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. Thing 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 you 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 Betaine 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 Betaine 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 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.

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. 

The brand I like to use is Betaine HCl w Pepsin from Hormone Balance Nutritionals.

 

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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.

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