Low Stomach Acid - Symptoms + Causes

Why is stomach acid so important?

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Stomach acid - also called hydrochloric acid due to its chemical structure of one hydrogen ion combined to one chlorine ion making HCL - is responsible for assisting with many important processes in the digestive system. Stomach acid is made up of hydrochloric acid, enzymes, bile and mucus to help protect the stomach lining, and is essential for many essential processes, such as: 

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• Sterilising food

• Protein and fat digestion

• Pepsin activation  

• Activating intrinsic factors

• Stimulating the delivery of bile acid and digestive enzymes

• Closing the oesophageal sphincter 

• Opening the pyloric sphincter

Low stomach acid creates a vicious cycle of poor digestion, chronic gut inflammation, microbial overgrowth, leaky gut, elevated stress hormones and lowered nutrient absorption (1).  The only things that will break this loop are to reduce stress in all its forms and support adequate stomach acid production.

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What are the symptoms of low stomach acid?

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The symptoms of low stomach acid are too many to list, but some of the most common ones I see include bloating, gas, indigestion, and acid reflux.

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However, having low-stomach acid over time leads to further disturbances in the gut microbiome and will eventually cause further digestive issues, which could include all or any of the following: 

 

• Constipation and diarrhea

• Malnutrition and malabsorption

• Poor hormone function

• Bile insufficiency and liver burden

• Chronic fatigue

• Adrenal fatigue

• Depression and anxiety

• Thyroid issues

• Heartburn

• Food sensitivities

• Histamine issues

• Skin irritation (psoriasis, dermatitis, eczema)

• Intestinal dysbiosis

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And even more disturbances and is even linked to some autoimmune conditions. 

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What are the main causes of low stomach acid?

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There are many number of things that can cause low stomach acid in our body including: poor diet and lifestyle choices, liver burden and bile insufficiency, toxic relationships, chronic stress and fear, and overuse of medications. 

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Below is a more detailed look at the causes of low stomach acid:

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1. Overuse of Anti-Biotics: Anti-biotics transform your microbiome and cause an increase in intestinal related inflammation in the body.  This inflammation causes a rise in stress hormones which reduce the bodies ability to produce HCL.

 

2. Helicobacter Pylori (aka H. Pylori) Infection: H. Pylori is known as a negative gram bacteria and is a common microbe that makes up our microbiome. And it is also present in the digestive lining. But the overuse of antibiotics, chronic stress, poor diet and lifestyle choices and more can cause a shift in the microbiome, a lowering of stomach acid and as a consequence, the overgrowth of Helicobacter Pylori. Helicobacter Pylori produces an enzyme called “urease” which breaks down the urea in the stomach into carbon dioxide and ammonia, causing belching and halitosis (or bad breath) for the individual. It also neutralises the acidifying effects of hydrochloric acid, which allows for further growth of H Pylori and more stress on the GI system (2).

 

3. Chronic Stress: Chronic stress is one of biggest causes of low stomach acid and intestinal dysbiosis. To the extent that it impairs the digestive systems ability to produce hydrochloric acid (HCL) and other digestive juices and enzymes. Our autonomic nervous system is composed of 2 main branches. The sympathetic and parasympathetic branches.

       

• Sympathetic System: Fight or flight

• Parasympathetic System: Rest, Digest, Repair and Reproduce

 

Proper digestion depends upon us being in a parasympathetic dominant state.  Chronic stress puts us in a sympathetic dominant state which restricts activity in the digestive tract and causes poor digestive function.

 

4. Poor Diet: A diet rich in processed foods, sugars, grains, etc. change our microbiome and cause chronic inflammation and elevated stress hormone production.  Blood sugar stabilization is very important for normalizing stress hormones.  Stay on a lower carbohydrate, higher fat, antioxidant rich diet and your stomach acid levels will improve.

 

5. Eating Too Fast:  This is one of the BIGGEST PROBLEMS we have in our society. We're constantly in a hurry and we eat a lot of meals in a hurried state and often on-the-go. But for proper digestion, it is critically important that we are relaxed and in the parasympathetic (rest and digest) when we eat, not the sympathetic (fight or flight) mode. When we relax, breathe deeply and chew our food slowly and mindfully, we increase parasympathetic activity.  

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6. Overuse of NSAIDs and SRI's: In our society, we pop panadol, aspirin, nurofen and ibuprofen like candy and assume that because they are sold over the counter they must be safe and have little side-effects. But unfortunately, this isn’t true! NSAIDs and SRI's wear down the stomach lining and reduce the ability of the stomach cells to produce HCL (3).

 

7. Using Proton Pump Inhibitors:  Proton pump inhibits and antacids are acid blocking medications that reduce acid levels in the stomach and provide temporary relief from acid reflux. Unfortunately, however, because acid reflux is commonly caused from too little acid, taking these medications further reduces stomach acid and leads to intestinal dysbiosis, inflammation and further dysfunction and stress on the body.

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8. Small Intestinal Bacterial Overgrowth (SIBO): It is hard to say whether the low stomach acid or dysbiosis comes first. What we do know is that low stomach acid allows for an elevated level of bacteria to enter into the digestive system alive and proliferate on undigested food particles, as a result of low HCL. But we also know that SIBO causes chronic stress in the body, reducing the bodies ability to produce adequate HCL. Either way, there is a HUGE connection between SIBO and low stomach acid levels.

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9. Aging: As we age in our society, all of the body's systems slow down and especially our digestive physiology. This is even more the case if we have chosen to entertain poor diet and lifestyle and have placed significantly more stress on your body than it can adapt too. If you take care of your body at an early age and keep your digestive system and liver functioning optimally throughout life, you should be able to produce enough HCL in your later years. Supplementing with HCL, digestive enzymes, bile salts and adopting other practices to help support health digestion function and stomach acid, will make a huge difference for you as you age.

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10. Food Sensitivities and Allergies: Some of the most common food sensitivities cause major stress in the body, which keeps us in a prolonged state of fight or flight. Be aware of trigger foods that can cause and exacerbate sensitivities and inflammation. Some of the most common offenders include, gluten, corn, soy, peanuts and pasteurised dairy. If you notice other foods not agreeing with you, than look to avoid those as well in the interim until you have had your blood markers functionally interpreted and your symptoms analysed by a functional health therapist. 

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There are a significant number of diet and lifestyle choices made in westernised countries that lead to and perpetuate the development of low stomach acid. Addressing low stomach acid should be one of the first places we look in order to improve overall digestive function, heal intestinal permeability, optimise nutrition and absorption and reduce overall stress on the body.

 

A tailored protocol is the best way to address your symptoms, support stomach acid and get your digestive issues under control. 

 

Here are some simple and effective tools to help improve stomach acid levels and improve digestion:

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1. Eat proteins foods at the beginning of your meal to stimulate the digestive enzymes necessary for digesting protein. 

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2. Eat your grass-fed and finished beef with raw honey. Raw honey is packed with enzymes. Try drizzling some on your meat for easier digestion. 

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3. Chew your food thoroughly. This is one of the most important parts of digestion. Food proteins need to be broken down to be properly digested. Our digestive process starts the moment we take that first bite through the secretion of saliva. The more we chew our food, the more saliva is released and the better we digest.

 

4. Limit liquid intake during meals until at least 30 minutes after a meal to allow for proper stomach acid production, pathogen sterilisation, and protein metabolism.

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5. Stay hydrated between meals to support proper gut motility. This pushes the contents of the intestines out of the body instead of back into the stomach. This is very important for those who are prone to SIBO.

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6. Betaine hydrochloride supplements help support healthy gut function and safely restore normal gastric acidity. (Do not confuse betaine HCl with anhydrous betaine, a methyl-donor nutrient taken to control homocysteine levels.)

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7. Always take the betaine HCL either half-way through the meal or right at the end of the meal. Taking it before a meal may create a false experience of heartburn and can turn off stomach acid production for this meal. Caution: Do not take HCL if you are taking any NSAIDs such as ibuprofen, tylenol, or aspirin.

 

8. HCl with pepsin. Add these to your diet when you consume protein. When you feel warmth in your stomach, that means you are taking enough. Then back it down a notch and monitor your response. Some people need one capsule, others need more as everyone is unique. Pepsin which is typically used in conjunction with HCl, is considered very safe when administered to assist digestion.

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9. Digestive enzymes help to break down food proteins. Make sure to get a high-quality blend.

 

10. Apple cider vinegar or Swedish bitters. One tablespoon of either in a 1/4 cup of water right before a meal can help support digestion.

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11. Fermented foods such as sauerkraut, kimchi, pickles, pickled ginger, and water kefir contain organic acids, enzymes and probiotics to assist with proper digestion. They are also anti-microbial and fight H. Pylori, the arch enemy of stomach acid production.

 

Taking the time to improve your stomach acid levels will make a huge difference to your symptoms and quality of life.

 

Please reach out via my contact form if you would like to find out more about supporting proper digestive function, increasing nutrition and supporting optimal stomach acid production.