Low stomach acid (hypochlorhydria)

Low stomach acid, independently of other conditions can be a major contributing factor to mineral depletion and associated conditions such as headaches, allergies, asthma, chronic fatigue, chronic pain syndromes, osteoarthritis, osteoporosis and poor control of intestinal pathogens activity.

The stomach acid’s primary functions are

  • Sterilize the food before it’s digested in the GI tract
  • Activate the release of the digestive enzyme pepsin to break down proteins

Most common symptoms of gastric acid insufficiency

The insufficient stomach acid level can cause symptoms similar to gastroesophageal reflux disease and is implicated in the following

  • Low of appetite
  • Protein indigestion. Eating meats causes discomfort and increase of inflammation due to insufficient enzyme activity in breaking down the proteins.
  • Allergies to foods and increased sensitivity to environmental allergies.
  • Acid reflux, GERD due to abnormal duodenum sphincter response to low gastic acid levels
  • Burping or feeling bloated immediately after eating due to abnormal intestinal contractions (gut motility) and excessive bacterial fermentation
  • Bad breath (Halitosis)
  • Undigested food in stools
  • Intestinal yeast and H. Pylori overgrowth
  • Small bowel bacterial overgrowth (SIBO)

If you have a history of the above symptoms, most likely you are affected by the hypochlorhydria. A reliable way to test  stomach acid production levels is to ask your doctor for Heidelberg pH test. If the test is not available and you still suspect that you have low stomach acid and associated indigestion, refer to the information provided below.

Addressing hypochlorhydria and its possible underlying causes

Although the stomach acid production can be increased with use of supplements, doing so without looking into a possible underlying cause can result is aggravation of the symptoms. The following underlying conditions and factors should be reviewed first, as they are most commonly the primary reasons contributing to a poor digestion.

  • Over-hydrating – Drinking too much water will lower stomach acid.
  • Hypercalcemia can cause pancreatic insufficiency – leading to one of the primary causes of indigestion
  • H. Pylori – about two thirds of world population is infected with H. Pylori infection. It affects the gastrointestinal lining and in conjunction with life stressors and unhealthy dietary patterns causes a multitude of chronic conditions. H. Pylori inhibits gastric acid production by affecting the health of parietal cells [srs]. Elevating gastric acid with H. Pylori infection present may cause ulceration and an array of other physiological and neurological symptoms due to die off and a damaged stomach lining. Refer to symptoms and treatment protocol for H. Pylori
  • Trace mineral and vitamin deficiencies of sodium, chloride, zinc, vitamins C, D, E and Bs, and particularly vitamin B3 (Niacin) are important to keep in check as the complex is critical for optimal stomach epithelial cells function.
  • Glutathione deficiency is most likely to be present with any gastrointestinal issues due to the depletion of minerals and therefore boosting glutathione levels can be beneficial while restoring the mineral capacity.
  • Low thyroid function can also be severely affected by the lack of proper minerals. Restoring the mineral capacity can resolve a poor thyroid function, consequently restoring the stomach acid production. However, a presence of hypothyroidism (including Hashimoto’s thyroiditis) that directly affects the stomach acid release can be checked by an endocrinologist.
    Note that H. Pylori may affect your thyroid function, and therefore it should be treated first if present. A full panel of thyroid tests would be helpful to check if thyroid affects your gastric acid production.
  • Very low protein diet and lack of essential fats in the diet is another major contributing factor to maldigestion complexes.
  • Oral health can affect virtually any organ in the body if compromised. Root canal procedures may alone lead to serious health risks. Refer to root canal procedures and oral health.
  • Use of antacids drugs that block gastric acid production such as proton pumps and over the counter antiacids
  • Pellagra (vitamin B3) deficiency [srs].

Suggested methods for restoring stomach acid production

If the above causes of low stomach acid production are ruled out  or have been treated, and the issue of underproduction of gastric acid remains unresolved, the following can be of help.

If you have stomach pains that are attributed to a damaged gastrointestinal lining, it should be treated first to avoid ulceration from an increased stomach acid production. L-Glutamine 500mg twice daily between meals and bone broth (contains collagen precursor proline) can help restoring the protective lining.

Factors that can improve gastric acid production efficiency and improve digestion

  • Do not snack between the meals
  • Chew foods very thoroughly as digestion starts in the mouth!
  • Eat in relaxed environment and do not lie down immediately after eating a meal
  • Avoid drinking any fluids with meals besides digestive helpers
  • Chew natural mastic, cinnamon or a gum with xylitol about 20 minutes before and immediately after meal
  • Do not drink too much water. Over-hydration depletes you of electrolytes. Drink as much as desired, however, it is common for those who start drinking recommended amounts of water to become excessively thirsty overtime due to depletion of electrolytes. If your diet is rich in vegetables and fruits, most of your hydration will come from these foods.

Foods and supplements that can help stimulate restoring gastric acid production

Consult with your doctor before using any of the below suggested supplements. Increasing stomach acid production while taking anti-inflammatory medications can be contraindicated.

Magnesium at 400-600mg daily in divided doses 30 minutes after a meal and before bed is essential, even if a mild hypoglycemia suspected. Deficiency of magnesium is another cause of gastric acid reflux because magnesium helps the sphincter at the bottom of the stomach relax, allowing the food to go down.

Bone broth should not be ignored. The most prevalent amino acid in the bone broth is glycine. Glycine regulates both hypochlorhydria and hyperchlorhydria. Glycine is also one of the primary precursors for glutathione, therefore the bone broth can significantly boost glutathione production.

Betaine HCL (as suggested below) should only be used as a last option of increasing the stomach acid. Building up the stomach acid production gradually with nutritional balancing is the best route of treatment.

The following supplements should be rotated and not used all at once except for vitamins and minerals, which can be taken daily. If you experience adverse reactions such as insomnia, hyperactivity and anxiety when taking stomach acid boosters, you may have a chronic herpes family viral infection, small intestinal bacterial overgrowth or H.Pylori bacterial overgrowth. If you experience similar side effects when eating a clove of garlic, an infectious cause is likely. Taking stomach acid boosters in smaller amounts that produce tolerable side effects may help to overcome infections responsible.

  • Stomach acid boosters
    • Pineapple juice 10 minutes before and/or with meals (1-2 oz)
    • Digestive bitters such as dandelion and gentian 15 minutes before each meal
    • Ginger contains zingibain (a protein-digesting enzyme) and increases activity of lipase and other digestive enzymes
    • Gastrazyme (vitamin U) 20 minutes before a meal
    • Diamine Oxidase Enzyme 20 minutes before a meal
    • Betaine HCL w/pepsin with each protein rich meal
  • Once a day at meal time (vitamin B3 should not be continuously used with the above listed stomach acid boosters)
    • Vitamin C 1000mg (buffered) [srs]
    • Vitamin D 1000UI [srs]
    • Vitamin B3 50-200mg (a three-week therapeutic supplementation with niacin in one study showed elevation of hypochlorhydria)
    • Vitamin B2 (Riboflavin ) and B6 (pyridoxine) are important co-factors  for conversion of tryptophan into niacin.
    • Zinc 15mg with 2mg chelated copper (If deficient on mineral hair analysis test)

Following the above regiment, the stomach acid production should be normalized within 4-8 weeks, after which the supplements should be gradually discontinued.