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. Pro Tip: 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 younger adults.

Sufficient stomach acid is a required part of a healthy digestive system.

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 fat 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!

The Dark Side of 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 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

Meal 1, start with two capsules 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 two capsules, reduce to one capsule before the next meal.
    • If these symptoms are NOT present, go to Step 3.

Step 3

Meal 2, increase your dose by one capsule (this would be three capsules) 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

Meal 3, increase your dose as described in Step 3. Each meal 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 Betaine HCl option? We recommend this one Betaine HCl.

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 you schedule a consult with our clinic to discuss your testing options.  

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