Stomach acid, which primarily consists of hydrochloric acid (HCL) and digestive enzymes, is your GI tract’s first crack at breaking down food, assimilating nutrition, and protecting your body from harmful bacteria and pathogens.
For many people, however, this step in digestion is problematic.
Cases of acid reflux and GERD are soaring, with those suffering looking for ways to tamper down the effects of excess stomach acid.
However, the real story is more pertinent to low stomach acid production, such as in the case of Hypochlorhydria.
Optimal health begins in the gut, and optimal gut health starts in the stomach.
Yes, you read that correctly!
Contrary to the seemingly simple logic of acid reflux being a problem of too much stomach acid, it’s actually a sign that something in your stomach acid production is dysfunctional, and it’s leading to a whole host of other issues like nutrient deficiencies and infection from harmful bacteria.
There are many reasons this can happen, including diet, stress, infections, certain medications, overeating, or normal aging.
The good news is that there are simple ways to fix these problems that are inexpensive and avoid stomach surgery.
The following article discusses some of these techniques and will arm you with the knowledge to help you improve stomach acid levels and get your gut health back on track.
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How Stomach Acid Production Works
Stomach acid, also called gastric acid, is made chiefly from hydrochloric acid (HCL) and digestive enzymes.1NCBI, How does the stomach work? Institute for Quality and Efficiency in Health Care (IQWiG); 2006
HCL is one of the most acidic substances, as its technically classified as a strong acid2NCBI, Hydrochloric acid NCBI. 2022
and contributes to the highly acidic environment of the human stomach.
Chemically, it is an acidic liquid with a pH within the range of 1 to 2. The main ingredients are hydrochloric acid (HCl) (about 0.5%), potassium chloride (KCl), and sodium chloride (NaCl).
When you consume a meal, HCL is secreted from the gastrointestinal walls by the parietal cells.3Philip T Ramsay , Aaron Carr, Gastric acid and digestive physiology Surg Clin North Am. 2011
Your low stomach PH (acidic) environment and its associated acid break food down enough to be further digested in your GI tract where nutrients are extracted, and proper elimination happens.
This also aids your immune system by shielding your upper GI from bacterial infection and other harmful pathogens.
The Problem With Low Stomach Acid
‌‌Hypochlorhydria (low stomach acid) occurs when there isn’t enough acid in the stomach, hindering other digestive processes.
The likelihood that you will get hypochlorhydria increases with certain risk factors.
These risk factors include age, high-stress levels, poor diet, smoking and drinking, lack of vitamins, antacids, and other medications.
Over time the lack of stomach acid production can lead to other GI problems in addition to gastroesophageal reflux.
One of the most common issues that arise is an H. Pylori infection.
Helicobacter pylori infection4Michael Pflock , Simone Kennard, Nadja Finsterer, Dagmar Beier, Acid-responsive gene regulation in the human pathogen Helicobacter pylori J Biotechnol. 2006
tends to inflame and irritate the stomach lining and leads to ulcers.5Cleveland Clinic, H. Pylori Infection Cleveland Clinic. 2021
Common Symptoms Of Low Stomach Acid
Typical examples and symptoms of low stomach acid levels include:
- Irritable bowel syndrome and painful gastric motility
- Undigested food in stool
- Feeling nauseated
- Heartburn from excess acid
- Deficiencies in crucial nutrients such as iron and vitamin B12.
Gastric acid is largely misunderstood.
It plays a significant role in overall health and contains many anti inflammatory properties.
Not having enough leads to many downstream health consequences.
The result of long-term low stomach acid can result in chronic health conditions such as :
- achlorhydria
- autoimmune disorders
- gastritis
- food allergies
- rheumatoid arthritis
- atrophic gastritis
- gastrointestinal disorders
- skin problems like acne
- anemia
Adequate Stomach Acid Levels and Protein Digestion
Although an entire industry has been built around lowering stomach acid levels, this approach has largely failed and may make your body vulnerable to more severe issues.
One primary reason is that HCL breaks down crucial nutrients such as protein.
To be correctly assimilated in the body, protein must be unfolded to expose the bonds that bind amino acids.
Pepsin6Karna Dev Bardhan , Vicki Strugala, Peter W Dettmar, Reflux revisited: advancing the role of pepsin Int J Otolaryngol. 2012, a digestive enzyme stimulated by HCL, can then cleave these bonds, which allows the protein to be broken down into smaller, more digestible amino acids.
This is especially important for those with gastric bypass surgery as this procedure can disrupt normal GI functioning.
Many people who have had gastric bypass surgery have their GERD symptoms disappear in the short term, only to return.
Crucial Digestive System Support
Having enough stomach acid is crucial to the proper functioning of your entire digestive process.
This includes:
- Triggering pancreatic juices and enzymes further down the GI tract.
- Stimulation of bile production and its release into the small intestine. Bile helps to emulsify fat and enlarge the surface area of the small intestine. It further aids digestion.
- Stimulating the release of cholecystokinin in the small intestines.
- Assimilating specific vitamins and minerals, e.g., Vitamin B12 and Calcium.
Hydrochloric Acid And Gastric Function
As stomach acid breaks food down, a thick, acidic mass called chyme is formed from the digested food particles and slowly makes its way into the digestive tract.7Tom C. Martinsen, Reidar Fossmark, and Helge L. Waldum, The Phylogeny and Biological Function of Gastric Juice—Microbiological Consequences of Removing Gastric Acid Int J Mol Sci. 2019
The low pH of chyme due to its interaction with stomach acid triggers the release of pancreatic juices.
These juices are a mixture of bicarbonate, water, salts, and the enzymes lipase (which breaks down fats), and amylase (which helps to digest carbohydrates and starchy foods),
Also present in this mixture are the proteases trypsin, chymotrypsin, and carboxypeptidase, which break down DNA and RNA from food.
How Low Stomach Acid Disrupts Normal Digestion
Low levels of stomach HCL production hinder the progression of the processes mentioned above by not successfully dropping the PH of the digested chyme, inhibiting the release of these enzymes, ultimately causing food to remain stagnant in the upper GI.
This stagnation ultimately causes fermentation and bloating.
Over time these disturbances due to low hydrochloric acid levels disrupt the proper functioning of your upper esophageal sphincter, allowing HCL to enter your esophagus, creating what we know as reflux.8Silvia Torrico, Mark Kern, Muhammad Aslam, Subashini Narayanan, Ananda Kannappan,Zhumei Sui, Candy Hofmann, and Reza Shaker Upper esophageal sphincter function during gastroesophageal reflux events revisitedAmerican Journal of Physiology-Gastrointestinal and Liver Physiology.2020
Acid Reflux Drugs: h2 blocker vs. PPI vs. Antacids
In mainstream medicine, acid reflux is typically treated with H2 Blockers, Antacids, and Proton Pump Inhibitors (PPIs).
They all work to reduce HCL and excess acid.
Although they help manage the health condition in the short term, they eventually do more harm than good and lead to more severe issues.
They are sometimes the underlying cause of certain digestive conditions, iron deficiency, and even weight loss.
Let’s take a look at each.
H2 Blockers – How they work
Examples of H2 receptor blockers include:
- nizatidine (Axid)
- famotidine (Pepcid, Pepcid AC)
- cimetidine (Tagamet, Tagamet HB)
- Ranitidine (Zantac)
H2 receptor blockers bind to specific H2 receptors on the surface of stomach cells, which release acid when taken.
Peer-reviewed studies on H2 blockers show a 70 percent reduction in stomach acid secretion over 24 hours.9Bethesda (MD), Histamine Type-2 Receptor Antagonists (H2 Blockers) National Institute of Diabetes and Digestive and Kidney Diseases; 2018
For those with damage to the gastric lining, the good news is that as secretion is reduced, damaged tissues have a chance to heal.
PPI’s (Proton Pump Inhibitors) – How They Work
PPIs reduce HCL production faster than H2 blockers are considered more potent than other medications.
The most popular PPIs include esomeprazole (Nexium), pantoprazole (Protonix), and omeprazole (Prilosec).
PPIs, such as Nexium® and Prilosec®, shut down the pump that releases acid into the stomach.
They typically require a 14-day regimen intended to treat frequent heartburn, and they do not provide relief immediately.
Antacids – How they work
An antacid, such as Tums®, neutralizes stomach acids but doesn’t prevent more acid from being produced.
They’re a short-term band-aid that eases acid reflux pain.
The effects of an antacid can last up to 2 hours after a dose.
Among the brands available are Gaviscon (alginic acid) and Pepto-Bismol (bismuth subsalicylate).
Other examples of Antacids include Rolaids, Mylanta, Maalox, etc.
How To Increase Stomach Acid Naturally
While the consequences of insufficient stomach acid levels are harmful, fixing the problem can be pretty easy and inexpensive.
It just requires patience and discipline.
Below are some practical ways to do so.
Thoroughly Chew Food
Digestion technically begins in the mouth.
That’s because chewing your food triggers a potent enzyme called salivary amylase.
Salivary amylase enzymatically boosts the breakdown of carbohydrates into smaller, more digestible constituents.10Catherine Peyrot des Gachons and Paul A. S. Breslin, Salivary Amylase: Digestion and Metabolic Syndrome Curr Diab Rep. 2019
Combining this enzyme to chewing and the job is easier for your stomach, using the break to heal.
PRO TIP: Combine this by eating slower, and you have a recipe for a healthier stomach and ultimately higher levels of stomach acid.
Avoid Stress Eating
Eating while stressed is a significant contributor to low levels of stomach acid.
Stress activates the sympathetic nervous system, the fight or flight response, which shuts down acid production.11David J. Sanders , A review: The agents and actions of sympathetic nerve and catecholamine inhibition of gastric mucosal function Histamine and Kinins. 1976
HCL and ultimately proper digestion relies on activating the parasympathetic nervous system, your rest, and digest mode.
PRO TIP: Take a short moment just before eating. Take a breath, practice gratitude, say a prayer, tap, or whatever makes you feel calm. This will ensure adequate HCL, proper digestion, and proper absorption of all nutrients.
Supplements That Increase Stomach Acid
As you practice the methods mentioned above, consider incorporating supplements.
These nutritional interventions are medically reviewed and proven to help boost low stomach acid and lower instances of reflux.
Betaine HCl with Pepsin
Betaine hydrochloride (HCl)12Thomas G Guilliams, Lindsey E Drake , ,Integr Med (Encinitas). 2020 is the most popular compound to increase stomach acid.
In medically reviewed studies, betaine HCl increased stomach acidity in people with low stomach acid levels.13Kristin Forssmann , Larissa Meier , Bernhard Uehleke , Cornelia Breuer , Rainer Stange, A non-interventional, observational study of a fixed combination of pepsin and amino acid hydrochloride in patients with functional dyspepsia BMC Gastroenterol. 201714Rajiv Heda; Fadi Toro; Claudio R. Tombazzi., Physiology, Pepsin StatPearls Publishing; 2022
For optimal results, look for HCL products that combine pepsin.
Pepsin, an enzyme commonly found in betaine HCL products, breaks down proteins into smaller units in the stomach acid.15Rawish Fatima; Muhammad Aziz, Achlorhydria StatPearls Publishing; 2022
The combination of hydrochloride and pepsin has shown success in significantly reducing symptoms like burning and pain in indigestion in study subjects in as little as six weeks.16Marc R Yago , Adam Frymoyer, Leslie Z Benet, Gillian S Smelick, Lynda A Frassetto, Xiao Ding, Brian Dean, Laurent Salphati, Nageshwar Budha, Jin Y Jin, Mark J Dresser, Joseph A Ware, The use of betaine HCl to enhance dasatinib absorption in healthy volunteers with rabeprazole-induced hypochlorhydria AAPS J. 2014
Best HCL Product: HCL Breakthrough
HCL Breakthrough from BiOptimizers features 100% plant-derived betaine HCL and full-spectrum digestive enzymes.
In addition to restoring healthy acid levels, this product improves mineral absorption, vitamin absorption, amino acid absorption leading to improvements in many health conditions.
In addition to the HCL product, I would recommend the Bioptimzers Complete BiOptimzied Digestive Stack.
This stack comes with Masszymes and P3-OM, which offer added digestive enzyme support and probiotics for better gut healing.
These will help your recovery and enhance overall gut performance.
CBD
CBD is a potent cannabinoid that can help induce activation of the parasympathetic nervous system via the endocannabinoid system.
This translates to lowered stress hormone production and better gastric enzyme responsiveness.17Vicente MartÃnez, Amaia Iriondo De-Hond, Francesca Borrelli, Raffaele Capasso, MarÃa Dolores del Castillo, and Raquel Abalo, Cannabidiol and Other Non-Psychoactive Cannabinoids for Prevention and Treatment of Gastrointestinal Disorders: Useful Nutraceuticals? name of publication. YEAR
Some clinical evidence even shows a direct connection between the endocannabinoid system and lowered reflux instances, improved upper and lower esophageal sphincter function, and better overall GI health.18Jonathan Gotfried , Rahul Kataria , Ron Schey , Review: The Role of Cannabinoids on Esophageal Function-What We Know Thus Far Cannabis Cannabinoid Res. 2017
Essential Oils
Essential oils are potent parasympathetic inducers necessary for naturally improving digestion and reflux.
My choice for this is Vibrant Blue Oils’ – PARASYMPATHETIC®- 5 ML.
With the help of a synergistic combination of clove and lime essential oils, this blend stimulates the body’s natural healing process.
Other Herbs And Natural Remedies Medically Reviewed To Help Low Stomach Acid
- Deglycyrrhizinated Licorice19Sug-Joon Ahn , Eun-Jung Cho, Hyoung-Jun Kim, Soon-Nang Park, Yun-Kyong Lim, Joong-Ki Kook, The antimicrobial effects of deglycyrrhizinated licorice root extract on Streptococcus mutans UA159 in both planktonic and biofilm cultures Anaerobe. 2012 (DGL),
- Ayurvedic Treatments20Pulok K Mukherjee , Ranjit K Harwansh , Shiv Bahadur, Subhadip Banerjee , Amit Kar , Joydeb Chanda, Sayan Biswas , Sk Milan Ahmmed , C K Katiyar, Development of Ayurveda – Tradition to trendy J Ethnopharmacol. 2017
- Apple Cider Vinegar
- Fermented Foods
- 1NCBI, How does the stomach work? Institute for Quality and Efficiency in Health Care (IQWiG); 2006
- 2NCBI, Hydrochloric acid NCBI. 2022
- 3Philip T Ramsay , Aaron Carr, Gastric acid and digestive physiology Surg Clin North Am. 2011
- 4Michael Pflock , Simone Kennard, Nadja Finsterer, Dagmar Beier, Acid-responsive gene regulation in the human pathogen Helicobacter pylori J Biotechnol. 2006
- 5Cleveland Clinic, H. Pylori Infection Cleveland Clinic. 2021
- 6Karna Dev Bardhan , Vicki Strugala, Peter W Dettmar, Reflux revisited: advancing the role of pepsin Int J Otolaryngol. 2012
- 7Tom C. Martinsen, Reidar Fossmark, and Helge L. Waldum, The Phylogeny and Biological Function of Gastric Juice—Microbiological Consequences of Removing Gastric Acid Int J Mol Sci. 2019
- 8Silvia Torrico, Mark Kern, Muhammad Aslam, Subashini Narayanan, Ananda Kannappan,Zhumei Sui, Candy Hofmann, and Reza Shaker Upper esophageal sphincter function during gastroesophageal reflux events revisitedAmerican Journal of Physiology-Gastrointestinal and Liver Physiology.2020
- 9Bethesda (MD), Histamine Type-2 Receptor Antagonists (H2 Blockers) National Institute of Diabetes and Digestive and Kidney Diseases; 2018
- 10Catherine Peyrot des Gachons and Paul A. S. Breslin, Salivary Amylase: Digestion and Metabolic Syndrome Curr Diab Rep. 2019
- 11David J. Sanders , A review: The agents and actions of sympathetic nerve and catecholamine inhibition of gastric mucosal function Histamine and Kinins. 1976
- 12Thomas G Guilliams, Lindsey E Drake , ,Integr Med (Encinitas). 2020
- 13Kristin Forssmann , Larissa Meier , Bernhard Uehleke , Cornelia Breuer , Rainer Stange, A non-interventional, observational study of a fixed combination of pepsin and amino acid hydrochloride in patients with functional dyspepsia BMC Gastroenterol. 2017
- 14Rajiv Heda; Fadi Toro; Claudio R. Tombazzi., Physiology, Pepsin StatPearls Publishing; 2022
- 15Rawish Fatima; Muhammad Aziz, Achlorhydria StatPearls Publishing; 2022
- 16Marc R Yago , Adam Frymoyer, Leslie Z Benet, Gillian S Smelick, Lynda A Frassetto, Xiao Ding, Brian Dean, Laurent Salphati, Nageshwar Budha, Jin Y Jin, Mark J Dresser, Joseph A Ware, The use of betaine HCl to enhance dasatinib absorption in healthy volunteers with rabeprazole-induced hypochlorhydria AAPS J. 2014
- 17Vicente MartÃnez, Amaia Iriondo De-Hond, Francesca Borrelli, Raffaele Capasso, MarÃa Dolores del Castillo, and Raquel Abalo, Cannabidiol and Other Non-Psychoactive Cannabinoids for Prevention and Treatment of Gastrointestinal Disorders: Useful Nutraceuticals? name of publication. YEAR
- 18Jonathan Gotfried , Rahul Kataria , Ron Schey , Review: The Role of Cannabinoids on Esophageal Function-What We Know Thus Far Cannabis Cannabinoid Res. 2017
- 19Sug-Joon Ahn , Eun-Jung Cho, Hyoung-Jun Kim, Soon-Nang Park, Yun-Kyong Lim, Joong-Ki Kook, The antimicrobial effects of deglycyrrhizinated licorice root extract on Streptococcus mutans UA159 in both planktonic and biofilm cultures Anaerobe. 2012
- 20Pulok K Mukherjee , Ranjit K Harwansh , Shiv Bahadur, Subhadip Banerjee , Amit Kar , Joydeb Chanda, Sayan Biswas , Sk Milan Ahmmed , C K Katiyar, Development of Ayurveda – Tradition to trendy J Ethnopharmacol. 2017
