool:
https://www.functionalmedicine.org/practitioner_search.aspx?id=117.
~ Jeanne HB Team
What is acv? How is it used to help the scalp? Thank you for your time and reply.
Much appreciation!
apple cider vinegar
Hello, I apologize if this is a stupid question. But if you suffer with acid reflux, bloating and you take an HCL pill but still experience the symptoms of Bloating & acid reflux. Do you continue taking them until you feel nothing or do you stop taking them?
how do you treat pernicious anemia?
Hi Robin,
According to nhlbi.nih.gov “Pernicious anemia usually is easy to treat with vitamin B12 shots or pills. If you have severe pernicious anemia, your doctor may recommend shots first. Shots usually are given in a muscle every day or every week until the level of vitamin B12 in your blood increases.” ~HB Team
The article states its an AI—->??
Hi Susan, Apple Cider Vinegar rinses are wonderful for gently cleansing, strengthening and conditioning hair. It also helps balance the scalps pH and reduces inflammation. Here is Magdalena’s clay shampoo recipe you might find helpful, it includes ACV: https://hormonesbalance.com/recipes/clay-shampoo/
~ Jeanne HB Team
I have been using the WOW Products for thinning hair which have ACV…shampoo, conditioner and oil treatments. It does it all. My hair is filling back in and I can see new growth all over. I am still loosing some, but NOTHING like before. I am on my first bottles!
I love these WOW Products. Just ordered the body cleaning gel for my e tire body as I shower…fantastic. Just sharing…
ACV – Apple Cider Vinegar. 🙂
Thank you J. Moore 🙂
I have been trying some of the recommended items above but they don’t really work for me. When I tried ACV in water, it sent me to the restroom immediately, and when I used lemon juice in warm water, the roof of my mouth became like sandpaper after a while. Did anyone else experience these issues? Any thoughts about why this might happen?
Hi Monica, have you tried Swedish Bitters (glycerine-based)? If you can’t tolerate any of the above, try ½ teaspoon of sea
salt before meals. ~ Jeanne HB Team
My husband takes Swedish Bitters in a small amount of water. I try to get him to take before meals, but he will only take right after a meal. It has helped the GERD that he has during the night following certain meals.
That is amazing Mary! Bitters really can make such a difference.
Yes, as an example, I have histamine intolerance and lemon juice and ACV make me sick. This is really frustrating as the suggested protocol is easy, many get a relief, but not me.
Hi Eugenia,
Histamine issues can be confusing and challenging to navigate. Please look in this link with additional support/resources for you https://mastcell360.com/histamine-intolerance-vs-mast-cell-activation-syndrome/. ~HB Team
Hello
Does a person do all three herbal and alternative treatment options at once, mentioned in the video referring to Hashimotos Protocol by Izabella Wentz?
Hello, for any questions or concerns regarding Dr. Wentz’s protocols we suggest contacting her customer service team to best answer those for you. Here is the email address: [email protected]
Thank you!
~ Jeanne HB Team
I have taken 4 rounds of antibiotics and bismuth etc to try to rid of hpylori without any success. Any recommendations for someone like me? Thank you,
Hi Kelly, we recommend working with a functional medical practitioner. If you need help locating one in your area, here is a good tool:
https://www.functionalmedicine.org/practitioner_search.aspx?id=117
~ Jeanne HB Team
Hi Jeanne
I am just wondering about other options for h.pylori treatment. I live in Panama, where there are no functional medicine practitioners unfortunately.
With regards to the baking soda test, I am always burping so I’m not sure how to differentiate that it is the baking soda that is making me burp or not. Also, with regards to the HCL test, my stomach always gets bouts of feeling warmth, so I’m not sure how to gauge if and when it’s the pills causing the warmth or not. I have about 80% of the other symptoms of low stomach acid.
Dears, Do not try to get red of H.Pylori. we need it to control the feed back of stomach acid on stomach cell, it is part of stomach ecosystem. whenever traced we should augment stomach acidity and discard anti acids, H blocker and PPI. THIS IS THE FUTURE of multi system disease treatment.
Hi Mahmoud,
We agree that stomach need stomach acid and to avoid the medications that disrupt this. However, H. pylori may be a cause or digestive issues. Please check out this video https://youtu.be/ZqcGiR29WAU ~HB Team
What do I do next keep taking them? So confused it’s like the post got cut off
Hi Dee,
This article is about doing at-home stomach acid testing. With further gut healing, you may not always need this type of supplemental support. You are correct in knowing that there is so much more to the subject regarding enzymes, inflammation, natural options to help increase stomach acid. Here is one of my favorite videos about stomach acid to learn more https://www.youtube.com/watch?v=ZqcGiR29WAU. I hope this helps ~HB Team
Hi! I just finished the initial testing phase and found taking 6 pills causes mild discomfort for me. While working on my gut health and diet, should I also continue taking 5 pills during meals? When do I know to stop doing this?
Hi Katharine,
Please make sure you are eating adequate protein at each meal. You will also want to download this free supplement guide to learn more https://hormonesbalance.com/supplement-guide/. Please consider doing a retest every few weeks and start to wean down as you tune into how the body is responding. ~HB Team
How in the world do I know when to wean down? I don’tHave heart burn. When I have acid reflux, it goes in my lungs and becomes asthma. I’ve been off the poi and in hcl with pepsin for 3 weeks, taking ten capsules with my dinner. I feel great but don’t want to reduce to fat and get in trouble
Hi Becky!
Please note, Magdalena recommends not taking more than eight capsules with a meal. You may consider making an appointment with a functional medicine doctor who can assist you on a more individualized basis.
Here is a great tool to find a functional medicine doctor in your area.
https://www.ifm.org/find-a-practitioner/
Healthy Regards,
HB Team
What if you have gastritis or an ulcer? Wouldn’t the betaine aggravate that?
Thanks!
Hi Angel,
Yes, those are conditions that are contraindicated for this supplement. Here is a free supplement guide to download and learn more related information, https://hormonesbalance.com/supplement-guide/ ~HB Team
Hi,
Is there a certain amount of time you have to wait before you start eating after you have taken your hcl supplement?
I have been consuming some before, during and after (almost at 10 pills) and nothing has happened.
I was up to 6 pills with ZERO effects, said ok, forget this. Its not going to work. I took the rest of the bottle at 6 caps per meal as I had spent all that money. Never had any change, never felt a burning or even warmth.
HI MC,
Please follow the directions in the article:
On Day One, start with one capsule (usually 500 to 750mg) of Betaine HCl, at the beginning of each meal. Note: This means a full meal, not a snack.
Watch for any feelings of warmth, discomfort, pain or burning in the throat or stomach.
If you experience any of these symptoms after just one capsule, do not take any more pills.
If these symptoms are NOT present, go to Step 3.
On Day Two, increase your dose by one capsule (this would be two capsules for a total of 1,000 to 1,500 mg for Day Two) of Betaine HCl at the beginning of each full meal.
If you feel any of the symptoms mentioned above (warmth, discomfort, pain or burning in your throat or stomach) decrease your dose to the level at which you had no symptoms and maintain this dose.
If you do not feel these symptoms go to Step 4.
On Day Three, increase your dose as described in Step 3. Each day increase the dose until you feel a warming sensation or until you reach a dose of seven capsules per meal. Do not take more than eight (8) capsules with a meal.
I hope this helps!
Jeanne HB Team
I’m confused, too, about the Betaine Hcl test. If you feel the symptoms described after taking one capsule, does that mean you likely have adequate stomach acid? If it takes two caps before symptoms (or 3 or 4 etc) does that mean your stomach acid is low to that degree and you should continue taking one less Betaine than the number that caused you to feel the symptoms?
My functional mech so doctor told me to take 1 less than the number at which I felt warmth or discomfort (5-10 min before a protein rich or large meal not snacks).
*functional medicine doctor not mech so doctor
How long does it take for the discomforts to start when trying to find the right dosage with the high protein meals? 30 min, 1hr or how long roughly?
Hi Phillip,
Please follow the direction in the article and listen to your body as everyone is different. If you experience any of those symptoms after just one capsule, do not take any more pills.
Jeanne HB Team
Can these tests be done if you’re on PPI med every 12 hours for severe delayed stomach emptying? My symptoms are getting worse, and I wanted to self check before going into the gastroenterologist
Any suggestions? Thanks.
Hi Nora,
The commenter MC, below, is correct, the PPI medications direct the body to decrease the amount of stomach acid made. Stomach acid is a natural defense. Please consider downloading this free supplement guide https://hormonesbalance.com/supplement-guide/ ~HB Team
I read if you are on PPI you shouldn’t be supplementing with hcl until you are off it completely as PPI reduces your stomach acid and hcl increases it.
Hi, my pills hold 1g pr pill. I am at 4 pills and will try 5 tomorrow. In other words, I’m getting close to your limit of pills or meal. Why don’t you recommend taking more pills? Why do you consider it to be dangerous?
Hi U,
Most times supplementation alone, is not the answer. There may need to be more supportive foods included in the diet for real and noticeable changes to occur. More does not always equal better. Have you seen this preview of Magdalena’s program, Cooking for Balance https://hormonesbalance.com/cfb/. It teaches about gut healing, liver support and sugar balancing to help the body heal naturally. ~HB Team
Hi, how come you don’t recommend 8 pills? I’m at 7 pills and still haven’t felt a burning sensation. Is it an obvious sensation when you do feel it?
Hi Chenille,
In the article, she says, “Do not take more than eight (8) capsules with a meal”. There are recommended limits to consider. You may also want to support the body additionally with dietary considerations. Here is the program preview for Cooking for Balance https://hormonesbalance.com/cfb/ to learn more. It has the foundational principles of healing the gut, supporting the liver and balancing sugar to bring the body back to balance. ~HB Team
Good morning 🌞
Excellent information!
My question:
I currently take Betaine HCI 648mg 1tab. a.m. as needed.
For over a year. Has helped tremendously with stomach issues (cancer survivor 5 years strong) I’ve been doing detox of liver e.t.c. since 2013.
Keeps my weight in tact as well. Almost at a point to quit coffee! This is a Big success!
I notice after 1 cup I feel acid in my throat only. Do you suggest I stop the Betaine until I completely quit the coffee? I do not suffer from IBS.
Your comments would be greatly appreciated.
Julee 🙋
I have been having severe sore throats for years. Have had several endoscopys and the doctor can see the redness in my throat but can’t understand what it’s coming from. When I get these soar throats they last for days, but I don’t have heartburn. Sometimes their so bad it feels like my esophagus is closing and I get severe pain in my back. I have been dealing with this for years and my doctors keep telling me to take ppi’s, but they make me feel worse. Even antacids make me feel sick. Can’t eat anything spicy. Please respond, thank you.
Most other places I’ve seen this type of test mentioned in they said you could take up to 8, 10 or even 14 pills at a time until you reach the right dosage. Either way at the worst case you’ll have some diehrria, not pleasent but it won’t kill you. When you reach the right dosage you’re supposed to continue taking it and with time you’ll supposedly need less and less (I’m currently still in the testing phase, up to 3 pills).
Hi Ben,
Magdalena does not recommend taking more than 8 capsules with one meal. How did the testing go for you? ~Deanna HB Team
There is no mention of what to do if/when it is confirmed there is low stomach acid.
Hi Terri,
You would want to check out this gut restore kit and possibly dietary changes to support gut healing. . ~Deanna HB Team
Hello, I was wondering, I was diagnosed with GERD, although Ive heard the diagnosis for that isnt always correct and I can actually not have enough acid so I have tried the Hcl and could barely handle 1 capsule, so do you think it means that I have too much acid?
Hi Lori,
It is very rare one has too much acid. What do you mean you could barely handle one capsule-what happened? ~Deanna HB Team
I did baking soda test for 3 days .. no burping ..means low st acid , right ? Took 1 pill w meals for one day .. burning in throat .. uncomfortable ..
confused now … I thought HCL was suppose to help
Thanks for this information! I’ve taken HCL w/pepsin – 250 mg. – as many as 4 at a meal, and never felt the ‘warmth’ you spoke of. I was afraid taking more would be harmful, so didn’t try. Good to know a way to test the limits!
Hi Janet,
How are you doing now with your stomach acid/digestion? ~Deanna HB Team
Nice post..
Hi Susan,
Thank you.
Angela, HB Team
I would like to test for h pylori, and I have read the best way is through breath and stool. I read here the GI map is the best way?
Hi Jocelyn,
Yes we recommend the GIMAP. Feel free to search our article “What lab tests to order to manage your hormones?” This article provides a resource to order your own lab tests. =)
Healthy Regards,
HB Team