Low Stomach Acid: Warning Signs, Complications, and Remedies

Low stomach acid is a common yet often overlooked condition that can significantly impact digestive health.  

Without enough stomach acid, your body struggles to break down food, absorb nutrients, and defend against harmful bacteria, potentially leading to more severe health issues.

Learn to recognize the warning signs of low stomach acid and explore natural remedies to help improve gastric acid production. 

What is hypochlorhydria (low stomach acid)?

Gastric juice, or stomach acid, comprises hydrochloric acid, mucus, digestive enzymes such as pepsin, and a protein called intrinsic factor.

Hypochlorhydria occurs when the stomach doesn’t produce enough hydrochloric acid, a key component of gastric juice that helps maintain the proper acidity in the stomach, essential for effective digestion.

Stomach acid is vital for initiating digestive processes, activating enzymes, breaking down proteins, absorbing nutrients, and protecting the digestive tract from harmful pathogens.

“Many people suffer from low stomach acid,” explains Dr. Berg. “This results in food not breaking down properly, leading to indigestion, gas, heartburn, and significant nutrient deficiencies.”

Low hydrochloric acid levels can also lead to gut microbe imbalances, reduced immunity, and impaired lower esophageal sphincter (LES) signaling, which can contribute to conditions such as acid reflux or gastroesophageal reflux disease (GERD).

Watch the video below to discover common signs and symptoms of low stomach acid.

Potential long-term effects and complications 

Low stomach acid production can have widespread effects on digestion, immune defenses, and overall health.

Stomach acid is the first line of defense against environmental pathogens and helps prevent harmful bacteria, such as Helicobacter pylori (H. pylori), from colonizing the stomach lining. 

When stomach acidity is low, H. Pylori can thrive and produce urease, an enzyme that weakens the stomach lining and neutralizes stomach acid. Over time, this can lead to peptic ulcers, atrophic gastritis, and an increased risk of gastric cancer.

Low stomach acid not only impairs the breakdown and absorption of essential nutrients but also disrupts gut motility and increases intestinal permeability. 

This can lead to nutrient deficiencies and contribute to digestive disorders such as irritable bowel syndrome (IBS) and leaky gut, where the weakened intestinal lining allows harmful substances to pass into the bloodstream, triggering body-wide inflammation and immune responses.

Causes and risk factors

Low stomach acid can result from medication use, poor dietary habits, and certain lifestyle factors. 

One significant contributor is the overuse of proton pump inhibitors (PPIs) and antacids. These medications, commonly used to alleviate symptoms of acid reflux and heartburn, suppress acid production. 

While they may temporarily relieve digestive upset, long-term use of these medications can significantly decrease stomach acidity, potentially diminishing gastrointestinal health and increasing the risk of H. Pylori infection. 

Chronic stress is another risk factor for low stomach acid levels. Stress activates the sympathetic nervous system, reducing gastric blood flow and impairing gastrointestinal secretions. 

A study published in the Journal of Comparative and Physiological Psychology highlights that chronic stress can significantly reduce gastric acid production.

Diets high in processed foods and refined carbohydrates can also disrupt stomach acid production, as they typically lack essential nutrients such as B vitamins, zinc, and potassium, which are crucial in supporting the body’s ability to produce hydrochloric acid.

Other common risk factors for low stomach acid include: 

• Advanced age

• Gastric bypass surgery

• Corticosteroid medication 

• Stomach or pancreatic cancer

• Zinc deficiency

• Chronic autoimmune disorders

Signs of low stomach acid

Recognizing the signs and symptoms of low stomach acid is crucial for timely intervention and the prevention of potential health complications linked to hypochlorhydria. 

Common signs of low stomach acid include:

• Heartburn and acid reflux

• Indigestion and bloating

• Gas and belching

• Bad breath

• Iron deficiency 

• Vitamin B12 deficiency 

• Loss of appetite for red meat 

• Fatigue and weakness

• Hair loss

• Brittle nails 

• Undigested food in stools

If you suspect you may have low stomach acid, it’s crucial to consult a healthcare provider to evaluate your health status and discuss treatment options based on your individual health needs. 

Testing stomach acid levels at home

When dealing with digestive issues, it’s crucial to consult with a healthcare professional for a definitive diagnosis and personalized guidance. 

However, there are several simple tests to help you gain valuable insights about your stomach acid levels. 

Here are three at-home acidity tests.

1. Baking soda test

Mix a quarter teaspoon of baking soda in eight ounces of cold water and drink it on an empty stomach. If you start burping within five minutes, it may indicate low stomach acid. 

2. Riddler’s gastric acid reflux point test

Find the bottom of your breastbone, then press gently about an inch below and to the left. Tenderness at this point may suggest a low stomach acid, as insufficient acid can lead to gastric distension and sensitivity in the surrounding tissues.  

3. Betaine hydrochloride (HCl) test

This test utilizes betaine HCl supplements to help determine potential stomach acidity. 

Start by taking one capsule with a high-protein meal. If you have enough stomach acid, you should burp within the first 1 to 5 minutes of taking the betaine HCI. Feeling a sense of heat can also indicate adequate amounts of stomach acid. 

If there’s no sensation or burping, it may be a sign of low stomach acid.

However, it's important to note that while this test can give an indication of stomach acid levels, it should be approached cautiously, as it may not be suitable for individuals with ulcers or gastritis.

It's always recommended to consult with a healthcare provider before conducting such at-home tests.

Natural ways to improve stomach acid

Promoting optimal stomach acid levels is essential for maintaining digestive health, facilitating nutrient absorption, and reducing the risk of infections.

Here are five natural ways to help improve stomach acid production. 

1. Betaine HCl

Betaine HCl supplements can provide direct support by increasing hydrochloric acid in the stomach over time. 

Taking these supplements with meals can help enhance digestion and nutrient absorption. However, it’s crucial to begin with a low dose and gradually adjust as needed.

2. Apple cider vinegar

The acetic acid in apple cider vinegar can help improve digestion by stimulating stomach acid production and activating key enzymes. Additionally, its antimicrobial properties help reduce harmful microbes that may contribute to low stomach acid levels, supporting a healthier digestive environment.

Consuming a tablespoon of raw, organic, unfiltered apple cider vinegar (ACV) diluted in a glass of water before meals can help increase stomach acidity and enhance overall digestive tract function.

Developing pain or a burning sensation in your stomach from an apple cider vinegar dilution or betaine HCl could indicate the presence of too much stomach acid or may be linked to gastritis or a gastric ulcer. 

In such cases, it’s crucial to consult a healthcare provider for guidance and focus on healing the stomach before using these methods. 

3. Limit processed foods and sugar

Diets high in processed foods and sugar can impair stomach acid production by lacking essential nutrients and promoting inflammation in the stomach lining. Additionally, sugar feeds potentially harmful bacteria, including H. Pylori, which can worsen hypochlorhydria.

Instead, focus on a healthy, low-carb diet rich in minimally processed, nutrient-dense foods that support digestive health and promote optimal stomach acid levels.

4. Manage stress levels

Chronic stress can inhibit stomach acid production by affecting the function of the vagus nerve, which stimulates gastric acid secretion. 

Practicing stress-reduction techniques such as breathing techniques and regular stretching can help improve stomach acid production and overall digestive health. 

In addition, adequate sleep and regular physical activity also help contribute to stress management and may play an important role in maintaining healthy stomach acid levels. 

5. Promote optimal nutrition 

Several essential nutrients are crucial for stimulating gastric acid secretion, including zinc, potassium, and B vitamins, especially vitamin B1.

Zinc is particularly crucial for synthesizing hydrochloric acid, and ensuring adequate zinc intake through foods such as oysters, beef, and pumpkin seeds is essential for stomach acid production.

Vitamin B1, or thiamine, supports the proper functioning of the vagus nerve, which signals the stomach to produce acid. This explains why foods rich in this essential vitamin, such as nuts, seeds, pork, and nutritional yeast, help promote healthy stomach acid levels.

Potassium also promotes acid production by facilitating and maintaining the function of the gastric proton pump in stomach lining cells. 

Consequently, consuming potassium sources such as spinach, kale, avocados, or a potassium-containing electrolyte powder can help support this process and improve overall health.

Key takeaways

Low stomach acid is a common condition that can significantly impact digestive health and overall well-being. 

If left untreated, low stomach acid can result in nutrient deficiencies, increased susceptibility to infections, digestive disorders, and chronic health conditions.

Natural remedies to help improve stomach acid include dietary changes, supplementation, stress management, and potential medication adjustments under the guidance of a healthcare professional.

FAQ

1. How can I fix low stomach acid?

To address low stomach acid, consider taking apple cider vinegar or betaine hydrochloride (HCl) supplements before meals, increasing your intake of zinc, potassium, and vitamin B1, managing stress levels, and eliminating processed and high-carbohydrate foods from your diet.

Additionally, antacids and medications such as proton pump inhibitors can contribute to low stomach acid. However, don’t change your medication regimen without consulting a healthcare provider.

2. How can I tell if I have low stomach acid?

Signs of low stomach acid include indigestion, bloating, gas, heartburn, acid reflux, nutrient deficiencies, and undigested food in stools.

At-home tests such as the Riddler’s gastric acid reflux point test, a baking soda test, or performing the betaine HCl challenge can help determine if you may have low stomach acid. 

3. Is GERD the same as low stomach acid?

Gastroesophageal reflux disease (GERD) isn’t the same as low stomach acid, although low stomach acid can contribute to the development of GERD-related symptoms. 

4. What foods cause low stomach acid?

Foods that can contribute to low stomach acid include processed foods, sugary snacks, refined carbohydrates, and unhealthy fats, as they lack essential nutrients and can promote inflammation in the stomach lining. 

Additionally, excessive consumption of alcohol, caffeine, and spicy foods can also irritate the stomach and impair acid production.

5. What vitamin deficiency causes low stomach acid?

Deficiencies in B vitamins, zinc, sodium, potassium, and magnesium can increase the risk of low stomach acid as these nutrients are essential for gastric hydrochloric acid production.

6. Can apple cider vinegar increase stomach acid?

Yes, apple cider vinegar's (ACV) acidity can help stimulate stomach acid release, lower the stomach's pH, and improve digestion. 

Source

1. https://psycnet.apa.org/record/1971-07712-001