low stomach acid

Low Stomach Acid: Your Complete Science-Backed Guide

December 30, 2018

If you have ever experienced problems with digestion or an infection in the stomach, then you may have experienced low stomach acid. You will also know all about how unpleasant these symptoms can be, and are probably not in a hurry to experience them again. In this guide, we'll be looking at the causes of low stomach acid, as well as its key indicators and possible solutions. So let's get started by looking at exactly what low stomach acid means for your body.

Glands in your stomach naturally produce acid or digestive juices in order to help your body break down food. (1) Stomach acid performs several vital functions for your body, and these functions include:

  1. Breaking down proteins to the point that your body can digest them. This process is called Proteolysis.
  2. Activating Pepsin production. Pepsin helps to break down the protein content of everything that passes through your stomach.
  3. Signalling to the pancreas to secrete digestive enzymes. Additionally, stomach acid also signals your stomach to pass the broken down food into the small intestine.
  4. Preventing infections. Stomach acid plays a huge role in killing any bacteria that came into your system with the food you ate.

Low stomach acid or Hypochlorhydria is what happens when you have a deficiency of stomach acid in your digestive system. (2) The acid that helps to complete the four functions mentioned above is Hydrochloric acid, and several factors can cause you to have low amounts of this chemical in your system. When this happens, you may have trouble breaking down the food you eat.

We're going to cover several causes of low stomach acid, signs of low stomach acid, how to test for low stomach acid, and how to overcome the misery of low stomach acid.

Contents:

Causes of Low Stomach Acid

  1. Age
  2. H. Pylori
  3. Medications
  4. Parasitic Infections
  5. Stress
  6. Vitamin Deficiency

Signs That You Have Low Stomach Acid Levels

  1. You Have Acid Reflux
  2. You Have Vitamin and Mineral Deficiencies (Especially Vitamin B12)
  3. You Don't Feel Well When You Eat Meat
  4. You Experience Bloating and Flatulence After You Eat
  5. You Have Undigested Food in Your Stool

Low Stomach Acid Tests: How to Know

  1. The Heidelberg Stomach Acid Test
  2. CBC and CMP
  3. Baking Soda Stomach Acid Test

Low Stomach Acid Treatment

  1. Finding Out if You Have Leaky Gut/SIBO
  2. Take Apple Cider Vinegar
  3. Take a Good Digestive Enzyme
  4. Add HCL and Pepsin to Your Diet
  5. Chew Your Food Adequately

Bottom Line

Causes of Low Stomach Acid

Unfortunately, there is more than one cause of low stomach acid. This can make it slightly more challenging and time-consuming to pinpoint exactly what is behind your low stomach acid levels.

However, don't lose hope - there are several key factors which can make it easier to find out what is causing your low stomach acid levels. It can be relatively easy to rule out some causes over others, but your physician can give you a definite answer.

Let's examine these causes in more detail;

1. Age

Did you know that your age can play a significant factor in your stomach acid levels? Several studies have found that your stomach acid levels drop significantly between the ages of 60 and 65. Roughly 30% of men and women over the age of 65 report a condition that results in no or very little stomach acid secretion. (3)

Menopause can also play a large role in your stomach acid levels. One study showed that around 40% of women who are in the postmenopausal stage had little or no stomach acid secretion. (4) A Japanese study showed that participants between 60 and 65 years old experienced a drop in their stomach acid levels as well, effecting between 40% and 60% of this age group. (5)

2. H. Pylori

H. Pylori or Helicobacter Pylori is a type of bacteria that you grows in your intestinal tract naturally. When it's regulated, it helps to keep your digestive system running smoothly. However, H. Pylori is also a bacteria that can negatively impact your stomach if the growth is left unchecked or becomes excessive. Roughly 60% of the adult population either has or has had an infection of the H. Pylori bacteria. (6)

This is significant because an infection of this bacteria can cause ulcers and negatively impact your stomach acid levels. If you leave this untreated, you could end up with low stomach acid, an irritated stomach lining, and painful ulcers or sores. (7)

3. Medications

Medications can cause your stomach acid levels to fluctuate, especially when you have issues with heartburn or acid reflux and you take antacids or Proton Pump Inhibitors (PPIs) to help manage the symptoms. This is due to the fact that these medications are specially designed to decrease the amount of stomach acid in your system. (8)

It makes sense that these medications can cause your stomach acid level to drop too low if you take them over an extended period. Another side effect is that these meds also help to neutralise your stomach's pH levels, and this can allow bacteria or microbes that normally wouldn't pass through the digestive tract to survive.

4. Parasitic Infections

Having a parasitic infection can be really serious and can throw off your entire body chemistry. In the United States alone, over 1.1 million people get infected with various parasites each year, and there are five main types of parasitic infections that people contract. (9)

These parasites put a major strain on your body, and this can negatively impact the glands that secrete stomach acid. This also reduces the overall amount of stomach acid present in your body, and making it easier for parasites to thrive because they won't encounter such an acidic environment. (10)

5. Stress

In the United States, roughly 75% of adults experience moderate to high levels of stress, while in Australia as many as 91% of adults report high stress levels. While a little stress is natural, and can be a good motivator, high levels of stress can negatively impact your stomach's natural acid levels.

When you feel stressed, your central nervous system activates your flight or fight response. Since your central nervous system connects directly to your digestive system, this can cause nasty reactions like spasms, a decreased blood flow and reduced stomach acid production. (11)

6. Vitamin Deficiency

Vitamin deficiencies are common issues for millions of people, particularly deficiencies in vitamin B12, iron and zinc. (12) Unfortunately, this can lead directly to low stomach acid levels.

This can be caused by a variety of things, including stress - which we discussed already - alcohol consumption, smoking and by having inadequate dietary intake. B vitamins are especially important because they help to regulate your stomach acid production and ensure that there isn't too much or too little. (13)

Signs That You Have Low Stomach Acid Levels

Now that you know the possible causes, it's time to look at some of the indicators. This can help you to better understand whether or not you are experiencing low stomach acid levels.

There are several common signs that could point to an imbalance in your stomach acid levels. You may experience one or more of these if you suffer from lower acid levels, and the severity of these symptoms can vary from person to person. This is why it's important to pay attention when you notice something new happening to your body. It'll give you a good idea whether or not you should contact your doctor.

1. You Have Acid Reflux

Acid reflux is a condition in which your stomach acid backs up into your oesophagus, and this health problem affects roughly 20% of people according to a study from the states. (15) This condition can result in things like a burning pain in your upper chest and oesophagus, a sour or bitter taste in your mouth, a sore throat, and erosion of your back molars. If you have issues with a weakened diaphragm, this can make you more prone to developing acid reflux.

Interestingly, acid reflux doesn't necessarily mean that you have excess acid. In fact, it's usually a good indicator that you have low stomach acid. Since most people believe that it's too much acid instead of too little which is causing the symptoms, many don't suspect an acid deficiency when they experience a reflux. The University of Cambridge proved this theory with a study they published in the middle of 2013. (16)

2. You Have Vitamin and Mineral Deficiencies (Especially Vitamin B12)

As we mentioned earlier, vitamin deficiencies are very common in people around the world, and mineral deficiencies are also very common. If you have low stress, don't smoke or drink and you eat a balanced diet but you still struggle with a vitamin or mineral deficiency, you could have low stomach acid. (17)

B vitamins, as well as zinc, are essential for healthy stomach acid production. If you're deficient in these areas, your stomach acid production can slow down. One study took 100 participants and split them into two groups. Group A received B vitamins and minerals while group B got a popular OTC treatment for stomach issues. Group A reported a 100% improvement compared to group B's 40% improvement rate. (18)

3. You Don't Feel Well When You Eat Meat

Some people can't get enough red meat, while other people don't like it all. Usually, this is down to taste, but there may be medical reasons also. If you simply don't feel right after you eat meat, you could have an issue with your stomach acid levels. You may feel sluggish, lethargic or even nauseous after you eat a large quantity of meat.

You need stomach acid to be able to break down larger amounts of protein contained in red meat, and having low stomach acid means that your body has to work harder to digest what you eat. (19)

4. You Experience Bloating and Flatulence After You Eat

When you eat, you may experience moderate levels of bloating or flatulence depending on the amount and the type of food you ingest. This is natural, however, it shouldn't be a regular. (20)

Low stomach acid makes it more difficult for your body to break down your food to levels where your body can easily extract the nutrients. This means that you can potentially get partially undigested food going through your system, and this can lead to excessive flatulence or an uncomfortable and bloating feeling. (21)

5. You Have Undigested Food in Your Stool

Each time you eat, the food travels to your stomach were digestive enzymes start breaking down the proteins and making them easier for your body to extract the nutrients. (22) When you have low stomach acid levels, this can result in your food not breaking down like it should.

If your food doesn't get broken down, your body won't be able to extract the nutrients it needs. Additionally, it may also result in undigested food in your stool. Once the food passes from your stomach to your intestines, your body tries to extract as many nutrients as possible. However, your stomach can't do this with undigested food, and it'll just expel it from your body. (23)

Three Low Stomach Acid Tests: How to Know

So, we have the indicators, and the causes, of low stomach acid, but how can you be sure of what the problem is?

If you think that you may have low stomach acid, there are a few tests that your physician can perform to give you a definitive answer. Additionally, you can do one of the tests at home, but you'll need your doctor's final diagnosis before you can be 100% sure whether or not you have low stomach acid, or something else.

1. The Heidelberg Stomach Acid Test

First up on our list of stomach acid tests is the Heidelberg Stomach Acid Test. This test is widely considered to be one of the best possible tests you can get to measure whether or not you have low stomach acid levels. It measures the exact levels of acid that your stomach can create. However, it's important to note that this test does typically cost around $350 USD, and you'll most likely pay this cost out of your own pocket because most insurance plans don't deem it medically necessary to know your stomach acid levels. (24)

To start the test, you'll get a small capsule that comes equipped with a radio transmitter. Once you swallow this capsule, you're ready to start the test. You'll start by drinking small amounts of a solution that contains baking soda which reduces the acidity levels in your stomach. As you drink this solution, the transmitter will record and give you accurate measurements of the acid in your stomach, helping you understand how your stomach is responding to this change. If your stomach acid levels don't return to normal levels after the initial effect of the baking soda solution, it's a good indicator that you have low stomach acid. (25)

The Heidelberg Stomach Acid Test Protocol

The Heidelberg Stomach Acid Test protocol simply tells you what to do before, during and after the Heidelberg Stomach Acid Test. This is a relatively non-invasive test, and it's popular because it is relatively inexpensive as far as medical testing goes. The total cost includes the test itself and the results. The typical protocol goes as follows:

  • Avoid antacids or acid-suppressing drugs for 96 hours before you take the test. This includes prescription and OTC medications.
  • Don't eat or drink anything 12 hours before your test.
  • Arrive to your doctor's office and swallow the small capsule with the transmitter.
  • Drink a solution containing baking soda.
  • Let the transmitter record how long it takes for the acid levels to return to normal.

Your physician will share the findings with you and determine if you have too much or too little acid in your stomach and advise on a treatment routine. (26)

2. CBC and CMP

CBC stands for complete blood count, and CMP stands for comprehensive metabolic panels. These are lab tests that you can request from your physician, and they're both pleasingly quick and simple. CBC and CMP tests measure a variety of things, and will tell your physician if you do or do not have low stomach acid levels. (27) These indicators include:

  • Chloride Levels - Chloride is a main component of stomach acid, and you want to see your chloride levels between 101 or 106. If your chloride levels are below 100, this is a sign of low stomach acid.
  • Serum Globulin or Serum Protein Levels - You need stomach acid for good protein digestion, and abnormal levels of serum globulin or serum protein can indicate low acid levels. Your serum globulin level should be between 2.4 and 2.8, while your serum protein level should be between 6.9 and 7.4.
3. Baking Soda Stomach Acid Test

The final test for low stomach acid also uses baking soda. However, this test is less accurate because it is performed at home, outside of lab conditions. Start by making a solution of baking soda and water and drink it. The baking soda will react with the acid levels in your stomach and make you burp, or at least it should.

If you don't feel the urge to burp in three to five minutes, it's a good indicator that you have lower stomach acid levels. You should perform this test when you wake up, and you'll want to do it three or four mornings in a row to get the most definitive answers possible.

How to Overcome Low Stomach Acid

Let's imagine that you completed your test and found out that you have low stomach acid. What next? Well, there are several things that you can do to overcome this condition. The best part is, you can do most of these things in the comfort of your own home, and they usually don't cost much, if anything at all. Our top five ways to overcome low stomach acid includes:

1. Finding Out if You Have Leaky Gut/SIBO

Your physician is the only one who can diagnose leaky gut or SIBO. (28) Leaky Gut Syndrome is a medical condition where small fissures or cracks appear in your intestinal walls. These small cracks allow bacteria to pass through your intestinal walls into the rest of your body. This can cause a variety of issues throughout your entire body including system-wide inflammation and problems with nutrient and vitamin deficiencies as these elements are not being absorbed as they should be.

There are several common symptoms associated with leaky gut that mirror those of low stomach acid levels including bloating, fatigue, vitamin and nutrient deficiencies and trouble digesting your food. (29) Once you find out whether or not you have leaky gut, you can start treating the condition and reducing the inflammation you experience.

2. Take Apple Cider Vinegar

Apple cider vinegar is an extremely popular natural remedy for a variety of health issues, including low stomach acid levels. Apple cider vinegar can also help you with weight loss, blood sugar issues, and combating bad bacteria. (30)

There is a very high acid content in apple cider vinegar, and this can help to naturally increase your stomach's acid levels and break down your food. All you have to do is mix a small amount of apple cider vinegar with water and drink it before each meal. (31)

3. Take a Good Digestive Enzyme

While digestive enzymes won't necessarily help to directly raise your stomach acid levels, they can help take some of the stain off of your digestive system by helping to break down the food you eat. In turn, this can encourage your glands to create more stomach acid.

One promising study showed that adding a quality digestive enzyme to the participants' diets helped to ease any symptoms that are commonly associated with low stomach acid. These include abdominal pain, bloating, flatulence, heartburn, nausea and loss of appetite. (32)

4. Add HCL and Pepsin to Your Diet

You can also take betaine HCL tablets that contain Pepsin. Most of these tablets have around 300 to 500 milligrams of active ingredients in total, and 100 to 200 of those milligrams are Pepsin. HCL and Pepsin are two important components of natural stomach acid, and are useful in the fight against low stomach acid. (33)

Taking HCL supplements with Pepsin can work to reintroduce acid back into your stomach, and will gradually help to raise your natural stomach acid levels. It may take several days before you start to notice a difference, and you will want to monitor yourself after you start these supplements for any side effects or other problems.

5. Chew Your Food Adequately

One of the easiest things you can do to help with your low stomach acid levels is to chew your food adequately each time you eat. You may be tempted to eat quickly, but this puts more stress on your digestive system, especially if you're already having issues with digestion.

How long to chew your food depends largely on the types of food you're eating because some foods require fewer chews than others. For example, if you're eating softer foods, you want to chew your food around 32 times before swallowing it. For foods that are tougher like steak, you want to aim for 40 chews per mouthful. Something that is water-based like watermelon only requires 10 or 15 chews per mouthful.

Bottom Line

Low stomach acid can be a troublesome condition to deal with, but there are things you can do to help overcome it, as well as tests you can take to get a proper diagnosis. As always, you should consult with your primary care physician before you add or take things away from your normal routine. These medical professionals can help advise you on the best course of action and can also help monitor you while you correct your low stomach acid levels.